Possible role of serum levels of vascular endothelial growth factor and endostatin in rheumatoid arthritis angiogenesis imbalance

To measure serum levels of the main angiogenic inducer marker [VEGF] and the main angiogenic inhibitor marker [endostatin] in rheumatoid arthritis patients. Also, to study their correlation to clinical and laboratory variables of the disease in an attempt to provide more insight regarding their possible role in the angiogenesis imbalance and pathogenesis of RA. Twenty RA patients and fifteen age and sex matched healthy persons served as a control group underwent full history taking, thorough clinical examination, and routine rheumatological profile. Measurement of serum VEGF and endostatin levels were done using enzyme linked immunosorbent assay [ELISA] in rheumatoid arthritis patients and compared with controls. Comparison between patients with or without systemic involvement regarding serum level of VEGF was done. Correlations between serum levels of VEGF and signs of disease activity were also done. A highly significant increase in the mean values of serum VEGF was found in RA patients compared to control subjects [t=11.83, p<0.00l], while there was no statistically significant difference between both RA and control groups regarding mean values of endostatin [t=0.06, p>0.05]. In addition a highly significant increase in the mean values of serum VEGF was found in RA Patients with extra-articular manifestation [EAM] compared to Patients without EAM [t=2.98, p<0.0l]. Serum VEGF was positively correlated with ESR, DAS, and CRP [r =8.48, p<0.01; r = 0.542, p< 0.5; and r = 0.49, p< 0.5] respectively. We found an imbalance between the production of angiogenic growth factors and angiogenic inhibitors in RA. This may play an important role in the angiogenesis imbalance and pathogenesis of RA. In addition we conclude that VEGF level is related to disease activity and extra-articular manifestation of RA, so it can be considered a good indicator for evaluation of disease activity, systemic organ involvement and planning treatment strategies

Orthostatic hypotension in stroke patients

To assess the incidence of orthostatic hypotension [OH] in stroke patients undergoing rehabilitation and to determine clinical variables associated with it. Thirty patients with a first clinical stroke who underwent rehabilitation within one month of stroke onset were included in this study. They were 17 males and 13 females. Their age ranged from 49 to 68 years [mean +/- SD= 58.1 +/- 6.3]. Patients were subjected to full history taking, thorough clinical examination and investigations. Patients' blood pressure was measured in the supine position and on tilting at 90[0]. OH was defined as a drop in systolic blood pressure [SBP] of 20 mmHg or more. OH was present in 14 [46.7%] patients. Age was highly significantly associated [p<0.001] with OH and admission modified Barthel Index [MBI] score was significantly associated [p<0.05] with OH. There was a non-significant correlation with the site of stroke or the use of anti-hypertensives. OH was common in stroke patients undergoing inpatient rehabilitation especially in older patients who have a lower functional status

Musculoskeletal pain in obese Egyptians

Obesity is associated with musculoskeletal pain and osteoarthritis. This study compares the prevalence of work-restricting musculoskeletal pain in obese and general population and investigates changes in the incidence of and recovery from musculoskeletal pain after surgical or conventional obesity treatment. A random sample of 50 subjects from the general population was compared with 50 obese subjects. For the obese subjects, information about musculoskeletal pain was also collected 6 and 12 months after obesity surgery or the start of non-surgical treatment. In both sexes, work-restricting pain in the neck and back regions and in the hip, knee and ankle joints was more common in the obese subjects than in the control population. Operated obese women had a lower incidence of work-restricting pain in the knee and ankle joints as compared with the conventionally treated control group over 6 and 12 months. Among subjects reporting symptoms at baseline, the recovery rate for pain in the knee and ankle joints in obese men and pain in the neck and back and in the hip, knee and ankle joints in obese women improved in the surgical group as compared with the control group after 12 months. Obese subjects have more problems with work-restricting musculoskeletal pain than the general population. Surgical obesity treatment reduces the long-term risk of developing work-restricting musculoskeletal pain and increases the likelihood of recovering from such pain

Effects of physical exercise on HCV chronic active hepatitis patients

Infection with HCV shows a high prevalence in our country and often becomes chronic and proceeds to a state of chronic active hepatitis, a condition which is not easy to treat and almost always end up in liver cirrhosis as well as a high risk of hepatocellular carcinoma. The aim of the this work was to study the effect of regular physical exercise over a period of 6 weeks on some parameters usually used to evaluate the liver condition and the activity of the disease. Patients were randomized into 3 groups; Group I: 20 patients with chronic active hepatitis due to infection with HCV and showed a significant reduction in ALT and AST levels over the period of the exercise program. Group II: 20 patients with decompensated liver condition due to HCV infection with at least one of the manifestations of liver cell failure and exhibited a bad exercise tolerance with non-significant changes in their laboratory data. Group III: 20 patients with compensated HCV liver disease were not included in the exercise program and were considered as a control group. It was concluded that physical exercise was well tolerated by HCV chronic active hepatitis patients and may be of benefit while in decompensated patients physical exercise should be restricted as much as possible