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1.
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2.
Aim of the work
To study the clinical characteristics and health related quality of life (HRQoL) in systemic lupus erythematosus patients.Patients and methods
94 adult SLE patients were included from those attending Zagazig University Hospitals. SLE disease activity index (SLEDAI) and Systemic Lupus International Collaborative Clinics damage Index (SLICC/DI) were recorded. The health-related quality of life (HRQoL) was assessed using the lupus-QoL (LQoL) questionnaire.Results
The mean age of the patients was 36.9?±?14.1?years and disease duration 5.8?±?4?years. All LqoL domains were reduced. LQoL was significantly related to the gender, SLEDAI, SLICC/DI, erythrocyte sedimentation rate (ESR), anti-nuclear antibody (ANA) and anti-double stranded deoxyribonucleic acid (ds-DNA) (p?<?0.0001, p?<?0.0001, p?=?0.03, p?=?0.002, p?=?0.02, p?<?0.0001 respectively). The LQoL was not related to the age, disease duration and level of education. All 8 domains significantly correlated with SLEDAI and SLICC/DI. Mucocutaneous manifestations lowered emotional health (43.3?±?5.7), body image (45.3?±?6.9) and fatigue (47.3?±?9.3) domains; neuropsychiatric manifestation lowered the emotional health (43.4?±?9.7), planning (47.3?±?8.8) and intimate relationship (49.2?±?11.7); musculoskeletal manifestations mainly worsened burden to others (31.3?±?10.5), pain (47.6?±?10.4) and physical health (50.3?±?11.3) while lupus nephritis mainly decreased physical health (60.4?±?11.4), fatigue (61.2?±?5.7), burden to others (62.4?±?11.4) and emotional health (67.4?±?20.3).Conclusions
SLE is a condition associated with high unmet need and considerable burden to patients. To our knowledge, no previous study has systematically examined the clinical features as well as HRQoL of SLE patients in Sharkia Governorate, Eastern Egypt. HRQoL is a multidimensional concept that encompasses physical, emotional and social components associated with SLE manifestations. 相似文献3.
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4.
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5.
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6.
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7.
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8.
L. Darwish M.M. Nguyen M. Saleem K.A. Eakin N. Herrmann K.S. Sugamori P.I. Oh P. Yang J. Mitchell K.L. Lanctôt W. Swardfager 《Journal of diabetes and its complications》2019,33(5):390-397
Background
Lower serum concentrations of the osteoblast-derived protein, osteocalcin, have been associated with poorer glycemic control, insulin resistance and atherosclerosis, and with the development of type 2 diabetes (T2DM).Methods
This study compares concentrations of two physiological forms of osteocalcin, carboxylated (cOCN) and uncarboxylated (unOCN), between participants with T2DM (n?=?20) and age-, gender- and body mass index (BMI)-matched participants without T2DM (n?=?40) among patients with coronary artery disease (CAD), and it explores relationships between osteocalcin concentrations and cardiovascular risk factors.Results
Concentrations of unOCN (2.71?±?1.86 vs. 4.70?±?2.03?ng/mL; t?=??3.635, p?=?0.001) and cOCN (8.70?±?2.27 vs. 10.77?±?3.69?ng/mL; t?=??2.30, p?=?0.025) were lower in participants with T2DM. In participants without T2DM, concentrations of cOCN were associated with fitness (VO2Peak rho?=?0.317, p?=?0.047) and lower body fat (rho?=??0.324, p?=?0.041). In participants with T2DM, lower unOCN was associated with HbA1c (rho?=??0.516, p?=?0.020). Higher body mass was associated with higher unOCN (rho?=?0.423, p?=?0.009) in participants without T2DM, but with lower concentrations of both unOCN (rho?=??0.590, p?=?0.006) and cOCN (rho?=??0.632, p?=?0.003) in participants with T2DM.Conclusion
In patients with CAD, lower osteocalcin concentrations were related to type 2 diabetes, and to adverse fitness, metabolic and obesity profiles. 相似文献9.
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10.
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11.
Adel M. Elsayed Abdelazeim M. Elhefny Mervat M. Abogabal Sameh A. Mobasher Amr Abdelzaher Khaled F. Alhassanein Safaa Sayed Maysa M. Haroon Hatem M. Soliman 《The Egyptian Rheumatologist》2019,41(1)
Aim of the work
To present the clinical and laboratory disease characteristics in Egyptian patients with progressive systemic sclerosis (SSc) and their nail fold capillaroscopy findings.Patients and methods
50 SSc patients were included. For all patients detailed history taking and clinical and rheumatological examination were performed. The modified Rodnan skin score (mRSS) and nail fold capillaroscopy were assessed.Results
The mean age was 41.4?±?12.7?years (range 16–67?years) and median disease duration was 5?years (range 1–40?years). Eight patients (16%) were males and 42 (84%) females (M:F 1:5.25). Skin tightness was present in all patients; mean mRSS was 17.5?±?10.4 (ranges 4–45). 44 (88%) patients had abnormal pulmonary function tests; 42 (84%) restrictive and 2 (4%) obstructive; 25 (50%) presented with interstitial lung disease. Pulmonary artery hypertension was recorded in 9 (18%) patients. Renal manifestations were the least common recorded system involvement (20%). Antinuclear antibodies were positive in 98%, rheumatoid factor in 4%, antitopoisomerase I in 36% and anticentromere in 8% of patients. 96% of patient had abnormal nail fold capillaroscopy. There was a significant negative correlation between mRSS with forced expiratory volume (r?=??0.46, p?=?0.001), forced volume capacity (r?=??0.47, p?=?0.001) and positively with the FEV1/FVC (r?=?0.3, p?=?0.035).Conclusion
Almost all patients have ANA seropositivity, abnormal PFTs and abnormal nailfold capillaroscopy. Antitopoisomerase I antibody seropositivity, ILD, abnormal PFT, worsening skin score, late pattern of nailfold capillaroscopy are more common in dcSSc. Extensive clinical examination and investigations should be considered for early diagnosis and follow up of Egyptian SSc patients. 相似文献12.
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13.
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14.
Ya-Chao Tao Meng-Lan Wang Ming Wang Yuan-Ji Ma Lang Bai Ping Feng En-Qiang Chen Hong Tang 《Digestive and liver disease》2019,51(3):412-418
Aims
To analyze the role of serum miR-125b-5p in reflecting liver damage and predicting outcomes in chronic hepatitis B (CHB) patients with acute-on-chronic liver failure (ACLF).Methods
CHB patients with normal hepatic function (n?=?100), moderate-to-severe liver damage (n?=?90), and ACLF (n?=?136) were included. Among hepatitis B virus (HBV)-ACLF patients, 86 and 50 were in the training and validation cohorts, respectively. Serum miR-125b-5p level was measured by quantitative real-time PCR.Results
Serum miR-125b-5p level increased with disease progression, and serum miR-125b-5p level was lower in surviving than in dead HBV-ACLF patients. Among HBV-ACLF patients, miR-125b-5p positively correlated with total bilirubin (TBil; r?=?0.214, p?<?0.05) and model for end-stage liver disease (MELD) score (r?=?0.382, p?<?0.001) and negatively correlated with prothrombin activity(PTA; r?=??0.215, p?<?0.05). MiR-122 showed a contrasting performance compared with miR-125b-5p. Cox regression analysis showed that miR-125b-5p, miR-122, and PTA were independent survival predictors for HBV-ACLF, and low miR-125b-5p and high miR-122 levels may predict a longer survival in HBV-ACLF. MiR-125b-5p (AUC?=?0.814) had a higher performance for survival prediction in HBV-ACLF compared with miR-122 (AUC?=?0.804), PTA (AUC?=?0.762), MELD score (AUC?=?0.799), and TBil (AUC?=?0.670) alone; predictive effectiveness of miR-125b-5p was increased by combination with miR-122 (AUC?=?0.898). MiR-125b-5p was an effective predictor of HBV-ACLF outcomes in the validation cohort.Conclusions
MiR-125b-5p increase is associated with severity of liver damage; high serum miR-125b-5p may serve as a predictor for poor outcomes in HBV-ACLF cases. 相似文献15.
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16.
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17.
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18.
Ali Gheysarzadeh Amir Ansari Mohammad Hassan Emami Amirnader Emami Razavi Mohammad Reza Mofid 《Pancreatology》2019,19(3):429-435
Background
Low-density lipoprotein receptor-Related Protein-1 (LRP-1) has been reported to involve in tumor development. However, its role in pancreatic cancer has not been elucidated. The present study was designed to evaluate the expression of LRP-1 in Pancreatic Ductal Adenocarcinoma Cancer (PDAC) as well as its association with prognosis.Methods
Here, 478 pancreatic cancers were screened for suitable primary PDAC tumors. The samples were analyzed using qRT-PCR, western blotting, and Immunohistochemistry (IHC) staining as well as LRP-1 expression in association with clinicopathological features.Results
The relative LRP-1 mRNA expression was up-regulated in 82.3% (42/51) of the PDAC tumors and its expression (3.72?±?1.25) was significantly higher than that in pancreatic normal margins (1.0?±?0.23, P?<?0.05). This up-regulation was stage dependent (P?<?0.05). A similar pattern of LRP-1 protein expression was discovered (P?<?0.05). The high expression of LRP-1 in the PDAC tissues was strongly correlated with the low survival time (P?=?0.001), TNM classification (P?=?0.001), low differentiations status (P?=?0.001), lymphatic invasion (P?=?0.01) and Perineural Invasion (PNI) status (P?=?0.001).Conclusions
Our finding for the first time revealed that LRP-1 expression inversely associated with poor prognosis and PNI in PDAC tumor. 相似文献19.
Jacopo Troisi Federica Belmonte Antonella Bisogno Olga Lausi Francesca Marciano Pierpaolo Cavallo Salvatore Guercio Nuzio Annamaria Landolfi Luca Pierri Pietro Vajro 《Digestive and liver disease》2019,51(4):516-523
Background
The pediatric obesity epidemic calls for the noninvasive detection of individuals at higher risk of complications.Aims
To investigate the diagnostic role of combined salivary uric acid (UA), glucose and insulin levels to screen noninvasively for metabolic syndrome (MetS) and nonalcoholic fatty liver disease.Methods
Medical history, clinical, anthropometric, and laboratory data including serum triglyceride, glucose, insulin, HOMA, HDL-cholesterol, and UA levels of 23 obese children (15 with [St+] and 8 without [St?] ultrasonographic hepatic steatosis) and 18 normal weight controls were considered.Results
Serum and salivary UA (p?<?0.05; R2?=?0.51), insulin (p?<?0.0001; R2?=?0.79), and HOMA (p?<?0.0001; R2?=?0.79) levels were significantly correlated; however their values tended to be only slightly higher in the obese patients, predominately in [St+], than in the controls. Notably, UA and insulin levels in both fluids increased in parallel to the number of MetS components. After conversion of the z-logit function including salivary/anthropometric parameters in a stepwise logistic regression analysis, a factor of 0.5 allowed for predicting hepatic steatosis with high sensitivity, specificity, and total accuracy.Conclusions
Salivary testing together with selected anthropometric parameters helps to identify noninvasively obese children with hepatic steatosis and/or having MetS components. 相似文献20.
Eman M. El-Serougy Nahla N. Eesa Hatem M. El-Azizi Hayat A. Badawi 《The Egyptian Rheumatologist》2019,41(1)