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1.
Cem Ozisler Askin Ates Yasar Karaaslan Ozgul Ucar Elalmis Izzet Selcuk Parlak Fulya Dortbas Kubilay Sahin Huseyin Tutkak 《The Egyptian Rheumatologist》2019,41(2)
Aim of the work
Cardiovascular diseases represent a major source of morbidity and mortality for patients with rheumatoid arthritis (RA). The increase in aortic stiffness, carotid intima-media thickness (CIMT) and serum osteoprotegerin (OPG) have been shown to be independent risk factors for cardiovascular events. This work aimed to investigate the clinical significance of these parameters in RA patients.Patients and methods
60 RA patients and 30 control with no primary cardiovascular risk factors were included. Disease activity score (DAS28) was assessed in patients. Aortic stiffness was evaluated by transthoracic echocardiography and CIMT evaluated by Doppler ultrasonography. OPG was determined by ELISA.Results
The 60 RA patients had a mean age of 40.8?±?8.3?years, disease duration of 6.9?±?4.9?years and were 46 females and 14 males. In RA patients, serum OPG and CIMT (thickest and mean) were significantly higher than the control (60.5?±?32.4?pg/ml vs 29.4?±?16.7?pg/ml, p?<?0.001; 0.73?±?0.18?mm vs 0.63?±?0.13?mm, p?<?0.001; 0.61?±?0.1?mm vs 0, 56?±?0.1?mm, p?=?0.007, respectively). The aortic stiffness tended to be higher in patients (6.9?±?4.8 vs 5.2?±?2.5, p?=?0.114) and in males (9.7?±?7.4) vs females (5.7?±?3.4, p?=?0.013). OPG levels were significantly higher in those with erosions (n?=?41) (68.6?±?34.5?pg/ml vs 49.1?±?22?pg/ml p?=?0.038) and in those seropositive (n?=?54) (65.4?±?32.2?pg/ml vs 36?±?18.3?pg/ml p?=?0.012). In patients, CIMT (thickest and mean) correlated significantly with the aortic stiffness (p?=?0.02 and p?=?0.04 respectively).Conclusion
RA is an independent risk factor associated with cardiovascular events. For determining this risk, measuring the serum OPG, CIMT and aortic stiffness may be a useful guide. 相似文献2.
Dahlia A. Hussein Samah A. El Bakry Nashwa A. Morshedy Soha E. Ibrahim Hossam Moussa Sakr Rania A. Abo-Shady 《The Egyptian Rheumatologist》2018,40(4):221-226
Aim of the work
To assess the level of serum cartilage oligomeric matrix protein (COMP) in early rheumatoid arthritis (RA) patients and study its relation to disease activity and musculoskeletal ultrasound (MSUS) findings.Patients and methods
The study included 40 early RA patients. Disease activity score (DAS28) was assessed. Serum COMP level was measured and MSUS findings of the small joints of hands done at base line and after 6?months of follow up.20 age and sex matched control were included.Results
Patients age was 38.8?±?9.3?years; 36 females and 4 males and disease duration 6.7?±?3.5?years. Serum COMP was significantly higher in patients (median 190?U/L; 90–750?U/L) compared to control (90?U/L; 80–130?U/L)(p?<?.001) being higher in more active (250?U/L) (p?=?.001) and significantly correlated with baseline synovial inflammation (p?=?.009). COMP levels were lowered after 6?months of receiving treatment (110 U/L; 30–180?U/L) (p?<?.001). The presence of bony erosions increased with more active disease (p?=??.003). There was a significant reduction in the erythrocyte sedimentation rate and COMP at follow up (p?<?.0001 and p?=?.001 respectively). No correlation was found between the COMP level with C-reactive protein, ESR, MSUS score or bony erosions at follow up.Conclusions
COMP significantly correlated with disease activity in early RA and could be used as a marker of activity. It correlates significantly with synovial inflammation detected by power Doppler. COMP may reflect the outcome and could be used as a prognostic marker in RA patients. COMP did not significantly correlate with bone erosions. 相似文献3.
Khadija Baccouche Linda Mani Nejla Elamri Neila Fathallah Hounaida Zaghouani Safaa Belghali Hela Zeglaoui Elyes Bouajina 《The Egyptian Rheumatologist》2018,40(4):249-253
Aim of the work
To assess the frequency and severity of peripheral enthesitis in spondyloarthritis (SpA) patients using musculoskeletal ultrasound (MSKUS) in B mode associated with power Doppler (PD) compared to a group of patients with mechanical low back pain (M-LBP).Patients and methods
The study included 40?SpA patients and 20?M-LBP patients as a control group. Ultrasound (US) in B mode and PD was performed at Achilles tendon (AT) and plantar fascia (PF).Results
The mean age of SpA patients was 41.9?±?14.3?years and disease duration 8.4?±?5.8?years. Axial form was found in 36 cases (90%) and peripheral form in 4 (10%). The mean ESR was 28.3?±?23.2?mm/1sth and the CRP was 22.9?±?31.2?mg/l. In SpA patients 109/160 (68.1%) of the assessed entheseal sites were significantly abnormal compared to 27/80 (33.8%) in M-LBP patients (AT p?<?.0001 and PF p?=?.02). Compared to the M-LBP patients, a significant difference was found in AT for hypoechogenicity (p?=?.006) and bone erosion (p?=?.005) and at both entheses for cortical hypervascularisation (AT: p?<?.0001 and PF: p?=?.03). Otherwise, in SpA patients, 60.2% (53/88) of non tender entheses showed at least one ultrasound abnormality compared to 77.8% (56/72) of tender entheses. A significant correlation was identified between clinical and ultrasound assessment (r?=?0.4, p?=?.01).Conclusion
The frequency of enthesitis was high among SpA compared with M-LBP patients and AT was the most affected enthesis. Abnormal vascularization in the cortical bone insertion of entheses was detected especially in SpA patients, and there was great evidence of subclinical enthesitis. 相似文献4.
Krystal K. Swasey Trevor J. Orchard Tina Costacou 《Journal of diabetes and its complications》2018,32(4):411-417
Aims
DCCT showed that intensive type 1 diabetes management reduces complication incidence but did not focus on other cardiovascular disease risk factors, whose control in type 1 diabetes has not been well-studied. We assessed trends in cardiovascular risk factors in type 1 diabetes and attainment of concurrent American Diabetes Association (ADA) guidelines/recommendations (for HbA1c, blood pressure, LDL cholesterol, triglycerides) for complication prevention.Methods
Individuals with childhood-onset type 1 diabetes (n?=?658; 49.4% women; baseline (1986–1988) median age 27 and duration 19?years) were followed biennially for up to 25?years, with surveys and/or examinations.Results
At the latest recorded follow-up, achievement of concurrent ADA recommendations increased for HbA1c (from 9.7 to 25.6%, p?<?.0001); was unchanged for blood pressure (from 89.7% to 87.4%, p?=?.36); and decreased for LDL cholesterol (from 62.3 to 39.7%, p?<?.0001). Adoption of intensive insulin therapy (from 5.9 to 64.4%, p?<?.0001) and hypercholesterolemia (from 67.3 to 78.9%, p?=?.0006) also increased. Overall, the proportion meeting all four recommendations was essentially unaltered (from 6.8% to 7.6%) (p?=?.69). Results were similar by gender.Conclusions
Although the adoption of intensive insulin therapy and obtaining ADA HbA1c recommendations are increasing, overall cardiovascular risk factor compliance remains low and merits further intervention. 相似文献5.
Mai A. Mohammed Shaimaa A.K. Rady Rabab A. Mohammed Samia M.H. Fadda 《The Egyptian Rheumatologist》2018,40(4):261-264
Aim of the work
This study aimed to investigate the plasma level of fibroblast growth factor-23 (FGF-23) in patients with primary knee osteoarthritis (KOA) and to elaborate its relation with radiographic and symptomatic severity of OA.Patients and methods
50 KOA patients were recruited from the Rheumatology and Rehabilitation Department, Beni-Suef University Hospital and 20 matched controls were also included. Plasma FGF-23 level was estimated by ELISA. Severity of the disease was assessed clinically by Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score and radiologically by Kellgren-Lawrence (KL) grading scale.Results
The mean age of the patients was 59.8?±?8.02?years (51–75?years) and disease duration 3.8?±?2.1?years (1–9?years); they were 8 males (16%) and 42 (84%) females with a body mass index of 34.04?±?5.3 (23.6–48.4). FGF-23 level was higher in KOA patients (96.2?±?148.9?pg/ml; 3.4–14814.6?pg/ml) than in control (18.3?±?11.1?pg/ml; 5–38.4?pg/ml) (p?=?.023). There was no significant difference in FGF-23 between males and females. FGF-23 was significantly increased in patients who had effusion (p?=?.004) or bilateral involvement (p?=?.023). Plasma FGF-23 level significantly correlated with disease severity sores; WOMAC and KL (p?=?.009, p?=?.01 respectively) and also with the age (p?=?.016), disease duration (p?=?.006) and body mass idex (p?=?.008)Conclusions
FGF-23 might be a potential biomarker for diagnosing and evaluating the onset and development of KOA and significantly correlated with the symptomatic and radiographic severity of the disease. Controlling KOA progression by inhibitors of FGF23 may be an issue of interest in further studies. 相似文献6.
Samia Salah-El-Din Mahmoud Doaa Ghaith Yomna Farag Bishoy Ibrahim 《The Egyptian Rheumatologist》2018,40(4):273-276
Introduction
Ferritin is an acute-phase reactant that is elevated in several autoimmune disorders. Serum ferritin levels have been correlated with disease activity scores of juvenile systemic lupus erythematosus (JSLE). Furthermore, enhanced levels of ferritin have also been described in lupus nephritis (LN).Aim of the work
To evaluate serum ferritin as a cheap and available marker of disease activity and renal involvement in Egyptian children with JSLE.Patients and methods
Forty-eight JSLE cases recruited from the Pediatric Rheumatology Clinic in Cairo University Specialized Children’s Hospital and 43 matched healthy children were enrolled in the study. SLE disease activity score-2000 (SLEDAI-2K) and renal activity score were assessed. Serum levels of ferritin, was quantified by enzyme-linked immunosorbent assay.Results
The mean age of the patients was 12.6?±?3.02?years and disease duration 3.4?±?2.5?years. Serum ferritin significantly higher in patients (416.1?±?1022.9?ng/ml) compared with control (36.1?±?18.2?ng/ml) (p?<?0.001). Serum ferritin was significantly higher in active (n?=?20) (890.4?±?1474.8?ng/ml) compared to inactive (n?=?28) (77.4?±?74.1?ng/ml) patients (p?<?0.001). A significant correlation was found between serum ferritin with SLEDAI-2K (r?=?0.35, p?=?0.014), renal-SLEDAI-2K (r?=?0.49, p?<?0.001) and with renal activity score (r?=?0.38, p?=?0.008). A significant correlation was found between serum ferritin and anti-double stranded-DNA (r?=?0.44, p?=?0.002) and complement 3 (r?=??0.42, p?=?0.003).Conclusion
Serum ferritin level can be considered a reliable biomarker for monitoring disease and renal activity in children with JSLE and LN. This may lead to improvement of management and consequently prognosis of JSLE patients as serum ferritin is an available and relatively cheap marker. 相似文献7.
Saud M. Elsaughier Ramadan Ghaleb Amr Salah Amin Khaled Sayed elmaghraby Khaled Abdelghany Baraka 《The Egyptian Heart Journal》2018,70(4)
Background
Patent ductus arteriosus is generally associated with hyperdynamic status. Given the vascular shunt between the aorta and pulmonary artery, intrinsic aortic changes occur (aortic stiffness). In the present study, we attempted to assess the impact of PDA on aortic stiffness and its connection with cardiovascular function before and after transcatheter closure of PDA.Patient and methods
Our study consisted of 60 children who were preparing for transcatheter closure of PDA and 60 healthy controls. All patients had clinical and echocardiographic proof of hemodynamically significant PDA.Results
Patients with PDA exhibited significantly higher ASI than controls before closure (p-value?<?0.05). After closure, ASI was significantly reduced (p-value?<?0.05), but still higher than that of controls (p-value?<?0.05) at the six-month follow-up assessment. Patients with PDA had significantly lower LVEF than controls before closure (p-value?<?0.05). After closure, LVEF was significantly enhanced (p-value?<?0.05), and no significant difference was noted amongst patients and controls (p-value?<?0.05) at the six-month follow-up assessment.Conclusion
Aortic stiffness is significantly increased in patients with PDA regardless of PDA size. Aortic stiffness is related to reduced heart function. ASI may be valuable for observing the course of patients with PDA before and after intervention. 相似文献8.
Maha A. Mohammed Shaimaa A.K. Rady Moustafa O. El-Mokadem Samia M.H. Fadda 《The Egyptian Rheumatologist》2018,40(3):173-178
Aim of the work
To assess the echocardiographic changes using Trans Thoracic Echocardiograghy in systemic lupus erythematosus (SLE) patients with and without antiphospholipid syndrome (APS) and to study the relation of the changes to the disease activity and damage.Patients and methods
This study was conducted on 50 SLE patients (25 with and 25 without APS) and 50 controls. The SLE disease activity index (SLEDAI) and Systemic Lupus International Collaborating Clinics Damage index (SLICC/DI) were assessed. Laboratory investigations were performed and transthoracic echocardiography (TTE) was done.Results
The mean age of the patients was 27.7?±?8.5?years and disease duration 4.1?±?3.7?years; 44 females and 6 males; 7.3:1. There was a high frequency of mitral (64%), aortic (22%) and tricuspid (24%) valve regurges as well as pericardial effusion (22%). Left ventricular hypertrophy and atrial dilation was present in 10% of the patients. The frequency of mitral, aortic and tricuspid regurge in SLE patients with APS tended to be higher (84%, 32% and 36%) than in those without (44%, 12% and 12%, respectively). There was a significant correlation between SLEDAI and pericardial effusion (p?=?0.001), between the SLICC/DI with the left ventricular diastolic dysfunction (LVDD) (p?=?0.001), the presence of lupus nephritis with the ejection fraction (p?=?0.02) and between hypertension with the LVDD (p?=?0.001).Conclusion
All SLE patients especially those with APS should be screened for the presence of structural cardiac abnormalities. TTE can be helpful as a noninvasive diagnostic tool for early detection of the abnormalities, resulting in earlier treatment and reduction in mortality and morbidity. 相似文献9.
Nuray Kahraman Ay Asim Enhos Yasin Ay Nijad Bakhshaliyev Aydin Nadir Erdem Karacop Ilke Celikkale Mahmut Uluganyan Razaman Ozdemir Omer Goktekin 《Journal of electrocardiology》2018,51(6):923-927
Background
Although transcatheter aortic valve implantation (TAVI) can successfully correct aortic narrowing, pre-existing pathophysiological alterations in the left ventricle are still a concern in terms of long-term mortality. This study aimed to examine the predictive role of fQRS morphology on long-term prognosis in patients undergoing TAVI due to severe aortic stenosis.Methods
A total of 117 patients undergoing TAVI due to severe aortic stenosis were included in this retrospective cohort study. Patients were assigned into two groups based on the presence (n?=?36) or absence (n?=?81) of fQRS. Predictors of long-term survival were estimated.Results
In-hospital mortality was higher in fQRS group (5.5% vs. 1.2%, p?=?0.0224). In the long-term, fQRS (OR: 3.06, 95% CI 1.29–7.27, p: 0.01), LVEF <50% (OR: 2.54, 95% CI 1.07–6.02, p: 0.03) and presence of atrial fibrillation (OR: 2.42, 95% CI 1.05–5.60, p: 0.03) emerged as significant independent predictors of short survival.Conclusion
Presence of fQRS on ECG, an indirect indicator of myocardial fibrosis, seems to have the potential to be used as a prognostic marker after TAVI procedure. Large prospective studies are warranted. 相似文献10.
Dahlia A. Hussein Samah A. El Bakry Nashwa A. Morshedy Soha E. Ibrahim Mostafa A. Mohammed 《The Egyptian Rheumatologist》2018,40(3):179-182
Aim of the work
To identify the ocular manifestations in Egyptian SLE patients and its relation with disease activity and antiphospholipid (aPL) antibodies.Patients and methods
The study included 100 patients and 30 matched controls. In patients, SLE disease activity index was scored and anti-phospholipids measured. All participants underwent complete ophthalmological examination including assessment of visual acuity, slit-lamp examination to assess anterior chamber and fundus examination to assess retina, choroid and optic disc.Results
Patients were 86 females and 14 males (F:M 6.1:1) with a mean age of 31.3?±?12.2?years and disease duration 4.8?±?4.7?years. 46% had ocular manifestations in the form of dry eye (24%), retinopathy (24%), reduced visual acuity in 17%, redness, ocular headache and glaucoma in 6% each, blurring of vision in 7% and cataract in 3%. Cotton-wool spots were the most common retinal abnormal finding followed by vasculitis, attenuated blood vessels, papilledema and pale optic disc. SLE patients with ocular affection especially retinopathy had significantly higher levels of anticardiolipin antibodies (ACL) IgM (11.9?±?5.3 vs 9.9?±?4.1 MPL), lupus anticoagulant (LAC) (41.9?±?15.1 vs 36.3?±?11.9 s), disease duration and SLEDAI compared to those without (p?=?.039, p?=?.04, p?=?.02 and p?=?.026 respectively). SLE patients with severe activity had more retinal affection (35%) than those with moderate (14.8%) and mild (14%) (p?=?.04).Conclusions
Ocular affection is frequent in SLE patients. Dry eyes and retinopathy (especially cotton-wool spots) are the most common findings. Anti-phospholipids (ACLIgM and LAC), active disease and disease duration are significantly related to eye affection especially retinopathy among SLE patients. 相似文献11.
Background
Coronary artery disease is one of the main causes of death in diabetes mellitus (DM). Egypt was listed among the world top 10 countries regarding the number of diabetic patients by the International Diabetes Federation (IDF).Aim of work
Assessment of the extent of coronary atherosclerotic disease and lesion tissue characterization among diabetic compared to non-diabetic Egyptian patients.Methodology
IVUS studies of 272 coronary lesions in 116 patients presented with unstable angina were examined. The patients were divided into two groups: diabetic group (50 patients with 117 lesions) and non-diabetic group (66 patients with 155 lesions).Results
As compared to the non-diabetic group, the diabetic patients were more dyslipidemic (84% vs 39.4%, p?=?0.001) with higher total cholesterol level (194.6?±?35.3 vs 174.4?±?28.5?mg/dl, p?=?0.001) and higher LDL-C (145.3?±?27.1 vs 123.2?±?31.4, p?=?0.001). Regarding lesions characteristics, the diabetic group had longer lesions (19.4?±?7.4 vs 16.3?±?7.9?mm, p?=?0.002) with higher plaque burden (60.8?±?15.3 vs 54.8?±?14.0, p 0.002) and more area stenosis percentage (60.8?±?15.6 vs 55.6?±?14.1, p?=?0.008). Structurally, the diabetic group lesions had more lipid content (19.8?±?8.8 vs 16.8?±?8.7, p?=?0.008) and more necrotic core (17.6?±?7.4 vs 14.7?±?4.8, p?=?0.008) but less calcification (6.9?±?3.6 vs 11.8?±?6.3, p?=?0.001). The RI was negative in both groups, 0.95?±?0.13 in the diabetic group vs 0.98?±?0.19 in non-diabetic group (p?=?0.5). Within the diabetic group lesions, the dyslipidaemic subgroup had more lipid content (23.?±?5.2 vs 14.6?±?8.6, p?=?0.01) but less fibrotic component (48.6?±?4.7 vs 59.1?±?13.6%, p?=?0.01) and less calcification (10.9?±?6.8% vs 14.07?±?3.8%, p?=?0.02) as compared to the nondyslipidaemic subgroup.Conclusions
Diabetic patients with coronary atherosclerosis in Egypt have longer lesions with higher plaque burden and more percent area stenosis with negative remodeling index. The diabetic lesions had more lipid content and more necrotic core but less calcification. 相似文献12.
Alpha Mamadou Diallo Jean-Luc Novella Céline Lukas Pierre-François Souchon Moustapha Dramé Maud François Bénédicte Decoudier Sara Barraud Anne-Sophie Salmon Déborah Ancelle Carl Arndt Brigitte Delemer 《Journal of diabetes and its complications》2018,32(8):753-758
Aims
To determine the relationship between early markers of diabetes control and diabetic retinopathy (DR) in type 1 diabetes.Methods
A historic cohort study was conducted on 712 patients from the CARéDIAB database. HbA1c and usual metabolic parameters were measured one year after diagnosis of diabetes. First occurrences of severe hypoglycemia and ketoacidosis during follow-up were selected as time-dependent markers of diabetes control. Data were analyzed in a Cox model using SPSS software to predict DR with significance level at p-value < 0.05.Results
In multivariate regression, any diabetic retinopathy was predicted by HbA1c (HR?=?1.38; CI?=?1.25–1.52; p?<?0.0001), severe hypoglycemia (HR?=?3; CI?=?1.99–4.52; p?<?0.0001), ketoacidosis (HR?=?1.96; CI?=?1.17–3.22; p?=?0.009), and age at diagnosis (HR?=?1.016; CI?=?1.002–1.031; p?=?0.02). Proliferative DR was predicted by HbA1c (HR?=?1.67; CI?=?1.51–1.79; p?<?0.0001), severe hypoglycemia (HR?=?3.67; CI?=?2.74–5.25; p?<?0.0001), and ketoacidosis (HR?=?2.37; CI?=?1.56–3.18; p?<?0.0001).Conclusion
This study shows that the failure to achieve diabetes control after the first year of diagnosis as well as early episodes of acute diabetes complications may contribute to the occurrence of diabetic retinopathy in type 1 diabetes patients. 相似文献13.
Maya Fayfman Georgia Davis Elizabeth W. Duggan Maria Urrutia David Chachkhiani Joanna Schindler Francisco J. Pasquel Rodolfo J. Galindo Priyathama Vellanki David Reyes-Umpierrez Heqiong Wang Guillermo E. Umpierrez 《Journal of diabetes and its complications》2018,32(12):1091-1096
Aim
We investigated if a dipeptidyl peptidase-4 inhibitor, sitagliptin, can prevent perioperative stress hyperglycemia in patients without prior history of diabetes mellitus undergoing general surgery.Methods
This double-blind pilot trial randomized general surgery patients to receive sitagliptin (n?=?44) or placebo (n?=?36) once daily, starting one day prior to surgery and continued during the hospital stay. The primary outcome was occurrence of stress hyperglycemia, defined by blood glucose (BG) >140?mg/dL and >180?mg/dL after surgery. Secondary outcomes included: length-of-stay, ICU transfers, hypoglycemia, and hospital complications.Results
BG >140?mg/dL was present in 44 (55%) of subjects following surgery. There were no differences in hyperglycemia between placebo and sitagliptin (56% vs. 55%, p?=?0.93). BG >180?mg/dL was observed in 19% and 11% of patients treated with placebo and sitagliptin, respectively, p?=?0.36. Both treatment groups had resulted in similar postoperative BG (148.9?±?29.4?mg/dL vs. 146.9?±?35.2?mg/dL, p?=?0.73). There were no differences in length-of-stay (4 vs. 3?days, p?=?0.84), ICU transfer (3% vs. 5%, p?=?1.00), hypoglycemia <70?mg/dL (6% vs. 11%, p?=?0.45), and complications (14% vs. 18%, p?=?0.76).Conclusion
Preoperative treatment with sitagliptin did not prevent stress hyperglycemia or complications in individuals without diabetes undergoing surgery. 相似文献14.
Georgia Tsipoura Helen Lazaratou Dimitrios Damigos Olga Vougiouka 《The Egyptian Rheumatologist》2018,40(3):197-201
Aim of the work
To describe and compare sleep disturbance in children and adolescents with inactive juvenile idiopathic arthritis (JIA) and to study their relation to health-related quality of life (HRQoL).Patients and methods
Fifty JIA patients and 50 controls along with their parents were studied. Sleep disturbance was assessed by the Children's Sleep Habits Questionnaire (CSHQ) and HRQoL was assessed according to the revised KINDLR questionnaire.Results
The 50 JIA children were 14 boys (28%) and 36 girls (72%); 58% children and 42% adolescent. The mean age of participants was comparable between boys (11.6?±?2.9 years) and girls (11.4?±?3.3?years) either in JIA (p?=?.76) or control (p?=?.56). Patients enrolled had enthesitis-related arthritis in 6(12%), RF-positive polyarthritis in 8(16%), oligoarthritis in 32(64%), systemic arthritis in 2(4%) and psoriatic arthritis in 2(4%). Patients had higher CSHQ score (45.5?±?8.2) and a lower KINDLR (72.4?±?16.8) compared to the control (40.4?±?3.4 and 78.3?±?5.4; p?<?.0001 and p?=?.02 respectively). There were no differences between children and adolescents however, Sleep Onset Delay was significantly highest in systemic-onset children (p?=?.028) and KINDLR emotional subscale was significantly increased in those with oligoarthritis (81.6?±?16.6) (p?=?.02). All subscales significantly correlated with their corresponding total score (p?<?.01). Age at onset” with Emotional subscale were predictive of poor sleep and with number of hospitalizations for poor quality of life.Conclusions
Children and adolescents with inactive JIA, while taking medications, experience more disturbed sleep than matched control. This disturbance in their sleep entails in significant lower levels of HRQoL. 相似文献16.
Ghada Youssef Ibrahim El Tebi Dina Osama Ahmed Shehahta Essam Baligh Zeinab Ashour Hany Gamal 《The Egyptian Heart Journal》2017,69(1):37-44
Background
Increased arterial stiffness can be used as a prognostic marker of arterial hypertension. The relationship between arterial stiffness and arterial hypertension seems to be reciprocal.Objective
Evaluation of changes of the arterial elastic prosperities in normotensive subjects, with and without parental history of hypertension.Subjects and Methods
One hundred and ten normotensive individuals, aged 20–30 years, were divided into two groups: group-A (n = 57) and group-B (n = 53) subjects with positive and negative parental history of hypertension, respectively. Systolic, diastolic and pulse pressures were measured using mercury sphygmomanometer. The elastic properties of the ascending aorta and the common carotid arteries were assessed using M-mode echo and B-mode imaging, respectively. Stiffness index of the digital volume pulse (SIDVP) was measured in the right index finger using photoplethysmography.Results
Group A subjects showed higher aortic stiffness index (p = 0.002), carotid stiffness index (p = 0.001), carotid pulse wave velocity (p ? 0.001) and stiffness index of digital volume pulse (p = 0.001). Group A subjects showed lower aortic distensibility (p = 0.001), aortic strain (p = 0.004), changes in aortic diameter (p = 0.022), carotid distension (p = 0.026), carotid distensibility coefficient (p ? 0.001) and carotid compliance coefficient (p = 0.002).Conclusion
The aortic and carotid stiffness parameters and SIDVP were higher in normotensive offspring of hypertensive parents. This finding could direct the attention towards the increased cardiovascular risk in this group and thus prompt earlier and tighter prevention of cardiovascular risk factors. 相似文献17.
Lior Yankelson Aviram Hochstadt Ben Sadeh Benley Pick Ariel Finkelstein Raphael Rosso Sami Viskin 《Journal of electrocardiology》2018,51(3):481-486
Objectives
To predict the QT interval in the presence of normal QRS for patients with left bundle branch block (LBBB).Background
There is no acceptable method for simple and reliable QT correction for patients with bundle branch block (BBB).Methods
We measured the QT interval in patients with new onset LBBB who had a recent electrocardiogram with narrow QRS for comparison. 48 patients who developed in-hospital LBBB were studied. Patients who had similar heart rate before and after LBBB were included. We used linear regression, the Bogossian method, and our new fixed QRS replacement method to evaluate the most reliable correction method.Results
JTc (QTc-QRS) interval was preserved before and after LBBB (328.9?±?25.4?ms before LBBB vs. 327.3?ms post LBBB (p?=?0.550). Mean predicted preLBBB QTc difference was 1.3?ms, ?21.3?ms and 1.6?ms for the three methods respectively (p?<?0.001 for Bogossian comparison with the other methods). Coefficients of correlation (R) between actual preLBBB QTc with predicted preLBBB QTc were 0.707, 0.683 and 0.665 respectively (p?>?0.3 for R comparisons between all methods). The average absolute difference in preLBBB QTc was 15.5?ms and 16.7?ms for the regression and fixed-gender methods (p value between the two?=?0.321) and 25.5?ms for the Bogossian method, which was found to be significantly underperforming.Conclusions
In patients with LBBB, replacing of the QRS duration after deriving the QTc interval with a fixed value of 88?ms for female and 95?ms for male provides a simple and reliable method for predicting the QTc before the development of LBBB. 相似文献18.
Mohamed A. El-Menoufy Abd El-Aziz A. El-Kak Mohamed A. Ahmed 《The Egyptian Rheumatologist》2019,41(2)
Background
Rheumatoid arthritis (RA) is associated with accelerated atherosclerosis which is not fully explained by traditional risk factors. Such excess risk appears to be driven by systemic inflammation.Aim of the work
Aim of the work was to compare between RA patients with and without CD4+CD28? T-cell expansion regarding carotid intima-media thickness (IMT) and brachial artery flow-mediated endothelium-dependent dilatation (FMEDD), as markers of early atherosclerosis.Patients and methods
The study was conducted on 39 female patients with no overt cardiovascular disease or risk factor and 28 age matched females as controls. Atherosclerotic changes were assessed through measurement of carotid IMT and FMEDD. CD4+CD28? T-cells were assessed by flow cytometry.Results
The mean age of the patients was 34.9?±?5?years and the disease duration of 6.1?±?2.1?years. Traditional risk factors were comparable between patients and controls. Serum homocysteine level tended to be higher in the patients (11?±?4.21?μmol/L) compared to the control (9.91?±?3.61?μmol/L). Patients had significantly higher carotid IMT (0.83?±?0.24?mm vs 0.6?±?0.15?mm, p?=?0.008) and lower FMEDD (3.27?±?1.49% vs 6.01?±?1.79%, p?=?0.002). Similarly, patients with CD4+CD28? expansion (n?=?12) had significantly higher IMT (1?±?0.23?mm) and lower FMEDD (2.25?±?1.06%) compared to those without (n?=?27) (0.76?±?0.21?mm and 3.67?±?1.47%); p?=?0.01, p?=?0.01 respectively; but not affected by receiving methotrexate or not. Laboratory investigations were comparable in patients with and without expansion.Conclusion
CD4+CD28? cells may contribute to the development of premature atherosclerosis in RA patients. Further studies are recommended to evaluate the benefit of CD4+CD28? T-cell modulation on the future development of atherosclerosis in these patients. 相似文献19.
Background
The aim of this study is to investigate the prevalence of metabolic syndrome (MetS), carotid intima media thickness (IMT), and serum C-reactive protein (CRP) levels in patients with chronic obstructive pulmonary disease (COPD), and the possible relationships among them.Methods
Fifty stable COPD patients and 40 healthy controls were included in the study. The participants were further divided into four groups according to their smoking status. Pulmonary function tests were performed in COPD patients. Anthropometric measurements and blood chemistry analysis, serum CRP levels and carotid intima-media thickness (IMT) measurements were performed in all the study population.Results
Prevalence of metabolic syndrome was 43% in COPD patients and 30% in the control group (p?=?0.173). FEV1% and FEV1/FVC were higher in COPD patients with MetS (p?=?0.001 and p?=?0.014, respectively) compared to those without MetS. Prevalence of MetS was significantly different among the COPD patients with different stages (p?=?0.017) with the highest value in stage 2 (59%). Carotid IMT was significantly higher in COPD patients than in control group (1.07?±?0.25 mm and 0.86?±?0.18 mm, respectively; p?<?0.001). Serum CRP levels were not different in COPD patients and controls, however they were higher in individuals with MetS compared to those without MetS regardless of COPD presence (p?=?0.02).Conclusions
Early markers of atherogenesis, in terms of carotid IMT, were found to be higher in COPD patients than in healthy controls. MetS prevalence was observed to decrease as the severity of airflow obstruction increased. Therefore, screening COPD patients for these cardiovascular risk factors would be a novel approach even in absence of symptoms.20.
Abdus Samad Ansari Simon de Lusignan William Hinton Neil Munro Simon Taylor Andrew McGovern 《Journal of diabetes and its complications》2018,32(6):602-608