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https://www.readbyqxmd.com/read/29354211/case-of-victims-of-modern-imaging-technology-increased-information-noise-concealing-the-diagnosis
#1
Abhishek Mahajan, G V Santhoshkumar, Ameya Shirish Kawthalkar, Richa Vaish, Nilesh Sable, Supreeta Arya, Subhash Desai
We present a case of tubercular arthritis who underwent numerous unnecessary investigations what is known as "victims of modern imaging technology" or VOMIT. Today there is an exponential rise in the volume of the medical imaging, part of which is contributed by unnecessary and unjustified indications. We discuss about the untoward effects of the uninhibited and careless use of modern imaging modalities and possible ways to avoid. Skeletal manifestation of the tuberculosis is still common in the endemic countries like India...
December 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/29350637/clinical-utility-of-eco-color-power-doppler-ultrasonography-and-contrast-enhanced-magnetic-resonance-imaging-for-interpretation-and-quantification-of-joint-synovitis-a-review
#2
Marina Carotti, Vittoria Galeazzi, Francesca Catucci, Marcello Zappia, Francesco Arrigoni, Antonio Barile, Andrea Giovagnoni
With the introduction of new biologics such as anti-TNF-alpha antibodies and other therapies in the treatment of inflammatory arthritis, capable of halting joint destruction and functional disability, there are new pressures on diagnostic and prognostic imaging. Early demonstration of pre-erosive inflammatory features and monitoring of the long-term effects of treatment are becoming increasingly important. Early detection of synovitis offers advantages in terms of allowing early instigation of therapy and may allow the identification of those patients displaying more aggressive disease who might benefit from early intervention with expensive DMARD therapy...
January 19, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29346649/endothelial-function-in-rheumatoid-arthritis
#3
Mohammad Adawi, Abdulla Watad, Nicola Luigi Bragazzi, Howard Amital, Saaida Golan, Sirchan Rizak, Blum Arnon
Background: Rheumatoid arthritis (RA) patients are at higher risk of accelerated atherosclerosis. We sought to assess endothelial dysfunction in RA to find a possible mechanistic pathway that will explain this clinical phenomenon. Methods: A prospective study recruited 44 RA patients with an active long standing (>12 months) disease. All underwent a detailed assessment of disease activity. To estimate the endothelial function the Brachial Artery Method was performed, measuring flow mediated diameter percent change (FMD%)...
January 15, 2018: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29342473/effectiveness-of-early-adalimumab-therapy-in-psoriatic-arthritis-patients-from-reuma-pt-early-psa
#4
Helena Santos, Mónica Eusébio, Joana Borges, Diana Gonçalves, Pedro Ávila-Ribeiro, Daniela Santos Faria, Carina Lopes, João Rovisco, Ana Águeda, Patrícia Nero, Paula Valente, Ana Rita Cravo, Maria José Santos
Objective To compare outcomes in psoriatic arthritis (PsA) patients initiating adalimumab (ADA), with short- and long-term disease duration and to evaluate the potential effect of concomitant conventional synthetic disease-modifying antirheumatic drugs (csDMARD) or glucocorticoids. Methods Analyses included adult PsA patients registered in the Rheumatic Diseases Portuguese Register (Reuma.pt) between June 2008-June 2016 who received ADA for ≥3 months. Psoriatic Arthritis Response Criteria (PsARC) response, tender and swollen joint count, inflammatory parameters, patient (PtGA) and physician global assessment (PhGA), Disease Activity Score-28 joints (DAS28), and Health Assessment Questionnaire Disability Index (HAQ-DI) were compared between patients with <5 years of disease (early PsA) and those with ≥5 years of disease duration (late PsA)...
October 2017: Acta Reumatológica Portuguesa
https://www.readbyqxmd.com/read/29339224/emerging-souvenirs-clinical-presentation-of-the-returning-traveller-with-imported-arbovirus-infections-in-europe
#5
Isabella Eckerle, Violeta Briciu, Onder Ergonul, Mihaela Lupse, Anna Papa, Amanda Radulescu, Sotirios Tsiodras, Christine Tsitou, Christian Drosten, Véronique Nussenblatt, Chantal Reusken, Louise Sigfrid, Nick J Beeching
BACKGROUND: Arboviruses are an emerging group of viruses that are causing increasing health concerns globally, including in Europe. Clinical presentation usually consists of a non-specific febrile illness that may be accompanied by rash, arthralgia and arthritis and/or with neurological or haemorrhagic syndromes. The range of differential diagnoses of other infectious and non-infectious aetiologies is broad, presenting a challenge for physicians. While knowledge of the geographic distribution of pathogens and the current epidemiological situation, incubation periods, exposure risk factors and vaccination history can help guide the diagnostic approach, the non-specific and variable clinical presentation can delay final diagnosis...
January 12, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29338762/predictors-of-remission-with-etanercept-methotrexate-induction-therapy-and-loss-of-remission-with-etanercept-maintenance-reduction-or-withdrawal-in-moderately-active-rheumatoid-arthritis-results-of-the-preserve-trial
#6
Josef S Smolen, Annette Szumski, Andrew S Koenig, Thomas V Jones, Lisa Marshall
BACKGROUND: The aim was to analyze characteristics that predict remission induction and subsequent loss of remission in patients with moderately active rheumatoid arthritis (RA) who received full-dose combination etanercept plus methotrexate induction therapy followed by reduced-dose etanercept or etanercept withdrawal. METHODS: Patients with Disease Activity Score based on 28-joint count (DAS28) >3.2 and ≤5.1 received open-label etanercept 50 mg once weekly (QW) plus methotrexate for 36 weeks...
January 16, 2018: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29336711/circulating-serum-interleukin-6-serum-chitinase-3-like-protein-1-and-plasma-vascular-endothelial-growth-factor-are-not-predictive-for-remission-and-radiographic-progression-in-patients-with-early-rheumatoid-arthritis-post-hoc-explorative-and-validation-studies
#7
C H Brahe, C Dehlendorff, M Østergaard, J S Johansen, L M Ørnbjerg, K Hørslev-Petersen, K Stengaard-Pedersen, P Junker, T Ellingsen, H Lindegaard, I Hansen, T Lottenburger, S Jacobsen, A G Jurik, M L Hetland
OBJECTIVE: To investigate serum interleukin-6 (IL-6), serum chitinase-3-like protein-1 (YKL-40), and plasma vascular endothelial growth factor (VEGF) as measures of disease activity and predictors of clinical remission and radiographic progression in two early rheumatoid arthritis (RA) randomized controlled trials (RCTs). METHOD: Treatment-naïve patients with early RA (< 6 months' duration) and active disease, participating in two investigator-initiated RCTs, were treated according to a predefined treat-to-target algorithm aiming at inflammatory control, using methotrexate (MTX) + cyclosporine versus MTX + placebo (CIMESTRA study, n = 150, 5 year follow-up) or MTX + adalimumab versus MTX + placebo (OPERA study, n = 180, 2 year follow-up)...
January 16, 2018: Scandinavian Journal of Rheumatology
https://www.readbyqxmd.com/read/29335344/can-ultrasound-be-used-to-predict-loss-of-remission-in-patients-with-ra-in-a-real-life-setting-a-multicenter-cohort-study
#8
Pascal Zufferey, Almut Scherer, Michael J Nissen, Adrian Ciurea, Giorgio Tamborrini, Laure Brulhart, Sandra Blumhardt, Martin Toniolo, Burkhard Möller, Hans-Ruedi Ziswiler
OBJECTIVE: Several studies have suggested that patients with rheumatoid arthritis (RA) presenting with ultrasound (US) synovitis despite clinical remission have more subsequent flares than those who show both clinical and sonographic remission. The objective of our study was to investigate whether these results could be translated to a real-life setting. METHODS: We compared the time from the first US performed in clinical remission to loss of remission (defined by a DAS28 > 2...
January 15, 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/29326960/risk-factors-for-clinician-diagnosed-lyme-arthritis-facial-palsy-carditis-and-meningitis-in-patients-from-high-incidence-states
#9
Natalie A Kwit, Christina A Nelson, Ryan Max, Paul S Mead
Background: Clinical features of Lyme disease (LD) range from localized skin lesions to serious disseminated disease. Information on risk factors for Lyme arthritis, facial palsy, carditis, and meningitis is limited but could facilitate disease recognition and elucidate pathophysiology. Methods: Patients from high-incidence states treated for LD during 2005-2014 were identified in a nationwide insurance claims database using the International Classification of Diseases, Ninth Revision code for LD (088...
January 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29326355/18f-fedac-as-a-targeting-agent-for-activated-macrophages-in-dba-1-mice-with-collagen-induced-arthritis-comparison-with-18f-fdg
#10
Seock-Jin Chung, Hai-Jeon Yoon, Gi Jeong Cheon, Hyewon Youn, Mi Jeong Kim, Lin Xie, Yun-Sang Lee, Jae Min Jeong, June-Key Chung, Keon Wook Kang, Ming-Rong Zhang
Activated macrophages have been known to play pivotal roles in the pathogenesis of rheumatoid arthritis (RA). 18F-FEDAC is a radiolabeled ligand for the translocator protein (TSPO), which is abundant in activated macrophages. We evaluated the feasibility of 18F-FEDAC in a murine RA model. Methods: RAW 264.7 mouse macrophages were activated by lipopolysaccharide. TSPO expression levels in activated and inactivated macrophages were measured by quantitative polymerase chain reaction (qPCR) and western blotting...
January 11, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/29316374/switched-memory-b-cells-are-increased-in-oligoarticular-and-polyarticular-juvenile-idiopathic-arthritis-and-their-change-over-time-is-related-to-response-to-tnf-inhibitors
#11
Emiliano Marasco, Angela Aquilani, Simona Cascioli, Gian Marco Moneta, Ivan Caiello, Chiara Farroni, Ezio Giorda, Valentina D'Oria, Denise Pires Marafon, Silvia Magni-Manzoni, Rita Carsetti, Fabrizio De Benedetti
OBJECTIVES: To investigate if abnormalities in B-cell subsets in JIA patients correlated with clinical features and response to treatment. METHODS: 109 patients diagnosed with oligo-JIA or poly-JIA were enrolled in the study. B-cell subsets in peripheral blood and synovial fluid were analyzed by flow cytometry. RESULTS: Switched memory B-cells (SwM B-cells) were significantly (p<0.0001) increased in patients compared to age- matched healthy controls (HC)...
January 5, 2018: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29315262/intraarticularly-injected-mesenchymal-stem-cells-stimulate-anti-inflammatory-molecules-and-inhibit-pain-related-protein-and-chondrolytic-enzymes-in-a-monoiodoacetate-induced-rat-arthritis-model
#12
Toru Ichiseki, Miyako Shimazaki, Yoshimichi Ueda, Shusuke Ueda, Masanobu Tsuchiya, Daisuke Souma, Ayumi Kaneuji, Norio Kawahara
Persistent inflammation is well known to promote the progression of arthropathy. mesenchymal stem cells (MSCs) have been shown to possess anti-inflammatory properties and tissue differentiation potency. Although the experience so far with the intraarticular administration of mesenchymal stem cell (MSC) to induce cartilage regeneration has been disappointing, MSC implantation is now being attempted using various surgical techniques. Meanwhile, prevention of osteoarthritis (OA) progression and pain control remain important components of the treatment of early-stage OA...
January 9, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29314707/comparison-of-early-versus-late-onset-familial-mediterranean-fever
#13
Nazife Sule Yasar Bilge, Ismail Sari, Dilek Solmaz, Soner Senel, Hakan Emmungil, Levent Kilic, Sibel Yilmaz Oner, Fatih Yildiz, Sedat Yilmaz, Duygu Ersozlu Bozkirli, Muge Aydin Tufan, Sema Yilmaz, Veli Yazisiz, Yavuz Pehlivan, Cemal Bes, Gozde Yildirim Cetin, Sukran Erten, Emel Gonullu, Fezan Sahin, Servet Akar, Kenan Aksu, Umut Kalyoncu, Haner Direskeneli, Eren Erken, Mehmet Sayarlioglu, Muhammed Cınar, Timucin Kasifoglu
AIM: Familial Mediterranean fever (FMF) is the most common autoinflammatory disease. One of the common characteristics of this disease is its young age predominance. Nearly 90% of patients experience disease flares during early adult age periods. Currently there are limited data for the comparison of early versus late onset FMF and therefore the primary aim of this study was to investigate these two subsets with regard to their certain demographic, clinical and genetic differences. METHODS: Early (≤ 20 years, Group 1) and late (> 20 years, Group 2) onset FMF patients were identified from the national FMF registry that involves 2246 patients from 15 adult rheumatology clinics located in different geographical areas of Turkey...
January 5, 2018: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/29313319/early-experience-with-a-tapered-titanium-porous-plasma-sprayed-stem-with-updated-design
#14
Antonio G Manocchio, Keith R Berend, Michael J Morris, Joanne B Adams, Adolph V Lombardi
INTRODUCTION: The Taperloc® Complete femoral stem (Zimmer Biomet, Warsaw, Indiana) builds on the widespread clinical success of the original Taperloc design used since 1982. Enhancements to the Complete design include a lowered caput-collum-diaphyseal (CCD) angle from 138° to 133° for improved offset, optimized neck taper with polished neck flats to increase range of motion, reduced distal geometry to improve proximal canal fill, and gradual off-loading that is the goal of tapered geometry...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29310668/prior-to-extension-transcriptomes-of-fibroblast-like-synoviocytes-from-extended-and-polyarticular-juvenile-idiopathic-arthritis-are-indistinguishable
#15
AnneMarie C Brescia, Megan M Simonds, Suzanne M McCahan, Kathleen E Sullivan, Carlos D Rose
BACKGROUND: Our intent was to identify differences between the transcriptome of fibroblast-like synoviocytes (FLS) in oligoarticular juvenile idiopathic arthritis (JIA) before extension when compared to persistent subtype of JIA, when the two are clinically indistinguishable. Additionally, we sought to determine if differences between the transcriptomes of FLS from extended-to-be and polyarticular course JIA could be detected. Our hypothesis was that intrinsic differences in the transcriptome of the FLS from extended-to-be JIA would distinguish them from persistent oligoarticular JIA, before the course is clinically apparent...
January 8, 2018: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/29303709/cost-effectiveness-of-early-treatment-of-acpa-positive-rheumatoid-arthritis-patients-with-abatacept
#16
Aljoscha S Neubauer, Christof Minartz, Kirsten H Herrmann, Christoph G O Baerwald
OBJECTIVES: Studies have reported that the presence of elevated anti-citrullinated protein antibodies (ACPA)/RF levels, together with joint erosions, is associated with higher disease burden in terms of disability and mortality in rheumatoid arthritis (RA). Abatacept has been shown to be effective in this patient population with favourable comparative data against adalimumab. However, few studies have investigated the cost-effectiveness of abatacept in this population to similar treatments such as TNFs...
December 15, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29297100/effect-of-daily-low-dose-prednisone-divided-or-single-daily-dose-in-the-treatment-of-african-americans-with-early-rheumatoid-arthritis
#17
Doyt L Conn, Athan Tiliakos, Gaobin Bao, Shuling Li, Kirk A Easley
Determine the effect of daily low divided or single daily dose of prednisone on the longitudinal change in the number of tender and swollen joints and HAQ scores in African Americans (AA) with early rheumatoid arthritis (RA) from the Consortium for the Longitudinal Evaluation of African Americans with Early Rheumatoid Arthritis (CLEAR) 1 Registry. In a prospective, multicenter observational cohort study, AA with early RA were enrolled and followed longitudinally for up to 5 years. 345 were enrolled. The mean age at enrollment was 51 years and 82% were women...
January 3, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29290546/characteristics-of-claims-in-the-management-of-septic-arthritis-in-japan-retrospective-analyses-of-judicial-precedents-and-closed-claims
#18
Yasuhiro Otaki, Makiko Ishida DaSilva, Yuichi Saito, Yasuaki Oyama, Giichiro Oiso, Tomohiko Yoshida, Masakazu Fukuhara, Mitsuru Moriyama
BACKGROUND: Septic arthritis (SA) cases can result in claims or litigation because of poor prognosis even if it is unavoidable. Although these claims or litigation are useful for understanding causes and background factors of medical errors, the characteristics of malpractice claims associated with SA remain undetermined in Japan. This study aimed to increase our understanding of malpractice claims in the clinical management of SA. METHODS: We analyzed 6 civil precedents and 16 closed claims of SA from 8530 malpractice claims processed between July 2004 and June 2014 by the Tokyo office of Sompo Japan Nipponkoa Insurance, Incorporated...
December 28, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29289987/pelvic-pyomyositis-in-children-changing-trends-in-occurrence-and-management
#19
Manish Kiran, Saffwan Mohamed, Ashley Newton, Harvey George, Neeraj Garg, Colin Bruce
AIMS: We present the largest series of paediatric pelvic pyomyositis from a temperate country, analyse the factors influencing long term prognosis and suggest a diagnostic protocol. MATERIALS AND METHOD: We included 41 patients diagnosed with primary paediatric pelvic pyomyositis between 1998 and 2016, in this study with a mean age of 7.5 years. Demographic, clinical, radiological and follow-up data were reviewed. Statistical analysis was performed to analyse the influence of early diagnosis and treatment on the final outcome...
December 30, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29289700/adherence-to-synthetic-disease-modifying-antirheumatic-drugs-in-rheumatoid-arthritis-results-of-the-observar-study
#20
Antonio Juan Mas, Santos Castañeda, José I Cantero Santamaría, José L Baquero, Francisco J Del Toro Santos
BACKGROUND: Treatment compliance with disease-modifying antirheumatic drugs (DMARD) is essential to achieve the therapeutic goals in rheumatoid arthritis (RA). However, despite the need for good compliance, there is evidence that patients with RA frequently fail to use DMARD for the control of RA. Thus, the main objective of the OBSERVAR study is to evaluate the reasons for the lack of therapeutic adherence to synthetic DMARD in these patients. PATIENTS AND METHODS: A Delphi process involving 18 randomly selected Spanish rheumatologists determined the level of agreement with 66 causes of noncompliance selected from the literature in relation to synthetic DMARD in RA...
December 27, 2017: Reumatología Clinica
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