Pub Date : 2023-11-13DOI: 10.1186/s43166-023-00219-4
Sally A. El-Leithy, Nahla Nader Adly, Rana Mohamed Taha, Nermin H. El-Gharbawy
Abstract Background Trigger finger is one of the most common causes of pain and dysfunction. The aim of our study was to compare the effectiveness of shock wave therapy versus local corticosteroid injection in the treatment of trigger finger in diabetic patients. Results The two groups were matched on age, HbA1c, VAS score, and grip force at week zero. There was statistically significant improvement in both groups after treatment. In comparing the two groups after 6 weeks of starting treatment either by shockwave therapy or by local corticosteroid injection, there was a statistically significant improvement in group 1 as regards VAS pain score ( p = 0.012), clinical signs (finger extension and locking) ( p = 0.018), hand grip dynamometer ( p < 0.001), and musculoskeletal ultrasound findings in comparison to group 2. Conclusion Trigger finger is a common complication of DM. Shockwave therapy was able to reduce pain and improve hand functional level and quality of life. Shockwave is an effective, safe, non-invasive method for conservative management of trigger finger.
{"title":"Extra-corporeal shock wave therapy versus local corticosteroid injection in treatment of chronic trigger finger in diabetic patients","authors":"Sally A. El-Leithy, Nahla Nader Adly, Rana Mohamed Taha, Nermin H. El-Gharbawy","doi":"10.1186/s43166-023-00219-4","DOIUrl":"https://doi.org/10.1186/s43166-023-00219-4","url":null,"abstract":"Abstract Background Trigger finger is one of the most common causes of pain and dysfunction. The aim of our study was to compare the effectiveness of shock wave therapy versus local corticosteroid injection in the treatment of trigger finger in diabetic patients. Results The two groups were matched on age, HbA1c, VAS score, and grip force at week zero. There was statistically significant improvement in both groups after treatment. In comparing the two groups after 6 weeks of starting treatment either by shockwave therapy or by local corticosteroid injection, there was a statistically significant improvement in group 1 as regards VAS pain score ( p = 0.012), clinical signs (finger extension and locking) ( p = 0.018), hand grip dynamometer ( p < 0.001), and musculoskeletal ultrasound findings in comparison to group 2. Conclusion Trigger finger is a common complication of DM. Shockwave therapy was able to reduce pain and improve hand functional level and quality of life. Shockwave is an effective, safe, non-invasive method for conservative management of trigger finger.","PeriodicalId":31002,"journal":{"name":"Egyptian Rheumatology and Rehabilitation","volume":"48 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136281588","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}
Pub Date : 2023-11-09DOI: 10.1186/s43166-023-00221-w
Yasser El Miedany, Mohammed Hassan Abu-Zaid, Maha El Gaafary, Mona Mansour, Mohamed Elwy, Deborah Palmer, Nihal Fathi, Waleed Hassan, Mohamed Mortada, Mervat Eissa, Samar Abdelhamed Tabra, Salwa Galal, Nermeen Fouad, Rehab Ali Ibrahim, Basma Medhat, Yasmin Adel, Rasha Ghaleb, Sally Saber, Naglaa Gadallah, Walaa Elwakil
Abstract Background Despite the recent advances in the management of inflammatory arthritis, a considerable proportion of arthritis patients remain symptomatic. This cohort has recently been identified as ‘difficult to treat’ (D2T). In view of the limited evidence base, management of these patients has been a challenge particularly in view of its associated significant economic health burden. A better understanding of the D2T may help recognise or develop new therapeutic targets and facilitate earlier intervention in the disease course to prevent the progression of such condition. The aim of this work is to address the unmet needs in the management of D2T arthritis and develop a comprehensive approach towards the identification and proper assessment of those patients. Results At the completion of round 3 Delphi process, a total of 20 items were obtained and divided into 5 domains. From 88.9 to 100% of respondents agreed with the recommendations (ranks 7–9). All 20 of the clinical standards that the scientific committee identified were agreed upon in terms of wording, recommendation grade, and level of evidence (i.e. 75% of respondents strongly agreed or agreed). Conclusion D2T inflammatory arthritis remains a relevant clinical challenge, despite the endorsement of the treat-to-target approach and the availability of a broad range of targeted arthritis medications. This study provided a comprehensive definition of the condition to facilitate the identification of this patients’ group. It also highlighted the goals and principles aiming at providing an effective framework for D2T assessment, closely monitor and set up a strategy to intervene in standard clinical practice.
{"title":"The identification, goals and principles of difficult-to-treat inflammatory arthritis: a consensus statement","authors":"Yasser El Miedany, Mohammed Hassan Abu-Zaid, Maha El Gaafary, Mona Mansour, Mohamed Elwy, Deborah Palmer, Nihal Fathi, Waleed Hassan, Mohamed Mortada, Mervat Eissa, Samar Abdelhamed Tabra, Salwa Galal, Nermeen Fouad, Rehab Ali Ibrahim, Basma Medhat, Yasmin Adel, Rasha Ghaleb, Sally Saber, Naglaa Gadallah, Walaa Elwakil","doi":"10.1186/s43166-023-00221-w","DOIUrl":"https://doi.org/10.1186/s43166-023-00221-w","url":null,"abstract":"Abstract Background Despite the recent advances in the management of inflammatory arthritis, a considerable proportion of arthritis patients remain symptomatic. This cohort has recently been identified as ‘difficult to treat’ (D2T). In view of the limited evidence base, management of these patients has been a challenge particularly in view of its associated significant economic health burden. A better understanding of the D2T may help recognise or develop new therapeutic targets and facilitate earlier intervention in the disease course to prevent the progression of such condition. The aim of this work is to address the unmet needs in the management of D2T arthritis and develop a comprehensive approach towards the identification and proper assessment of those patients. Results At the completion of round 3 Delphi process, a total of 20 items were obtained and divided into 5 domains. From 88.9 to 100% of respondents agreed with the recommendations (ranks 7–9). All 20 of the clinical standards that the scientific committee identified were agreed upon in terms of wording, recommendation grade, and level of evidence (i.e. 75% of respondents strongly agreed or agreed). Conclusion D2T inflammatory arthritis remains a relevant clinical challenge, despite the endorsement of the treat-to-target approach and the availability of a broad range of targeted arthritis medications. This study provided a comprehensive definition of the condition to facilitate the identification of this patients’ group. It also highlighted the goals and principles aiming at providing an effective framework for D2T assessment, closely monitor and set up a strategy to intervene in standard clinical practice.","PeriodicalId":31002,"journal":{"name":"Egyptian Rheumatology and Rehabilitation","volume":" 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135285984","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}
Pub Date : 2023-11-06DOI: 10.1186/s43166-023-00222-9
Valentina Živković, Tatjana Cvetković, Biljana Radovanović Dinić, Vladimir Jurišić
Abstract Background The aim of the study was to investigate the association of neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte ratios (PLR) with standard inflammation parameters, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), complement component C3, anti-double-stranded deoxyribonucleic acid (anti-dsDNA), anti-nucleosome and anti-C1q antibodies, and serum and urinary monocyte-chemoattractant protein-1 (MCP-1) with disease activity in patients with systemic lupus erythematosus (SLE). Results This study included 160 patients (145 female and 15 male patients), hospitalized at the Rheumatology Department. A positive correlation between NLR and ESR ( p < 0.01), anti-dsDNA antibodies ( p < 0.05), and PLR ( p < 0.001) was obtained, with a negative correlation with C3 ( p < 0.005). PLR shows a positive correlation with ESR ( p < 0.001), CRP ( p < 0.005), anti-dsDNA antibodies ( p < 0.001), anti-nucleosome antibodies ( p < 0.05), and urine MCP-1 ( p < 0.05), with a negative correlation with C3 ( p < 0.005). Univariate analysis showed that all the examined laboratory parameters were independent predictors of disease activity ( p < 0.001), while the method of standard multiple regression analysis revealed the most significant ESR and serum MCP-1 ( p < 0.05). Conclusions NLR and PLR, as inexpensive and accessible biomarkers, can help in routine clinical practice for the estimation of disease activity in SLE patients.
{"title":"Correlation of hematological parameters, antibodies and cytokines with disease activity in systemic lupus erythematosus: a cross-sectional study","authors":"Valentina Živković, Tatjana Cvetković, Biljana Radovanović Dinić, Vladimir Jurišić","doi":"10.1186/s43166-023-00222-9","DOIUrl":"https://doi.org/10.1186/s43166-023-00222-9","url":null,"abstract":"Abstract Background The aim of the study was to investigate the association of neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte ratios (PLR) with standard inflammation parameters, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), complement component C3, anti-double-stranded deoxyribonucleic acid (anti-dsDNA), anti-nucleosome and anti-C1q antibodies, and serum and urinary monocyte-chemoattractant protein-1 (MCP-1) with disease activity in patients with systemic lupus erythematosus (SLE). Results This study included 160 patients (145 female and 15 male patients), hospitalized at the Rheumatology Department. A positive correlation between NLR and ESR ( p < 0.01), anti-dsDNA antibodies ( p < 0.05), and PLR ( p < 0.001) was obtained, with a negative correlation with C3 ( p < 0.005). PLR shows a positive correlation with ESR ( p < 0.001), CRP ( p < 0.005), anti-dsDNA antibodies ( p < 0.001), anti-nucleosome antibodies ( p < 0.05), and urine MCP-1 ( p < 0.05), with a negative correlation with C3 ( p < 0.005). Univariate analysis showed that all the examined laboratory parameters were independent predictors of disease activity ( p < 0.001), while the method of standard multiple regression analysis revealed the most significant ESR and serum MCP-1 ( p < 0.05). Conclusions NLR and PLR, as inexpensive and accessible biomarkers, can help in routine clinical practice for the estimation of disease activity in SLE patients.","PeriodicalId":31002,"journal":{"name":"Egyptian Rheumatology and Rehabilitation","volume":"12 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135634704","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}
Pub Date : 2023-11-01DOI: 10.1186/s43166-023-00223-8
Mohammad Mejahed, Amira M. Ibrahim, Tamer Haydara, Salma Ragab, Takwa A. Gabr
Abstract Background Patients with peripheral neuropathy (PN) have subtle central pathology that might contribute to cognitive impairment. P300 is a cognitive potential that is connected to both sensory and cognitive processes. Subjects with neurocognitive disorders have considerably longer P300 latency. This study aims to investigate P300's potential as a marker of early-stage cognitive deterioration in PN patients and also, the effect of gender on P300 in patients with PN. Results A study group of 60 subjects with PN of various etiologies and no other neurological conditions was included, in addition to, a control group of 40 volunteers with normal hearing sensitivity and no central or peripheral auditory neurological abnormalities. P300 response showed significant delayed latencies in study group when compared to control group. Male group had significant delayed P300 latencies in comparison to female group. As regard P300 amplitude, male group showed no statistically significant differences in comparison to female group. Conclusions Although patients with PN apparently have normal cognitive function, the results in this study revealed the possibility of subtle cognitive impairment. Cognitive functions are affected in both axonal PN and demyelinating PN, however there were no differences found between the two subgroups. Auditory evoked potentials, particularly P300 can be used easily for early detection of subclinical cognitive impairment before appearance of any neurological manifestations. P300 latencies are more important than amplitudes and may be used alone or in addition to amplitudes in cognitive function assessment.
{"title":"P300 in peripheral neuropathy: cognitive functions assessment and gender effect","authors":"Mohammad Mejahed, Amira M. Ibrahim, Tamer Haydara, Salma Ragab, Takwa A. Gabr","doi":"10.1186/s43166-023-00223-8","DOIUrl":"https://doi.org/10.1186/s43166-023-00223-8","url":null,"abstract":"Abstract Background Patients with peripheral neuropathy (PN) have subtle central pathology that might contribute to cognitive impairment. P300 is a cognitive potential that is connected to both sensory and cognitive processes. Subjects with neurocognitive disorders have considerably longer P300 latency. This study aims to investigate P300's potential as a marker of early-stage cognitive deterioration in PN patients and also, the effect of gender on P300 in patients with PN. Results A study group of 60 subjects with PN of various etiologies and no other neurological conditions was included, in addition to, a control group of 40 volunteers with normal hearing sensitivity and no central or peripheral auditory neurological abnormalities. P300 response showed significant delayed latencies in study group when compared to control group. Male group had significant delayed P300 latencies in comparison to female group. As regard P300 amplitude, male group showed no statistically significant differences in comparison to female group. Conclusions Although patients with PN apparently have normal cognitive function, the results in this study revealed the possibility of subtle cognitive impairment. Cognitive functions are affected in both axonal PN and demyelinating PN, however there were no differences found between the two subgroups. Auditory evoked potentials, particularly P300 can be used easily for early detection of subclinical cognitive impairment before appearance of any neurological manifestations. P300 latencies are more important than amplitudes and may be used alone or in addition to amplitudes in cognitive function assessment.","PeriodicalId":31002,"journal":{"name":"Egyptian Rheumatology and Rehabilitation","volume":"17 1-2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135216093","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}
Pub Date : 2023-10-30DOI: 10.1186/s43166-023-00224-7
Wafaa K. Makarm, Rabab S. Zaghlol, Lobna I. Kotb
{"title":"Correction: Risk assessment score for adverse pregnancy outcome in systemic lupus erythematosus patients","authors":"Wafaa K. Makarm, Rabab S. Zaghlol, Lobna I. Kotb","doi":"10.1186/s43166-023-00224-7","DOIUrl":"https://doi.org/10.1186/s43166-023-00224-7","url":null,"abstract":"","PeriodicalId":31002,"journal":{"name":"Egyptian Rheumatology and Rehabilitation","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136022943","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}
Pub Date : 2023-10-16DOI: 10.1186/s43166-023-00220-x
Yousra Hisham Abdel-Fattah, Mowaffak Moustafa Abdel Hamid, Sara Ibraheem Mohamed Seleem Metawaa, Sarah Sayed Eltawab
Abstract Background Knee osteoarthritis (KOA) is a degenerative disease that affects all parts of the joint including the surrounding ligaments, tendons, and muscles. Biomechanical changes that occur in KOA cause aggravation of symptoms with further joint damage. Thus, modifying the biomechanics of the knee joint may help in the prevention and treatment of KOA. For that reason, our aim was to assess the effect of combined balance and strengthening exercise programs in patients with different grades of primary KOA. Results All studied groups showed comparable significant improvement in quadricep muscle strength, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (< 0.001), time-up and go score (< 0.001), 6-m walk time (< 0.001), and dynamic balance (< 0.001) at the end of exercise program. Furthermore, patients with mild-moderate KOA showed a significant improvement in pain, physical function, total WOMAC scores, and dynamic balance compared to those with more severe KOA. Conclusion Combined balance and strengthening exercise programs may help improve pain, physical function, and dynamic balance in patients with KOA regardless of its severity. However, following exercise patients with milder forms of KOA may show greater improvement compared to patients with severe KOA.
{"title":"The effect of combined balance and strength exercise program in patients with different grades of primary knee osteoarthritis","authors":"Yousra Hisham Abdel-Fattah, Mowaffak Moustafa Abdel Hamid, Sara Ibraheem Mohamed Seleem Metawaa, Sarah Sayed Eltawab","doi":"10.1186/s43166-023-00220-x","DOIUrl":"https://doi.org/10.1186/s43166-023-00220-x","url":null,"abstract":"Abstract Background Knee osteoarthritis (KOA) is a degenerative disease that affects all parts of the joint including the surrounding ligaments, tendons, and muscles. Biomechanical changes that occur in KOA cause aggravation of symptoms with further joint damage. Thus, modifying the biomechanics of the knee joint may help in the prevention and treatment of KOA. For that reason, our aim was to assess the effect of combined balance and strengthening exercise programs in patients with different grades of primary KOA. Results All studied groups showed comparable significant improvement in quadricep muscle strength, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (< 0.001), time-up and go score (< 0.001), 6-m walk time (< 0.001), and dynamic balance (< 0.001) at the end of exercise program. Furthermore, patients with mild-moderate KOA showed a significant improvement in pain, physical function, total WOMAC scores, and dynamic balance compared to those with more severe KOA. Conclusion Combined balance and strengthening exercise programs may help improve pain, physical function, and dynamic balance in patients with KOA regardless of its severity. However, following exercise patients with milder forms of KOA may show greater improvement compared to patients with severe KOA.","PeriodicalId":31002,"journal":{"name":"Egyptian Rheumatology and Rehabilitation","volume":"13 10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136112496","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}
Pub Date : 2023-10-10DOI: 10.1186/s43166-023-00204-x
Shereen Ismail Fawaz, Shin-Ichi Izumi, Amr Saeed Zaki, Shaimaa Elmetwally Eldiasty, Amr Saadawy, Heba Gamal eldin Saber, May Farouk Gadallah, Hossam Salaheldin Labib
Abstract Background Stroke is one of the leading causes of disability worldwide, with hand and arm weakness, affecting the patients’ daily activities and quality of life. Recently, repetitive peripheral magnetic stimulation (rPMS) was found to enhance neuroplasticity and motor recovery post-stroke hemiparesis via its deep proprioceptive stimulation and simulation of lost voluntary movement. Objective To determine the therapeutic effect of rPMS on the functional improvement of upper limb in patients with hemiparesis following cerebrovascular insult and to compare the effect of therapy in subacute and chronic cases. Results Post-rehabilitation program both the Fugl-Meyer-Upper Extremity scale (FM-UE) and Functional Independence Measures (FIM) scale showed highly significant improvement in the active group, compared to controls. Regarding active range of motion (AROM) of the shoulder abductors, triceps, wrist extensors and supinators, significant differences were also found in the active group in comparison to controls. Modified Ashworth scale showed also significant change in the active group. When dividing our patients according to the duration post-stroke, into subacute group (6 weeks to 6 months post-stroke) and chronic group (more than 6-month post-stroke), the subacute group showed significant improvements in the FM-UE scale, and in the AROM of wrist extensors and supinators but not in the chronic group. Ultrasonographic measurements showed a significant decrease in cross sectional area of the control group. Conclusion rPMS is potentially effective in improving motor recovery post-stroke, especially in the subacute stage.
{"title":"Repetitive peripheral magnetic stimulation for improving upper limb function in post-stroke hemiparesis","authors":"Shereen Ismail Fawaz, Shin-Ichi Izumi, Amr Saeed Zaki, Shaimaa Elmetwally Eldiasty, Amr Saadawy, Heba Gamal eldin Saber, May Farouk Gadallah, Hossam Salaheldin Labib","doi":"10.1186/s43166-023-00204-x","DOIUrl":"https://doi.org/10.1186/s43166-023-00204-x","url":null,"abstract":"Abstract Background Stroke is one of the leading causes of disability worldwide, with hand and arm weakness, affecting the patients’ daily activities and quality of life. Recently, repetitive peripheral magnetic stimulation (rPMS) was found to enhance neuroplasticity and motor recovery post-stroke hemiparesis via its deep proprioceptive stimulation and simulation of lost voluntary movement. Objective To determine the therapeutic effect of rPMS on the functional improvement of upper limb in patients with hemiparesis following cerebrovascular insult and to compare the effect of therapy in subacute and chronic cases. Results Post-rehabilitation program both the Fugl-Meyer-Upper Extremity scale (FM-UE) and Functional Independence Measures (FIM) scale showed highly significant improvement in the active group, compared to controls. Regarding active range of motion (AROM) of the shoulder abductors, triceps, wrist extensors and supinators, significant differences were also found in the active group in comparison to controls. Modified Ashworth scale showed also significant change in the active group. When dividing our patients according to the duration post-stroke, into subacute group (6 weeks to 6 months post-stroke) and chronic group (more than 6-month post-stroke), the subacute group showed significant improvements in the FM-UE scale, and in the AROM of wrist extensors and supinators but not in the chronic group. Ultrasonographic measurements showed a significant decrease in cross sectional area of the control group. Conclusion rPMS is potentially effective in improving motor recovery post-stroke, especially in the subacute stage.","PeriodicalId":31002,"journal":{"name":"Egyptian Rheumatology and Rehabilitation","volume":"195 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136291818","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}
Pub Date : 2023-10-10DOI: 10.1186/s43166-023-00208-7
Yasmin Adel, Yousra Sadeq, Shereen A. Machaly
Abstract Background Although several cytokines and markers have been recognized to assess disease activity in Behçet’s disease (BD), they are not routinely utilized in daily practice. This study aimed at assessing the usefulness of calprotectin and ischemia-modified albumin (IMA) serum concentrations to measure disease activity in BD. Results The active BD cases had significantly greater IMA serum levels than inactive BD cases ( p = 0.013) and controls ( p < 0.001). In addition, the inactive BD group had significantly higher IMA serum levels than controls ( p < 0.001). The serum calprotectin levels in active and inactive BD groups were significantly greater compared to those measured in controls ( p < 0.001). On the other hand, the difference in serum calprotectin concentration was insignificant between the active and inactive BD patients. Binary logistic regression analysis revealed that hs-CRP and IMA serum levels are the strongest predictors for the activity of the active BD ( p = 0.011 and 0.005, respectively). ROC curve analysis for the ability of IMA serum level to discriminate between active and inactive BD groups revealed an AUC = 0.738. Conclusion Serum calprotectin and IMA concentrations were significantly elevated in BD. IMA was significantly greater among active BD cases in comparison to inactive BD cases indicating its potential importance as a new marker of activity in BD. Trial registration Trial registration on ClinicalTrials.gov: NCT05868538.
{"title":"Evaluation of calprotectin and ischemia-modified albumin serum levels as biomarkers to measure disease activity in Behçet’s disease","authors":"Yasmin Adel, Yousra Sadeq, Shereen A. Machaly","doi":"10.1186/s43166-023-00208-7","DOIUrl":"https://doi.org/10.1186/s43166-023-00208-7","url":null,"abstract":"Abstract Background Although several cytokines and markers have been recognized to assess disease activity in Behçet’s disease (BD), they are not routinely utilized in daily practice. This study aimed at assessing the usefulness of calprotectin and ischemia-modified albumin (IMA) serum concentrations to measure disease activity in BD. Results The active BD cases had significantly greater IMA serum levels than inactive BD cases ( p = 0.013) and controls ( p < 0.001). In addition, the inactive BD group had significantly higher IMA serum levels than controls ( p < 0.001). The serum calprotectin levels in active and inactive BD groups were significantly greater compared to those measured in controls ( p < 0.001). On the other hand, the difference in serum calprotectin concentration was insignificant between the active and inactive BD patients. Binary logistic regression analysis revealed that hs-CRP and IMA serum levels are the strongest predictors for the activity of the active BD ( p = 0.011 and 0.005, respectively). ROC curve analysis for the ability of IMA serum level to discriminate between active and inactive BD groups revealed an AUC = 0.738. Conclusion Serum calprotectin and IMA concentrations were significantly elevated in BD. IMA was significantly greater among active BD cases in comparison to inactive BD cases indicating its potential importance as a new marker of activity in BD. Trial registration Trial registration on ClinicalTrials.gov: NCT05868538.","PeriodicalId":31002,"journal":{"name":"Egyptian Rheumatology and Rehabilitation","volume":"145 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136295196","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}
Pub Date : 2023-10-09DOI: 10.1186/s43166-023-00218-5
Yasser El Miedany, Maha El Gaafary, Naglaa Gadallah, Safaa Mahran, Nihal Fathi, Mohammed Hassan Abu-Zaid, Samar abd Alhamed Tabra, Radwa H. Shalaby, Belal Abdelrafea, Waleed Hassan, Osama Farouk, Mahmoud Nafady, Ahmed Mohamed Farghaly, Shereef Ibrahim Mohamed Ibrahim, Mohamed Abdelfattah Ali, Karim Mohamed Elmaradny, Sally Eskandar Saber Eskandar, Walaa Elwakil
Abstract Mini abstract This work studies the direct cost of hip fractures in Egypt. The direct cost was calculated based on the incidence of hip fracture in Egypt retrieved from the national database. The result of this work raises red flags to the policy makers in Egypt that such fragility fractures are preventable, should appropriate approaches be implemented. Background This study provides an analysis for the healthcare system in Egypt. It was carried out to assess the direct annual cost incurred to the Egyptian healthcare system in 2023 as a result of fragility hip fractures in older adult Egyptians. Results The direct costs of hip fractures incurred during the first year after the injury were estimated at 1,969,385,000 Egyptian pounds (US $63,734,142.4). Time from fracture to surgery was 2.2 + 0.5 days. The average hospital stay after hip fracture surgery was 5.2 + 2.6 days. 4.5% of patients died after surgery, on average 2.3 + 0.4 months. After being discharged from the hospital, all patients needed home care. Conclusion Hip fractures have a significant clinical and financial impact on patients and the healthcare system. This study raises red flags for the healthcare policy makers in Egypt, as the financial burden due to the direct costs of hip fractures justifies extensive prevention programs for osteoporosis and fragility fractures. There is an urgent need to implement diagnostic approaches and validated management protocols for bone health disorders and its associated fractures in Egypt.
{"title":"Health economics: direct cost of osteoporotic hip fracture in Egypt—an analysis for the Egyptian healthcare system by the Egyptian Academy of Bone Health","authors":"Yasser El Miedany, Maha El Gaafary, Naglaa Gadallah, Safaa Mahran, Nihal Fathi, Mohammed Hassan Abu-Zaid, Samar abd Alhamed Tabra, Radwa H. Shalaby, Belal Abdelrafea, Waleed Hassan, Osama Farouk, Mahmoud Nafady, Ahmed Mohamed Farghaly, Shereef Ibrahim Mohamed Ibrahim, Mohamed Abdelfattah Ali, Karim Mohamed Elmaradny, Sally Eskandar Saber Eskandar, Walaa Elwakil","doi":"10.1186/s43166-023-00218-5","DOIUrl":"https://doi.org/10.1186/s43166-023-00218-5","url":null,"abstract":"Abstract Mini abstract This work studies the direct cost of hip fractures in Egypt. The direct cost was calculated based on the incidence of hip fracture in Egypt retrieved from the national database. The result of this work raises red flags to the policy makers in Egypt that such fragility fractures are preventable, should appropriate approaches be implemented. Background This study provides an analysis for the healthcare system in Egypt. It was carried out to assess the direct annual cost incurred to the Egyptian healthcare system in 2023 as a result of fragility hip fractures in older adult Egyptians. Results The direct costs of hip fractures incurred during the first year after the injury were estimated at 1,969,385,000 Egyptian pounds (US $63,734,142.4). Time from fracture to surgery was 2.2 + 0.5 days. The average hospital stay after hip fracture surgery was 5.2 + 2.6 days. 4.5% of patients died after surgery, on average 2.3 + 0.4 months. After being discharged from the hospital, all patients needed home care. Conclusion Hip fractures have a significant clinical and financial impact on patients and the healthcare system. This study raises red flags for the healthcare policy makers in Egypt, as the financial burden due to the direct costs of hip fractures justifies extensive prevention programs for osteoporosis and fragility fractures. There is an urgent need to implement diagnostic approaches and validated management protocols for bone health disorders and its associated fractures in Egypt.","PeriodicalId":31002,"journal":{"name":"Egyptian Rheumatology and Rehabilitation","volume":"290 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135095476","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}
Pub Date : 2023-10-05DOI: 10.1186/s43166-023-00191-z
Sherihan M. Salama, Shereen I. Fawaz
Abstract Background Rheumatoid arthritis (RA) is a chronic immune-mediated inflammatory disorder characterised by synovial hypertrophy, proliferation, and pannus formation encroaching on articular structures resulting in uncontrolled spread of joint destruction. Survivin is an anti-apoptotic protein that plays an important role in tissue growth and tumour development. The objective of this research is to study the role of Survivin as a predictor of treatment response to anti-tumor necrosis factor (anti-TNF) in RA patients who had failure of conventional disease modifying anti rheumatic drugs (DMARDs) treatment. Results All patients had active RA evaluated with DAS 28 activity score: 73.3% of them had high disease activity, while 22.7% were in moderate activity. Serum survivin level ranged from 725 pg/ml to 2750 pg/ml. Its level was significantly higher in patients than in controls with a p value of < 0.001. After receiving anti-TNF treatment for 3 months, serum survivin level was reassessed, and it ranged from 525 pg/ml to 2100 pg/ml. There was a significant decreased in the biomarker serum level after receiving the treatment when compared to its level before starting treatment. Conclusion Our results showed that the assessment of serum survivin may be a useful diagnostic tool for detection of RA patients also it has a valuable predictive value in assessment of responce to biologic treatments given to the patients. This conclusion was reached after detection of high survivin levels in the sera of RA with high disease activity and reduced functional outcomes. Moreover, the biomarker has a good prognostic value in detection of response to biologic treatment indicated by the reduction of serum level after receiving the treatment and improvement of clinical disease activity.
{"title":"Role of serum survivin as a predictor of response to biological treatment in rheumatoid arthritis patients","authors":"Sherihan M. Salama, Shereen I. Fawaz","doi":"10.1186/s43166-023-00191-z","DOIUrl":"https://doi.org/10.1186/s43166-023-00191-z","url":null,"abstract":"Abstract Background Rheumatoid arthritis (RA) is a chronic immune-mediated inflammatory disorder characterised by synovial hypertrophy, proliferation, and pannus formation encroaching on articular structures resulting in uncontrolled spread of joint destruction. Survivin is an anti-apoptotic protein that plays an important role in tissue growth and tumour development. The objective of this research is to study the role of Survivin as a predictor of treatment response to anti-tumor necrosis factor (anti-TNF) in RA patients who had failure of conventional disease modifying anti rheumatic drugs (DMARDs) treatment. Results All patients had active RA evaluated with DAS 28 activity score: 73.3% of them had high disease activity, while 22.7% were in moderate activity. Serum survivin level ranged from 725 pg/ml to 2750 pg/ml. Its level was significantly higher in patients than in controls with a p value of < 0.001. After receiving anti-TNF treatment for 3 months, serum survivin level was reassessed, and it ranged from 525 pg/ml to 2100 pg/ml. There was a significant decreased in the biomarker serum level after receiving the treatment when compared to its level before starting treatment. Conclusion Our results showed that the assessment of serum survivin may be a useful diagnostic tool for detection of RA patients also it has a valuable predictive value in assessment of responce to biologic treatments given to the patients. This conclusion was reached after detection of high survivin levels in the sera of RA with high disease activity and reduced functional outcomes. Moreover, the biomarker has a good prognostic value in detection of response to biologic treatment indicated by the reduction of serum level after receiving the treatment and improvement of clinical disease activity.","PeriodicalId":31002,"journal":{"name":"Egyptian Rheumatology and Rehabilitation","volume":"2010 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134947787","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}
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