Relationship between electrodiagnostics, MRI findings and clinical picture in lumbar canal stenosis

To study the relationship between the electrodiagnostic and the MRI findings of the lumbar spine and to correlate them to the clinical features in patients with degenerative lumbar spinal stenosis [LSS]. Fifty-six patients diagnosed as having LSS, on the basis of typical clinical features and compatible MRI findings, were included in this study. In addition to history and examination, patients were assessed for disease severity using the maximal walking distance and the visual analogue scale. MRI parameters of lumbar spinal stenosis were assessed. Needle electromyography of the paraspinal muscles and nerve conduction studies including F-wave and H-reflex were performed. Patients were 33 males and 23 females. The body mass index statistically significantly correlated with the patient scores on the visual analogue scale. No significant relation could be detected between age, sex, duration of disease and disease severity. Both of the smallest and the smallest two anteroposterior spinal canal diameters showed no statistical significant correlation with the disease severity. The fibrillations in electromyographic testing statistically highly significantly [p<0.001] negatively correlated with the maximal walking distance and positively correlated with the patient scores on the visual analogue scale. It also statistically highly significantly correlated with the age. MRI findings are related to the diagnosis but not to severity ot the clinical lumbar spinal stenosis. Electrophysiologic studies especially paraspinal muscles denervation potentials seem to be a more sensitive criterion in assessing the severity of symptoms in patients with LSS

Prevalence and risk factors of carotid plaques detected with B-mode ultrasound in rheumatoid arthritis

To determine the prevalence of increased intima-media thickness [IMT] of the carotid arteries and its relationships with classical atherosclerosis risk factors and disease features in patients with rheumatoid arthritis [RA]. Twenty female RA patients were included in the study. All patients were subjected to full history taking, thorough clinical examination and laboratory investigations. In addition, intima-media thickness [IMT] and presence of carotid plaques were assessed using carotid B-mode ultrasound. Presence of traditional cardiovascular [CV] risk factors was also investigated. Plaques could be detected in 40% of our patients. There was a statistically highly significant correlation between the presence of plaques and patients' age, disease duration and deformed joint count [p<0.001]. There was also a statistically significant relationship between the presence of plaques and increased ESR and CRP levels, lower body mass index, presence of diabetes mellitus, hypertension, hypercholesterolemia and higher cumulative glucocorticoid doses [P<0.05]. It did not correlate significantly with tender or swollen joint count, subcutaneous nodules or rheumatoid factor positivity. Increased IMT was statistically significantly correlated with age, disease duration, ESR, diabetes mellitus, hypertension and hypercholesterolemia. RA patients with carotid plaques had significantly longer disease duration, higher deformed joint count, higher ESR, higher levels of CRP and higher cumulative glucocorticoid dose than those without plaque. Increased IMT was correlated with the disease duration and ESR. These findings suggest that there is increased risk of atherosclerosis in patients with rheumatoid arthritis especially those with more severe disease and longer disease duration

Plasma adrenomedullin level in systemic lupus erythematosus patients and its relation to disease activity and lupus nephritis

To study the plasma adrenomedullin [AM] level in systemic lupus erythematosus [SLE] patients and investigate its relation to disease activity and lap us nephritis. Taking, thorough clinical examination, laboratory investigations, disease activity assessment using SLE Disease Activity Index [SLEDAI] and plasma AM assay. Renal histopathology was done for the patients with overt renal involvement. Patients were divided into two subgroups: subgroup [1a] included patients with a history of renal involvement, and subgroup [1b] included patients without renal involvement. Ten age and sex-matched healthy subjects were included as a control group. SLE patients had highly significant higher plasma AM concentration than controls. In SLE patients, there was significant positive correlation between plasma AM concentration and each of SLEDAI and prednisolone dose. On the other hand, plasma AM concentration didn't show significant correlation with age, SLE disease duration, creatinine, proteinuria, C3 and C4. Subgroup [1a] had statistically significant higher plasma AM concentration and higher SLEDAI with increased proteinuria and creatinine than subgroup [1b]. SLE patients had higher plasma AM concentration than controls. SLE patients with a history of renal involvement had significant higher plasma AM concentration than those without renal involvement. These results suggest that AM has a role in the pathogenesis of SLE and lupus nephritis