pathophysiology of esophageal affection in rheumatic diseases

This study comprised 42 Egyptian female patients, 15 RA, 15 SLE and 12 SSc patients, compared to 12 healthy subjects matched with age and sex. Esophageal manometry and upper gastrointestinal endoscopic biopsy were performed for all subjects. The results of this study revealed manometric abnormalities in the three diseases. Hypoperistalsis and diminished resting lower esophageal sphincter pressure were evident in RA and SSc patients but more severe in SSc. Hypotonic lower esophageal sphincter was the prominent feature in SLE patients. Retrograde and non-transmitted contractions were detected in a variable percentage in the three diseases. No correlation was found between manometric abnormalities and disease activity, while; there was a significant correlation between these abnormalities and disease severity in SSc patients. Reflux esophagitis was detected in 26.7% of RA and 75% of SSc patients. Histopathological study revealed esophageal mucosal damage due to chronic inflammatory process and vasculitic changes in RA and SSc. The esophagus was histopathologically normal in SLE patients

Value of single-photon-emission computed tomography scan in the diagnosis of neuropsychiatric manifestations of systemic lupus erythematosus

The aim of this study was to predict CNS affection in SLE patients using SPECT and to study the previous parameter as prognostic tool for CNS affection in SLE patients. We studied 30 SLE patients diagnosed according to the American College of Rheumatology [ACR] criteria for the classification of SLE. Ten normal healthy subjects were also included as a control group. SLE patients were categorized into 3 groups: Group I: with major NPSLE [n=7]; Group II: with minor NPSLE [n=3] and Group III: without NPSLE [n=20] Abnormal SPECT scan was found in 83% in group I, 33% in group II, normal SPECT scan in 72% in group III and normal SPECT scan in 100% in the control group

Tibial somatosensory evoked potentials as a new prognostic tool for predicting functional ambulation outcome in acute traumatic paraplegia

The study included 20 patients with post- traumatic paraplegia or paraparesis due to acute spinal cord injury with onset 72 hours to 2 weeks after trauma. Ten normal subjects of both sexes served as control. Aim of this work is to assess the efficacy and accuracy of tibial SEP as a prognostic ambulatory tool compared to clinical and radiological tools in acute paraplegic spinal cord injured individuals in order to efficiently plan the rehabilitation program. Patients underwent full medical history, thorough clinical and neurological examination according to the standards of ASIA [American Spinal Injury Association], radiological examination by X-ray, CT and/or MRI. SEP for both tibial nerves. All patients received complete rehabilitation program according to the stage of SCI. Neurological status and tibial SEP were assessed again after 12 months. Barthel score was used to grade functional outcome with assessment of ambulation status. The study revealed that 65% of patients were able to ambulate in the community at 1 year while 35% were non-ambulant at all. The initial Lower Extremity Motor Score [LEMS], pin prick sensory limb scores and tibial SEP were highly significantly correlated to the degree of ambulatory capacity finally achieved, while there was non-significant relation between the initial sense of position or CT grade with final ambulatory outcome