effect of conditioning exercise on the health status and pain in patients with rheumatoid arthritis: a randomized controlled clinical trial

Rheumatoid Arthritis [RA] is a systemic and inflammatory disease of unknown etiology which is mostly characterized by inflammation of the synovial joints. Studies have proved that most people with RA avoid doing physical activities due to fear that it may worsen the pain or cause pressure on joints, resulting in decreased muscle strength and ultimately leading to disability of patients. We aimed to investigate the effects of conditioning exercises on the health status and pain in patients suffering from RA. In this randomized controlled clinical trial, we enrolled 66 women with confirmed RA referred to the rheumatology clinic of Hafez hospital, Shiraz, southwest Iran during May-July 2013. Balanced block randomization method was used to randomize the participants into case and control groups [two groups of 33 each].Data were collected using visual analog scale [VAS], Arthritis Impact Measurement Scales 2 short form [AIMS2-SF], and demographic questionnaire. After obtaining written informed consent, the participants in the case group were asked to participate in conditioning exercise programs including aerobic, isometric, and isotonic exercises and received a training booklet explaining the exercises that they could do at home after the intervention. There was a statistically significant difference between the health status scores of the patients in the case groups before and after the intervention [P=0.001]. The pain score also decreased significantly in the case group compared with the control group after the intervention [P=0.003]. We concluded that physical training programs, especially conditioning exercises, could improve the health status and reduce pain in patients with RA

Anti-cardiolipin and anti-neutrophil cytoplasmic antibodies in Iranian patients with behcet's disease

The prevalence of anti-Neutrophil Cytoplasmic Antibodies [ANCAs] and anti-Cardiolipin Antibodies [anti-CL Ab] in Behcet's Disease [BD] and also their roles in vascular involvement is controversial. To assess the prevalence of ANCAs and anti-CL Ab as well as their correlations with clinical manifestations in Iranian patients with BD. In this case/control study, the sera from 88 patients with BD and 88 healthy controls were evaluated. The levels of ANCAs and anti-CL Ab were measured using indirect ELISA method. The levels of anti-CL, anti-PR3 and anti-MPO [Myeloperoxidase] IgG autoantibodies between BD patients and healthy controls were not statistically different [p=0.21, p=0.28 and p=0.74, respectively]. In addition, there were no significant deferences between BD patients with and without vascular involvement in the levels of anti-CL [1.42 +/- 1.24 GPLU/ml and 1.58 +/- 1.18 GPLU/ml, respectively; p=0.71], anti-PR3 [0.0 +/- 0.0 U/ml and 0.08 +/- 0.27 U/ml, respectively; p=0.10] and anti MPO [0.48 +/- 0.23 U/ml and 0.52 +/- 0.22 U/ml, respectively; p=0.41] IgG autoantibodies. Nevertheless, mean titer of anti-CL IgG was higher in male patients with skin rash than those without skin rash [2.2 +/- 0.88 GPLU/ml and 1.11 +/- 1.22 GPLU/ml, respectively; p=0.017]. While anti-CL, antiPR3 and anti-MPO IgG autoantibodies do not play a major role in susceptibility to BD or pathogenesis of vascular involvement in our patients, anti-CL Ab might be involved in skin lesion development in Iranian male BD patients. However, the results should be confirmed in other studies

Anticardiolipin antibody in patients with Behcet's disease with and without vascular thrombosis

The clinical value of IgG anticardiolipin antibody in patients with Behcet's disease with or without vascular thrombosis was evaluated. IgG isotype of anticardiolipin [aCL] antibody was assessed in 40 Behcet's disease [BD] patients with venous or arterial thrombosis, 40 BD patients without venous or arterial thrombosis and 80 healthy subjects as controls. The levels of IgG aCL were determined by an indirect ELISA method. Color Doppler Sonography, Magnetic Resonance Imaging and conventional angiography were the procedures used for other clinical evaluations. Out of 40 patients with vascular thrombosis, 20[50%] were positive for low to moderate level of IgG aCL. In patients without thrombosis 22[55%] were positive for low to moderate level of IgG aCL while in none [0%] of the healthy subjects the IgGaCL was positive, neither low nor moderate. The number of patients with headache but having a normal cerebral magnetic resonance imaging [MRI], was higher in anticardiolipin positive patients without vascular thrombosis as compared to those with vascular thrombosis, [P = 0.001].Arthritis was noticed in both patents groups. 15% of aCL positive patients without thrombosis had arthritis as compared to none in aCL negative patients without thrombosis [P = 0.02]. The results of this study indicate that although the frequency of IgG aCL was found to be higher in Iranian patients with BDin comparison with the previous reports, except in arthritis the observed elevated IgG aCL does not correlate with clinical disease manifestations, or vascular thrombotic complications