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Aim of the work
To assess the diagnostic value of salivary gland ultrasonography (SGUS) for Sj?gren's syndrome (SS) and to compare it with minor salivary gland biopsy (MSGB) in patients with sicca symptoms.Patients and methods
Thirty patients with suspected SS (sicca symptoms only) were included in the study. The diagnosis of SS was confirmed according to the 2012 American College of Rheumatology criteria. SGUS was performed for all patients and the bilateral echostructure of the parotid and submandibular glands were graded from 0 to 3. SGUS score ≥2 was considered abnormal. A complete work up for SS was performed in all patients including a standardized clinical examination performed by the same rheumatologist, serological and laboratory tests, ocular tests and MSGB. Schirmer’s test and the Ocular Staining Score (OSS) using rose Bengal were performed.Results
Of the 30 patients, 10 had primary sicca symptoms (mean age 42.3 ± 13.1 years) and 20 secondary (49.5 ± 8.6 years) and most were females. The frequency of SS syndrome by ACR criteria was 6.7%. By adding ultrasound item to ACR criteria (SGUS score ≥2) the frequency of SS syndrome increased to 10%. The SGUS (cutoff score ≥2) showed a sensitivity of 66.6% and a specificity of 85.2% for SS diagnosis. Histopathology of MSGB showed no significant correlation with SGUS scores and remained the most diagnostic method for SS that had sensitivity and specificity of 100%.Conclusion
SGUS is a noninvasive method with high diagnostic value for diagnosis of primary and secondary SS. 相似文献Background
Carpal tunnel syndrome (CTS) is the most common upper limb neuropathy with increasing incidence especially among females, having a high economic and social impact on patients. CTS can be treated either with conservative measures or surgically. Steroid injection, as a conservative treatment, could be carried out using anatomical landmarks or via ultra-sonographic guidance.Aim of the work
To compare the clinical outcomes of the ultrasound guided injection versus blinded one for management of CTS.Patients and methods
Thirty patients with CTS were included in this study. Diagnosis was based on clinical, electro-physiological and ultrasound imaging. 28 patients had moderate CTS and 2 patients mild. Patients were equally grouped; 15 patients with ultrasound-guided injection technique and another 15 were injected blindly. Injection was performed once at baseline with 0.5 ml lidocaine 1% and 40 mg of triamcinolone. Evaluation at baseline and after 4 weeks of injection included Boston carpal tunnel questionnaire; symptom severity scale and functional status scale, nerve conduction study, ultrasound parameters (cross-sectional area, flattening ratio).Results
Patients were 28 females and 2 males; their mean age was 35.3 ± 7.5 years with unilateral CTS and disease duration of 8.8 ± 1.9 years. Patients with ultrasound-guided injection had significant improvement of clinical, neurophysiological, ultrasound parameters outcomes than blind injected patients. Reported complications at baseline included tingling sensation in 6 (40%) patients injected blindly while non in US-guided injected. No complications were reported in all patients after 4 weeks.Conclusion
Ultrasound-guided injection of the carpal tunnel provides precision, maximizes the effectiveness and reduces complications. 相似文献Background
Chronic hepatitis C virus (HCV) infection is a major worldwide public health problem. Egypt has the highest prevalence of adult HCV infection in the world, averaging 15%–25% in rural communities. Mannan-binding lectin (MBL) is a liver-derived pluripotent serum lectin that plays a role in the innate immune system of the host. It is an acute-phase protein that is involved in the activation of the classical complement pathway. MBL may play a defensive role in HCV infection.Objectives
To investigate the relationship between MBL concentration and HCV infection in Egyptian patients suffering chronic hepatitis C.Patients and Methods
Serum samples obtained from 35 Egyptian hepatitis C patients and 30 normal controls were assayed for MBL. MBL concentrations were correlated to disease characteristics and treatment response.Results
Serum MBL was significantly higher in HCV patients than in controls, but no relationship was found between MBL concentration and disease progression in terms of hepatic fibrosis and inflammation. Responders to interferon (INF)-based therapy had significantly higher serum MBL than non-responders.Conclusions
We found no association between serum MBL concentration and progression of HCV related liver disease. Responders to INF-based therapy had significantly higher serum MBL than non-responders. 相似文献Background and Objectives:
To compare our initial experience in laparoscopic surgery for ovarian endometriomas performed through an umbilical incision using a single 3-channel port and flexible laparoscopic instrumentation versus traditional laparoscopy.Methods:
This study was conducted in 3 tertiary care referral centers. Since September 2009, we have performed laparoendoscopic single-site surgery in 24 patients diagnosed with ovarian endometriomas. A control group of patients with similar diagnoses who underwent traditional operative laparoscopy during the same period was included (n = 28). In the laparoendoscopic single-site surgery group, a multichannel port was inserted into the peritoneum through a 1.5- to 2.0-cm umbilical incision.Results:
Patients in the laparoendoscopic single-site surgery group were significantly older (P = .04) and had a higher body mass index (P = .005). Both groups were comparable regarding history of abdominal surgery, lateral pelvic side wall involvement, and cul-de-sac involvement. After we controlled for age and body mass index, the size of the resected endometriomas, duration of surgery, and amount of operative blood loss were comparable in both groups. When required, an additional 5-mm port was inserted in the right or left lower quadrant in the laparoendoscopic single-site surgery group to allow the use of a third instrument for additional tissue retraction or manipulation (10 of 24 patients, 41.6%). However, adhesiolysis was performed more frequently in the conventional laparoscopy group. The duration of hospital stay was <24 hours in both groups. No intraoperative complications were encountered. All incisions healed and were cosmetically satisfactory.Conclusion:
The laparoendoscopic single-site surgery technique is a reasonable initial approach for the treatment of endometriomas. In our experience, an additional side port is usually needed to treat pelvic side wall and cul-de-sac endometriosis that often accompanies endometriomas. 相似文献Methods: Thirty subjects with schizophrenia were selected to receive 14 sessions of a culturally adapted behavioural family psychoeducational programme (BFPEP). Another 30 subjects received standard treatment as usual (STU) for 6 months. Pre- and post-intervention outcomes were assessed using the Positive and Negative Syndrome Scale (PANSS), Drug Attitude Inventory 10-item scale (DAI-10), Quality of Life Scale (QLS) and Social Functioning Questionnaire (SFQ).
Results: There was a no significant difference between BFPEP and STU at baseline on all measures. There was a significant difference (p?<?.05) between pre- and post-treatment scores for BFPEP on all measures, a significant difference (p?<?.05) between pre- and post-treatment scores for STU on all measures (favouring pre-treatment scores) and a significant difference (p?<?.05) favouring BFPEP over STU on all measures post-treatment.
Conclusions: These results demonstrate the feasibility and effectiveness of implementing family therapy psychoeducational interventions in different cultural settings, with relatively minor modifications. This may have implications for mental health policy makers to make available such programmes for patients and mental health professionals. 相似文献