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Introduction: Systemic Lupus Erythematosus [SLE] is an autoimmune disease affect nearly every organ system. Pulmonary involvement, which is a common manifestation of SLE, can remain undiagnosed if asymptomatic. This study aimed to evaluate the efficiency of spirometric findings in early detection of silent pulmonary involvement and examine its correlation with the six minute walk test in SLE patients
Materials and Methods: In this cross-sectional study fifty patients, who met the American College of Rheumatology criteria for SLE, were recruited from the outpatient rheumatology clinic at the Imam Reza Hospital of Mashhad between July 2013 and September 2014. First, a checklist including demographic information and previous medical documents was completed. Then, spirometry and 6MWT was performed to evaluate subclinical pulmonary involvement and assess patients' exercise capacity
Results: Based on the results of pulmonary function tests, patients were divided into two groups. A total of 40 patients with normal pattern were placed in one group and 10 patients with restrictive pattern in the other. The difference between SLE patients with and without abnormal spirometry were statistically significant in regard to anti-RNP positivity but total distance walked in six minute, was not significantly different between two groups [p=0.356]. Additionally, there were no significant correlations between 6MWD and FVC in SLE patients in the either group as determined by Pearson's correlation coefficient testing. [R=0.439,P=0.205 in SLE patients with normal spirometry and R=0.191,P=0.237 in those with abnormal pattern] Conclusion: Considering the impact of anti-U1RNP positivity with restrictive pattern on spirometry, it can be deemed as a pulmonary involvement predictor in SLE patients. However, lack of correlation between 6MWT and spirometric parameters is suggestive of restrictive lung involvement, which in turn, demonstrates a multifactorial basis for limited exercise capacity in patients with SLE. Thus, the application of the 6MWT as a measure of pulmonary function is called into question
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Knee pain Is one of the most common reasons patients visit their physician. In this regard Magnetic Resonance Imaging [MRI] is the tool of preference for diagnosis. The aim of this study was to determine appropriate guidelines for knee MRI administration using the RAND Appropriateness Method [RAM]-2013. This qualitative study was done in the Mashhad University of Medical Sciences in 2013. The most appropriate approved knee MRI administration clinical guidelines were evaluated using Guidelines Evaluation and Research Appraisal [AGREE]. Panel members consisting of six orthopedic and three rheumatologic doctors gave scores ranging from 1 to 9 for each scenario. The indications were grouped as appropriate, equivocal and inappropriate. Data were analyzed by descriptive statistics and SPSS ver. 18 software. Sixty-three scenarios were extracted from the guidelines and then the scenarios were evaluated in 26 indications. Thirty-two [50.79%] cases were considered appropriate, 12 [19.04%] cases uncertain and 19 [30.1%] cases inappropriate. The RAND appropriateness method is helpful in identifying the opinion of stakeholders in health care systems. Moreover, making practical use of clinical guidelines can improve patients' quality of care and prevent un-necessary costs
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Introduction: Pulmonary arterial hypertension [PAH] is a late progressive sclerodermarelated complication, which can lead to right heart failure and cor pulmonale. Given that cardiac catheterization is a diagnostic method of choice for PAH, and considering the high risks of this method, the purpose of this study was to evaluate the relationship between serum Pro-Brain natriuretic peptide [Pro-BNP] Levels and PAH in patients with limited scleroderma
Materials and Methods: In this cross sectional study, during June 2011- Dec 2013, referring patients to two major educational hospitals, Mashhad- Iran, with scleroderma, who were afflicted with the disease for at least two years [or more], were enrolled in the study if they met the inclusion and exclusion criteria. All the patients underwent echocardiography to determine the pulmonary artery pressure [PAP]. Afterwards, the subjects were referred to a lung center for performing body plethysmography, carbon monoxide diffusing capacity [DLCO], and 6-minute walk test [6MWT]. Pro-BNP Serum level was determined using flourescent immune assay method
Results: The present study included 20 patients [18 female subjects] with the mean age of 43.28 +/- 9.56 yrs, and the mean pro-BNP level of 138 pg/ml. The logarithmic correlation between PAP values, Forced Vital Capacity /DLCO ratio, and pro-BNP level, which was measured using Pearson's correlation coefficient, showed a significant association among these variables[ respectively, r=0.76, P=0.001; r=0.677, P=0.011]. Moreover, the DLCO decrease was associated with increasing pro-BNP level, though this relationship was not significant
Conclusion: This study showed that there was a significant relationship between the serum levels of pro-BNP marker and increased PAP in the echocardiography, DLCO reduction, and FVC/DLCO increase. In fact, this serum marker can be used in patients with systemic scleroderma [SSc] to evaluate the status of PAH
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Background: Osteoarthritis is a degenerative joint disorder of articular cartilage and is the most common type of arthritis in the elderly. There are only a few reports regarding the use of Hydroxychloroquine in the treatment of osteoarthritis
Methods: To investigate the effects of Hydroxychloroquine on the symptoms of mild to moderate knee osteoarthritis [Kellgren and Lawrence grade II and III], we performed a double-blind, placebocontrolled study in 44 patients. The patients were randomly assigned to two groups: one group received Hydroxychloroquine pills [200 mg twice daily] and the other group received placebo pills. Symptoms were assessed by the Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] at baseline and at the end of weeks 4, 8, 12, 16, 20, and 24
Results: Approximately, 98% of the patients were women at an average age of 47 years. There was no significant difference in the baseline characteristics between the two groups. In the placebo group, maximum improvement occurred at the 4th week; and during the remaining time, there was no significant improvement. In the Hydroxychloroquine group, maximum improvement occurred at the 8[th] week and persisted over the entire remaining follow-up period. There were significant differences between the two groups regarding the degree of reduction in the WOMAC total score and the WOMAC subscales scores of pain, stiffness, and function at the end of weeks 4, 8, 12, 16, 20, and 24
Conclusion: Hydroxychloroquine conferred significant improvement in the symptoms of mild to moderate knee osteoarthritis in our patients and may, accordingly, be recommended for knee osteoarthritis treatment
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Type II diabetes is the most common metabolic disease in the world. The aim of present study wos to determine the effects of whortleberry on glucose control index and lipid profile in patients with type II diabetes. The present study was a randomized trial [IRCT: 1389]. The sample was 75 patients with type II diabetes [30 people in intervention and 45 people in control group] in Karaj-Iran. The control groups took placebo capsules [starch] and whortleberry [500 mg, twice a day after breakfast and lunch] was administered in intervention group. Vein blood samples were taken at the beginning and end of study to measure fasting blood glucose, glycosylated hemoglobin [HbA1c], insulin serum, Triglyceride, total Cholesterol and its contents. Using HOMA Score, insulin resistance was also measured. Descriptive statistics and chi-squared, T- independent, paired T and ANCOVA testes were used for data analysis. After 90 days of the intervention, there was a significant difference in FBS, two hour blood sugar [BS2hpp] and HOMA Score between Whortleberry and control group. Also In whortleberry group, in all glucose control indexes, there were significant differences After 90 days of the intervention. This study demonstrated that using of oral whortleberry supplement for adjusting blood glucose is suitable for patients with type II diabetes patients. Therefore using of it along with medical treatment can be recommended
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Glycogen storage disease [GSDs] comprise several rare inherited diseases caused by abnormalities of enzymes that regulate the synthesis of Glycogen. A- 26 years old man admitted to the hospital because of pain and swelling in his ankles. Also, he had delay of puberty. In diagnostic evaluation, the patient had hyperuricemia, hyperlipidemia and adenomatous nodules in the liver. Liver biopsy revealed Glycogen storage disease type 1. gouty arthritis in glycogen storage disease is not uncommon; however, glycogen storage disease as a reason of gouty arthritis is rare. Because of growth failure, delayed puberty and laboratory results we strongly suspected to an underlying disease as a cause of hyperuricemia and gouty arthritis leading to glycogen storage disease diagnosis
Subject(s)
Humans , Male , Arthritis, Gouty , Hyperuricemia , AnkleABSTRACT
Recent studies on human indicate that the introduction of therapeutic use of tolerogenic dendritic cell [DC] for chronic inflammatory conditions is imminent. For the purpose of defining CGRP potency in tolerogenic DC production, we investigated the phenotype and IL-12 production of DCs generated from the monocytes of rheumatoid arthritis [RA] patients in the presence of the calcitonin gene-related peptide [CDRP], as a multifunctional neuropeptide. DCs were generated from isolated monocytes from four resistant and two early female RA patients using IL-4, GM-CSF, and CGRP at concentrations of 0, 1, and 100 nM. Then, the phenotype of neuropeptide-treated or untreated DCs was determined using flow cytometry and the IL-12 production was measured by ELISA. Our study showed that, on the last day of the culture, at a concentration of 1 nM CGRP, the mean fluorescence intensity [MFI] for CD80 increased [14.13%] and the MFIs for CD83, CD86, and HLA-DR decreased [14.57%, 5.28%, and 6.88% respectively]. Moreover, at 100 nM CGRP concentration, the MFI for CD80 increased [11.10%] and the MFIs for CD83, CD86, and HLA-DR decreased [4.27%, 18.60%, and 19.75% respectively]. In addition, our results indicated that the mean concentrations of IL-12 produced at 0, 1, and 100 nm CGRP concentrations measured 13.72 +/- 2.41, 11.01 +/- 1.61, and 7 +/- 1.34 pg/ml respectively. Decreased CD83, CD86, and HLA-DR expression and reduced IL-12 production by CGRP were found in the RA patients' monocyte-derived DCs. CD83 is a well-defined DC activation marker. HLA-DR and CD86 are appropriate molecules for inducing an immune response. IL-12 promotes cell-mediated immunity. Therefore we suggest that CGRP may be used as an inducer in the production of tolerogenic DCs