Continual infusion of intrathecal baclofen [ITB]: long term effect on spasticity

Spasticity is a disorder of muscular function causing muscular tightness or spasm which occurs when there is damage to the central nervous system whether it is of spinal cord or brain origin. This insult could be either pathological or traumatic. Thirty-three patients had intrathecal Baclofen pumps implanted for severe spasticity. These patients either did not respond to or tolerate oral medications. All patients showed significant improvement in their spasms following the procedure. Improvement was noted not only in spasticity, but also in pain, management of sleep disturbance, activities of daily living, indoor and outdoor mobility and behavior. The number of complications was acceptable, and generally were not lifethreatening. Infection was the significant complication in two patients and this led to explantation of their pumps. Patient satisfaction was very high and was related to improvement in the quality of life for the patients

Serum levels of hyaluronic acid [HA] and cartilage oligomeric matrix protein [COMP] as predictors of disease progression in rheumatoid arthritis

To measure the serum concentrations of specific cartilage and bone molecules reflecting tissue turnover to investigate disease activity. The study included 30 rheumatoid arthritis [RA] patients with age range 42 - 66 years. Sixteen patients had rapid erosive disease and fourteen had slow erosive, compared with 20 matched apparently healthy volunteers. All studied individuals were subjected to full history taking, clinical examination and laboratory investigations including measurement of serum levels of cartilage oligomeric matrix protein [COMP], hyaluronic acid [HA], high sensitive C- reactive protein [CRP], erythrocyte sedimentation rate [ESR] and RF concentration as well as measurement of activity of RA by disease activity score [DAS] 28 joint counts. The study showed a significantly higher values of COMP, HA, CRP and ESR in slow erosive [p<0.001] and rapid erosive [p<0.0001] RA patients when compared to controls. There were significantly higher values of COMP, HA, CRP and ESR in rapid erosive RA patients compared to slow erosive RA patients. A significant positive correlation between serum levels of COMP and HA and age, disease duration, Larsen score, DAS and CRP and ESR was found. Also there was a significant positive correlation between serum levels of COMP and HA [r = 0.674, p<0.01]. It could be concluded that the measurement of some serological biomarkers that reflect bone and cartilage destruction in RA patients, could be used to investigate disease activity and increase the knowledge of the basic pathophysiology of joint disease