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1.
Aim of the work
This work aimed to measure serum ferritin and transferrin levels and to study the presence of metabolic syndrome (MetS) in Egyptian systemic lupus erythematosus (SLE) females and to correlate them with disease activity, damage, clinical status and subclinical atherosclerosis.Patients and methods
The study included 50 SLE female patients and 25 matched control. SLE disease activity index (SLEDAI) and damage index (DI) were assessed and the presence of MetS determined. Serum ferritin was measured by enhanced chemi-luminescence and the carotid intima-media thickness (cIMT) was assessed by B-mode ultrasound.Results
The mean cIMT (0.71?±?0.14?mm) and ferritin (2098?±?132.99?ng/ml) were significantly higher in patients compared to controls (0.62?±?0.05?mm and 71.7?±?18.7?ng/ml; p?=?0.003 and p?<?0.001, respectively). 28% of patients and 12% controls had MetS. 6(12%) had a thickened cIMT (≥0.9?mm), 3 of them had atherosclerotic plaques (≥1.3?mm). The cIMT significantly correlated (p?<?0.05) with age (r?=?0.54), disease duration (r?=?0.55), SLEDAI (r?=?0.37), DI (r?=?0.52), ferritin (r?=?0.31), cholesterol (r?=?0.32), triglycerides (r?=?0.7), fasting blood sugar (r?=?0.72), systolic (r?=?0.68) and diastolic (r?=?0.7) blood pressure and negatively with transferrin (r?=??0.31), low (r?=??0.32) and high-density lipoprotein (r?=??0.53) and C3 (r?=??0.66). Patients with MetS had significantly higher cIMT (0.9?±?0.3?mm) versus those without (0.64?±?0.1?mm)(p?<?0.0001).Conclusion
MetS in SLE is a associated with accelerated atherosclerosis while serum ferritin and transferrin are strong indicators of SLE activity and damage. Considering the association with MetS and measuring the cIMT in SLE patients is recommended and provides a useful marker for detecting subclinical cases and predicting future cardiovascular events. 相似文献2.
Osama M. Momtaz Soha H. Senara Sherif H. Zaky Eman S. Mohammed 《The Egyptian Rheumatologist》2019,41(2):129-133
Aim of the work
To determine the frequency of critical complications of systemic lupus erythematosus (SLE) admitted to the intensive care unit (ICU), study the risk factors and outcome.Patients and methods
Fifty SLE patients consequently admitted to the ICU were prospectively studied. The SLE Disease Activity Index (SLEDAI) was assessed.Results
The mean age of the patients was 29.3?±?8.7?years; they were 42 females (84%) and disease duration of 4.9?±?3.4?years. The overall mortality was 24% (12 patients) and tended to be higher in males (37.5% vs 21.5%). The commonest causes of death were infection (p?<?0.001) and pulmonary complications (p?=?0.04) in all non-survivors. Metabolic acidosis was significantly increased in deceased patients (75%) compared to survivors (23.7%) (p?=?0.003). Cardiac and CNS complications were significantly increased in non-survivors (p?=?0.04 and p?=?0.03 respectively). Acute renal failure was significantly more frequent in mortality case 9/12 compared to survivors (28.9%) (p?=?0.007) as well as abnormal arterial blood gases (100% vs 57.9%; p?=?0.005). The SLEDAI was significantly increased in non-survivors (41.8?±?8.2) compared to survivors (21.4?±?5.1) (p?=?0.001). There was a significant correlation between mortality and SLEDAI (r?=?0.58, p?=?0.001) and inversely with the pH (r?=??0.38, p?=?0.01). On multiple regression, only increasing SLEDAI was a significant predictor of mortality (β0.26, OR 1.29, 95%CI 1.12–1.49; p?<?0.0001). Mortality prediction by SLEDAI showed at a cut-off of 28.5; sensitivity 84% and specificity 90% (p?=?0.001).Conclusion
SLE patients admitted to the ICU are at an increased risk of mortality especially those with high disease activity. The main causes of mortality were infection, respiratory, cardiac and neurological complications. 相似文献3.
Dina F. Elessawi Geilan A. Mahmoud Wael S. El-Sawy Hala F. Shieba Shimaa M. Goda 《The Egyptian Rheumatologist》2019,41(1)
Aim of the work
To evaluate the level of anti-nucleosome (anti-NCS) antibodies in systemic lupus erythematosus (SLE) patients and study their association with disease activity and lupus nephritis.Patients and methods
The study was carried out on 50 SLE patients; 47 females and 3 males and 30 matched controls. The SLE disease activity index (SLEDAI) was assessed. Plasma levels of anti-NCS antibodies were measured. Renal biopsy was done in those with lupus nephritis.Results
The mean age of patients was 28.3?±?12.9?years; disease duration was 5.5?±?6.02?years and the SLEDAI.5?±?7.8. LN was present in 60% of the patients. Anti-nuclear antibodies (ANA) were positive in 48 (96%) and the anti-double stranded deoxyribonucleic acid positive in 38 (76% of the patients. The anti-NCS antibodies level was significantly increased in the patients (470.1?±?369.4?U/ml) compared to the control (36.43?±?14.58?U/ml) (p?=?0.0001). The anti-NCS was detected in 48/50(96%) patients at a cut-off of 65?U/ml. There was no significant difference in the anti-NCS antibodies levels between those with nephritis (456.53?±?362.59?U/ml) and those without (490.4?±?387.96?U/ml) (p?=?0.84). A significant correlation was present between the anti-NCS antibodies and photosensitivity (p?=?0.032), ESR (p?=?0.03), complement (C3) consumption (p?=?0.01) and urinary casts (p?=?0.04). A non-significant correlation was detected between level of anti-NCS and grades of nephritis (p?=?0.49) or SLEDAI (p?=?0.09).Conclusion
Anti-NSC antibodies could be a useful addition to the laboratory tests that can help in the diagnosis of SLE. Also, it has a significant association to photosensitivity but no relation to with disease activity or renal involvement. 相似文献4.
Asmaa A. Shaaban Nadia A. Elkadery Hebatallah A. El-Shamy Rana A. El-Hilaly Nadia G. El-Hefnawy Nesrine A. Mohamed 《The Egyptian Rheumatologist》2019,41(1)
Aim of the work
To investigate the role of endothelial protein C receptor (EPCR) (membrane and soluble forms) as a biomarker of lupus nephritis (LN) in systemic lupus erythematosus (SLE) patients and to study its relation to the prognosis and response to treatment.Patients and methods
The study included 30 SLE patients and 30 matched healthy volunteers as well as 10 renal biopsies from surgical nephrectomy as a control for membranous (mEPCR) examination. SLE disease activity index-2000 and damage index were assessed. Serum sEPCR was measured. Renal expression of mEPCR was analyzed. All patients were reassessed after 3?months.Results
Patients were 26 females and 4 males with a mean age of 29.6?±?10.04?years and disease duration of 4.4?±?3.5?years. Their mean SLEDAI was 13.9?±?9.9 and damage index 1?±?1.5. Serum levels of sEPCR were significantly higher in patients with LN (19.9?±?5.7?ng/ml) than those without (8.95?±?4.2?ng/ml) and controls (5.3?±?2.6?ng/ml)(p?<?0.001). SLE patients with cutaneous vasculitis (n?=?9) had significantly higher sEPCR levels than those without (18.1?±?7.8 vs 10.2?±?5.2?ng/ml)(p?=?0.02). There was a significant correlation between sEPCR percentage of change and of SLEDAI-2k with and without LN (p?<?0.01 and p?<?0.05). A significant difference was observed in sEPCR according to the prognosis and treatment response after 3?months. mEPCR stained positively in glomeruli and tubules of LN patients with no relation to histopathological grading.Conclusion
sEPCR plays a role in the pathogenesis, is related to a bad prognosis and poor response to treatment in LN. mEPCR was not related to LN grading. 相似文献5.
Naglaa S. Ghazy Rasha A. Abdel Noor Maaly M. Mabrouk Wael F. Mohammed 《The Egyptian Rheumatologist》2019,41(2)
Background
End stage renal disease can decrease lupus activity especially after renal replacement therapy, so assessment of activity after starting hemodialysis (HD) is essential to avoid immunosuppressive complications and prevent flares.Aim of the work
To assess lupus activity in patients on regular HD and determine the differences in activity and number of lupus flares between patients who were maintained on steroids and immunosuppressives and those not.Patients and methods
Thirty-five systemic lupus erythematosus (SLE) patients on regular HD. were recruited from 14 hemodialysis centers in five cities in Gharbia Governorate, Egypt. The patient?s files were reviewed and SLE disease activity index (SLEDAI) was measured.Results
The mean age of patients was 30.7?±?9.2?years and were 29 females and 6 males with a median disease duration of 6?years and SLEDAI of 3. 57.1% of the cases did not record lupus flare after dialysis while 42.9% were active; 11 (31.4%) of them had 1 flare, 3 (8.6%) had 2 flares and 1 (2.9%) had 3 flares. and according to the SLEDAI grading, 77.2% had no flare, 11.4% had mild flare and 11.4% moderate; none had a severe flare. There was no significant difference between those maintained on steroids or immunosuppressives and patients who stopped treatment after HD as regard number of flares and disease activity grading.Conclusions
Lupus activity is not uncommon after starting hemodialysis but giving a prolonged immunosuppressive therapies is not necessary in all cases and should be given cautiously to avoid their side effects. 相似文献6.
Shadia I. Allam Rehab A. Sallam Doaa M. Elghannam Atif I. El-Ghaweet 《The Egyptian Rheumatologist》2019,41(1):11-14
Background
The diagnosis of early rheumatoid arthritis (RA) is challenging. B-cell chemokine (CXCL13) plays a critical role in the disease pathogenesis.Aim of the work
To assess the diagnostic value of serum CXCL13 in early RA and compare it with rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies.Patients and methods
The study included 60 RA patients; 30 early, 30 established RA and 30 healthy controls. The modified health assessment questionnaire (MHAQ), modified Sharp-van der Heijde score (MSS) and disease activity score (DAS28) were assessed in RA patients. RF, anti-CCP and serum level of CXCL13 were measured.Results
Patients had a mean age of 39?±?7.4?years and disease duration of 4.4?±?5.7?years; they were 46 females and 12 males (F:M 3.8:1). Serum CXCL13 was significantly higher in early (191.7?±?74.4?pg/ml) compared to established (136.4?±?79?pg/ml) RA (p?=?0.007) which were not observed with RF and anti-CCP; both were higher than in control (30.4?±?13.5?pg/ml) (p?<?0.001). In early RA, the frequencies of CXCL13, RF and anti-CCP positivity were 90%, 73.3% and 56.7% while in the established cases the frequencies were 36.7%, 66.7% and 63.3% respectively. CXCL13 significantly correlated with DAS28 (early: 0.49, p?=?0.006; established: r?=?0.38, p?=?0.04) but not with MHAQ or MSS. The CXCL13 significantly correlated with both the RF and anti-CCP in both early and established cases (p?<?0.001).Conclusion
CXCL13 is an important for the diagnosis of early RA with a superior diagnostic performance compared to RF and anti-CCP. It may also be considered a potential biomarker of disease activity. 相似文献7.
Aim of the work
To measure serum peptidyl arginine deiminase (PADI4) enzyme level in rheumatoid arthritis (RA) patients and to assess its role in diagnosis and monitoring patient improvement.Patients and methods
The study included 31 RA patients and 10 age and sex matched healthy controls. Serum PADI4 and anti-cyclic citrullinated peptide (anti-CCP) were measured. Disease activity score (DAS28) was calculated. Patients were followed-up at 3 months with measurement of serum PADI4, anti-CCP and DAS28.Results
Mean age of the patients was 42.4?±?7.8 years, female:male?=?5.2:1 and disease duration 8.1?±?5.4 years. The DAS28 was 5?±?1.2 and modified health assessment questionnaire (MHAQ) was 0.8?±?0.6. Mean anti-CCP (129.3?±?74.8?ng/ml) and PADI-4 levels (532.9?±?240.9?pg/ml) in patients were significantly higher than in controls (8.4?±?4.4?ng/ml and 156?±?31?pg/ml respectively; p?<?0.001 both). At a cut-off value?≥?250?pg/ml, PADI4 was highly diagnostic for RA (sensitivity 90.3%, specificity 100%; area under curve?=?0.97 with no significant difference from anti-CCP at a cut-off of 15 ng/ml (sensitivity 93.5%, specificity 100%; AUC ?=?0.99). Serum PADI4 level showed a significant correlation with DAS28 (r?=?0.49, p?=?0.047). At follow up (n?=?20), no significant difference in PADI4, anti-CCP level or DAS28 scores was found but changes in serum PADI4 level significantly correlated with changes in DAS28 (r?=?0.82, p?<?0.001). Mean serum PADI4 level was significantly lower in improved patients (184.4?±?10.2?pg/ml) compared to unimproved (563.3?±?251.9?pg/ml, p?<?0.001).Conclusion
Serum PADI4 was diagnostic for RA and comparable with anti-CCP. It correlated with disease activity and could be a promising follow up marker of remission. 相似文献8.
Marwa A. Hammad Shaimaa M. Abdel-Latif Omaima Z. Shehata Amany M. Mohiey El-Din 《The Egyptian Rheumatologist》2019,41(1)
Background
Endothelial cell dysfunction has been described in Behçet disease (BD) not only as a cause of major vascular events but also related to chronic inflammation in different organ systems.Aim of the work
To study the relation of serum endocan, a marker of endothelial dysfunction, with clinical manifestations and disease activity in BD patients.Patients and methods
This study included 23 BD patients and 23 matched controls. Disease activity was assessed by the Behcet Disease Current Activity Form (BDCAF). Serum endocan was measured in all subjects.Results
The mean age of the patients was 32.5?±?6.8?years and they were 16 males and 7 females (M:F 2.3:1) with mean disease duration of 7?±?5.2?years. Their mean BDCAF was 2.26?±?1.32. A significant difference was found between serum endocan level among active patients 328.24?±?195.3?ng/L, inactive patients (169.8?±?35.7?ng/L) and controls (160.6?±?39.7?ng/L)(p?=?0.001). Patients with genital ulcers, papulopastular lesions and arthritis at the time of the study had higher serum endocan level than those without (p?=?0.002, p?=?0.006 and p?=?0.0001 respectively). Serum endocan levels correlated significantly with the BDCAF, neutrophil/lymphocyte ratio, platelet lymphocyte ratio and C-reactive protein (r?=?0.94, p?=?0.0001; r?=?0.82, p?=?0.0001, r?=?0.44, p?=?0.04 and r?=?0.48, p?=?0.02 respectively). The optimum serum endocan cut-off point for active BD was 191.5?ng/L with a sensitivity and specificity of 100% and 86% respectively (area under curve 0.99, 95% confidence interval 0.96-1).Conclusion
Serum endocan may serve as a potential marker of disease activity in BD. Patients with genital ulcers, papulopastular lesions and arthritis showed higher serum endocan levels. 相似文献9.
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10.
Doaa H. Ibrahim Nagat M. El-Gazzar Hanan M. El-Saadany Radwa M. El-Khouly 《The Egyptian Rheumatologist》2019,41(2)
Aim of the work
To compare the efficacy of ultrasound-guided platelet rich plasma (PRP) versus corticosteroid injection for treatment of rotator cuff tendinopathy (RCT).Patients and methods
Thirty patients with RCT of the shoulder were randomly divided into 2 equal groups (15 each) treated by subacromial subdeltoid ultrasound-guided injection of PRP (group I) or corticosteroid (group II). Patients were evaluated using visual analogue scale (VAS) for pain, functionally assessed using the Shoulder Disability Questionnaire (SDQ) and range of motion (ROM) determined before and 8?weeks after injection. Ultrasonographic findings of the patients were also reported.Results
Patients mean age was comparable between both groups (group I: 46.8?±?10.6 and group II: 41.5?±?12.5?years). The VAS at basline in group I (8.3?±?1.1) and II (8.1?±?1.2) significantly improved after injection (2.3?±?1.4 and 2.3?±?1.3; p?=?0.0008 and p?=?0.0009 respectively). The SDQ significantly improved in group I (90.3?±?9.5 to 24.3?±?5; p?=?0.0009) and group II (89.3?±?7.3 to 23.3?±?6.2; p?=?0.0007) after injection. There was a significant improvement in both groups after injection regarding the ROM (flexion, abduction, extension, internal and external rotation). There was a significant improvement in the frequency of tendinitis/bursitis in group II (66.6%) vs group I (50%) (p?=?0.0008) while the improvement in the tear and effusion was higher in group I (66% and 60%) compared to group II (28.5% and 50%; p?=?0.0005 and p?=?0.001 respectively).Conclusions
Both PRP and corticosteroid injections were effective in the treatment of RCT. PRP is a safe and good alternative to corticosteroid injection that promotes healing and decreases inflammation. Ultrasound-guided injection may increase the efficacy. 相似文献11.
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12.
Anna Testa Eleonora Giannetti Antonio Rispo Matilde Rea Erasmo Miele Elena Scarpato Anna Opramolla Olga Maria Nardone Nicola Imperatore Imma Di Luna Annamaria Staiano Fabiana Castiglione 《Digestive and liver disease》2019,51(4):524-528
Introduction and aim
The transitional process of young patients affected by inflammatory bowel disease from pediatric to adult care is a crucial step. Our study aimed to investigate the 1-year success outcome of this transitional process.Methods
From 2013 to 2018, we evaluated the transitional process of patients with Crohn’s disease or ulcerative colitis. For each patient, the following parameters 12 months before and 12 months after the transition were evaluated: Body Mass Index, disease activity and smoker status, number of outpatient visits and the pharmacological therapy, the number of disease exacerbations, hospitalizations and surgical interventions.Results
We enrolled 106 patients with IBD. No statistically significant difference was found between patients’ Body Mass Index before and after transition. There was a significant reduction in the number of exacerbations and hospitalizations in the 12 months post-transition (pre-transition exacerbations: 0.74?±?0.79, post-transition exacerbations: 0.35?±?0.57, p?<?0.001; pre-transition hospitalizations: 0.28?±?0.44, post-transition hospitalizations: 0.1?±?0.3, p?<?0.001). In contrast, there was no significant difference in the number of outpatient visits (3.40?±?1.4 vs 3.25?±?1.2; p?=?ns) and of patients undergoing surgery (0.9% vs 1.8%, p?=?ns).Conclusion
The parameters used as success indicators of the transition program confirm the achievement of continuity of care from Pediatrics to adult Gastroenterology, in a critical phase of the natural history of IBD patients. 相似文献13.
Eman M. El-Serougy Nahla N. Eesa Hatem M. El-Azizi Hayat A. Badawi 《The Egyptian Rheumatologist》2019,41(1)
Background
Evaluation of remission in Rheumatoid Arthritis (RA) largely relies on composite scores based on clinical and laboratory assessments however, patients can fulfill clinical remission criteria as defined by composite scores, yet still have evidence of synovitis detectable on imaging.Aim of the work
To evaluate hand and wrist joints in patients with RA in clinical remission using power Doppler (PD) ultrasonography and to study the association between ultrasonographic findings and composite index scores.Patients and methods
This study was conducted on 50 RA patients in clinical remission. Ten matched healthy subjects were included as control. The modified health assessment questionnaire (MHAQ) was assessed in the patients; disease activity was calculated using a composite index score including disease activity score (DAS28) and clinical disease activity index (CDAI). Ultrasonographic assessment of the hand and wrist joints was performed.Results
The mean age of the patients was 50.9?±?9.2?years, disease duration was 10.6?±?5.5?years and were 38 females and 12 males. The mean DAS28 was 2.3?±?0.3. On ultrasonographic examination, 14 (28%) patients had normal synovium, while 18 (36%) showed synovial hypertrophy without evidence of inflammation and 18 (36%) had PD signals. DAS28 was higher in patients with PD signals (2.36?±?0.3) compared to those without synovitis (2.3?±?0.28). There was a significant correlation between PD activity and CDAI (p?=?0.005), MHAQ (p?=?0.002) and disease duration (p?=?0.023).Conclusion
Power Doppler ultrasound can detect residual inflammation in RA patients in clinical remission and its scores were signficantly associated with the clinical disease activity index and functional status. 相似文献14.
Abbed K.M. Hameed Tamer O. El-Said Hamdia Y. Askar Basma A. ElKady 《The Egyptian Rheumatologist》2019,41(2)
Background
Numerous tools to assess activity of rheumatoid arthritis (RA) are available to use. For any marker to be a more appropriate indicator of disease activity, it should be more authentic to the patho-physiologic basis of the disease.Aim of the work
To determine the performance of serum adenosine deaminase (sADA) in measuring disease activity in RA.Patients and Methods
100 RA patients and 100 matched controls were included in the study. The disease activity score (DAS28) with erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were assessed. sADA level was determined by spectrophotometry. The sADA level was integrated in the DAS28 formulae and the corresponding values were determined.Results
The mean age of the RA patients was 61.8?±?9.7?years, 68% were females and they had a disease duration of 12.5?±?3.7?years. The mean DAS28-ESR was 4.2?±?1.3 and DAS28-CRP 3.5?±?1.1. The mean sADA was significantly higher in the patients (33.6?±?11.6?U/L) compared to the control (25.1?±?9.9?U/L) (p?<?0.001). The sADA level and DAS28-sADA did not differ according to the gender, methotrexate use, rheumatoid factor or anti-citrullinated protein autoantibodies positivity. The mean DAS28-sADA significantly increased in higher activity categories (p?<?0.001). sADA significantly correlated with the disease activity parameters. DAS28-sADA significantly correlated with DAS28-ESR (r?=?0.57, p?<?0.001) and DAS28-CRP (r?=?0.604, p?<?0.001). DAS28-sADA showed a sensitivity of 0.9 and specificity 0.69 for detection of disease activity measured with DAS28-ESR and was 0.88 and 0.65 when measured with DAS28-CRP.Conclusion
Integration of sADA in the DAS28 index can be a useful marker that reflects RA activity. 相似文献15.
Zubair Khan Sunit Tolia Kumar Sanam Gunjan Gholkar Marc Zughaib Sunil Naik Marcel Zughaib 《Cardiovascular Revascularization Medicine》2019,20(3):202-206
Background
Renal artery (RA) stenosis has been implicated in the pathophysiological mechanism for resistant hypertension. Despite the increasingly diagnosed frequency of hemodynamically significant lesions, the value of RA revascularization remains controversial. Our group had previously demonstrated significant blood pressure (BP) reduction in a retrospective cohort of appropriately selected patients undergoing RA stenting up to 18-months of follow-up. We herein present long-term clinical outcomes data 5-years post revascularization on 26 subjects who continued follow-up at our institution.Methods
Retrospective analysis was performed on subjects who underwent RA stenting at our institution for hemodynamically significant (≥70%) RA stenosis and systolic hypertension on ≥3 antihypertensive agents. Clinical outcome data for systolic blood pressure (SBP), diastolic blood pressure (DBP), creatinine level and number of antihypertensive drugs was assessed prior to and then later at 6–12?months and 3–5?years post RA stenting.Results
Mean age was 69?±?9?years; 27% (7/26) were male. Median follow-up was 5.1?years. Blood pressure reduction was sustained at long-term follow-up (135/70?±?18/11?mmHg) compared to initial reduction noted at 6-months (136/69?±?16/8?mmHg; p?≤0.01 for both) and from baseline (162/80?±?24/18?mmHg; p?≤0.001 for both). The number of antihypertensive agents also decreased from 4.1?±?1.0 to 2.7?±?2.1 (p?=?0.002) at 6-months and was sustained at long-term follow-up, 3.4?±?1.2 (p?=?0.03) with no difference in renal function between short- and long-term follow-up compared to baseline.Conclusions
This study shows sustained benefit of RA stenting in BP reduction in an appropriately selected cohort with significant stenosis ≥70% and uncontrolled hypertension on multiple medications on long-term follow-up. 相似文献16.
Nermeen A. Fouad Maha H. Nassr Hanan M. Fathi Othman M. Zaki Ahmed A. Negm Soha H. Senara 《The Egyptian Rheumatologist》2019,41(2):93-97
Aim of the work
To determine the serum progranulin levels in rheumatoid arthritis (RA) patients and to study its relation with disease activity assessed clinically and by ultrasound (US).Patients and methods
The study included 52 RA patients and 19 age and sex matched controls. Disease activity score (DAS-28) and modified health assessment questionaire were assessed. Progranulin was measured by ELISA. Ultrasound examination was performed and the German US7 score (USS) recorded.Results
The patients mean age was 42.8?±?10.5?years; disease duration was 4.9?±?5.02?years; 47 females and 5 males with a mean DAS28 of 4.4?±?0.9 (3 in remission; 5 low activity; 31 moderate and 13 high). The mean serum progranulin level in patients (9.5?±?45.5?ng/ml) was significantly elevated compared to control (32.74?±?9.2?ng/ml) (p?<?0.0001). There was a significant difference in the progranulin levels and USS according to the grades of disease activity (p?<?0.0001 and p?=?0.037 respectively). The progranulin and USS significantly correlated with the DAS28 (r?=?0.64, r?=?0.58; p?<?0.0001 respectively) and erythrocyte sedimentation rate (p?<?0.0001). The progranulin and USS significantly correlated with each other (r?=?0.32, p?=?0.02). At a cut-off value 51.5?ng/ml, progranulin would discriminate between patients and control at sensitivity 96.2%, specificity 100% and accuracy 99%.Conclusion
Serum progranulin levels were higher in RA patients than age and sex matched controls. It significantly correlated with disease activity measured by DAS28, ESR and ultrasound activity measured by German US7 score. Serum progranulin levels may be a useful biomarker in RA disease. Ultrasound correlated with ESR and DAS28 in RA patients. 相似文献17.
Hamdi Wafa Alaya Raja Kaffel Dhia Boughanmi Nada Zouche Imene Kchir Mohamed Montacer 《The Egyptian Rheumatologist》2019,41(1)
Aim of the work
To investigate the bone mineral density (BMD) in rheumatoid arthritis (RA) Tunisian patients, to identify the risk factors associated with its decrease and to assess the fracture risk.Patients and methods
The study included 173 patients and 173 matched healthy controls. BMD was assessed by the dual-energy X-ray absorptiometry. The risk of hip fracture (HF) and major osteoporotic fracture (MOF) were assessed using the fracture risk assessment tool (FRAX). The disease activity, radiological severity and functional status were investigated.Results
The mean age of patients was 54.1?±?11.04?years and 141 were females; 71.6% menopausal. Disease duration was 8.2?±?8?years and disease activity score was 5.54?±?1.26. Sharp van-der-Heijde (SvdH) score was 113.9?±?106.8, health assessment questionairre (HAQ) score 1.03?±?0.9. The BMD was significantly reduced in 138 (79.8%) patients and FRAX was higher compared to control (p?<?.001). The frequency of osteoporosis (48% vs. 18.5%), the risk of MOF (1.8?±?2.6 vs. 0.6?±?0.3) and HF (0.7?±?1.7 vs. 0.08?±?0.1) were significantly higher in RA patients than in controls. Bone loss in RA was significantly associated with age, low body mass index (BMI), longer disease duration, rheumatoid factor, SvdH, atlantoaxial subluxation and corticosteroids use. Menopause, low calcium intake, erythrocyte sedimentation rate and HAQ were risk factors for reduced BMD. The risk of MOF and HF was associated with age, menopause, calcium intake, BMI, disease duration, HAQ, SvdH, cumulative dose and duration of corticosteroids.Conclusion
bone loss and fragility fracture are frequent in RA and related to disease severity, function impairment and corticosteroids use. 相似文献18.
Marion Chambaz Mikael Verdalle-Cazes Charlotte Desprez Lucie Thomassin Cloé Charpentier Sébastien Grigioni Laura Armengol-Debeir Valérie Bridoux Guillaume Savoye Céline Savoye-Collet 《Digestive and liver disease》2019,51(3):358-363
Background
The long-term management of perianal Crohn’s disease for patients on anti-TNF-α therapy remains challenging.Aim
To evaluate the long-term course and complications of patients with perianal fistulas treated with anti-TNF-α based on their clinical remission and healing on MRI.Methods
Patients were evaluated clinically and by MRI. Deep remission was defined as clinical remission associated with the absence of contrast enhancement and T2 hyperintensity on MRI. Flare-free survival, surgery and hospitalizations were compared based on the presence or not of deep remission.Results
Forty-eight consecutive patients were included with a median follow-up of 62?months after anti-TNF-α first administration. Deep remission was observed in 16 patients (33.4%). For patients in deep remission, the median time to any perianal event was 116?months (95–130) versus 42?months (8–72) in patients with pathological MRI (p?<?0.001). Sixteen patients (50%) with pathological MRI had perianal surgery versus 2 (12.5%) in the deep remission group (p?<?0.05). The mean duration of cumulative hospital stays was 0.75?±?0.52?days in the deep remission group versus 19.7?±?7.4 in the pathological group (p?<?0.05).Conclusions
Higher flare-free survival and lower rates of surgery and hospitalization were found in patients achieving deep remission. 相似文献19.
Sex differences in treatment and prognosis of acute coronary syndrome with interventional management
Virginia Ruiz-Pizarro Carlos Ferrera Juan Carlos Gómez-Polo Julián Palacios-Rubio Carmen Rico-García Amado Antonio Fernández-Ortiz Ana Viana-Tejedor 《Cardiovascular Revascularization Medicine》2019,20(3):183-186
Objective
Female sex has been associated with differences in diagnostic and management of acute coronary syndrome (ACS). Our aim was to analyze sex differences in ACS with interventional management in a tertiary care hospital.Methods
Patients with ACS admitted to a Spanish tertiary care referral center were included prospectively and consecutively. All patients included in the study underwent a coronary angiography.Results
From the total cohort of 1214 patients, 290 (24%) were women. Women were older (71?±?12.8 vs 64?±?13.4?years, p?<?0.001) and showed lower ischemic risk and higher hemorrhagic risk scores (GRACE 159?±?45 vs 171?±?42, p?=?0.005; CRUSADE 41?±?19 vs 28?±?17, p?<?0.001). There were no significant differences in time to coronary angiography and revascularization rates between sex groups. A lower proportion of women received high-potency antiplatelet agents (29% vs 41.3%, p?=?0.004). In-hospital evolution and one-year mortality were similar between groups.Conclusions
In our population, there were no gender differences in management and prognosis of ACS. Differences in risk profile among groups could have an influence on antiplatelet therapy. 相似文献20.
Carlos Taxonera Antonio López-Sanromán Isabel Vera-Mendoza Eugeni Domènech Vicente Vega Ruiz Ignacio Marín-Jiménez Jordi Guardiola Luisa Castro María Esteve Eva Iglesias Daniel Ceballos Pilar Martínez-Montiel Javier P. Gisbert Miguel Mínguez Ana Echarri Xavier Calvet Jesús Barrio Joaquín Hinojosa Pilar Nos 《Digestive and liver disease》2019,51(4):529-535