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Are All Oral COX-2 Selective Inhibitors the Same? A Consideration of Celecoxib, Etoricoxib, and Diclofenac. 所有口服COX-2选择性抑制剂都是一样的吗?塞来昔布、依托昔布和双氯芬酸的考虑。
IF 2.3 Q3 Medicine Pub Date : 2018-12-09 eCollection Date: 2018-01-01 DOI: 10.1155/2018/1302835
Chris Walker

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been widely used for the treatment of arthritic conditions. Drugs in this heterogeneous class alleviate pain and inflammation by inhibiting cyclooxygenase-2 (COX-2). Cyclooxygenase-1 (COX-1) inhibition has traditionally been associated with increased gastrointestinal (GI) harm, whereas increased COX-2 selectivity has more recently become associated with greater risk of cardiovascular (CV) harm. When the entirety of data is considered, NSAIDs can be seen to exhibit a range of COX isoform selectivity, with all oral NSAIDs appearing to be associated with an increase in CV events. This review focuses on a comparison of the efficacy and the GI and CV safety profiles of three commonly used NSAIDs-celecoxib, etoricoxib, and diclofenac-using direct comparisons where available. While all three treatments are shown to have comparable efficacy, there are differences in their safety profiles. Both celecoxib and etoricoxib are associated with less GI harm than diclofenac despite the similarity of its COX-2 selectivity to celecoxib. Each of the three medicines under consideration is associated with a similar overall risk of CV events (fatal and nonfatal heart attacks and strokes). However, there are consistent differences in effects on blood pressure (BP), reported both from trials using ambulatory techniques and from meta-analyses of randomized trials, reporting investigator determined effects, with etoricoxib being associated with a greater propensity to destabilize BP control than either diclofenac or celecoxib.

非甾体类抗炎药(NSAIDs)已被广泛用于关节炎的治疗。这类异质药物通过抑制环氧合酶-2 (COX-2)来减轻疼痛和炎症。环氧化酶-1 (COX-1)抑制传统上与胃肠道(GI)损害增加有关,而COX-2选择性增加最近与心血管(CV)损害风险增加有关。考虑到所有的数据,非甾体抗炎药可以显示出一定范围的COX亚型选择性,所有口服非甾体抗炎药似乎都与心血管事件的增加有关。这篇综述的重点是比较三种常用的非甾体抗炎药——塞来昔布、依托昔布和双氯芬酸的疗效和GI和CV安全性。虽然这三种治疗方法都显示出相当的疗效,但它们的安全性存在差异。尽管塞来昔布和依托昔布的COX-2选择性与双氯芬酸相似,但塞来昔布和依托昔布对胃肠道的危害都小于双氯芬酸。正在考虑的三种药物中的每一种都与心血管事件(致命性和非致命性心脏病发作和中风)的总体风险相似。然而,在使用动态技术的试验和随机试验的荟萃分析中,对血压(BP)的影响存在一致的差异,报告了研究者确定的影响,与双氯芬酸或塞来昔布相比,依托昔布更倾向于破坏血压控制的稳定。
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引用次数: 35
The Effect of Prednisone on Tuberculin Skin Test Reaction in Patients with Rheumatoid Arthritis. 泼尼松对类风湿性关节炎患者结核菌素皮试反应的影响。
IF 2.3 Q3 Medicine Pub Date : 2018-10-21 DOI: 10.1155/2018/2586916
Olga Reitblat, Tsahi T Lerman, Ornit Cohen, Tatiana Reitblat

Objectives: To assess the correlation between prednisone and methotrexate (MTX) treatment duration and dosage with the TST induration diameter of the TST reaction among rheumatoid arthritis (RA) patients.

Method: We retrospectively analyzed consecutive cases of RA patients who were TNF-i therapy candidates. TST measurements, prednisone and methotrexate dosages, and treatment durations were recorded. A control group was randomly selected from healthy subjects. We compared TST reaction size between the following three groups: RA patients with current prednisone treatment, RA prednisone naïve patients, and healthy individuals.

Results: Our study sample comprised 43 RA patients with prednisone treatment, 22 prednisone naïve patients, and 195 healthy subjects. There was no significant difference in mean TST between the groups (5.3±6.6, 7.8±6.2, and 7.6±7.0, respectively, p=0.149). No correlation was noted between TST size and prednisone u-y (r=0.229, p=0.140) or methotrexate u-y in patients with and without prednisone therapy (r=0.219, p=0.158; and r=-0.293, p=0.186, respectively).

Conclusions: Our results show that the TST reaction size among RA patients may not be affected by prednisone therapy. In addition, the TST reaction of RA patients may present similarly to that of healthy individuals. Therefore, we suggest that the criterion of a TST reaction of 5 mm to define latent TB infection in our population should be reevaluated.

目的:评估泼尼松和甲氨蝶呤(MTX)治疗时间和剂量与类风湿性关节炎(RA)患者TST反应的TST硬化直径的相关性。方法:我们回顾性分析了TNF-i治疗候选RA患者的连续病例。记录TST测量、泼尼松和甲氨蝶呤剂量以及治疗持续时间。对照组是从健康受试者中随机选择的。我们比较了以下三组患者的TST反应大小:目前接受泼尼松治疗的RA患者、未接受泼尼松松治疗的患者和健康人。结果:我们的研究样本包括43名接受泼尼松治疗的RA患者、22名泼尼松幼稚患者和195名健康受试者。两组之间的平均TST没有显著差异(分别为5.3±6.6、7.8±6.2和7.6±7.0,p=0.149)。在接受和不接受泼尼松治疗的患者中,TST大小与泼尼松u-y(r=0.229,p=0.140)或甲氨蝶呤u-y之间没有相关性(分别为r=0.219,p=0.158;r=-0.293,p=0.186)患者可能不会受到泼尼松治疗的影响。此外,RA患者的TST反应可能与健康人相似。因此,我们建议应该重新评估TST反应为5mm的标准来定义我们人群中的潜在结核病感染。
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引用次数: 3
Population-Wide Associations between Common Viral Pathogens and Self-Reported Arthritis: NHANES 2009-2012. 常见病毒病原体与自我报告的关节炎之间的人群相关性:NHANES 2009-2012。
IF 2.3 Q2 RHEUMATOLOGY Pub Date : 2018-10-01 eCollection Date: 2018-01-01 DOI: 10.1155/2018/7684942
Anna Shmagel, Grace Skemp-Dymond, Lisa Langsetmo, John T Schousboe, Kristine Ensrud, Robert Foley

Objective: Persistent infectious agents have been implicated in chronic and recurrent inflammation, which may trigger or worsen many types of arthritis. Our objective was to determine whether exposure to herpes simplex virus (HSV) and human papillomavirus (HPV) is associated with self-reported arthritis among US adults.

Methods: We used data from two consecutive cycles of the National Health and Nutrition Examination Survey (NHANES) from 2009 until 2012 (N of examined adults ages 20-69 = 9483). Participants were classified as having arthritis by self-report. Viral serology for HSV-1 and HSV-2 and HPV PCR studies from oral rinse and vaginal swabs were available for analysis. We compared HSV-1 and HSV-2 seropositivity as well as oral and vaginal HPV DNA positivity between participants with self-reported arthritis vs. those without, adjusting for age, gender, race, income, education, BMI, and the use of immunosuppressive medications. We used three comparator outcomes, gout, kidney stones, and hypertension, to evaluate whether the associations were specific or not to arthritis.

Results: Arthritis was associated with older age, female gender, non-Hispanic White and Non-Hispanic Black race, higher BMI, and lower socioeconomic status. HSV-2 seropositivity, but not HSV-1 seropositivity, was independently associated with arthritis after adjustment for age, gender, race, income, education, BMI, and the use of immunosuppressive medications: AOR 1.48 (1.10-1.99). Oral HPV DNA positivity was also independently associated with arthritis: AOR 1.63 (1.17-2.28). After adjustment, there was no statistically significant difference in vaginal HPV DNA positivity between those with vs. those without arthritis: AOR 1.22 (0.90-1.66). There were no significant associations between viral exposures and any of the comparator outcomes.

Conclusions: HSV-2 seropositivity and oral HPV DNA positivity were associated with self-reported arthritis and not with comparator outcomes, after adjustment for multiple potential confounders. These findings should be confirmed in longitudinal studies.

目的:持久性感染源与慢性和复发性炎症有关,这些炎症可能引发或加重多种类型的关节炎。我们的目的是确定暴露于单纯疱疹病毒(HSV)和人乳头瘤病毒(HPV)是否与美国成年人自我报告的关节炎有关。方法:我们使用了2009年至2012年连续两个周期的国家健康和营养检查调查(NHANES)的数据(20-69岁接受检查的成年人的N=9483)。参与者通过自我报告被归类为患有关节炎。HSV-1和HSV-2的病毒血清学以及口腔冲洗液和阴道拭子的HPV PCR研究可用于分析。我们根据年龄、性别、种族、收入、教育程度、BMI和免疫抑制药物的使用情况,比较了自我报告患有关节炎的参与者与未患有关节炎参与者之间的HSV-1和HSV-2血清阳性以及口腔和阴道HPV DNA阳性。我们使用了三种比较结果,痛风、肾结石和高血压,来评估这些相关性是否与关节炎有关。结果:关节炎与年龄较大、女性、非西班牙裔白人和非西班牙裔黑人、较高的BMI和较低的社会经济地位有关。在调整了年龄、性别、种族、收入、教育程度、BMI和免疫抑制药物的使用后,HSV-2血清阳性(而不是HSV-1血清阳性)与关节炎独立相关:AOR 1.48(1.10-1.99)。口腔HPV DNA阳性也与关节炎独立相关:AOR1.63(1.17-2.28)。调整后,关节炎患者与非关节炎患者的阴道HPV DNA阳性率没有统计学上的显著差异:AOR 1.22(0.90-1.66)。病毒暴露与任何对照结果之间没有显著关联。结论:在对多种潜在混杂因素进行校正后,HSV-2血清阳性和口腔HPV DNA阳性与自我报告的关节炎相关,而与对照结果无关。这些发现应该在纵向研究中得到证实。
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引用次数: 0
Red Cell Distribution Width Is Positively Correlated with Atherosclerotic Cardiovascular Disease 10-Year Risk Score, Age, and CRP in Spondyloarthritis with Axial or Peripheral Disease. 脊柱关节炎伴轴向或外周疾病患者的红细胞分布宽度与动脉粥样硬化性心血管疾病 10 年风险评分、年龄和 CRP 呈正相关。
IF 2.3 Q3 Medicine Pub Date : 2018-09-27 eCollection Date: 2018-01-01 DOI: 10.1155/2018/2476239
Hassan Ahmad, Mariam Khan, Michelle Laugle, Desmond A Jackson, Christopher Burant, Charles J Malemud, Ali D Askari, Maya Mattar, David E Blumenthal, David A Zidar, Donald D Anthony

Background: Red blood cell distribution width (RDW) is a routine hematologic parameter that is a predictor of cardiovascular disease (CVD) events and is independent of combined traditional risk factor scoring systems. The RDW has also been associated with rheumatic disease activity. Whether RDW is associated with traditional CVD risk factors or Atherosclerotic Cardiovascular Disease (ASCVD) 10-year CVD risk score in patients with seronegative spondyloarthritis with axial or peripheral disease has not been previously determined.

Methods: We performed a retrospective, chart review study evaluating the relationship between RDW, albumin, hemoglobin, C-reactive protein (CRP), absolute lymphocyte count (ALC), and ASCVD scoring parameters [age, hypertension status, diabetes mellitus (DM) status, lipid profile, and smoking status] in a cohort of spondyloarthritis patients, taking into consideration their HLA-B27 status, race, and treatment status.

Results: RDW was found to positively correlate with ASCVD 10-year score and age, and ASCVD score did not change over time after patients were treated for spondyloarthritis. Albumin was found to negatively correlate with ASCVD 10-year risk score. Both RDW and albumin correlated with CRP. ALC failed to correlate with ASCVD 10-year score but did show a tendency to be associated with CVD, CVD events, and cardiac conduction abnormalities.

Conclusions: These data indicate that further study is warranted to evaluate RDW, albumin level, and ALC as potential predictors of CVD in the spondyloarthritis patient population.

背景:红细胞分布宽度(RDW)是一项常规血液学参数,是心血管疾病(CVD)事件的预测指标,与传统的风险因素综合评分系统无关。RDW 还与风湿病的活动性有关。在血清阴性脊柱关节炎伴轴向或外周疾病患者中,RDW是否与传统心血管疾病风险因素或动脉粥样硬化性心血管疾病(ASCVD)10年心血管疾病风险评分相关,此前尚未确定:我们对一组脊柱关节炎患者的 RDW、白蛋白、血红蛋白、C 反应蛋白 (CRP)、绝对淋巴细胞计数 (ALC) 和 ASCVD 评分参数 [年龄、高血压状况、糖尿病 (DM) 状况、血脂状况和吸烟状况] 之间的关系进行了回顾性病历回顾研究评估,同时考虑了患者的 HLA-B27 状况、种族和治疗状况:结果:发现 RDW 与 ASCVD 10 年评分和年龄呈正相关,而 ASCVD 评分在脊柱关节炎患者接受治疗后并未随时间发生变化。白蛋白与 ASCVD 10 年风险评分呈负相关。RDW和白蛋白均与CRP相关。ALC未能与ASCVD 10年评分相关,但显示出与心血管疾病、心血管疾病事件和心脏传导异常相关的趋势:这些数据表明,有必要进行进一步研究,以评估RDW、白蛋白水平和ALC作为脊柱关节炎患者群体心血管疾病的潜在预测因素。
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引用次数: 0
Integration of Genome-Wide DNA Methylation and Transcription Uncovered Aberrant Methylation-Regulated Genes and Pathways in the Peripheral Blood Mononuclear Cells of Systemic Sclerosis. 全基因组DNA甲基化和转录的整合揭示了系统性硬化症外周血单个核细胞中异常甲基化调控基因和途径。
IF 2.3 Q3 Medicine Pub Date : 2018-09-02 eCollection Date: 2018-01-01 DOI: 10.1155/2018/7342472
Honglin Zhu, Chengsong Zhu, Wentao Mi, Tao Chen, Hongjun Zhao, Xiaoxia Zuo, Hui Luo, Quan-Zhen Li

Objective. Systemic sclerosis (SSc) is a systemic connective tissue disease of unknown etiology. Aberrant gene expression and epigenetic modifications in circulating immune cells have been implicated in the pathogenesis of SSc. This study is to delineate the interaction network between gene transcription and DNA methylation in PBMC of SSc patients and to identify methylation-regulated genes which are involved in the pathogenesis of SSc. Methods. Genome-wide mRNA transcription and global DNA methylation analysis were performed on PBMC from 18 SSc patients and 19 matched normal controls (NC) using Illumina BeadChips. Differentially expressed genes (DEGs) and differentially methylated positions (DMPs) were integrative analyzed to identify methylation-regulated genes and associated molecular pathways. Results. Transcriptome analysis distinguished 453 DEGs (269 up- and 184 downregulated) in SSc from NC. Global DNA methylation analysis identified 925 DMPs located on 618 genes. Integration of the two lists revealed only 20 DEGs which harbor inversely correlated DMPs, including 12 upregulated (ELANE, CTSG, LTBR, C3AR1, CSTA, SPI1, ODF3B, SAMD4A, PLAUR, NFE2, ZYX, and CTSZ) and eight downregulated genes (RUNX3, PRF1, PRKCH, PAG1, RASSF5, FYN, CXCR6, and F2R). These potential methylation-regulated DEGs (MeDEGs) are enriched in the pathways related to immune cell migration, proliferation, activation, and inflammation activities. Using a machine learning algorism, we identified six out of the 20 MeDEGs, including F2R, CXCR6, FYN, LTBR, CTSG, and ELANE, which distinguished SSc from NC with 100% accuracy. Four genes (F2R, FYN, PAG1, and PRKCH) differentially expressed in SSc with interstitial lung disease (ILD) compared to SSc without ILD. Conclusion. The identified MeDEGs may represent novel candidate factors which lead to the abnormal activation of immune regulatory pathways in the pathogenesis of SSc. They may also be used as diagnostic biomarkers for SSc and clinical complications.

目标。系统性硬化症(SSc)是一种病因不明的系统性结缔组织疾病。循环免疫细胞中的异常基因表达和表观遗传修饰与SSc的发病机制有关。本研究旨在描述SSc患者PBMC中基因转录与DNA甲基化的相互作用网络,并鉴定参与SSc发病的甲基化调控基因。方法。使用Illumina BeadChips对18例SSc患者和19例匹配正常对照(NC)的PBMC进行全基因组mRNA转录和整体DNA甲基化分析。对差异表达基因(DEGs)和差异甲基化位点(dmp)进行综合分析,以鉴定甲基化调控基因和相关分子途径。结果。转录组分析在SSc和NC中鉴定出453个基因(269个上调,184个下调)。全球DNA甲基化分析鉴定出618个基因上的925个dmp。整合这两个列表,发现只有20个基因的DMPs呈负相关,包括12个上调基因(ELANE、CTSG、LTBR、C3AR1、CSTA、SPI1、ODF3B、SAMD4A、PLAUR、NFE2、ZYX和CTSZ)和8个下调基因(RUNX3、PRF1、PRKCH、PAG1、RASSF5、FYN、CXCR6和F2R)。这些潜在的甲基化调节的DEGs (MeDEGs)在与免疫细胞迁移、增殖、激活和炎症活动相关的途径中富集。使用机器学习算法,我们确定了20个medeg中的6个,包括F2R、CXCR6、FYN、LTBR、CTSG和ELANE,它们以100%的准确率区分了SSc和NC。4个基因(F2R、FYN、PAG1和PRKCH)在伴有间质性肺病(ILD)的SSc与无ILD的SSc中表达差异。结论。所鉴定的MeDEGs可能是导致SSc发病过程中免疫调节通路异常激活的新的候选因子。它们也可作为SSc和临床并发症的诊断性生物标志物。
{"title":"Integration of Genome-Wide DNA Methylation and Transcription Uncovered Aberrant Methylation-Regulated Genes and Pathways in the Peripheral Blood Mononuclear Cells of Systemic Sclerosis.","authors":"Honglin Zhu,&nbsp;Chengsong Zhu,&nbsp;Wentao Mi,&nbsp;Tao Chen,&nbsp;Hongjun Zhao,&nbsp;Xiaoxia Zuo,&nbsp;Hui Luo,&nbsp;Quan-Zhen Li","doi":"10.1155/2018/7342472","DOIUrl":"https://doi.org/10.1155/2018/7342472","url":null,"abstract":"<p><p><i>Objective.</i> Systemic sclerosis (SSc) is a systemic connective tissue disease of unknown etiology. Aberrant gene expression and epigenetic modifications in circulating immune cells have been implicated in the pathogenesis of SSc. This study is to delineate the interaction network between gene transcription and DNA methylation in PBMC of SSc patients and to identify methylation-regulated genes which are involved in the pathogenesis of SSc. <i>Methods.</i> Genome-wide mRNA transcription and global DNA methylation analysis were performed on PBMC from 18 SSc patients and 19 matched normal controls (NC) using Illumina BeadChips. Differentially expressed genes (DEGs) and differentially methylated positions (DMPs) were integrative analyzed to identify methylation-regulated genes and associated molecular pathways<i>. Results.</i> Transcriptome analysis distinguished 453 DEGs (269 up- and 184 downregulated) in SSc from NC. Global DNA methylation analysis identified 925 DMPs located on 618 genes. Integration of the two lists revealed only 20 DEGs which harbor inversely correlated DMPs, including 12 upregulated (ELANE, CTSG, LTBR, C3AR1, CSTA, SPI1, ODF3B, SAMD4A, PLAUR, NFE2, ZYX, and CTSZ) and eight downregulated genes (RUNX3, PRF1, PRKCH, PAG1, RASSF5, FYN, CXCR6, and F2R). These potential methylation-regulated DEGs (MeDEGs) are enriched in the pathways related to immune cell migration, proliferation, activation, and inflammation activities. Using a machine learning algorism, we identified six out of the 20 MeDEGs, including F2R, CXCR6, FYN, LTBR, CTSG, and ELANE, which distinguished SSc from NC with 100% accuracy. Four genes (F2R, FYN, PAG1, and PRKCH) differentially expressed in SSc with interstitial lung disease (ILD) compared to SSc without ILD. <i>Conclusion.</i> The identified MeDEGs may represent novel candidate factors which lead to the abnormal activation of immune regulatory pathways in the pathogenesis of SSc. They may also be used as diagnostic biomarkers for SSc and clinical complications.</p>","PeriodicalId":51715,"journal":{"name":"International Journal of Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2018-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/7342472","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36514109","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: 21
Work Ability and Employment in Rheumatoid Arthritis: A Cross-Sectional Study on the Role of Muscle Strength and Lower Extremity Function. 类风湿关节炎的工作能力和就业:肌肉力量和下肢功能作用的横断面研究。
IF 2.3 Q3 Medicine Pub Date : 2018-08-01 eCollection Date: 2018-01-01 DOI: 10.1155/2018/3756207
Carolin Berner, Sandra Haider, Igor Grabovac, Thomas Lamprecht, Karl Heinrich Fenzl, Ludwig Erlacher, Michael Quittan, Thomas Ernst Dorner

Objective: The aim of the present study was to assess the association between muscle strength, lower extremity function, employment status, and work ability in RA patients.

Methods: One hundred seropositive RA outpatients of working age were included in this cross-sectional study. Employment status was assessed by interview and work ability by the Work Ability Index-Single Item Scale (WAS). Muscle strength was determined using dynamometer measurement of isometric hand grip and knee extensor strength. Lower extremity function was measured using the short physical performance battery (SPPB). Regression models estimate the association between unemployment, work ability and muscle strength, and lower extremity function, controlling for sociodemographic and disease-related factors.

Results: Forty-one percent of the RA patients were not gainfully employed, and their median work ability had a good WAS value (7.00 [4.00-7.00]). Patients with better knee extensor strength (OR=1.07, 95% CI [1.02-1.12) and better physical performance (OR=1.71, 95% CI [1.18-2.49]) had a significantly better chance of gainful employment. The odds for hand grip strength remained significant when adjusted for sociodemographic (OR=1.5, 95% CI [1.00-1.09]), but not for disease-specific variables. Better hand grip strength (β=0.25, p=0.039) and better knee extensor strength (β=0.45, p=0.001) as well as better lower extremity function (SPPB) (β=0.51, p<0.001) remained significantly associated with work ability following adjustment for sociodemographic and disease-specific variables.

Conclusions: The association of employment status and work ability with parameters of physical fitness suggests that improvement in muscle strength and lower extremity function may positively influence work ability and employment in individuals with RA.

目的:本研究的目的是评估RA患者肌肉力量、下肢功能、就业状况和工作能力之间的关系。方法:选取100例工作年龄的RA门诊血清阳性患者进行横断面研究。就业状况以面试方式评估,工作能力以工作能力指数单项量表(was)评估。肌肉力量是用测力仪测量等距握力和膝关节伸肌力量来确定的。采用短物理性能电池(SPPB)测量下肢功能。回归模型估计失业、工作能力、肌肉力量和下肢功能之间的关系,控制社会人口和疾病相关因素。结果:41%的RA患者无酬就业,工作能力中位数WAS值较好(7.00[4.00-7.00])。膝关节伸肌力量较好的患者(OR=1.07, 95% CI[1.02-1.12])和身体表现较好的患者(OR=1.71, 95% CI[1.18-2.49])有较好的就业机会。经社会人口学因素调整后(OR=1.5, 95% CI[1.00-1.09]),手握力的优势仍然显著,但对疾病特异性变量没有影响。更好的握力(β=0.25, p=0.039)、更好的膝伸肌力量(β=0.45, p=0.001)和更好的下肢功能(SPPB) (β=0.51, p)结论:就业状况和工作能力与体质参数的相关性表明,肌肉力量和下肢功能的改善可能对RA患者的工作能力和就业有积极的影响。
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引用次数: 15
Wrist Arthrodesis in Rheumatoid Arthritis Using an LCP Metaphyseal Locking Plate versus an AO Wrist Fusion Plate. LCP干骺端锁定钢板与AO腕部融合钢板在类风湿关节炎中的应用。
IF 2.3 Q3 Medicine Pub Date : 2018-07-10 eCollection Date: 2018-01-01 DOI: 10.1155/2018/4719634
Toshitake Taii, Takumi Matsumoto, Sakae Tanaka, Ichiro Nakamura, Katsumi Ito, Takuo Juji

Objectives: Although wrist arthrodesis using a plate is an established treatment with a well-documented successful union rate for severely destroyed wrists, plate-related complications are a matter of great concern.

Methods: We retrospectively compared wrist arthrodesis using an AO wrist fusion plate in nine and a locking compression plate (LCP) metaphyseal plate in seven cases of rheumatoid arthritis.

Results: The mean follow-up was 40.6 months in the AO wrist fusion plate group and 57.2 months in the LCP metaphyseal plate group. Bone union at the arthrodesis site was achieved in all cases in both groups. Comparison of the original position of the fusion on the immediate postoperative radiographs and the position on the most recent follow-up radiographs demonstrated good stability in both groups. Plate-related complications occurred in four cases in the AO wrist fusion plate group and no cases in the LCP metaphyseal plate group. Complications included pain over the plate, wound dehiscence and infection, extensor tendon adhesion, and fracture in one case each.

Conclusion: Wrist arthrodesis using an LCP metaphyseal plate was favorable for rheumatoid arthritis patients with comparable stability to that of and a lower risk of plate-related complications than an AO wrist fusion plate.

目的:虽然使用钢板进行腕部关节融合术是一种成熟的治疗方法,对于严重破坏的手腕有充分的文献证明其成功愈合率,但钢板相关的并发症是一个非常值得关注的问题。方法:我们回顾性比较了9例使用AO手腕融合钢板和7例使用锁定加压钢板(LCP)干骺端钢板的腕关节融合术。结果:AO腕部融合钢板组平均随访40.6个月,LCP干骺端钢板组平均随访57.2个月。两组所有病例均实现了关节融合术部位的骨愈合。术后立即x线片上融合的原始位置与最近随访x线片上的位置比较显示两组均具有良好的稳定性。AO腕部融合钢板组出现4例钢板相关并发症,LCP干骺端钢板组无一例。并发症包括钢板疼痛、伤口裂开和感染、伸肌腱粘连和骨折各1例。结论:使用LCP干骺端钢板进行腕关节融合术有利于类风湿关节炎患者,其稳定性与AO腕关节融合板相当,且钢板相关并发症的风险低于AO腕关节融合板。
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引用次数: 3
Gum Arabic Fibers Decreased Inflammatory Markers and Disease Severity Score among Rheumatoid Arthritis Patients, Phase II Trial. 阿拉伯胶纤维降低类风湿关节炎患者的炎症标志物和疾病严重程度评分,II期试验。
IF 2.3 Q3 Medicine Pub Date : 2018-07-05 eCollection Date: 2018-01-01 DOI: 10.1155/2018/4197537
Ebtihal Kamal, Lamis AbdelGadir Kaddam, Maha Dahawi, Montaser Osman, Mohammed Abdelraman Salih, Alnour Alagib, Amal Saeed

Background: Rheumatoid arthritis (RA) is autoimmune inflammatory disease that attacks the synovium of the joints. Both TNFa and interleukin-1 play crucial roles in the pathogenesis of RA. Gum Arabic (GA) is gummy exudates from Acacia senegal tree. Gum Arabic fermentation by colonic bacteria increases serum butyrate concentrations, so it is considered as prebiotic agent. Gum Arabic (GA) has anti-inflammatory activity through its derivative butyrate. To the best of our knowledge, this is the first study conducted to investigate GA intake on inflammatory markers among RA patients.

Patients and methods: This is clinical trial phase II in which 40 patients were enrolled aged 18 to 70 years. Patients received 30g/day GA for 12 weeks. TNF α, ESR, and complete blood count were measured and DAS-28 was calculated before and after regular GA consumption. Study was approved by the Ethical committee of National Medicines and Poisons Board.

Results: This study showed significant decrease in level of serum TNF α (p value 0.05) [95% CI, 0.65 -16.5], ESR (p value 0.011) [95% CI, 2.6 -18.89], and number of swollen and tender joints in RA patients after 12 weeks of GA intake which reflected as significant decrease in disease severity score DAS 28 P.V:0.00 [95% CI, 1.25 -1.99]. On the other hand, GA had trivial change in blood indices.

Conclusion: Gum Arabic has favorable immune modulator effect on rheumatoid arthritis. It can be utilized in clinical practice as adjuvant therapy.

Trial registration: This trial was registered with ClinicalTrials.gov Identifier: NCT02804581 Registered at 19 June 2016, prospective registration.

背景:类风湿关节炎(RA)是攻击关节滑膜的自身免疫性炎症性疾病。tnf - fa和白细胞介素-1在RA的发病机制中都起着至关重要的作用。阿拉伯胶(GA)是塞内加尔合欢树(Acacia senegal tree)的胶状渗出物。阿拉伯胶经结肠菌发酵可提高血清丁酸盐浓度,可作为益生元制剂。阿拉伯胶(GA)通过其衍生物丁酸酯具有抗炎活性。据我们所知,这是第一个调查GA摄入对RA患者炎症标志物影响的研究。患者和方法:这是临床II期试验,其中40例患者入组,年龄在18至70岁之间。患者服用30g/天GA,持续12周。定期服用GA前后分别测定TNF α、ESR、全血细胞计数和DAS-28。研究得到了国家药品和毒物委员会伦理委员会的批准。结果:本研究显示,服用GA 12周后,RA患者血清TNF α水平(p值0.05)[95% CI, 0.65 -16.5], ESR (p值0.011)[95% CI, 2.6 -18.89],肿胀和压痛关节数量显著降低,反映为疾病严重程度评分DAS 28 P.V:0.00 [95% CI, 1.25 -1.99]显著降低。另一方面,GA对血液指标的影响较小。结论:阿拉伯胶对类风湿关节炎具有良好的免疫调节作用。它可以作为辅助治疗在临床实践中使用。试验注册:该试验已在ClinicalTrials.gov注册,注册号:NCT02804581,注册日期为2016年6月19日,前瞻性注册。
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引用次数: 48
Possible Modulation of Vascular Function Measures in Rheumatoid Arthritis by Homocysteine. 同型半胱氨酸可能调节类风湿关节炎的血管功能。
IF 2.3 Q3 Medicine Pub Date : 2018-07-02 eCollection Date: 2018-01-01 DOI: 10.1155/2018/8498651
Mahmoud A Alomari, Omar F Khabour, Khaldoon Alawneh, Rania A Shammaa

The effect of homocysteine on cardiovascular diseases is still equivocal, especially in rheumatoid arthritis patients. In this investigation, the association between homocysteine with blood flow and vascular resistance in rheumatoid arthritis was examined. Serum levels of homocysteine were determined in thirty-one rheumatoid arthritis patients and nineteen apparently healthy subjects using ELISA. Additionally, strain-gauge plethysmography was used to determine both forearm blood flow and vascular function at rest and after occlusion. Forearm occlusion blood flow (patients: 21.9 ± 6.55 versus control: 25.5 ± 6.10ml/100mL/min) was lower (p < 0.05) while occlusion vascular resistance (patients: 4.77 ± 2.08 versus controls 3.05 ± 0.96U) was greater (p < 0.01) in rheumatoid arthritis than in the controls. Level of serum homocysteine was similar (p = 0.803) in rheumatoid arthritis group and healthy group. In addition, level of serum homocysteine was correlated with resting blood flow (r = -0.41; p < 0.02) and resting vascular resistance (r = 0.31, p < 0.05) in the patients group. The study confirms altered vascular function in rheumatoid arthritis. Uniquely, the results show that homocysteine was related to resting, but not postischemia, vascular measures. These relationships indicate that homocysteine might impact the vasculature in rheumatoid arthritis.

同型半胱氨酸对心血管疾病的影响仍不明确,特别是在类风湿性关节炎患者中。在这项调查中,同型半胱氨酸与血流量和血管阻力在类风湿关节炎之间的关系进行了检查。采用ELISA法测定了31例类风湿关节炎患者和19例表面健康受试者的血清同型半胱氨酸水平。此外,应变计体积描记术用于测定静止和闭塞后前臂血流和血管功能。类风湿关节炎患者前臂闭塞血流(21.9±6.55 ml/100mL/min)低于对照组(25.5±6.10ml/100mL/min) (p < 0.05),闭塞血管阻力(4.77±2.08 ml/ min)高于对照组(3.05±0.96U) (p < 0.01)。类风湿关节炎组与健康组血清同型半胱氨酸水平相似(p = 0.803)。此外,血清同型半胱氨酸水平与静息血流量相关(r = -0.41;P < 0.02)和静息血管阻力(r = 0.31, P < 0.05)。该研究证实了类风湿关节炎患者血管功能的改变。独特的是,结果显示同型半胱氨酸与静息有关,而与缺血后血管测量无关。这些关系表明同型半胱氨酸可能影响类风湿关节炎的血管系统。
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引用次数: 4
Musculoskeletal Disorders in Patients with Diabetes Mellitus: A Cross-Sectional Study. 糖尿病患者的肌肉骨骼疾病:一项横断面研究。
IF 2.3 Q3 Medicine Pub Date : 2018-06-19 eCollection Date: 2018-01-01 DOI: 10.1155/2018/3839872
A Majjad, Y Errahali, H Toufik, J H Djossou, M A Ghassem, J Kasouati, A El Maghraoui

Introduction: A variety of musculoskeletal disorders (MS) have been associated with diabetes mellitus (DM). This study aimed at assessing the prevalence and associated factors of MS disorders in Moroccan diabetic patients.

Methods: A cross-sectional study enrolled consecutive patients with DM. We recorded demographic features of patients and characteristics of DM. MS disorders and vascular complications were assessed by clinical examinations and investigations. Associated factors of MS disorders were assessed by univariate and multivariate analyses.

Result: 376 subjects were included; 84.6% had type 2 DM. The participants' median age was 54 years [45-62]; 41% had one or more vascular complications. 34.4% had one or more MS disorders. Osteoarthritis was present in 19.4% of patients. Hand disorders were seen in 14.4%. Shoulder capsulitis was present in 12.5%. Long duration of diabetes and dyslipidemia were associated with increased prevalence of hand abnormalities (P = 0.017; P = 0.019, respectively). Age and dyslipidemia were associated with shoulder capsulitis (P = 0.019; P = 0.047, respectively). Female gender, overweight, and nephropathy were associated with increased odds of osteoarthritis (P = 0.009, P = 0.004, and P = 0.032, respectively).

Conclusion: MS disorders are frequent in this population and associated with various factors. HbA1c level does not appear to be associated with development of MS disorders.

多种肌肉骨骼疾病(MS)与糖尿病(DM)相关。本研究旨在评估摩洛哥糖尿病患者多发性硬化症的患病率及相关因素。方法:一项横断面研究纳入了连续的糖尿病患者。我们记录了患者的人口学特征和糖尿病的特征。通过临床检查和调查来评估MS疾病和血管并发症。通过单因素和多因素分析评估多发性硬化症的相关因素。结果:共纳入376例受试者;84.6%为2型糖尿病。参与者的中位年龄为54岁[45-62];41%有一种或多种血管并发症。34.4%患有一种或多种多发性硬化症。19.4%的患者存在骨关节炎。手部障碍占14.4%。12.5%的患者出现肩包膜炎。糖尿病和血脂异常持续时间长与手部异常患病率增加相关(P = 0.017;P = 0.019)。年龄和血脂异常与肩囊炎相关(P = 0.019;P = 0.047)。女性、超重和肾病与骨关节炎发病率增加相关(分别为P = 0.009、P = 0.004和P = 0.032)。结论:多发性硬化症在该人群中较为常见,且与多种因素有关。HbA1c水平似乎与多发性硬化症的发展无关。
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引用次数: 31
期刊
International Journal of Rheumatology
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