International Journal of Clinical Rheumatology最新文献_第8页

The effect of bone growth stimulators on venous congestion in osteoarthritis of the knee 骨生长刺激剂对膝关节骨关节炎静脉充血的影响

International Journal of Clinical Rheumatology Pub Date : 2020-01-01 DOI: 10.37532/1758-4272.2020.15(5).143-151

K. Willeford, B. Do

{"title":"The effect of bone growth stimulators on venous congestion in osteoarthritis of the knee","authors":"K. Willeford, B. Do","doi":"10.37532/1758-4272.2020.15(5).143-151","DOIUrl":"https://doi.org/10.37532/1758-4272.2020.15(5).143-151","url":null,"abstract":"Background: The aim of the present study was to determine if there is an effect to decrease intraosseous venous congestion in osteoarthritis of the knee with the use of bone growth stimulators. This is based on the understanding that osteoarthritis of the knee is primarily a disease of subchondral bone and the joint changes are secondary. Bone growth stimulators are a promising future treatment modality because of the effects of bone remodeling. Methods: WOMAC scores, RAND health survey scores, and intraossous venous congestion were measured prior to and after treatment with noninvasive bone growth stimulators utilizing ultrasound technology on twenty patients with osteoarthritis of the knee. There were twenty participants in the treatment group and ten in the control group. Results: There was a 100% response rate with a high level of statistical significance with decreased venous congestion. The mean intraosseous pressure before treatment was 29.48 mm Hg and after treatment was 15.13 mm Hg. There was also a high level of significance for all portions of the two independent quality of life scales. Conclusions: This is the second study in the world’s literature of treatment of subchondral bone in osteoarthritis of the knee. Intraosseous venous congestion is discussed as initiating a cascade of events culminating in the constellation of molecular, biochemical and structural changes and is the unifying factor leading to impaired nutrition of the subchondral bone and cartilage, micro-fractures and alterations of trabecular microarchitecture, subchondral bone stiffening from intraosseous hypertension and fibrosis, culminating in the loss of the articular cartilage and in osteophyte formation.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"38 1","pages":"143"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77463120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Occipital neuralgia reavealing an atlantoaxial subluxation in an ankylosing spondylitis patient 强直性脊柱炎患者枕神经痛表现为寰枢关节半脱位

International Journal of Clinical Rheumatology Pub Date : 2020-01-01 DOI: 10.37532/1758-4272.2020.15(6).178-182

R. Dhahri, H. Tbini, M. Slouma, L. Metoui, I. Gharsallah, K. Amri, L. Nouisri, Ridha Chkili Mondher Yedeas

引用次数: 0

From pancreatic neoplasm to increase of glands: A case report of IgG4-related disease and its spectrum 从胰腺肿瘤到腺体增生:1例igg4相关疾病及其谱

International Journal of Clinical Rheumatology Pub Date : 2020-01-01 DOI: 10.37532/1758-4272.2020.15(4).93-99

Pedro Weingrill, Caio Cesar Demore, M. Floriano, Patricia Tessari, Vinicius Ribas de Abreu Borges Anderson Ricardo Roman Goncalves

{"title":"From pancreatic neoplasm to increase of glands: A case report of IgG4-related disease and its spectrum","authors":"Pedro Weingrill, Caio Cesar Demore, M. Floriano, Patricia Tessari, Vinicius Ribas de Abreu Borges Anderson Ricardo Roman Goncalves","doi":"10.37532/1758-4272.2020.15(4).93-99","DOIUrl":"https://doi.org/10.37532/1758-4272.2020.15(4).93-99","url":null,"abstract":"Background: IgG4-Related Diseases (IgG4-RD) represent a fibroinflammatory immune-mediated condition that might affect several organs. Due to its variable clinical presentation and differential diagnosis, early and accurate diagnosis is a real challenge. This case report aims to improve the general knowledge about IgG4-RD, enabling early and correct diagnosis, avoiding unnecessary interventions, and ensuring the best quality of life for the patient. Case Report: A 44-year-old man with diabetes mellitus and dyslipidemia presented with submandibular glands hypertrophy and a positive rheumatoid factor. He had a recent medical history of undiagnosed urinary symptoms and findings of renal nodules on an abdominal Computed Tomography. Besides that, he had undergone laparotomy with enteroanastomosis after pancreatic cancer was suspected, one year before the glands’ hypertrophy appeared. After he has been reassessed by a rheumatologist, the IgG4-RD was considered due to increase in serum IgG4, affection of a pair of salivary glands, presence of low-density areas in the renal cortex, bilaterally, affection of the pancreas and biliary ducts with dense inflammatory infiltrate and storiform fibrosis in the pancreas biopsy. The treatment with prednisone was started and the patient evolved with clinical, laboratory, and radiologic resolution after that. Conclusions: The IgG4-RD is worth reporting due to the many different clinical presentations. In this case, the diagnosis was done after years of the initial symptoms, and the patient evolved with significant improvement after the right treatment was prescribed. Corroborating to the importance of correct and early diagnosis.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"8 1","pages":"93"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80232904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of neonatal lupus erythematosus presenting as hypopigmented atrophic scars 新生儿红斑狼疮表现为低色素萎缩性疤痕1例

International Journal of Clinical Rheumatology Pub Date : 2020-01-01 DOI: 10.37532/1758-4272.2021.16(1).001

H. Dharmadji, Dhaifina Alkatirie, O. Suwarsa, E. Sutedja, Miranti Pangastuti Hendra Gunawan

引用次数: 1

Obstructive sleep apnea and fatigue in patients with inflammatory arthritis taking TNF-inhibitors 使用tnf抑制剂治疗炎性关节炎患者的阻塞性睡眠呼吸暂停和疲劳

International Journal of Clinical Rheumatology Pub Date : 2020-01-01 DOI: 10.37532/1758-4272.2020.15(3).38-42

Rebecca S. Overbury, Shaobo Pei, Brian Breviu, D. Walsh

{"title":"Obstructive sleep apnea and fatigue in patients with inflammatory arthritis taking TNF-inhibitors","authors":"Rebecca S. Overbury, Shaobo Pei, Brian Breviu, D. Walsh","doi":"10.37532/1758-4272.2020.15(3).38-42","DOIUrl":"https://doi.org/10.37532/1758-4272.2020.15(3).38-42","url":null,"abstract":"p>Background: Fatigue is common in inflammatory arthritis (IA). Obstructive sleep apnea (OSA) causes fatigue and is common in IA. OSA and IA are associated with systemic inflammation, including elevated levels of tumor necrosis factor alpha (TNFα). Tumor necrosis factor inhibitors (TNFi) reduce musculoskeletal symptoms and fatigue in IA. The effects of TNFi on OSA are unknown. Our goal was to explore the relationships between TNFi, fatigue, and OSA in IA. Methods: Consecutive patients starting TNFi for IA and high risk for OSA were enrolled. OSA was assessed with the Apnea Hypopnea Index (AHI) and percent time below 90% oxygen saturation (%time < 90%). Fatigue was assessed with the Functional Severity Scale (FSS). Sleep was assessed with the Functional Outcome of Sleep Questionnaire (FOSQ). IA was assessed with the patient global assessment of arthritis (PGA). Parameters were compared before and after TNFi. Changes in OSA, sleep, and fatigue outcomes were adjusted for changes in the PGA. Findings: Eighteen participants completed the study between September 2011 and February of 2014. The mean age was 54 years. 72% were male. Before and after TNFi: mean AHIs were 12.5 and 13.1, respectively (p=0.97); mean %times < 90% were 29.5 and 35.4, respectively (p=0.18); and mean FSS scores were 43.1 and 41.3, respectively (p=0.08); mean FOSQ scores were 11.4 and 11.8, respectively (p=0.09). Conclusions: OSA parameters did not improve with TNFi, but there were statistically non-significant trends toward improvement in fatigue and sleepiness with TNFi.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"15 12 1","pages":"38"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86964405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nail-bed infarctions as a paradoxical effect of abatacept in rheumatoid arthritis 甲床梗死作为阿巴肽在类风湿关节炎中的矛盾作用

International Journal of Clinical Rheumatology Pub Date : 2020-01-01 DOI: 10.37532/1758-4272.2020.15(4).100-108

S. M. A. Galil, Mohamed Fahmi

{"title":"Nail-bed infarctions as a paradoxical effect of abatacept in rheumatoid arthritis","authors":"S. M. A. Galil, Mohamed Fahmi","doi":"10.37532/1758-4272.2020.15(4).100-108","DOIUrl":"https://doi.org/10.37532/1758-4272.2020.15(4).100-108","url":null,"abstract":"Objective: Evaluating a group of Rheumatoid Arthritis (RA) patients under abatacept therapy regarding the risk of developing vasculitis. Methods: An exploratory study was conducted on RA patients with ongoing combined methotrexate/ abatacept therapy and reporting a case who developed small-vessel vasculitis. Follow-up visits with thorough clinical examination and routine laboratory investigations were done every 3-6 months. Disease activity was assessed by the Clinical Disease Activity Index (CDAI). Functional assessment was done by Health Assessment Questionnaire (HAQ) score. Results: Sixteen biologic-naive female patients with newly diagnosed moderate-to-severe RA under abatacept therapy (mean age, 44 ± 10.86 years) were enrolled in this study. The mean disease duration was 4.63 ± 2.20, mean duration of methotrexate/abatacept therapy was 22.75 ± 9.40 months. All over the follow-up periods, patients were clinically improved with low disease activity score and within normal laboratory investigations apart from rising titers of Sedimentation Rate (ESR) and C-Reactive Protein (CRP). One patient was presented by nail-bed infarctions after 15 months follow-up of abatacept therapy. Abatacept–induced small-vessel vasculitis was the most likely diagnosis. The remaining 15 patients still clinically free of any manifestations suggesting vasculitis. Conclusion: Abatacept can induce vasculitis in RA patients having risk factors for RV. Combination therapy of methotrexate/abatacept may be a delaying or inhibiting factor in the appearance of RV manifestations. Persistently elevated acute phase reactants despite clinical and laboratory improvement on early aggressive treatment of RA is an alarm for a possibly imminent vasculitis.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"56 1","pages":"100"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91308140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

PTPN22, CTLA4, FcγRIIa, FcγRIIIa and FcγRIIIb polymorphisms in Tunisian patients with systemic lupus erythematosus 突尼斯系统性红斑狼疮患者PTPN22、CTLA4、FcγRIIa、FcγRIIIa和FcγRIIIb多态性

International Journal of Clinical Rheumatology Pub Date : 2019-01-01 DOI: 10.4172/1758-4272.1000216

T. Dhaouadi, I. Sfar, L. Hassine, S. Turki, N. Khalfallah, Taieb Ben Abdallah Yousr Gorgi

{"title":"PTPN22, CTLA4, FcγRIIa, FcγRIIIa and FcγRIIIb polymorphisms in Tunisian patients with systemic lupus erythematosus","authors":"T. Dhaouadi, I. Sfar, L. Hassine, S. Turki, N. Khalfallah, Taieb Ben Abdallah Yousr Gorgi","doi":"10.4172/1758-4272.1000216","DOIUrl":"https://doi.org/10.4172/1758-4272.1000216","url":null,"abstract":"Background: Pathogenesis of systemic lupus erythematosus (SLE) involves both T cell tolerance breakdown and pathogenic autoantibodies. Polymorphisms in T cell regulatory proteins (PTPN22 and CTLA-4) and IgG receptors (FcγR) genes could impact their functions. Consequently, we aimed to study the role of PTPN22, CTLA-4, FcγRII and FcγRIII polymorphisms on either SLE susceptibility or its severity. Methods: Consequently, PTPN22 rs2476601 (R620W), CTLA-4 rs231775 (+49 A/G), FcγRIIa rs1801274 (R131H), FcγRIIIa rs396991 (F158V) and FcγRIIIb Na1/Na2 polymorphisms were examined in 137 SLE patients and 100 healthy blood donors matched in age, gender and ethnic origin. Results: The PTPN22-620*W mutant allele was significantly more prevalent in SLE patients comparatively to controls; p=0.001, OR [95% CI] = 7.8 [1.73-48.85]. Inversely, the frequency of the CTLA-4*G/G homozygous genotype was significantly lower in patients (35%) than in controls; p=0.02, OR [95% CI] = 0.54 [0.31-0.94]. Regarding to FcγR polymorphisms, while the FcγRIIIa*V allele was more prevalent in case of SLE (0.562 vs 0.35); p=0.001, OR [95% CI] = 2.77 [1.38-5.68], FcγRIIa and FcγRIIIb did not show any association with SLE. Analytic results showed that the prevalence of anti-dsDNA autoantibody was significantly higher in patients carrying PTPN22*W allele p=0.038. Otherwise, no correlation was found between the five studied polymorphisms and either clinical or biological patients characteristics. Conclusion: PTPN22 R620W, CTLA-A +49 A/G and FcγRIIIa F158V polymorphisms seem to be related to SLE susceptibility in Tunisian.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"156 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79942917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Chronic recurrent multifocal osteomyelitis-case report of two patients and review of literature. 慢性复发性多灶性骨髓炎2例报告并文献复习。

International Journal of Clinical Rheumatology Pub Date : 2019-01-01 DOI: 10.4172/1758-4272.1000220

Eugenia Schwarzkopf, Narasimhan P Agaram, Spencer Ha, Daniel E Prince

{"title":"Chronic recurrent multifocal osteomyelitis-case report of two patients and review of literature.","authors":"Eugenia Schwarzkopf, Narasimhan P Agaram, Spencer Ha, Daniel E Prince","doi":"10.4172/1758-4272.1000220","DOIUrl":"https://doi.org/10.4172/1758-4272.1000220","url":null,"abstract":"Background: Chronic Recurrent Multifocal Osteomyelitis (CRMO) is an autoinflammatory skeletal disease characterized by unifocal or multifocal nonbacterial inflammatory bone lesions in the metaphysis of long bones. Common sites of CRMO are tibia, pelvis, proximal femur, clavicle, calcaneum and vertebrae. However, unifocal presentation or presentation in adults, atypical locations, and absence of recurrence have also been reported.Methods and findings: We describe two cases of female patients with unifocal presentation of nonbacterial inflammatory bone lesions in the upper and lower extremity. Furthermore, a review of literature is presented.Conclusion: Although CRMO is seen primarily in children and adolescents, and usually occurs in a multifocal pattern, our cases illustrate that this disease can arise in adult patients and in a single location. The diagnosis of CRMO should be made in a multi-disciplinary approach amongst orthopedic surgeons, radiologists and pathologists.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"14 1","pages":"24-30"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/1758-4272.1000220","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37193664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Relapsing IgG4-related orbital inflammatory pseudotumor after achieving success with rituximab 利妥昔单抗治疗成功后，igg4相关眼窝炎性假瘤复发

International Journal of Clinical Rheumatology Pub Date : 2019-01-01 DOI: 10.4172/1758-4272.1000224

O. Vega-Hinojosa, M BerioskaManzaneda, A LisetteM.BedoyaMMartinSangueza

引用次数: 0

Mobile health applications in rheumatology: Could they improve our care and research? 风湿病的移动医疗应用:它们能改善我们的护理和研究吗?

International Journal of Clinical Rheumatology Pub Date : 2019-01-01 DOI: 10.4172/1758-4272.1000223

Maurits Mp, Yuminaga H, Huizinga Twj, Knevel R

引用次数: 5