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1.
The aim of this study was to investigate the relationship between onychopathy and distal interphalangeal (DIP) joint involvement in psoriatic patients. Twenty-five consecutive unselected, unrelated patients with psoriatic onychopathy and 25 consecutive unselected, unrelated patients with psoriatic arthritis without onychopathy, were enrolled in the study. X-ray films of the hands were taken to identify DIP arthritic involvement and/or bone changes of the distal phalanx, which were categorized into five classes (0: no lesions; 1: tuftal minimal erosions; 2: tuftal bone resorption; 3: tuftal periosteal osteitis; 4: overlap of erosive and osteitic changes). Ten psoriatic patients with onychopathy and 8 without showed DIP arthritis, with no statistical differences in this distribution (p=0.556). Bone changes of the distal phalanx were found in all 25 psoriatic patients with onychopathy and in 18 without. The distribution of patients in different categories of involvement of the distal phalanx showed that patients without onychopathy were markedly distributed in the categories with no or minimal lesions, whereas patients with onychopathy had structural changes prevailing included in categories with more severe bone changes (osteitis and overlap of erosive and osteitic changes) (p=0.002). Onychopathic patients with DIP arthritis were older than those without (p<0.0001) and showed a longer duration of onychopathy (p<0.0001). Although the occurrence of DIP arthritis seems to depend on the duration of nail involvement, no statistical difference has been found in the distribution of DIP arthritis in psoriatic patients with or without onychopathy. In contrast, a topographical association between bone changes of the distal phalanx and dystrophy of the adjacent nail may be advanced.Abbreviations DIP
Distal interphalangeal 相似文献
2.
Busquets-Pérez N Rodriguez-Moreno J Gómez-Vaquero C Nolla-Solé JM 《Clinical rheumatology》2012,31(1):139-143
The aim of the study was to assess the prevalence of moderate to severe psoriasis (MS-P) in patients with psoriatic arthritis
(PsA) and the relationship between MS-P and other variables related to arthritis. One hundred sixty-six consecutive patients
with PsA periodically monitored at a university hospital’s PsA unit in northeastern Spain were included in the study. Patients
with psoriasis were classified as having MS-P when systemic treatment for skin was required. Clinical criteria for treatment
indication was BSA >10 and/or PASI >14 and/or psoriasis affecting a very sensitive area of the body. Demographic and clinical
data related to arthritis were assessed, including PsA pattern, age of onset of psoriasis and arthritis, disease activity
index, and treatment required over the course of the disease. Moderate–severe psoriasis were more prevalent in women (p = 0.027). One hundred nine patients (65.7%) had psoriatic nail disease, and MS-P was more frequent in these patients (40
(77%) vs. 69 (61%), p = 0.028). Patients with spondyloarthropathy were significantly associated with MS-P (7 (16%) vs. 3 (3%), p = 0.014). No statistical association was observed between severe psoriasis and the age of onset of psoriasis or arthritis,
involvement of distal interphalangeal joints, laboratory findings (HLA B27, RF), functional class, or disease activity indices.
We report a high prevalence of severe psoriasis among patients with psoriatic arthritis, higher in women and patients with
psoriatic nail disease and axial spondyloarthropathy. 相似文献
3.
Mean platelet volume (MPV), an indicator of platelet activation, is a newly emerging risk factor for atherothrombosis. There
is evidence of platelet activation in psoriasis and psoriatic arthritis (PsA). The association between psoriasis, PsA, and
atherosclerosis is well documented, yet, the underlying mechanisms remain unclear. The aim of this study was to investigate
the differences of MPV values in patients with psoriasis, PsA, and healthy subjects and the correlation between MPV and the
clinical disease activity. A total of 106 patients with psoriasis were included in this study. The study population grouped
as 48 patients with PsA (group 1) and 58 patients without PsA (group 2) and 95 healthy controls (group 3). MPV was measured
in psoriasis and PsA patients. MPV values were collected from standard complete blood count samples. Clinical features and
PASI scores in group 1 and 2 were also recorded. MPV in patients with psoriasis 8.7 ± 0.9 fL was significantly higher than
that of control subjects 7.3 ± 0.8 fL (p < 0.001). There was also statistical difference between MPV levels of patients with (9.5 ± 0.8) and without (8.0 ± 0.7) arthritis
(p < 0.001). MPV levels were positively correlated with psoriasis area and severity index score (p = 0.000, r = +0.735). MPV levels showed positive correlation with disease duration (p = 0.01, r = 0.518). MPV levels are increased in patients with psoriasis and PsA. MPV may be a marker for the severity of psoriasis.
This study may confirm previous observation indicating increased platelet activation in psoriasis. Increased platelet activity
could contribute to increasing the atherosclerotic risk in patients with psoriasis and PsA. 相似文献
4.
Psoriatic nail disease and distal interphalangeal (DIP) arthritis both are common manifestations of psoriatic arthritis (PsA). Several clinical characteristics are allegedly associated with DIP joint damage, particularly nail psoriasis. However, there is little evidence to substantiate this phenomenon. The purpose of this study is to investigate the relationship between DIP involvement, nail psoriasis and other parameters. A cross-sectional study involved 45 patients from local rheumatology clinic. Four hundred fifty psoriatic fingernails scored, and the radiographs of all these fingers were reviewed to define PsA DIP arthritic changes. 64.4 % patients had nail psoriasis and 35.6 % had DIP arthritis. Univariate analysis identified that swollen joint-count, digits with chronic dactylitis, HLA-B27 status and nail psoriasis were associated with DIP arthritis. Regression model supported that nail disease was the most significant associated factor of DIP arthritis (OR 9.7, p?=?0.05). Nail psoriasis was identified in 40.2 % of digits. Pitting (29.6 %), onycholysis (15.1 %), crumbling (8.2 %), nail bed hyperkeratosis (2.0 %) were noted with the mean modified Nail Psoriasis Severity Index of 0.95 +/?1.68. Among all digits, 57 had DIP arthritis while 393 did not. Within DIP joints with PsA radiological change, 59.6 % had nail disease. Chi-square test with the Bonferroni correction further supported an association between nail psoriasis and DIP involvement with p value of 0.001. Two specific nail subtypes—crumbling and onycholysis—were found to be significantly associated with DIP disease. A significant proportion of PsA patients had nail involvement and DIP arthritis. PsA patients with nail changes may be more susceptible to DIP disease. 相似文献
5.
Chen-Liang Chou Min-Jung Wu Chia-Li Yu Ming-Chi Lu Song-Chou Hsieh Tsai-Hung Wu Chung-Tei Chou Chang-Youh Tsai 《Clinical rheumatology》2010,29(8):875-881
Anti-agalactosyl IgG antibody (anti-Gal(0) IgG) has been regarded as a useful serological marker for rheumatoid arthritis
(RA). It is unknown whether it is also elevated in serum and implicated in the pathogenesis of joint inflammation in seronegative
spondyloarthropathy (SpA) such as ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Sera were collected from 43 patients
with AS or PsA with axial joint involvement, 22 patients with RA, and 25 healthy normal individuals for the detection of anti-Gal(0)
IgG with a cup-type lectin enzyme immunoassay (Eitest CA.RF). The disease activity of the AS/PsA was evaluated by Bath Ankylosing Spondylitis Disease Activity Score (BASDAI), the
serum C-reactive protein (CRP) and IgA were measured by nephelometry, and erythrocyte sedimentation rate (ESR) was measured
by Westergren’s method. The median titers of anti-Gal(0) IgG were significantly elevated in patients with RA (167.85, 15.73∼797.58 AU/mL)
and AS/PsA (186.15, 34.71∼651.19 AU/mL), compared to those of the normal controls (13.04, 12.00∼202.43 AU/mL). The titers
of the anti-Gal(0) IgG in patients with AS/PsA were correlated to the BASDAI scores (r
2 = 0.422, SEE = 1.443, p < 0.001) and serum CRP (r
2 = 0.345, SEE = 2.434, p < 0.001) but not to IgA (r
2 = 0.0259, SEE = 126.30, p < 0.001) or ESR (r
2 = 0.171, SEE = 31.053, p = 0.0059). Collectively, the anti-Gal(0) IgG is elevated and vaguely correlated with the disease activity of AS/PsA although
its titers in these patients were erratic. The result of the present investigation has suggested that anti-Gal(0) IgG may
be more ubiquitously present in inflammatory arthritides including RA or SpA. 相似文献
6.
Eithne Murphy Pascale Roux-Lombard Terence Rooney Oliver FitzGerald Jean-Michel Dayer Barry Bresnihan 《Clinical rheumatology》2009,28(3):285-291
We investigated the relationship between disease activity, serum biological mediators of joint damage, and periarticular bone
loss in inflammatory arthritis. Patients with early inflammatory arthritis were recruited from a dedicated early arthritis
clinic. At the time of recruitment, all had clinical evidence of synovitis. Patients were assessed at baseline and at 1-year
follow-up. Periarticular and axial bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Serum levels
of matrix metalloproteinase 1 and tissue inhibitor of metalloproteinases 1 (TIMP-1) were measured by enzyme-linked immunosorbent
assay. A total 38 patients were included in the study. Twenty had rheumatoid arthritis (RA) and 18 had a seronegative spondylarthropathy
(SpA). At baseline, periarticular hand BMD measurements were similar in RA and SpA. At 1 year, the mean periarticular hand
BMD was significantly lower in RA (p < 0.05). Significant inverse correlations between both the Ritchie articular index and C-reactive protein levels and the
change in periarticular hand BMD at 1 year were observed in RA (r = −0.792, p < 0.001 and r = −0.478, p = 0.045, respectively). Baseline TIMP-1 levels correlated with the change in periarticular hand BMD at 1 year in RA (r = 0.519, p = 0.02). At 1 year, radiographic measures of joint damage were highest in RA. Inverse correlations between the change in
periarticular hand BMD and the changes in erosion score (r = −0.90, p = 0.04) were observed in patients demonstrating significant periarticular bone loss. Persistent disease activity was associated
with increased periarticular bone loss in the hands in patients with RA, consistent with synovitis-mediated periarticular
bone loss. The correlation between baseline TIMP-1 levels and periarticular bone loss over 1 year suggests that TIMP-1 may
have utility as a biomarker of periarticular bone loss in early RA. 相似文献
7.
L. K. J. van Romunde A. Cats J. Hermans H. A. Valkenburg 《Rheumatology international》1984,4(2):61-65
Summary Arthritis of the terminal joints of the hands and feet occurred more frequently (P<0.015) in patients with seronegative poly-arthritis combined with psoriasis (S–P+; n=92) than in patients with seronegative polyarthritis alone (S–P–; n=72). However, the prevalence of affection of these joints was too low to consider this feature a sensitive marker for psoriatic arthritis. Furthermore, neither asymmetrical joint involvement nor the absence of ulnar deviation of the fingers appeared to be characteristic of this disease. A positive correlation was found between the presence of nail psoriasis and limitation of function of the distal interphalangeal (DIP) joints. The DIP finger joints and the interphalangeal joints of the toes were affected more often in the S–P+ group than in patients with seropositive polyarthritis without psoriasis (S+P–; n=46), but arthritis of the other joints was observed more frequently in the latter group. 相似文献
8.
The aim of the study was to investigate the rate of bone formation in patients with psoriatic arthritis (PsA) compared to
controls and patients with psoriasis vulgaris without PsA (PS). Osteocalcin (OC) and other parameters of bone turnover were
measured in 32 patients with PsA and 17 patients with PS and compared to controls (n= 50). Patients with PsA do not generally present with different OC levels (3.0 ± 1.6 ng/ml), than controls (3.6 ± 1.17 ng/ml),
if disease activity or sex are not considered. Women with PsA had significantly lower OC levels (2.28 ± 0.44 ng/ml) than female
controls (4.11 ± 1.7 ng/ml) or women with PS (3.0 ± 0.89 ng/ml). However, mean disease activity (2.27 ± 1.0 vs 2.95 ± 0.92)
was also significantly lower in women than men. Furthermore, we found a significant correlation between alkaline phosphatase
(AP) and OC in all patients with PsA (r=0.49, P < 0.05). Disease activity of PsA had an influence on OC levels. Patients with no disease activity had lower OC levels (2.2 ± 0.7 ng/ml)
than patients with a high activity (OC 3.92 ± 1.25, P < 0.05). Similar results were obtained with alkaline phosphatase. In addition, we found a significant correlation between
clinical activity and OC (r= 0.38, P < 0.02) and alkaline phosphatase (r=0.49, P < 0.01). Patients with PsA show a corresponding increase in OC levels, if disease activity is high. The proliferative changes
in active PsA may be related to inflammatory mechanisms coupled with bone formation.
Received: 28 May 1999 / Accepted: 11 February 2000 相似文献
9.
L. K. J. van Romunde A. Cats J. Hermans H. A. Valkenburg E. de Vries 《Rheumatology international》1984,4(2):67-73
In a group of patients with seronegative polyarthritis and psoriasis, the radiological features and the incidence of histocompatibility antigens were compared with those of a group of patients with seronegative polyarthritis but not psoriasis. No radiological criteria proved to be characteristic of psoriatic arthritis. In the group of patients with seronegative polyarthritis and psoriasis, erosions of the distal interphalangeal (DIP) joints were seen more frequently and were more severe than in the group of patients with seronegative arthritis without psoriasis. For the group of patients with seronegative polyarthritis and psoriasis, correlation was found between psoriatic nail lesions and erosions of the DIP joints, but this correlation was not found between the nail involvement and erosion of the adjacent DIP joint. No significant differences were found for the incidence of histocompatibility antigens between patients with seronegative polyarthritis with or without psoriasis. However, differences were found between these two groups and either the seropositive polyarthritis group or blood bank donors. 相似文献
10.
Di Minno MN Iervolino S Peluso R del Puente A Russolillo A Coppola A Ruosi C Guida A Scarpa R Di Minno G 《Clinical rheumatology》2011,30(7):915-919
Because of joint haemorrhages, severe haemophilia subjects often have limitations in their daily activities. Current orthopaedic
scores (OJS) in haemophilia miss mild joint impairments and only pick up severe alterations. Twelve young severe haemophiliacs
(20.25 ± 1.9 years of age), were evaluated for OJS as well as for indices employed in rheumatoid arthritis [28-joint Disease
Activity Score (DAS-28), Ritchie index, Health Assessment Questionnaire (HAQ), visual analogue scale (VAS)], spondyloarthritis
[Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), HAQ, VAS] and osteoarthritis [Knee injury and Osteoarthritis
Outcome Score (KOOS), VAS]. Twenty-four matched apparently healthy subjects and 29 subjects with psoriatic arthritis (PsA)
with oligoarticular involvement (one to three swollen joints) served as controls. In addition to the impairment of target
joints (elbow, in five of five in those on-demand treatment; three, elbows; four, knee in those on secondary prophylaxis),
HAQ (mean 0.71 ± 0.95) and VAS (3.12 ± 2.36) documented a quality of life and a perception of pain in haemophiliacs similar
to that of PsA subjects (p = 0.061 and p = 0.063, respectively). Their Ritchie index did not differ from that of subjects with psoriatic arthritis (5.75 ± 8.1 vs
7.73 ± 9.22; p = 0.408), nor did the BASDAI score with respect to psoriatic arthritis patients (p = 0.105). Six of 12 haemophiliacs (50%) had KOOS values from 70 to 50 (significant function joint impairment); 3 of 12 (25%)
showed DAS-28 values >3.2 (moderate disease activity), 2 of 12 (16.6%) severe disease activity (>5.1). All these indices significantly
correlated with VAS and HAQ in haemophilia subjects. A rheumatologic assessment may help identify early polyarticular disease
and subclinical abnormalities involving joints not usually studied (not target joint) in haemophiliacs. These pilot data provide
the rationale for testing a systemic involvement in haemophiliacs by means of high-tech imaging and to start early-onset prophylaxis/treatment
in this setting. 相似文献
11.
Levent Ozgonenel Esra Cetin Sule Tutun Pinar Tonbaklar Hale Aral Guvenc Guvenen 《Clinical rheumatology》2010,29(5):473-477
Vascular endothelial growth factor (VEGF) is known to be involved in the pathogenesis of rheumatoid arthritis (RA). In order
to elucidate the association between VEGF levels and RA disease activity, VEGF concentrations were measured in RA patients
at different phases and severity levels. Thirty-eight healthy subjects and 40 patients with RA were prospectively included
in the study. Subjects were further categorized into four subgroups (high, moderate, low, or remission) using the disease
activity score-28 (DAS28) scoring system. VEGF levels were significantly higher in patients than controls (p < 0.001). VEGF levels differed significantly in controls, early and late-phase RA patients (p = 0.002). A significant difference was found between controls and patients with high RA disease activity scores (p < 0.0001). VEGF levels were not correlated with age (r = −0.016; p = 0.921) or sex (r = 0.209; p = 0.921). VEGF values were correlated with erythrocyte sedimentation rate (r = 0.445; p = 0.004), but was not correlated with serum rheumatoid factor levels (r = −0.130; p = 0.424) in the patient group. In conclusion, higher VEGF levels are associated with late phase and high disease activity
in RA, independent of age and sex. 相似文献
12.
Tarakci E Yeldan I Kaya Mutlu E Baydogan SN Kasapcopur O 《Clinical rheumatology》2011,30(11):1415-1420
The aim of this study was to assess the relationships between physical activity level and anxiety, depression, and functional
ability in children and adolescents with juvenile idiopathic arthritis (JIA). Cross-sectional study design including patients
with JIA aged between 8 and 17 years and healthy controls was used. Sociodemographic data and clinical features were assessed.
Physical activity level and energy expenditure were assessed with a 1-day activity diary. Anxiety was screened by The Screen
for Child Anxiety Related Emotional Disorders (SCARED) questionnaire. Depressive symptoms were assessed by the Children’s
Depression Inventory (CDI). Functional ability was assessed with the Childhood Health Assessment Questionnaire (CHAQ). Pain
and overall well-being were measured using a visual analog scale (VAS). Fifty-two patients and 48 controls were included with
a mean age of 12.13 ± 2.92 and 11.27 ± 1.59 years, respectively. The mean disease duration was 64 months. The JIA group had
significantly less time in physical activity (p = 0.000), decrease in energy expenditure (p = 0.04), and higher CHAQ scores (p = 0.000) compared with the control group. In the JIA group, significant relationships were found between the number of active
joint and disease duration (r = 0.44, p = 0.000) and VAS pain (r = 0.30, p = 0.02), between SCARED and CDI (r = 0.54, p = 0.000). Significant relationships were found between VAS overall well-being and CDI (r = 0.29, p = 0.03), CHAQ (r = 0.37, p = 0.000), and VAS pain (r = 0.41, p = 0.000). Correlation between CHAQ and CDI (r = 0.34, p = 0.01) was significant. The result of our study suggested that only depression was related to anxiety, functional ability,
and well-being in children and adolescents with JIA. 相似文献
13.
The aim of this study was to evaluate serum and synovial levels of IL-17A by ELISA in rheumatoid arthritis (RA) and find out
the correlations between IL-17A levels and various clinical, laboratory parameters and RA disease activity and severity indices.
Group I consists of 30 adult active RA patients fulfilling the ARA 1987 revised criteria, with knee effusion and receiving
basic therapy, and with a mean age of 41.47 ± 11.49 years and mean disease duration of 9.5 ± 4.16 years. Group II consisted
of 13 healthy volunteers, age- and sex-matched, with a mean age of 39.08 ± 14.19 years. RA patients showed significantly higher
mean serum IL-17A levels than controls (11.25 ± 9.67 vs. 0.6 ± 1.4 pg/mL, respectively, p = 0.0002). Synovial IL-17A levels showed a significant positive correlation with serum IL-17A levels (r = 0.5 and p = 0.005). RA patients with negative rheumatoid factor (RF) had non-significantly higher mean serum IL-17A levels (12 ± 9.86 pg/mL)
compared to those with positive RF (10.82 ± 9.81 pg/mL); however, the mean synovial IL-17A levels were nearly the same. Significant
positive correlations were found between both serum and synovial IL-17A levels and DAS-28 scores (r = 0.556, 0.392 and p = 0.001, 0.032, respectively). RA patients with class III functional status showed significantly higher mean serum IL-17A
levels (17.53 ± 13.43 pg/mL) than classes I and II (8.97 ± 6.97 pg/mL, p = 0.009). These led us to conclude that the elevated serum and synovial IL-17A levels in RA patients parallel the degree
of disease activity and severity. This may highlight the usefulness of IL-17 (especially serum level) as a possible marker
for more aggressive joint involvement and damage. 相似文献
14.
Costa L Caso F D'Elia L Atteno M Peluso R Del Puente A Strazzullo P Scarpa R 《Clinical rheumatology》2012,31(4):711-715
The objective of the study was the evaluation of arterial stiffness, a cardiovascular risk factor, in patients with psoriatic
arthritis (PsA). Twenty PsA patients classified on the basis of the CASPAR criteria (M/W, 14/6; mean age, 38.6 years; range,
22–53), attending our out-patient clinic, and 20 healthy control subjects (M/W, 14/6; mean age, 38.7 years; range, 22–53)
matched for age, weight, height and with similar cardiometabolic profile entered the study. An exclusion criterion was the
presence of known cardiovascular risk factors. Central hemodynamic parameters and aortic pulse wave velocity (aPWV) were assessed
non-invasively by a SphygmoCor device. A significantly higher aPWV was recorded in PsA patients when compared to controls.
The difference remained statistically significant after adjustment for age, weight, height, heart rate (HR) and central mean
pressure (mean±SE; PsA, 8.3 ± 0.2 versus control, 6.8 ± 0.2 m/s; p < 0.0001). Among PsA patients, aPWV was related to known duration of disease (r = 0.63; p = 0.003). This result was confirmed after adjustment for the main confounders (β = 0.011; p = 0.013). These results support the concept of psoriatic disease as a systemic condition involving not only the skin, joints
and gastrointestinal tract but also arterial vessels. The involvement of the vascular system indicates the presence of pathogenetic
mechanisms that could accelerate the atherosclerotic process in this condition. 相似文献
15.
Micha T. Maeder Peter Ammann Hans Rickli Otto D. Schoch Wolfgang Korte Christoph Hürny Jonathan Myers Thomas Münzer 《Sleep & breathing》2008,12(1):7-16
The obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular abnormalities including left ventricular hypertrophy,
left ventricular diastolic dysfunction, and endothelial dysfunction. The present study evaluated whether N-terminal pro-B-type
natriuretic peptide (NT-proBNP) and peak oxygen consumption (peak VO2), both integral markers of cardiovascular function, are related to OSAS severity. In addition, we tested whether NT-proBNP
levels depend on body composition in OSAS patients, similar to what has been reported in patients without OSAS. Eighty-nine
patients with untreated OSAS underwent NT-proBNP measurement, dual X-ray absorptiometry, and cardiopulmonary exercise testing.
In a representative subgroup (n = 32), transthoracic echocardiography was performed. The severity of OSAS was classified based on apnea–hypopnea index (AHI)
values as mild (AHI 5–15 h−1), moderate (AHI 15–30 h−1), and severe (AHI >30 h−1). OSAS was mild in 19 (21%), moderate in 21 (24%), and severe in 49 (55%) patients. NT-proBNP levels did not differ among
patients with mild [30 (10–57)], moderate [37 (14–55)], and severe [24 (13–49) pg/ml; p = 0.8] OSAS and were not related to body mass index (r = 0.07; p = 0.5), percent lean body mass (r = −0.17; p = 0.1), and percent fat mass (r = 0.18; p = 0.1). Percent predicted peak VO2 was on average normal and did not differ among patients with mild (115 ± 26), moderate (112 ± 23), and severe OSAS (106 ± 29%;
p = 0.4). Body weight-indexed peak VO2 did not differ among patients with mild (31.9 ± 10.3), moderate (32.1 ± 7.9), and severe OSAS (30.0 ± 9.9 ml kg−1 min−1; p = 0.6) either. Lower NT-proBNP (β = −0.2; p = 0.02) was independently but weakly associated with higher body weight-indexed peak VO2. In the echocardiography subgroup, NT-proBNP was not significantly related to left ventricular mass index (r = 0.26; p = 0.2). In conclusion, NT-proBNP and peak VO2 are not related to OSAS severity, and NT-proBNP poorly reflects left ventricular hypertrophy in OSAS. The lack of a relationship
between NT-proBNP and OSAS severity is not due to a significant influence of body composition on NT-proBNP. There is an association
between higher NT-proBNP and lower peak VO2, indicating that NT-proBNP is a marker of cardiorespiratory fitness in patients with OSAS. However, the association is too
weak to be clinically useful. 相似文献
16.
Psoriasis is a common inflammatory skin disease, and conflicting data have been published about osteoporosis and bone turnover
markers in patients with psoriatic arthritis. The aim of this study was to assess bone mineral density (BMD) and bone turnover
markers in psoriatic patients with and without peripheral arthritis and to investigate the relationship between clinical parameters
and markers of bone turnover. Forty-seven patients (24 women, 23 men) with psoriasis were included to the study. Demographic
data and clinical characteristics were recorded. Erythrocyte sedimentation rate and C-reactive protein were assessed as disease
activity parameters. BMD was determined for lumbar spine and total hip by dual X-ray absorptiometry (DXA). Serum Ca, P, alkalen
phosphatase (ALP), and serum type I collagen cross-linked C telopeptide (CTX) were measured as bone turnover markers in all
patients. The patients were divided into two groups according to their peripheral arthritis status. The clinical and laboratory
variables, as well as bone mass status of the groups, were compared with each other. Eighteen patients had peripheral arthritis.
All the female patients were premenopausal. None of the patients had radiologically assessed axial involvement. There was
no significant difference between the BMD levels of psoriatic patients with and without arthropathy. One patient (5%) had
osteoporosis, and nine (50%) patients had osteopenia in arthritic group, while eight (27.5%) patients had osteopenia in patients
without arthritis. Serum CTX, ALP, Ca, and P levels were not significantly different in arthritic than in non-arthritic patients
(p > 0.05). In patients with psoriatic arthritis, the duration of arthritis was negatively correlated with BMD values of lumbar
spine and total femur and serum CTX levels, suggesting an association of increased demineralization with the duration of joint
disease. In conclusion, psoriatic patients with peripheral arthritis with longer duration of joint disease may be at a risk
for osteoporosis, which can require preventative treatment efforts. 相似文献
17.
Our objectives were: (1) to assess the relationship between self-reported measures (Western Ontario and McMaster University
Osteoarthritis Index (WOMAC) and Medical Outcomes Study Short Form-36 (SF-36)) and a performance-based timed-up-and-go (TUG)
test in a hip and knee joint replacement population and (2) to determine the predictors of postoperative functional status
as measured by the 12-week WOMAC and TUG scores. We surveyed 200 patients undergoing primary hip or knee replacement surgery
for demographic data and outcome scores at baseline and 12-week follow-up. There was a weak correlation between preoperative
TUG scores and preoperative SF-36 physical function scores (r = −0.28, p < 0.0001), SF-36 role-physical scores (r = −0.21, p = 0.0022) and WOMAC (r = 0.29, p < 0.0001) scores. The relationship was stronger between the postoperative TUG scores and WOMAC scores (r = 0.43, p < 0.0001), SF-36 physical function scores (r = −0.39, p < 0.0001) and SF-36 role-physical (r = −0.33, p < 0.0001) scores. Significant predictors for the TUG test at 12-week follow-up were age (p = 0.004) and preoperative TUG scores (p < 0.0001). Given low-to-moderate relationship between self-reported and performance-based tools, both tests are needed to
assess the true level of patient disability. 相似文献
18.
OBJECTIVE: To determine differences in disease onset, extent, and manifestations of psoriasis among patients with active, inflammatory psoriatic arthritis (PsA), and to examine relationships that may exist between psoriasis and PsA. METHODS: Baseline demographic, clinical, and laboratory data were analyzed from 221 patients enrolled in a multicenter cooperative study, and relationships between measures of psoriasis and PsA were determined. RESULTS: Mean percentage of body surface area (BSA) affected by psoriasis was modest (12+/-17), and mean severity of erythema, induration, and scaling was moderate (4.9+/-2.1 on a 0-9 scale). Spanish Americans tended to have a higher mean percentage of BSA (18.5%) than Caucasians (11%; p = 0.067), as well as higher target lesion severity (5.55 vs. 4.84; p = 0.077). Patients with psoriatic nail disease (180/221, 81%) had significantly greater number of involved distal interphalangeal (DIP) joints (p = 0.004). There were no other significant associations of skin pattern or regional involvement with PsA. CONCLUSION: Patients with active PsA have generally mild skin disease, and baseline relationships between psoriasis and PsA tend to be weak except for nail involvement and DIP joint activity. 相似文献
19.
Chun-Hsiung Chen Hung-An Chen Hsien-Tzung Liao Chin-Hsiu Liu Chang-Youh Tsai Chung-Tei Chou 《Clinical rheumatology》2010,29(10):1155-1161
The objective of the study was to investigate the role of receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin
(OPG) in ankylosing spondylitis (AS). Serum levels of soluble RANKL (sRANKL) and OPG were measured in 42 AS patients and 26
healthy controls. We evaluated the AS patient's disease activity, functional ability, global assessment, and physical mobility
and tested markers of systemic inflammation, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels. Serum
levels of sRANKL [mean (SD), 4.75 (1.88) vs. 3.70 (1.14) pmol/l, p = 0.015] and OPG [mean (SD), 5.18 (1.19) vs. 4.52 (0.85) pmol/l, p = 0.026] were significantly higher in the 42 AS patients than the 26 healthy controls. Interestingly, serum OPG levels correlated
significantly with ESR (r = 0.417, p = 0.007), CRP (r = 0.524, p < 0.001), tragus-to-wall distance (r = 0.556, p < 0.001), fingertip-to-floor distance (r = 0.423, p = 0.007), and occiput-to-wall distance (r = 0.465, p = 0.002) and correlated inversely with modified Schober index (r = −0.525, p = 0.001), cervical rotation (r = −0.403, p = 0.022), lateral lumbar flexion (r = −0.587, p < 0.001), and chest expansion (r = −0.553, p < 0.001). Moreover, in the AS patients with higher (≥4.925 pmol/l, n = 21) serum OPG levels, there were significant increases in the tragus-to-wall distance (p = 0.007), fingertip-to-floor distance (p = 0.023), and CRP levels (p = 0.014) and decreased in the modified Schober index (p = 0.012), lateral lumbar flexion (p = 0.019), and chest expansion (p = 0.005). Serum levels of sRANKL and OPG are increased in the AS patients and may participate in the disease process of AS.
Production of OPG has association with poor physical mobility and may reflect systemic inflammation in AS. 相似文献
20.
Cakar E Dincer U Kiralp MZ Taskaynatan MA Yasar E Bayman EO Ozgul A Dursun H 《Clinical rheumatology》2007,26(10):1607-1613
This study has focused on sexual problems of male ankylosing spondylitis (AS) patients. Initially, patients’ perceptions about
the effects of disease on sexual intercourse were assessed. Secondly, we investigated the factors that relate to the disease
and affect sexual intercourse negatively. Thirdly, we compared data from the patients whose sexual intercourse were affected
negatively with of those whose sexual intercourse were unaffected. This is a cross-sectional and double-centered study. A
total of 53 married or sexually active male patients, who were certainly diagnosed with AS according to modified New York
criteria, were assessed. Twenty seven patients (50.94%) expressed that their sexual life was affected negatively by the AS
in general (affected patients), and 26 patients (49.06%) expressed no negative effect (unaffected patients). Both affected
and unaffected patients were compared with each other with regard to educational level, joint involvement, functionality,
disease activity, quality of life, and depression status. Mean BASFI, BASDAI scores were worse in the affected group, and
the difference was statistically significant (p = 0.012, p = 0.039, respectively). There were statistically significant differences between the groups with regard to lumbar column
and hip involvement (p = 0.035, p = 0.021; respectively). The physical functioning, role limitations due to physical problems, vitality/energy/fatigue, general
mental health, and general health perception subscale scores of SF-36 were worse in the affected group, and the differences
were statistically significant (p = 0.027, p = 0.023, p = 0,013, p = 0.005, p = 0.045, respectively). Affected patients’ Beck Depression Inventory scores were worse than those of unaffected patients,
and the difference between the groups was statistically significant (p = 0.039). Sexual problems are common in AS patients and might usually be associated with joint involvement, decreased functionality,
increased disease activity, decreased health quality, and depression. Therefore, while examining AS patients and managing
their treatments, special attention must be given to all domains of life instead of only physical problems. 相似文献