Serum YKL-40 in rheumatoid arthritis and its correlation with disease activity

To determine the serum level of YKL-40 in rheumatoid arthritis [RA] patients and to find out its correlation with the disease activity. The study was conducted on 20 RA patients recruited from the Rheumatology and Rehabilitation Department of Ain Shams University Hospitals, as well as 10 apparently healthy individuals who served as a control group. Patients with liver disease, myocardial infarction or malignancies were excluded. Also patients taking slow-acting drugs or had intra-articular injections in the previous month before the study were not included. All the patients and the controls were subjected to complete history taking, thorough clinical examination, radiological and laboratory tests. Serum YKL-40 level was measured in the patients and the controls using ELISA test. Serum YKL-40 level was significantly higher in RA patients as compared to the control group. Serum YKL-40 level showed a positive significant correlation with the disease duration, the parameters of disease activity in RA patients and with the disease severity as assessed with Larsen's radiological score. Measurement of serum YKL-40 level in RA patients is a laboratory test that can be used as a new parameter other than the conventional markers of inflammation, which are ESR and serum CRP level. Also, it helps to asses the disease activity as well as the progression and the destructive effect of the disease on the joints

Effects of intensive rehabilitation on locomotor capacity after total knee replacement

To evaluate the effectiveness of a pre- and post-operative exercise protocols and intensive functional rehabilitation [IFR] program on locomotory capacity in the first three months after primary total knee arthroplasty [TKA] for severe osteoarthritis. The study was conducted on 20 patients-with severe osteoarthritis knees who underwent TKA. They were divided randomly into 2 equal groups. The first group received an intensive rehabilitation program while the second received ordinary rehabilitation program. Before program start all patients were subjected to clinical examination. Postural assessment was done to all patients twice pre-operatively and 12 weeks post-operatively using Computerized Dynamic Posturography including motor control, adaptation and sensory organization tests, The ordinary rehabilitation group showed a statistically significant increase in post-operative weight symmetry p<0.05 compared with normal. There were statistically significant high values in both groups in pre- and post-operative strength symmetry p<0.05 compared with normal. Adaptation test toes down showed a statistically significant difference from normal in both groups of rehabilitation in all trials post-operatively, and in intensive rehabilitation group in trial 1, and trial 3, while in ordinary rehabilitation program in trial 2 pre-operatively p<0.05. Amplitude scaling f with affected side of the lower limb, showed a statistically significant decrease in ordinary rehabilitation group in small / and medium f. p<0.05. Intensive rehabilitation group showed no significant change in comparison to normal. There was more balance affection in toes up position in ordinary rehabilitation group. There was better balance in intensive rehabilitation group on affected side