Comparative study of focal sialadenitis in patients with rheumatoid arthritis, ankylosing spondylitis and seronegative spondyloarthropathy

Focal sialadenitis may be present among connective tissue disease patients. This study was conducted to evaluate the presence of focal sialadenitis and its risk factors among patients with rheumatoid arthritis [RA], Ankylosing Spondylitis [AS] and spondyloarthropathies [SpA]. The study comprised 26 patients. They were subgrouped as follows: 12 RA patients, 8 AS and 6 SpA patients. They underwent full history and clinical examination. Schirmer's test and stimulated saliva collection test were added. Laboratory tests included rheumatoid factor, Antinuclear Antibody [ANA], anti-RO [SS-A] and anti-La [SS-B]. Labial salivary gland biopsies were taken from patients. Focal sialadenitis was observed in 4 [33.3%] of RA patients, 2 [25%] of AS and 1 [16.7%] of SpA patients. The presence of focal sialadenitis correlated negatively with the amount of stimulated salivary secretions and positively with age, the presence of RF, ANA and SS-A only in RA patients. However, in AS and SPA patients, no associations were found with any clinical or laboratory tests. The use of corticosteroids, methotrexate, antimalarials or sulfasalazine had no effect on the presence of focal sialadenitis among studied patients in all groups. In conclusion,focal sialadenitis can be present in patients with RA,AS and SpA but more frequent in RA as autoimmune sialadenitis caused decreased salivary secretions among RA patients. Focal sialadenitis can occur before the appearance of ocular or oral symptoms. It is minimally invasive and may be a potential useful tool for diagnosis of secondary sicca syndrome. Ocular dryness cannot be confined among these patients with Schirmer's test alone especially in old age

Effect of inspiratory muscle training on dyspnea in chronic obstructive pulmonary disease

To evaluate the effect of inspiratory muscle training among COPD patients on the inspiratory muscle strength and severity of dyspnea. Twenty COPD patients were included in this study. They were subjected to thorough clinical examination, Radiological chest assessment, FEV [1]/FVC%, FEV [I] of predicted measurement, maximal inspiratory muscle strength [PI [max]] and dyspnea evaluation, before and after inspiratory muscle training protocol [IMT] for 6 weeks. Dyspnea was evaluated by Mahler's base linedyspnea index [BDI] before IMT and by Mahler's transitional dyspnea index [TDI] after 6 weeks of IMT.All subjects tolerated the training load with a high significant important of FEV[1] /FVC%, FEV[1]% of predicted and PI max which reflects an important of inspiratory muscle strength. There were an improvement in TDI categories when compared to the initial one in BDI as the effort needed to produce certain task was decreased after IMT with a total perception of reduced dyspnea. IMT is of beneficial effects for improving inspiratory muscle strength and reduce dyspnea in COPD. Application of home training programme is recommended for COPD patients