The present work was conducted to estimate the prevalence of adult Behçet’s disease (BD) in adult Egyptian and to study the clinical pattern and influence of age at-onset and sex on disease phenotype. Also, we investigated the spectrum of presentation and frequencies along the north-to-south gradient of the country.
Patients and method
The population-based, multicenter, cross-sectional study included 1526 adult BD patients from 26 specialized Egyptian rheumatology centers. Demographic, clinical, and therapeutic data are assessed for all patients.
Results
The mean age of patients was 35.7 ± 9.84 years, disease duration 6.58 ± 5.25 years, and age at onset 29.37 ± 8.6 years; 91 were juvenile-onset (JoBD). There were 1102 males and 424 females (M:F 2.6:1). Regarding co-morbidities, 19.92% were diabetic, and 26.05% were hypertensive. The mean body mass index was 27.57 ± 5.24 (43.1% overweight; 25.9% obese). The mean BD current activity form was 4.48 ± 4.28. Regarding the medications use, systemic steroid and colchicine were the most common drugs used (947 (90.2%) and 611 (82.7%), respectively). The overall estimated prevalence of BD in Egypt was 3.6/100,000 population being highest in the two main cities: Alexandria (15.27) and Cairo (8.72). Pathergy test was positive in 43.4%. 90.2% were receiving systemic steroids and 8.3%, biologics. Disease characteristics were comparable between JoBD and adult-onset BD cases. Central nervous system (CNS), deep venous thrombosis (DVT), and gastrointestinal (GIT) involvement were significantly higher in males (p = 0.01, p = 0.001, and p = 0.001 respectively) while joint affection (p = 0.001) and disease activity (p = 0.011) were increased in females.
Conclusions
This study provides current prevalence of BD in Egypt; 3.6/100,000 with no remarkable north-to-south gradient. The sex influences the disease phenotype with the CNS, DVT, and GIT involvement are higher in males, while the joint affection and disease activity were increased in females.
Key Points
• The prevalence and phenotype of Behçet’s disease across Egypt is presented in a multicenter nationwide study.
• The potential influence of the age at onset and sex on disease phenotype is highlightened.
• A review of the literature worldwide is presented allowing comparisons with studies from other nations.
BRCA1 BRCA2 mutational spectrum in the Middle East, North Africa, and Southern Europe is not well characterized. The unique history and cultural practices characterizing these regions, often involving consanguinity and inbreeding, plausibly led to the accumulation of population‐specific founder pathogenic sequence variants (PSVs). To determine recurring BRCA PSVs in these locales, a search in PUBMED, EMBASE, BIC, and CIMBA was carried out combined with outreach to researchers from the relevant countries for unpublished data. We identified 232 PSVs in BRCA1 and 239 in BRCA2 in 25 of 33 countries surveyed. Common PSVs that were detected in four or more countries were c.5266dup (p.Gln1756Profs), c.181T>G (p.Cys61Gly), c.68_69del (p.Glu23Valfs), c.5030_5033del (p.Thr1677Ilefs), c.4327C>T (p.Arg1443Ter), c.5251C>T (p.Arg1751Ter), c.1016dup (p.Val340Glyfs), c.3700_3704del (p.Val1234Glnfs), c.4065_4068del (p.Asn1355Lysfs), c.1504_1508del (p.Leu502Alafs), c.843_846del (p.Ser282Tyrfs), c.798_799del (p.Ser267Lysfs), and c.3607C>T (p.Arg1203Ter) in BRCA1 and c.2808_2811del (p.Ala938Profs), c.5722_5723del (p.Leu1908Argfs), c.9097dup (p.Thr3033Asnfs), c.1310_1313del (p. p.Lys437Ilefs), and c.5946del (p.Ser1982Argfs) for BRCA2. Notably, some mutations (e.g., p.Asn257Lysfs (c.771_775del)) were observed in unrelated populations. Thus, seemingly genotyping recurring BRCA PSVs in specific populations may provide first pass BRCA genotyping platform. 相似文献
Objective To evaluate the value of peak time(PT) and corrected peak time(PTc) in the assessment of left ventricular long axis systolic function in patients with dilated cardiomyopathy(DCM).Methods Thirty-one DCM cases and thirty-six healthy cases were investigated using echocardiography.To obtain image of apical four-chamber view and apical two-chamber view, PT was measured by the technique of tissue motion annular displacement.The value of PTc was corrected by R-R interval.The critical value of PT and PTc was obtained by ROC curves.Results Compared with the PT of control group, the PT of DCM group at the site of septal and lateral were significantly increased ( P <0.05), but the PT at the site of anterior and inferior were no significantly increased ( P >0.05).The PTc at the four sites were significantly increased compared with control group ( P <0.05).The areas of under the ROC curve of PTc was 0.849 (95 % CI 0.699~0.929, P = 0.000), sensitivity and specificity of diagnosis cardiac dysfunction were 80.6 % and 66.7% respectively.Conclusions The PTc was significantly increased in patients with DCM.PTc was useful to evaluate left ventricular dysfunction in DCM patients. 相似文献
A 72-year-old man was hospitalized for exacerbation of chronic obstructive pulmonary disease and was treated with oral prednisone and 7 days of moxifloxacin. Five days after completing the antibiotic course, he developed watery diarrhea and diffuse, crampy abdominal pain. On presentation he was afebrile, and abdominal examination revealed diffuse tenderness without peritoneal signs. Stool tested positive for Clostridium difficile toxin A by enzyme-linked immunosorbent assay. Despite starting oral metronidazole, the patient developed a fever of 101.2 degrees F 36 hours after his initial episode of diarrhea, 12 hours after admission. His abdominal pain intensified and became localized to the right and left lower quadrants. Computed tomography scan revealed both a thickened cecal wall and an edematous appendix with ileocecal stranding consistent with appendicitis. Appendectomy was performed, and the appendix was found to be suppurative in appearance and nonperforated. The cecum had mild edema and erythema, whereas the colon and rectum were grossly unaffected. Pathology examination revealed exudative material in the appendiceal lumen and a diffuse transmural inflammatory cell infiltrate. The patient had an uneventful recovery and continued to improve on oral metronidazole. Although Clostridium difficile colitis and appendicitis are each very common independently, C. difficile as an etiology of appendicitis is exceedingly rare. A review of the literature revealed 2 prior cases. We speculate that this association is underdiagnosed, because milder cases might respond to antibiotic therapy alone, and severe cases might involve the entire colon and require total colectomy. In each scenario, the involvement of the appendix might be overlooked. 相似文献
BACKGROUND: This study aims to identify which among the metabolic syndrome (MS) definitions are closely associated with pathological levels of leptin, adiponectin, resistin, tumour necrosis alpha (TNF-alpha) and C-reactive protein (CRP) among type 2 diabetics. MATERIALS AND METHODS: Three hundred and five (160 males; 145 females) adult type 2 diabetic Saudis participated in this cross-sectional study. Leptin, adiponectin, resistin, TNF-alpha and CRP were analysed, using enzyme-linked immunosorbent assays (ELISA). Each participant was screened for MS based on the definitions of WHO, AHA/NHLBI and IDF. RESULTS: IDF holds the most identified patients [190 (62.3%)] in both, males [107 (66.9%)], and females [83 (57.2%)]. In males, hyperleptinemia, hypoadiponectinemia and hyperresistinemia were strongest in the AHA/NHLBI-defined MS [odds ratio (95% confidence interval 'CI') of 2.03 (1.05-3.93); 1.31 (0.55-3.1); 1.63 (0.42-6.4) respectively]. The risk of elevated CRP was highest on the WHO definition [odds ratio (95% CI) of 2.04 (0.46-9.04)]. In females, the IDF-defined MS has the strongest association in all four parameters: odds ratio (95% CI), as follows: leptin [2.09 (0.14-30.71)]; adiponectin [6.00 (0.47-76.17)]; resistin [0.47 (0.18-1.23)] and CRP [3.07 (0.21-45.10)]. CONCLUSION: Gender differences exist in assessing the risk of various adipocytokine abnormalities in relation to the various criteria. This study supports the use of IDF definition among females and AHA/NHLBI in males in studies involving MS and obesity, since these definitions hold stronger predicting powers in detecting pathological levels of key adipocytokines. 相似文献
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
【目的】探讨并比较耳后进路夹层法与内植法鼓膜修补术疗效。【方法】收集需行鼓膜修补术患者80例(92耳),按手术方法分为夹层法组42例(46耳)与内植法组38例(46耳)。分别观察两组术后听力恢复情况、术前术后言语频率平均听阈、术后3个月鼓膜情况、术后6个月愈合率。【结果】术后听力恢复情况夹层法优于内植法(P <0.05);夹层法术后言语频率平均听阈明显高于内植法(P <0.01);术后随访3个月后两组引起再穿孔、鼓膜内陷的发生有统计学差异( P <0.05);术后6个月愈合率比较,夹层法优于内植法,两组有统计学差异( P <0.05)。【结论】耳后进路夹层法与内植法鼓膜修补术短期疗效相当,但前者更有利于听力恢复,是治疗鼓膜穿孔的较为理想的方法。 相似文献