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Clinical Rheumatology

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https://www.readbyqxmd.com/read/28647902/ultrasonography-assessment-of-heel-entheses-in-patients-with-spondyloarthritis-a-comparative-study-with-magnetic-resonance-imaging-and-conventional-radiography
#1
Rodrigo Aguila Maldonado, Santiago Ruta, María Laura Valuntas, Mercedes García
The aim of the present study was to determine the agreement between ultrasonography (US), magnetic resonance imaging (MRI), and conventional radiography (CR) in the detection of findings indicative of enthesopathy in spondyloarthritis (SpA) patients. A cross-sectional study was performed in 40 SpA patients. Heel entheses (Achilles tendon and plantar fascia) were bilaterally examined by US, MRI, and CR. The three imaging modalities were carried out by three independent operators blinded to the other imaging modality data...
June 25, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28646368/tnf%C3%AE-blockers-followed-by-continuation-of-sulfasalazine-and-methotrexate-combination-a-retrospective-study-on-cost-saving-options-of-treatment-in-spondyloarthritis
#2
Aswin M Nair, P Sandhya, Bijesh Yadav, Debashish Danda
High cost deters continuous use of tumor necrosis factor α blockers (TNFi) in developing countries. The objective of this study was to evaluate outcome and expenditure incurred in Spondyloarthritis (SpA) patients beyond a year of follow-up after receiving four doses of infliximab (IFX) over and above background therapy of methotrexate (MTX) and sulfasalazine (SSZ) combination. Electronic medical records were screened for patients with SpA satisfying the Assessment of Spondyloarthritis International Society (ASAS) criteria between 2008 and 2014...
June 23, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28639002/risk-factors-of-flare-in-rheumatoid-arthritis-patients-with-both-clinical-and-ultrasonographic-remission-a-retrospective-study-from-china
#3
Jingjing Han, Yan Geng, Xuerong Deng, Zhuoli Zhang
Ultrasonographic remission in addition to clinical remission is probably becoming a new target in the treatment of rheumatoid arthritis. The current study aimed to investigate the risk factors of flare in RA patients who achieved both clinical and ultrasonographic remission. RA patients fulfilled both clinical remission and ultrasonographic remissions were retrospectively enrolled in this study. Baseline clinical, laboratory, and ultrasonographic data were collected. Durations of clinical remission before enrollment and medication strategy during follow-up were recorded...
June 22, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28634699/cost-effective-analysis-of-disease-modifying-anti-rheumatic-drugs-in-rheumatoid-arthritis
#4
Ashit Syngle, Sudeep Kaur, Inderjeet Verma, Tanya Syngle, Vijaita Syngle
The main objective of the study was to perform the pharmacoeconomic analysis of synthetic disease-modifying anti-rheumatic drugs in rheumatoid arthritis patients. A prospective, observational study was conducted in 98 rheumatoid arthritis (RA) patients meeting 2010 Rheumatoid Arthritis Classification Criteria. Treatment-naive RA patients were initiated on synthetic disease-modifying anti-rheumatic drugs (DMARD/s) and followed up for 3 months. Average cost-effectiveness analysis was done by taking Health Assessment Questionnaire Disability Index (HAQ-DI) score as a measure of effectiveness...
June 21, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28634698/association-between-characteristics-of-pain-and-stiffness-and-the-functional-status-of-patients-with-incident-polymyalgia-rheumatica-from-primary-care
#5
A Cawley, J A Prior, S Muller, T Helliwell, S L Hider, B Dasgupta, K Barraclough, C D Mallen
This paper aims to examine the relationship between different characteristics of pain and stiffness and the functional status of patients with newly diagnosed polymyalgia rheumatica (PMR). Baseline analysis of an inception cohort study was conducted. Patients aged ≥18 years, with a new diagnosis of PMR were recruited from 382 English general practices. Participants were mailed a baseline questionnaire, including separate pain and stiffness manikins and numerical rating scales (NRS), a question on their ability to raise their arms above their head and the modified Health Assessment Questionnaire (mHAQ) to examine participants' functional status...
June 20, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28634697/in-psoriatic-arthritis-dkk-1-and-pth-are-lower-than-in-rheumatoid-arthritis-and-healthy-controls
#6
Angelo Fassio, Luca Idolazzi, Ombretta Viapiana, Camilla Benini, Elisabetta Vantaggiato, Francesco Bertoldo, Maurizio Rossini, Davide Gatti
Psoriatic Arthritis (PsA) is characterized by bone erosive damage often associated with exuberant bone formation especially in enthesial sites. Dkk-1 and sclerostin are the main inhibitors of the WNT/β-catenin signaling pathway and play a key role in the regulation of both bone formation and resorption. We performed this study in order to compare the serum levels of the WNT-pathway regulators along with bone turnover markers (BTM) and parathyroid hormone (PTH) between three different groups: one group of female patients affected by PsA, one group of female patients affected by rheumatoid arthritis (RA), and healthy female controls (HC)...
June 20, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28634696/prominent-midfoot-involvement-in-children-with-enthesitis-related-arthritis-category-of-juvenile-idiopathic-arthritis
#7
Sanat Phatak, Namita Mohindra, Abhishek Zanwar, Amita Aggarwal
Foot involvement is common in juvenile idiopathic arthritis (JIA) but is often unrecognized and difficult to treat. This study was done to assess clinical and radiological involvement of the feet and its impact on function in Indian children with enthesitis-related arthritis (ERA). We enrolled consecutive children with ERA with disease duration of less than 5 years. All patients underwent clinical examination of the feet and filled the juvenile arthritis foot index (JAFI) questionnaire. Ultrasound (US) of foot joints and entheses and extremity magnetic resonance imaging (MRI) scan of one foot were done...
June 20, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28631083/is-there-a-relationship-between-serum-ox-ldl-oxidative-stress-and-pon1-in-knee-osteoarthritis
#8
Cemil Ertürk, Mehmet Akif Altay, Ali Bilge, Hakim Çelik
Previous in vitro studies have shown that oxidized low-density lipoprotein (ox-LDL) plays a role in the pathogenesis of osteoarthritis (OA). Paraoxonase-1 (PON1) protects both low-density lipoproteins (LDLs) and high-density lipoprotein (HDLs) against oxidative damage from circulating cells. In addition, PON1 is inactivated by ox-LDL and preserved by antioxidants. However, the relationship between serum ox-LDL, oxidative stress, and PON1 in knee OA remains unclear. Therefore, we investigated ox-LDL association with oxidative stress and PON1 in knee OA, and evaluated their relationships using radiological and clinical parameters...
June 19, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28624931/familial-mediterranean-fever-review-of-the-literature
#9
Mansour Alghamdi
Familial Mediterranean fever (FMF) is the most common monogenic periodic fever syndrome and characterized by recurrent episodes of fever, serositis, arthritis, dermal manifestations, and long-term renal complications. The MEFV gene was described in 1997 as the gene responsible for FMF and is inherited in autosomal recessive manner. It encodes mutated protein pyrin, an important player in the innate immune system and the component of inflammasome which leads to exaggerated inflammatory response through uncontrolled production of interleukin-1...
June 18, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28623421/comparison-of-dual-energy-ct-ultrasound-and-surface-measurement-for-assessing-tophus-dissolution-during-rapid-urate-debulking
#10
Dodji V Modjinou, Svetlana Krasnokutsky, Soterios Gyftopoulos, Virginia C Pike, Elaine Karis, Robert T Keenan, Kristen Lee, Daria B Crittenden, Jonathan Samuels, Michael H Pillinger
Tophaceous gout is painful and impairs quality of life. The optimal modality for assessing tophus resolution in response to urate-lowering treatment remains poorly defined. Using pegloticase as a model system for resolving tophi, we compared multiple imaging and physical diagnostic strategies for assessing tophus resolution. A 32-year-old subject with chronic refractory tophaceous gout was enrolled and received 6 months of pegloticase treatment. Measurements of tophi using vernier calipers (monthly), photographs and musculoskeletal ultrasound (MSK-US; every 3 months), and dual-energy CT (DECT) were compared...
June 16, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28616661/clinical-relevance-of-p-glycoprotein-activity-on-peripheral-blood-mononuclear-cells-and-polymorphonuclear-neutrophils-to-methotrexate-in-systemic-lupus-erythematosus-patients
#11
Mario García-Carrasco, Claudia Mendoza-Pinto, Salvador Macías-Díaz, Ivet Etchegaray-Morales, Socorro Méndez-Martínez, Pamela Soto-Santillán, Beatriz Pérez-Romano, Erick A Jiménez-Herrera, Omar Guzmán-Ruiz, Alejandro Ruiz-Argüelles
To elucidate the relationship between P-glycoprotein activity on peripheral blood leukocytes of systemic lupus erythematosus (SLE) patients with lupus arthritis and the clinical response to methotrexate. An observational study was made in patients with SLE according to ACR criteria 1997 who had arthralgia and arthritis and received methotrexate for ≥3 months. Methotrexate responders and non-responders were compared according to the Clinical Disease Activity Index. Mononuclear cells and polymorphonuclear neutrophils were isolated from SLE patients and P-glycoprotein expression was measured using the relative fluorescence index and percentage of positive cells...
June 14, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28612244/cerebral-venous-sinus-thrombosis-in-beh%C3%A3-et-s-disease-a-retrospective-case-control-study
#12
Jing Shi, Xinxiang Huang, Guohua Li, Li Wang, Jinjing Liu, Yan Xu, Xiaofeng Zeng, Wenjie Zheng
The objective of the study is to investigate the clinical features of Behçet's disease (BD) complicated with cerebral venous sinus thrombosis (CVST). We retrospectively analyzed the clinical features of age- and gender-matched BD patients with and without CVST. Of the 840 BD patients enrolled, 21 (2.5%, 11 female, mean age 30.3 ± 9.5) were diagnosed as CVST. Eighteen patients (85.7%) developed neurologic manifestations after BD onset, with an average interval of 47.6 months (SD 36.1). Onset of neurologic symptoms was mostly progressive (89...
June 14, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28612243/increased-expression-of-bruton-s-tyrosine-kinase-in-peripheral-blood-is-associated-with-lupus-nephritis
#13
Wei Kong, Wei Deng, Yue Sun, Saisai Huang, Zhuoya Zhang, Bingyu Shi, Weiwei Chen, Xiaojun Tang, Genhong Yao, Xuebing Feng, Lingyun Sun
Systemic lupus erythematosus (SLE) is an autoimmune disease manifested by multiorgan impairment. It is reported that B cells participate in the onset of SLE. Bruton's tyrosine kinase (Btk), as a downstream signaling molecule of B cell antigen receptor (BCR) signaling pathway, is involved in the development, activation, and survival of B cells. The aim of our study was to explore the specific role of Btk in lupus nephritis (LN). We determined the percentages of Btk+ B cells in peripheral blood mononuclear cells (PBMCs) from SLE patients by flow cytometry and analyzed the correlation between the percentage of Btk+ B cells and lupus-related clinical indexes...
June 14, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28612242/histopathologic-classification-of-anti-neutrophil-cytoplasmic-antibody-associated-glomerulonephritis-achievements-limitations-and-perspectives
#14
Andrea Hinojosa-Azaola, Ariadna Jiménez-González
Clinical and histological factors have been identified as predictors of early and late renal outcome in ANCA-associated vasculitides (AAV). The presence and severity of kidney involvement at diagnosis are associated with poor prognosis in both patient and renal survival. Histologic findings remain the gold standard for diagnosing patients with AAV. In order to quantify the extent of the morphological parameters in the renal biopsies and to identify the histopathological lesions that predict renal outcome, several scoring systems have been proposed to systematically assess kidney biopsies in AAV...
June 14, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28612241/evaluating-the-cost-effectiveness-of-biologic-treatments-for-psoriatic-arthritis-can-we-make-better-use-of-patient-data-registries
#15
Thomas Patton, Laura Bojke, Matthew Walton, Andrea Manca, Philip Helliwell
The primary aim of this study is to explore the extent to which registry data may fulfill the evidence requirements of cost-effectiveness analysis (CEA) studies evaluating biologic therapies for the treatment of psoriatic arthritis (PsA), where trial data are lacking or insufficient. In addition, the paper aims to identify how future data collection in PsA registries might be better tailored to inform CEA research. A review of the literature was performed to identify existing registries containing PsA patients...
June 13, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28612240/clinical-characteristics-of-peripheral-spondyloarthritis-without-psoriasis-inflammatory-enteropathy-or-preceding-infection-from-a-single-rheumatology-clinic-in-northern-india
#16
Anand Narayan Malaviya, Neha Agrawal, Nilesh Sahebrao Patil
The objective of this study was to characterise the peripheral arthritis of spondyloarthritis (pSpA) excluding psoriatic-, inflammatory enteropathy-related, post-infectious reactive-SpA and arthritis associated with axial SpA/ankylosing spondylitis (axSpA/AS). Patients presenting with the clinical features of the broad spectrum of SpA were screened for the presence of peripheral arthritis using the Assessment of SpondyloArthritis International Society (ASAS) criteria. The other conditions that could cause pSpA, e...
June 13, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28601944/glucocorticoid-induced-leucine-zipper-expression-is-associated-with-response-to-treatment-and-immunoregulation-in-systemic-lupus-erythematosus
#17
Saeed Mohammadi, Mohammad Reza Ebadpour, Sima Sedighi, Mohsen Saeedi, Ali Memarian
Systemic lupus erythematosus (SLE) is an autoimmune disorder in which cytokine balance is disturbed. Glucocorticoids (GCs) are shown to balance immune response by transcriptional regulation of glucocorticoid receptor target genes such as Glucocorticoid-induced leucine zipper (GILZ) which has been introduced as an endogenous anti-inflammatory mediator. In the present study, we assessed the expression of GILZ in association with interferon-γ (IFN-γ), interleukine-10 (IL-10), and B lymphocyte stimulator (BLyS) plasma levels in SLE patients...
June 10, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28600618/application-of-omics-in-predicting-anti-tnf-efficacy-in-rheumatoid-arthritis
#18
Xi Xie, Fen Li, Shu Li, Jing Tian, Jin-Wei Chen, Jin-Feng Du, Ni Mao, Jian Chen
Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by progressive joint erosion. Tumor necrosis factor (TNF) antagonists are the most widely used biological disease-modifying anti-rheumatic drug in RA. However, there continue to be one third of RA patients who have poor or no response to TNF antagonists. Following consideration of the uncertainty of therapeutic effects and the high price of TNF antagonists, it is worthy to predict the treatment responses before anti-TNF therapy. According to the comparisons between the responders and non-responders to TNF antagonists by omic technologies, such as genomics, transcriptomics, proteomics, and metabolomics, rheumatologists are eager to find significant biomarkers to predict the effect of TNF antagonists in order to optimize the personalized treatment in RA...
June 10, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28597134/digital-tomosynthesis-as-a-new-diagnostic-tool-for-assessing-of-chronic-gout-arthritic-feet-and-ankles-comparison-of-plain-radiography-and-computed-tomography
#19
Chang-Nam Son, Yoonah Song, Sang-Hyon Kim, Seunghun Lee, Jae-Bum Jun
This aimed to compare the three radiographic methods of digital tomosynthesis (DT), plain radiography, and computed tomography (CT) for evaluating changes in feet of patients with chronic gouty arthritis. Two independent radiologists read the plain radiography, DT, and CT images of 30 male patients with gout. The degrees of erosion and joint space narrowing were scored using the Sharp-van der Heijde scoring method in 18 foot joints, which consisted of four proximal interphalangeal and one interphalangeal joint of the first toe, five metatarsophalangeal, five tarsometatarsal, and three naviculo-cuneiform joints of the foot...
June 8, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28597133/real-life-10-year-retention-rate-of-first-line-anti-tnf-drugs-for-inflammatory-arthritides-in-adult-and-juvenile-onset-populations-similarities-and-differences
#20
Ennio Giulio Favalli, Irene Pontikaki, Andrea Becciolini, Martina Biggioggero, Nicola Ughi, Micol Romano, Chiara Crotti, Maurizio Gattinara, Valeria Gerloni, Antonio Marchesoni, Pier Luigi Meroni
The aim of this study is to retrospectively analyze 10-year drug survival of first-line TNF inhibitor (TNFi) in rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), and juvenile idiopathic arthritis (JIA) patients, comparing withdrawal rates and discontinuation pattern between adult- and juvenile-onset populations. RA, AS, PsA, and JIA patients treated with infliximab, etanercept, or adalimumab as first TNFi between 1999 and 2015 were extracted from a local registry. Drug survival up to 10-year follow-up was evaluated by the Kaplan-Meier method and compared according to age (adult vs juvenile onset), TNFi agent, and discontinuation reason by a stratified log-rank test...
June 8, 2017: Clinical Rheumatology
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