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1.
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2.
Walid Elmoghazy Khalid Ahmed Adarsh Vijay Yasser Kamel Ahmed Elaffandi Walid El-Ansari Rasul Kakil Hatem Khalaf 《Arab Journal Of Gastroenterology》2019,20(1):38-43
Background and study aims
Hepatocellular carcinoma (HCC) with extrahepatic metastasis has been studied, however, data from the Middle East remain scarce. In this study, we assess epidemiology of HCC in Qatar, and identify predictors of the metastatic behaviour.Patients and methods
All newly-diagnosed HCC patients on top of liver cirrhosis between 2011 and 2015 were included in the study.Results
A total of 180 patients met our inclusion criteria. The mean age was 58.8?±?10.5?years with a mean follow-up of 1.0?±?1.1?years. There were 150 male patients and HCV was the most common cause of liver cirrhosis 108 (60%), and 22 (12.2%) patients were classified as Child-Pugh class C. The overall survival of 51.1%, and 47 (26%) had at least one extrahepatic metastasis at the time of diagnosis. Single site metastasis was diagnosed in 10 patients, whereas 37 patients had multiple sites metastases.We compared patients who had metastases with patients who did not have metastasis at the time of diagnosis of HCC regarding several variables, and analysis revealed that tumour diameter larger than 5?cm (OR?=?6.10, 95% CI?=?1.85–20.12) (p?=?0.003), and bilobar liver involvement (OR?=?5.49, 95% CI?=?1.10–27.30) (p?=?0.037) were independent predictors of metastatic behaviour of HCC.Conclusion
The incidence of HCC is rising in our population, extrahepatic metastasis is no longer rare and tumours larger than 5?cm and bilobar involvement are determinants of the extrahepatic metastasis. 相似文献3.
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4.
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5.
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6.
Peregrine G. Green Pieter R. Stella Indulis Kumsārs Jo Dens Jeroen Sonck Johan Bennett Armando Bethencourt Benigno Ramos López Dariusz Dudek Robert J. van Geuns Steve Ramcharitar 《Cardiovascular Revascularization Medicine》2019,20(4):316-323
Aims
We report the first 5?year clinical follow-up data for the Tryton® bifurcation stent.Methods and results
Clinical outcomes at five years were collected from 8 centres. Non-hierarchical Major Adverse Cardiovascular Events (MACE) and Major Adverse Cerebrovascular and Cardiovascular Events (MACCE) were collected. Diabetic and non-diabetic populations were compared, along with small (≤2.5?mm) vs large (>2.5?mm) side branch size.173 patients with a follow up rate of 98% at 5?years were analysed. Non-hierarchical MACE was low at 9.8%, consisting of cardiac death of 1.2% (n?=?2) and MI of 1.7% (n?=?3). Target lesion revascularization (TLR) rate was 6.9% (n?=?12). Non-hierarchical MACCE was also low, with major bleeding in 2.3% (n?=?4) and strokes in 1.7% (n?=?3) of patients. There was only 1 case (0.6%) of stent thrombosis that was definite and occurred very late (782?days). All-cause mortality was low, with 8.7% combined cardiac and non-cardiac death (n?=?15). Diabetic patients had significantly higher event rates, but there was no difference in events with lesion stratification by side branch size.Conclusions
The Tryton® Side-Branch Stent has a non-hierarchical MACE of 9.8% and MACCE of 13.9% at 5?years. The TLR was 6.9% with only 1 case of stent thrombosis recorded. 相似文献7.
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8.
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9.
Mazen M. Alsheikh Abeer M. El-Shafey Heba H. Gawish Enas T. El-Desoky 《The Egyptian Rheumatologist》2019,41(2)
Aim of the work
The aim of this study was to evaluate interleukin-23 (IL-23) level in the sera of rheumatoid arthritis (RA) patients and to determine its relation with disease activity and severity.Patients and methods
This study was carried out on 40 RA patients and 40 healthy control subjects. All patients were subjected to full history taking, thorough clinical examination, radiological and laboratory investigations including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), anti-cyclic-citrullinated peptide (anti-CCP) antibodies. Serum IL-23 was measured by enzyme-linked immunosorbent assay. Disease activity score (DAS-28) and rheumatoid arthritis severity scale (RASS) were assessed.Results
Patient's mean age was 43.3?±?10.4?years and they were 37 females and 3 males. The mean disease duration of the patients was 4.98?±?4.1?years (1–15?years) with a mean DAS-28 of 4.8?±?1.2 (2.4–7.6) and RASS of 41.1?±?16.9 (16.7–85). The mean IL-23 serum level was significantly higher in RA patients (67.6?±?39.2?pg/ml) compared to the control (37.7?±?15.6?pg/ml) (p?<?0.001). There were significant correlations between IL-23 levels with the DAS-28 (r?=?0.35,?p?=?0.02), RASS (r?=?0.31, p?=?0.04), CRP (r?=?0.39, p?=?0.02), ESR (r?=?0.45, p?=?0.004), RF (r?=?0.48, p?=?0.002) and anti-CCP antibodies (r?=?0.35, p?=?0.04). At a cut-off value of 45?(pg/ml), IL-23 had a sensitivity of 77.8% and a specificity of 75% for detection of active disease and at 43.5?pg/ml the sensitivity was 88.2% and specificity 83.3% for occurrence of physical damage.Conclusion
IL-23 could be a useful marker for disease activity in RA. Its correlation with RASS suggested that IL-23 might be a therapeutic target for prevention of disability. 相似文献10.
Deepakraj Gajanana Manisha Ganapathi Raikar Pradhum Ram Vikas Bhalla Vincent Figueredo Sean Janzer Jon C. George 《Cardiovascular Revascularization Medicine》2019,20(3):207-209
Introduction
There is scarcity of data validating portable digital ankle-brachial index (ABI) with contrast angiography in peripheral arterial disease (PAD). Our aim was to provide an objective analysis of the relationship between digital ABI (dABI) and peripheral angiographic data.Methods
Consecutive patients with symptoms of PAD between May 2014 to May 2015 at Einstein Medical Center, Philadelphia, who were undergoing simultaneous dABI and peripheral angiography, were evaluated. Measurements were made using the FloChec? Digital ABI system (Bard) prior to the scheduled peripheral angiogram.Results
The final cohort consisted of 51 patients. Mean age was 68.8?±?9.5?years with 55% being male. Aorto-iliac disease accounted for 13% of the total lesions, while femoro-popliteal lesions comprised 55%. The FloChec? digital ABI had a sensitivity of 84% and a positive predictive value of 84%. The area under the receiver operating characteristic curve was 0.74 (p?=?0.007). On multivariate analysis, FloChec? digital ABI was still an independent predictor of PAD, Odds ratio 6.8 (2.3–20.6, p?=?0.001).Conclusion
A portable, point-of-care digital ABI system can be used as a valuable, simple, cost-effective and reliable screening tool with high sensitivity and accuracy. To date, ours is the first study validating FloChec? digital ABI with the gold standard angiographic data. 相似文献11.
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12.
Sunay Shah Ryan Gindi Mir B. Basir Akshay Khandelwal Mohammad Alqarqaz Mohammad Zaidan Michele Voeltz Gerald Koenig Henry E. Kim William W. O&#x;Neill Khaldoon Alaswad 《Cardiovascular Revascularization Medicine》2019,20(2):133-136
Introduction
The purpose of the study is to develop an optimal TR-Band weaning strategy while minimizing vascular access site complications of hematoma or radial artery occlusion (RAO).Methods
The trial was a randomized, prospective, single center study of 129 patients who underwent cardiac catheterization via the radial artery. Group A was an accelerated protocol in which weaning was initiated 20?min after sheath removal. Group B was an adjusted protocol, in which weaning was dependent on the amount of anti-platelet or anti-coagulation used. All patients underwent radial artery ultrasound to demonstrate arterial patency.Results
Baseline characteristics were similar in both groups, and PCI was performed in 36.7% of patients in Group A and 37.7% of patients in Group B. RAO occurred in 7.7% of patients overall, with no statistical difference between groups (Group A 5% versus Group B 10.1%, p-value?=?0.337). Hematoma formation >5?cm in diameter occurred in 4.6% of patients in the overall cohort, without statistical difference between groups (Group A 5% versus Group B 4.3%, p-value?=?1). The TR-Band duration was significantly shorter in Group A compared to Group B (112.9?±?50.7 versus 130.7?±?51.1 in minutes, respectively, p-value?=?0.013).Conclusion
We have demonstrated an accelerated weaning protocol is simple to utilize for nursing staff without increased vascular site complications of RAO or hematoma formation. 相似文献13.
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.
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16.
17.
Emily B. Schroeder Chan Zeng Andrew T. Sterrett Tina K. Kimpo Andrea R. Paolino John F. Steiner 《Journal of diabetes and its complications》2019,33(4):289-295
Aims
To examine the relationship between food insecurity and emergency department (ED) visits, hospitalizations, A1c, and diabetes medication adherence over one year of follow-up among individuals >65?years with diabetes mellitus.Methods
We conducted a longitudinal cohort study of adults >65?years with diabetes who did (n?=?742) or did not (n?=?2226) report food insecurity at baseline. We used conditional logistic regression for the ED visits or hospitalization outcomes, and mixed effects models for A1c and non-insulin diabetes medication adherence.Results
In bivariate analyses, individuals with food insecurity were more likely to have an ED visit (OR?=?1.40, 95% CI 1.15–1.72) or hospitalization (OR?=?1.41, 95% CI 1.11–1.78) in the year after the food security assessment. In addition, A1c was higher (7.5% vs. 7.2%, p?<?0.001). There was no difference in medication adherence. These differences persisted with adjustment for basic demographic and clinical characteristics, but were attenuated with further adjustment for socioeconomic status.Conclusions
Differences in diabetes outcomes by food insecurity status were attenuated by adjustment for socioeconomic status. Adverse outcomes in individuals with diabetes and food insecurity may be driven by effects of food insecurity per se or be mediated by a constellation of basic resource needs or lower socioeconomic status. 相似文献18.
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19.
Gjin Ndrepepa Sebastian Kufner Katharina Mayer Salvatore Cassese Erion Xhepa Massimiliano Fusaro Endri Hasimi Stefanie Schüpke Karl-Ludwig Laugwitz Heribert Schunkert Adnan Kastrati 《Cardiovascular Revascularization Medicine》2019,20(2):101-107
Background
Whether there are sex differences in the outcome of patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) remains controversial. We undertook this study to assess whether there are sex-related differences in the long-term mortality in a large series of patients with CAD after PCI.Methods
The study included 18,334 patients (4735 women and 13,599 men) with CAD treated with PCI. Propensity matching was performed to obtain a group of patients (3000 women and 3000 men) matched for all characteristics available in database. The primary outcome was a composite of cardiac mortality, myocardial infarction or stroke at 3?years of follow-up.Results
The primary outcome occurred in 660 women and 1440 men (Kaplan-Meier [KM] estimates, 15.2% in women and 11.6% in men, unadjusted hazard ratio [HR]?=?1.35, 95% confidence interval [CI] 1.24 to 1.49; P?<?0.001). Women were at higher risk of all-cause mortality (15.4% vs. 12.3%; P?<?0.001), cardiac mortality (10.2% vs. 7.6%; P?<?0.001) and stroke (2.6% vs. 1.4%; P?<?0.001) than men. In matched patients, the primary outcome occurred in 371 women and 322 men (KM estimates, 13.4% vs. 11.6%, HR?=?1.18 [1.01–1.36], P?=?0.033). Women were at higher risk of myocardial infarction (4.2% vs. 3.1%; P?=?0.044) but not cardiac (8.7% vs. 8.2%; P?=?0.306) or all-cause death (12.5% vs. 12.9%; P?=?0.991) or stroke (1.9% vs. 1.6%; P?=?0.550) than men.Conclusions
After propensity matching, women remained at a higher risk of a composite of cardiac mortality, myocardial infarction or stroke up to 3?years after PCI than men. 相似文献20.
Dylan Zylla Grace Gilmore Justin Eklund Sara Richter Anders Carlson 《Journal of diabetes and its complications》2019,33(4):335-339