Disease Activity

Progression of Rheumatoid arthritis (RA) and osteoarthritis (OA) is associated with inflammation and oxidative stress. Previous studies have shown that there was no difference between RA and OA patients regarding the percentages of the different lymphocytes subsets reflecting the abnormalities in T cells and its subsets that may contribute to the pathogenesis of OA as in RA. Therefore, the present study was aimed to analyze that whether disease activity of OA is able to affect a few serological and biochemical parameters in the same way as RA does or differently. The study was done on 36 asymptomatic controls (25 women), 28 patients with OA (20 women), 36 patients with RA (22 women). Patients with OA were screened according to radiological and clinical finding of Kellgren and Lawrence grade and ACR criteria and assessed by VAS and WOMAC score. Patients with RA were selected who were fulfilling 4/5 symptoms of ACR criteria, and their DAS28-CRP, VAS score, and RF positivity were evaluated. Participants of the groups were matched for sex, age, weight, and height (body mass index). The BMI of all three groups was also found to be the same (P > 0.05). The mean level of LDL, Cholesterol, MDA, CRP, and Triglyceride was significantly (P < 0.05 or P < 0.01) higher in both OA and RA as compared to control. The mean level of total lipid, cholesterol, MDA, CRP, and triglyceride was found to be significantly (P < 0.05 or P < 0.01) higher in RA as compared to OA. The pre-treatment CRP level of both groups of patients showed significant and direct relation with total lipid (r = 0.27, P < 0.05) and cholesterol (r = 0.66, P < 0.01). Inverse relation was observed between Uric acid and Creatinine (r = −0.26, P < 0.05) and cholesterol and HDL (r = −0.34, P < 0.01). Our study shows the similar trend in lipid profile and other parameters studied in both patients with OA and patients with RA with more pronounced changes in RA.

Atopic dermatitis (AD) is characterized by alterations in cellular and humoral immunity including elevated serum levels of IgE, IL-2 receptor (IL-2R) and eosinophil cationic protein (ECP). In order to evaluate the relevance of these serum parameters as indicators of disease activity, the concentrations of IgE, IL-2R and ECP were measured in serum samples of patients with an acute exacerbation of AD (n=19) on admission to hospital and every 6 days up to discharge, and compared with those from normal non-atopic controls (n= 15). The severity of the disease in the AD patients was examined using an established clinical scoring system. On admission, AD patients showed significantly elevated serum levels of IgE, IL-2R and ECP compared with normal controls (P≤0.0001). Clinical improvement was associated with a decrease of both the clinical score (P≤0.001) and serum ECP levels (P≤0.005). No significant changes in serum IgE and serum IL-2R were observed. In addition, there was a significant correlation between serum ECP and the clinical score (R=0.67, P≤0.001). These data indicate that serum ECP may be a helpful tool for monitoring disease activity in AD.

Schistosoma haematobium-related morbidity was studied in the perennial irrigation area of Office du Niger and the small reservoirs area of Plateau Dogon in Mali. Questionnaire, clinical, parasitologic, and ultrasound examination data were collected from 1,041 individuals at the baseline survey in 1991; 705 were re-examined one year after treatment. At baseline, the overall prevalence of S. haematobium infection was 55.2%; half of those infected had no clinical symptoms and 30% had pathologic lesions. Both infection and morbidity were more frequent in children than in adults, with a peak prevalence at 7-14 years of age. The rates of lesions were more than twice as high in those heavily infected as in lightly infected individuals. Reagent strip testing for microhematuria was more sensitive in detecting individuals with pathologic lesions than in detecting individuals with infection. One year after treatment with praziquantel, more than 80% of the urinary tract lesions had cleared. It ...

Chest ultrasonography is a useful tool for assessing disease activity in the peripheral lung parenchyma, pleura, chest wall, diaphragm, and mediastinum. Ultrasound imaging also provides highly useful guidance in invasive diagnostic and therapeutic procedures. The main advantages of this imaging technology are the absence of ionizing radiation and the possibility of real-time bedside applications. The chief indications and limitations of chest ultrasonography and the principal sonographic signs are reviewed.

Osteoporosis (OP) is a well documented complication of some rheumatic diseases. Rheumatoid arthritis (RA) represents the paradigm of bone loss which occurs both locally (iuxta-articular OP and bone erosions) and systemically (generalized osteoporosis and fractures). Both local and systemic bone loss in RA are mainly due to an imbalance in the RANKL/OPG ratio produced by pro-inflammatory cytokines. There is sub- stantial evidence that bone loss does occur also in systemic lupus erythematosus, ankylosing spondylitis and scleroderma. The pathogenesis of bone loss is multifactorial, with disease-dependent and disease-independent factors. Glucocorticoids represent the single most important risk factor for OP, even at low dose, and are associated with a significant increase in fracture risk. Functional impairment, hypovitaminosis D due to lack of sun exposure, disease activity and drugs, such as immunosuppressant and anticoagulants, also play a role.

Measurement of health-related quality of life (HRQL) is becoming more important in studies of patients with inflammatory bowel disease. The McMaster IBDQ is the most widely used HRQL instrument for these patients. However, its use with patients in the United Kingdom has not been validated. This study develops and validates a UK version of the McMaster IBDQ (UK IBDQ). The

The objectives of this study were to compare the psychological status of patients in active and inactive disease states, to assess social support, and to identify correlates of psychological distress in patients with inflammatory bowel disease (IBD). This cross-sectional study was conducted in 200 patients (mean age 36.7 yr [SD = 14.8], 119 [59.5%] female) with long-standing IBD who were seen in tertiary care. Psychosocial assessments included psychological distress (Symptom Checklist-90R), social support (Social Support Questionnaire-6), perceived stress (Perceived Stress Scale-10), and recent minor stressful events (Weekly Stress Inventory). Disease activity was assessed with the Harvey Bradshaw Index. Patients reported higher levels of satisfaction with social support and smaller network sizes compared with normative values. Using multiple linear regression, the independent correlates of psychological distress (p = 0.0001; adjusted R2 = 0.62) were as follows: active disease (p = ...

Frequent assessments of rheumatoid arthritis (RA) disease activity allow timely adaptation of therapy, which is essential in preventing disease progression. However, values of acute phase reactants (APRs) are needed to calculate current composite activity indices, such as the Disease Activity Score (DAS)28, the DAS28-CRP (i.e. the DAS28 using C-reactive protein instead of erythrocyte sedimentation rate) and the Simplified Disease Activity Index (SDAI). We hypothesized that APRs make limited contribution to the SDAI, and that an SDAI-modification eliminating APRs - termed the Clinical Disease Activity Index (CDAI; i.e. the sum of tender and swollen joint counts [28 joints] and patient and physician global assessments [in cm]) - would have comparable validity in clinical cohorts. Data sources comprised an observational cohort of 767 RA patients (average disease duration 8.1 +/- 10.6 years), and an independent inception cohort of 106 patients (disease duration 11.5 +/- 12.5 weeks) who ...

The expression of chemokine receptors on lymphocytes in the blood and CSF of multiple sclerosis (MS) patients was analyzed at relapse and remission. Both CD4+ and CD8+ cells in CSF at relapse were enriched for Th1-type receptors CXCR3 and CCR5 expression, and were reduced for Th2-type receptors CCR3 and CCR4 expression compared with those of the blood. CCR1 and CCR2 expressions on T cells were increased in CSF and blood, respectively. At remission, CCR5 expression, but not CXCR3 expression, was reduced in CSF CD4+ cells. A biased Th1/Th2 balance may play a critical role in active inflammation and CCR5 on CSF CD4+ cells is a good marker of the disease activity.

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Objectives. In the past, treatment options for ankylosing spondylitis (AS) have been limited, and the introduction of new treatments such as infliximab will have a noticeable impact on health-care budgets. The objective of this study was therefore to assess the current burden of the disease and estimate the cost-effectiveness of infliximab treatments. Methods. A cross-sectional retrospective observational study of resource

Serum levels of acute phase reactants (APR) were measured in patients with rheumatoid arthritis (RA) and the correlations of these parameters with the disease activity score (DAS28) were investigated. The study included 47 patients with RA and 50 healthy controls. Laboratory tests included erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), haptoglobin (Hp), ferritin, and plasma fibrinogen. Disease activity was assessed using the DAS28 score. The means (+/- SD) of ESR, CRP, Hp, ferritin, and fibrinogen levels were respectively 36.0 +/- 23.5 mm/hr, 2.4 +/- 1.9 mg/dl, 121.3 +/- 34.2 mg/dl, 67.7 +/- 36.2 ng/ml, and 371.2 +/- 96.0 mg/dl in the patients with RA, vs 16.4 +/- 11.3 mm/hr, 0.4 +/- 0.3 mg/dl, 104.0 +/- 35.3 mg/dl, 50.9 +/- 23 ng/ml, and 332.2 +/- 58.5 mg/dl in the controls. All of the APR levels were significantly higher in patients vs controls (p &lt; 0.001 for ESR and CRP; p &lt; 0.05 for Hp, ferritin, and fibrinogen). There were significant correlations b...