Sex hormones in relation to bone mineral density and bone turnover markers in rheumatoid patients

To study the changes in serum and salivary testosterone in rheumatoid arthritis [RA] patients and their implication on bone mineral density [BMD] and bone turnover markers. The above mentioned hormonal levels were measured in fifty post-menopausal RA women [thirty patients with glucocorticoid therapy and twenty treated with other drugs]. Bone turnover markers were also assessed namely Carboxy terminal cross linked telopeptide of type I collagen [ICTP] and carboxy terminal propeptide of type I procollagen [PICP] as well as their relation to BMD was assessed. Although serum and salivary testosterone were higher than controls, there was no significant difference between patients and controls. We observed significantly lower salivary testosterone level in RA on steroids as compared to those not taking steroids. Also salivary testosterone correlated with lumbar BMD and inversely with ICTP

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

Prevalence of staphylococci in rheumatoid arthritis patients

Recent studies suggested that staphylococcal exotoxin may be involved in the pathogenesis of rheumatoid arthritis. The objective of this study was to determine the prevalence of oral staphylococcal carriage in patients with RA compared with healthy controls. This study was performed on 27 patients with RA and 25 healthy volunteers. Clinical and laboratory data of RA activity were studied. Tongue and anterior nasal swabs were obtained for culture on blood agar. Isolates of staphylococci were identified and collected from oral cavity of 96.3% of RA patients, 53.8% of whom carried staphy. aureus. On the other hand 88% of the healthy volunteers showed staphylococci, 36.4% of whom carried staph aureus. The carriage rate of staph aureus was significantly higher in RA patients than in healthy controls [P<0.05]. So we conclude that the oral carriage of staph. aureus was common in patients with RA. This may be the source of septic arthritis in such patients

possible prognostic role of VCAM-1 in stroke patients

The vascular endothelium promotes inflammation through the up-regulation of inflammatory leukocyte-endothelial cell adhesion molecules such as intercellular adhesion molecule-1 [ICAM-1], vascular cell adhesion molecule-1 [VCAM-1] and E-selectin. These molecules bind to circulating leucocytes and facilitate their migration into the Central Nervous system CNS. In the CNS, these cells produce a number of cytotoxic molecules that may facilitate cell death and increase the infarct volume. To define the extent of expression of VCAM-1 in correlation to the clinical disability and outcome in stroke patients. Complete lipid profile, fibrinogen assay, lipoprotein [a] and FIM were determined in 25 recent stroke patients at the time of admission and compared with 15 matched apparently healthy control subjects. The difference between the mean total cholesterol [TC] level of patients and controls was not significant. However, high density lipoprotein [HDL] was significantly lower in patients as compared to controls but low density lipoprotein LDL was significantly higher. The concentration of Lp [a] and fibrinogen level, were significantly higher in the patients' group than controls. The concentration of VCAM-1 was significantly higher in stroke patients as compared to controls. Multiple regression analysis was performed to assign the predictors for functional independence measures [FIM] as a clinical outcome for the functional disability. The independent parameters were the duration of stroke as well as the laboratory tests [lipid profile, Lp [a], fibrinogen and VCAM-1]. The duration of stroke and VCAM-1 level negatively correlated with FIM, meaning that patients with high VCAM-1 level demonstrated more functional disability as manifested by low FIM score. The most sensitive parameters that can predict FIM were the duration of stroke and VCAM-1 level. Further research on the role of inflammatory CAMs in the pathogenesis of ischemic cerebrovascular disorders should lead to new diagnostic and therapeutic strategies in an attempt to reduce leukocyte-induced damage in stroke