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1.
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2.
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3.
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4.
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5.
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6.
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7.
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8.
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9.
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10.
Hamdi Wafa Alaya Raja Kaffel Dhia Boughanmi Nada Zouche Imene Kchir Mohamed Montacer 《The Egyptian Rheumatologist》2019,41(1)
Aim of the work
To investigate the bone mineral density (BMD) in rheumatoid arthritis (RA) Tunisian patients, to identify the risk factors associated with its decrease and to assess the fracture risk.Patients and methods
The study included 173 patients and 173 matched healthy controls. BMD was assessed by the dual-energy X-ray absorptiometry. The risk of hip fracture (HF) and major osteoporotic fracture (MOF) were assessed using the fracture risk assessment tool (FRAX). The disease activity, radiological severity and functional status were investigated.Results
The mean age of patients was 54.1?±?11.04?years and 141 were females; 71.6% menopausal. Disease duration was 8.2?±?8?years and disease activity score was 5.54?±?1.26. Sharp van-der-Heijde (SvdH) score was 113.9?±?106.8, health assessment questionairre (HAQ) score 1.03?±?0.9. The BMD was significantly reduced in 138 (79.8%) patients and FRAX was higher compared to control (p?<?.001). The frequency of osteoporosis (48% vs. 18.5%), the risk of MOF (1.8?±?2.6 vs. 0.6?±?0.3) and HF (0.7?±?1.7 vs. 0.08?±?0.1) were significantly higher in RA patients than in controls. Bone loss in RA was significantly associated with age, low body mass index (BMI), longer disease duration, rheumatoid factor, SvdH, atlantoaxial subluxation and corticosteroids use. Menopause, low calcium intake, erythrocyte sedimentation rate and HAQ were risk factors for reduced BMD. The risk of MOF and HF was associated with age, menopause, calcium intake, BMI, disease duration, HAQ, SvdH, cumulative dose and duration of corticosteroids.Conclusion
bone loss and fragility fracture are frequent in RA and related to disease severity, function impairment and corticosteroids use. 相似文献11.
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12.
Aim of the work
This study aimed to assess long-term articular damage and function in rheumatoid arthritis (RA) patients in relation to the type of treatment. Early disease modifying anti-rheumatic drug (DMARD) therapy has not been evaluated in this study.Patients and methods
One hundred and fifty RA patients (141 females and 9 males) with disease duration more than five years and disease activity score-28 (DAS-28) <3.2 were included in this study. Sixty patients received disease modifying anti-rheumatic drugs (DMARDs) (group A), 60 received DMARDs and corticosteroids (CS) (group B), and 30 patients received CS only (group C). The functional outcome was assessed using the Modified Health Assessment Questionnaire (MHAQ). The articular damage was measured by using Rheumatoid Arthritis Articular Damage (RAAD) Score. The van der Heijde modification of the Sharp erosion score was used to define the plain X-ray of both hands and feet.Results
The mean age of the patients was 49.3?±?11.5?years, and disease duration was 12?±?7.9?years. There was a significant difference between the RAAD, visual analogue scale and MHAQ scores among the three groups (p?=?0.001), with higher score in group C followed by B. By using Multiple regression analysis to examine the relationship between RAAD score and other independent variables there was a significant association of the RAAD score with higher X-ray score (p?<?0.001) and with patients taking steroids only (p?=?0.001).Conclusion
Although, use of corticosteroids may help to control the disease activity, but it increases the risk of overall joint damage. 相似文献13.
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14.
Objectives
To assess safety, efficacy and follow-up results of transcatheter closure of ventricular septal defect (VSD) using Nit-Occlud_ Lê VSD Coil (pfm medical, KÖln, Germany).Background
Transcatheter VSD closure has achieved encouraging results but more follow-up studies are needed.Patients and methods
Between January 2012 and December 2013 in the cardiology department, Tanta University Hospital, Tanta, Egypt, 80 patients underwent percutaneous VSD closure using Nit-Occlud_ Lê VSD Coil. Early and mid- term follow-up was done for 3 years, follow-up was concluded in 2016.Results
The mean age of patients was 5.34?±?3 years, and their mean weight was 17.24?±?8.17 kg. Overall, 77 of 80 patients had perimembranous VSD with aneurysmal tissue; eight had multiple right ventricular exits, 14 had deficient aortic rim, two had high outlet muscular, and one had Gerbode defect. The procedure was successful in 98.75% of patients, and was aborted in one patient because of the development of complete heart block and the coil had to be removed. The mean procedure time was 104.98?±?9.50 minutes. The mean fluoroscopy time was 30.58?±?2.79 minutes. The immediate complete occlusion rate was 62%, which increased to 82.3% on the second day, and 94.9% by the 3rd month, and 97.5% by 1 year. There was a significant decrease in mitral incompetence after 6 months of follow-up (p?=?0.002), and only one patient had trivial aortic incompetence prior to the procedure that remained the same during follow-up period.Conclusion
Using Nit-Occlud_ Lê VSD-Coil to close VSD is safe and feasible in VSDs with various morphology. 相似文献15.
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.
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18.
Hanaa S. El-Banna Doaa W. Nada Manal S. Hussein Shymaa A. Hablas Nivine F. Darwish Mohammed H. Abu-Zaid Suzan E. Gadou 《The Egyptian Rheumatologist》2019,41(2):151-155
Aim of the work
To study the ability of ultrasound to detect subclinical synovitis in children with oligoarticular and polyarticular juvenile idiopathic arthritis (JIA) and to assess the disease activity according to the clinical, laboratory, and musculoskeletal ultrasonographic (MSUS) evaluation.Patients and methods
The study included 40 children with oligoarticular or polyarticular JIA diagnosed according to the ILAR criteria. 800 joints (20 joints for each patient: knees, wrists, 2nd–5th metacarpophalangeal and 2nd–5th proximal interphalangeal joints) were subjected to MSUS scanning for synovial hypertrophy, joint effusion and power Doppler (PD) signals. Disease activity assessment using Juvenile Arthritis Disease Activity Score (JADAS-10), and functional assessment By Childhood Health Assessment Questionnaire (CHAQ) were done for all patients.Results
The mean age of patients was 10.3?±?3.9 (3–16)?years, 24 females and 16 males and the disease duration was 3.7?±?2.8 (0.5–12)?years. There was a significant difference between number of clinically (n?=?192; 24%) and MSUS (440 by gray scale and 240 by PD) affected joints (p?<?0.001). Comparing clinical and ultrasound activity, 70 joints were clinically inactive but showed PDUS signals. There was a significant (p?<?0.05) correlation of the MSUS findings with the disease duration, number of clinically activite joints, JADAS10, CHAQ and acute phase reactants.Conclusion
MSUS is superior to clinical examination in early detection of synovitis. It is a reliable method for disease activity assessment in JIA patients, so it can be used in association with standard clinical examination for better classification, diagnosis, treatment strategy and prognosis of JIA subtypes. 相似文献19.
Sex differences in treatment and prognosis of acute coronary syndrome with interventional management
Virginia Ruiz-Pizarro Carlos Ferrera Juan Carlos Gómez-Polo Julián Palacios-Rubio Carmen Rico-García Amado Antonio Fernández-Ortiz Ana Viana-Tejedor 《Cardiovascular Revascularization Medicine》2019,20(3):183-186
Objective
Female sex has been associated with differences in diagnostic and management of acute coronary syndrome (ACS). Our aim was to analyze sex differences in ACS with interventional management in a tertiary care hospital.Methods
Patients with ACS admitted to a Spanish tertiary care referral center were included prospectively and consecutively. All patients included in the study underwent a coronary angiography.Results
From the total cohort of 1214 patients, 290 (24%) were women. Women were older (71?±?12.8 vs 64?±?13.4?years, p?<?0.001) and showed lower ischemic risk and higher hemorrhagic risk scores (GRACE 159?±?45 vs 171?±?42, p?=?0.005; CRUSADE 41?±?19 vs 28?±?17, p?<?0.001). There were no significant differences in time to coronary angiography and revascularization rates between sex groups. A lower proportion of women received high-potency antiplatelet agents (29% vs 41.3%, p?=?0.004). In-hospital evolution and one-year mortality were similar between groups.Conclusions
In our population, there were no gender differences in management and prognosis of ACS. Differences in risk profile among groups could have an influence on antiplatelet therapy. 相似文献20.
Dina F. Elessawi Geilan A. Mahmoud Wael S. El-Sawy Hala F. Shieba Shimaa M. Goda 《The Egyptian Rheumatologist》2019,41(1)