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Imaging in ankylosing spondylitis  

DEFF Research Database (Denmark)

Imaging is an integral part of the management of patients with ankylosing spondylitis and axial spondyloarthritis. Characteristic radiographic and/or magnetic resonance imaging (MRI) findings are key in the diagnosis. Radiography and MRI are also useful in monitoring the disease. Radiography is the conventional, albeit quite insensitive, gold standard method for assessment of structural damage in spine and sacroiliac joints, whereas MRI has gained a decisive role in monitoring disease activity in clinical trials and practice. MRI may also, if ongoing research demonstrates a sufficient reliability and sensitivity to change, become a new standard method for assessment of structural damage. Ultrasonography allows visualization of peripheral arthritis and enthesitis, but has no role in the assessment of axial manifestations. Computed tomography is a sensitive method for assessment of structural changes in the spine and sacroiliac joints, but its clinical utility is limited due to its use of ionizing radiation andlack of ability to assess the soft tissues. It is exciting that with continued dedicated research and the rapid technical development it is likely that even larger improvements in the use of imaging may occur in the decade to come, for the benefit of our patients.

Østergaard, Mikkel; Lambert, Robert G W

2012-01-01

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Conventional treatments for ankylosing spondylitis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Management of ankylosing spondylitis (AS) is challenged by the progressive nature of the disease. To date, no intervention is available that alters the underlying mechanism of inflammation in AS. Currently available conventional treatments are palliative at best, and often fail to control symptoms in the long term. Current drug treatment may perhaps induce a spurious state of "disease remission," which is merely a low level of disease activity. Non-steroidal anti-inflammatory drugs are first ...

Dougados, M.; Dijkmans, B.; Khan, M.; Maksymowych, W.; Linden, S.; Brandt, J.

2002-01-01

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Diagnosis of Ankylosing Spondylitis  

Science.gov (United States)

... stiffness worsen with immobility, especially at night and early morning. The back pain and stiffness tend to ease with physical activity and exercise. Positive response to NSAIDs (nonsteroidal anti-inflammatory drugs). A physical examine will entail looking for ...

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Spinal instability in ankylosing spondylitis  

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Full Text Available Background: Unstable spinal lesions in patients with ankylosing spondylitis are common and have a high incidence of associated neurological deficit. The evolution and presentation of these lesions is unclear and the management strategies can be confusing. We present retrospective analysis of the cases of ankylosing spondylitis developing spinal instability either due to spondylodiscitis or fractures for mechanisms of injury, presentations, management strategies and outcome. Materials and Methods: In a retrospective analysis of 16 cases of ankylosing spondylitis, treated surgically for unstable spinal lesions over a period of 12 years (1995-2007; 87.5% (n=14 patients had low energy (no obvious/trivial trauma while 12.5% (n=2 patients sustained high energy trauma. The most common presentation was pain associated with neurological deficit. The surgical indications included neurological deficit, chronic pain due to instability and progressive deformity. All patients were treated surgically with anterior surgery in 18.8% (n=3 patients, posterior in 56.2% (n=9 patients and combined approach in 25% (n=4 patients. Instrumented fusion was carried out in 87.5% (n=14 patients. Average surgical duration was 3.84 (Range 2-7.5 hours, blood loss 765.6 (± 472.5 ml and follow-up 54.5 (Range 18-54 months. The patients were evaluated for pain score, Frankel neurological grading, deformity progression and radiological fusion. One patient died of medical complications a week following surgery. Results: Intra-operative adverse events like dural tears and inadequate deformity correction occurred in 18.7% (n=3 patients (Cases 6, 7 and 8 which could be managed conservatively. There was a significant improvement in the Visual analogue score for pain from a pre-surgical median of 8 to post-surgical median of 2 (P=0.001, while the neurological status improved in 90% (n=9 patients among those with preoperative neurological deficit who could be followed-up (n =10. Frankel grading improved from C to E in 31.25% (n=5 patients, D to E in 12.5% (n=2 and B to D in 12.5% (n=2, while it remained unchanged in the remaining - E in 31.25% (n=5, B in 6.25% (n=1 and D in 6.25% (n=1. Fusion occurred in 11 (68.7% patients, while 12.5% (n=2 had pseudoarthrosis and 12.5% (n=2 patients had evidence of inadequate fusion. 68.7% (n=11 patients regained their pre-injury functional status, with no spine related complaints and 25% (n=4 patients had complaints like chronic back pain and deformity progression. In one patient (6.2% who died of medical complications a week following surgery, the neurological function remained unchanged (Frankel grade D. Persistent back pain attributed to inadequate fusion/ pseudoarthrosis could be managed conservatively in 12.5% (n=2 patients. Progression of deformity and pain secondary to pseudoarthrosis, requiring revision surgery was noted in one patient (6.2%. One patient (6.2% had no neurological recovery following the surgery and continued to have nonfunctional neurological status. Conclusion: In ankylosing spondylitis, the diagnosis of unstable spinal lesions needs high index of suspicion and extensive radiological evaluation Surgery is indicated if neurological deficit, two/three column injury, significant pain and progressive deformity are present. Long segment instrumentation and fusion is ideal.

Badve Siddharth

2010-01-01

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Traumatic death in ankylosing spondylitis  

DEFF Research Database (Denmark)

Ankylosing spondylitis (AS) is a chronic rheumatic disease that causes spinal rigidity with an increased risk of spinal fractures. We present a case report where a middle-aged man, in apparent good health, died following a fall from his bike. Postmortem computed tomography (CT) showed several fractures in the cervical and thoracic spine, with displacement into the spinal canal as well as spinal changes consistent with AS. The cause of death was determined to be upper spinal cord injury caused by cervical spinal fractures that were facilitated by spinal rigidity from AS. Further investigation into the medical records revealed that the decedent had previously been treated for AS. This case report illustrates the importance of obtaining a detailed medical history when investigating deaths, including nonfatal conditions, such as AS. Furthermore, it shows the value of CT in the evaluation of the mechanism and manner of death.

Thomsen, Asser H; Jurik, Anne Grethe

2010-01-01

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Bone scintigraphy in ankylosing spondylitis  

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Twelve patients with ankylosing spondylitis (11 males and one female) were examined by both bone scintigraphy and dual energy X-ray absorptiometry (DEXA). Bone scintigraphy revealed increased accumulation in the sacroiliac joint in 6 patients, the spines in 10, and the other joints, including the sternoclavicular joint, in 8 patients. Each one patient had an intense tracer uptake in the finger and toe joints. In 4 patients in whom DEXA was concurrently performed at the level of 2nd to 4th lumbar vertebrae, there was no consistent tendency for mean bone mineral density. In 2 of 3 patients receiving DEXA for the radius, bone marrow density was within the normal range. (N.K.).

Otsuka, Nobuaki; Fukunaga, Masao; Tomomitsu, Tatsushi (Kawasaki Medical School, Kurashiki, Okayama (Japan)); Morita, Rikushi

1991-10-01

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Evidence-based recommendations for the diagnosis of ankylosing spondylitis: results from the Australian 3E initiative in rheumatology.  

Science.gov (United States)

As part of the 3E program, we conducted a systematic literature review and gathered consensus from 23 practising Australian rheumatologists to develop guidelines for early identification of ankylosing spondylitis and specialist referral. In three rounds of break-out sessions followed by discussion and voting, the specialist panel addressed three questions related to diagnosis of ankylosing spondylitis: In individuals with back pain, what are the early clinical features that suggest ankylosing spondylitis? How useful is imaging in identifying early ankylosing spondylitis? Based on which clinical features should a general practitioner refer a patient to a rheumatologist for further evaluation? The panel agreed on six recommendations related to the three questions: 1a. Early clinical features to suggest ankylosing spondylitis include inflammatory back pain and age at symptom onset rule out the diagnosis of ankylosing spondylitis. 2a. Despite low sensitivity to detect changes of early ankylosing spondylitis, plain radiographs of the pelvis and spine are appropriate initial imaging techniques. 2b. Magnetic resonance imaging is a useful imaging modality for detecting early changes of ankylosing spondylitis. 3. Individuals with inflammatory back pain should be referred to a rheumatologist for further evaluation. Effective dissemination and implementation of these recommendations are important to standardise the approach to early diagnosis of ankylosing spondylitis. PMID:18279132

Kain, Tracey; Zochling, Jane; Taylor, Andrew; Manolios, Nicholas; Smith, Malcolm D; Reed, Mark D; Brown, Matthew A; Schachna, Lionel

2008-02-18

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Magnetic resonance imaging for ankylosing spondylitis  

International Nuclear Information System (INIS)

Ankylosing spondylitis (AS) is the prototypical form of the spondyloarthropathies, which at a prevalence of 2% is among the most frequent rheumatic diseases. Spondyloarthropathy comprises the following five disorders: AS, reactive arthritis, psoriatic arthritis, enteropathic arthritis in Crohn's disease, and ulcerosing colitis as well as undifferentiated spondyloarthropathy. In 99% of the patients with AS initial abnormal findings affect the sacroiliac joints. The radiographic changes required for diagnosing AS occur as late as 5-9 years after the onset of clinical symptoms. MRI of the sacroiliac joints reliably demonstrates both chronic inflammatory changes (erosions, sclerotic changes, bone bridges) and acute inflammatory changes (synovitis, capsulitis, osteitis) and allows for grading the chronicity and acuity of such changes. Enthesitis of the interosseous ligaments of the retroarticular space is a manifestation of AS. Spondylodiscitis (Andersson 1937) may occur as an inflammatory or non-inflammatory process (transdiscal fatigue fracture). Inflammations of the facet and costospinal joints developing into ankylosis are typical of AS. Changes of the vertebral bodies occur as anterior (Romanus 1952), posterior, and marginal spondylitis. All forms of spondyloarthropathies are furthermore characterized by asymmetrical synovitis of the large joints, particularly of the legs (gonarthritis, coxitis, tarsitis, peripheral oligoarthritis), rheumatic fibroosteitis (pelvic entitis), rheumatic fibroosteitis (pelvic enthesitis, rheumatic calcaneopathy), and peri- and synchrondritis of the public symphisis and sternal synchondrosis. Since early inflammatory changes of the spinal column and of the extravertebral localizations in AS are demonstrated by MRI before they become apparent on radiographs, and thereby the diagnostic gap could be closed, the early use of MRI for diagnostic and follow-up is commendable, when new therapeutical options like the so-called 'biologicals' are employed. (orig.)

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Ankylosing Spondylitis and Postural Balance  

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Full Text Available Objective: In this study, we aimed to investigate that, due to postural changes, the patients with ankylosing spondyilitis (AS have poorer postural balance than healthy subjects.Materials and Methods: Thirty patients with AS (19 female, 11 male and 20 healthy subjects (13 female, 7 male were tested by using the Tetrax Interactive Balance System. The general stability, Fourier analysis showing patterns of sway intensity within eight frequency bands between 0.1 and 3 Hz, and weight distribution index (WDI were evaluated. Data were also compared with disease duration and finger-floor distance, occiput-wall distance and Schober test. Statistical analyses were performed using SPSS 11.0 for Windows program. Mann-Whitney U test was used to compare groups and Pearson Correlation analysis was used for correlation. Results: There was no statistically significant difference on general stability, Fourier analysis scores, WDI between patients with AS and healthy subjects. A negative correlation was found between Schober test and general stability score. (r=-0,390 p=0,03. No other correlations were found between stability scores, Fourier analyses scores, WDI and occiput-wall distance, finger-floor distance and disease duration.Conclusion: The patients with AS have good postural balance. Disease duration and quantitative measurements of posture do not affect postural balance.

Mahmut Nafiz Akman

2008-09-01

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Concomitance of Ankylosing Spondylitis and Multiple Sclerosis: A Case Report  

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Full Text Available Multiple sclerosis and ankylosing spondylitis are two autoimmune diseases in which genetic and environmental factors play an important role in the etiopathogenesis. It has been shown in various studies that multiple sclerosis may be associated with various autoimmune pathological conditions such as thyroid disease and pernicious anemia. Moreover, other rheumatic diseases such as rheumatoid arthritis and lupus have been reported to be associated with multiple sclerosis. Also concomitant ankylosing spondylitis patients have been observed among reports in the medical literature. In this case report, a male patient, 39 years old, who was diagnosed as having ankylosing spondylitis and multiple sclerosis has been presented. The etiology and therapy approaches of the concomitance of ankylosing spondylitis and multiple sclerosis were discussed in the light of clinical findings of the case.

Nurettin TA?TEK?N

2009-03-01

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Intravenous methylprednisolone pulse therapy in ankylosing spondylitis.  

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For several years the medical treatment of active ankylosing spondylitis (AS) has been NSAID because gold, penicillamine, antimalarials and steroids have been without efficacy. In 1981, Mintz et al reported that methylprednisolone pulse therapy (MPPT) had an excellent effect in patients with AS. Seven patients with active AS and insufficient efficacy of NSAID for three months were treated with one gram methylprednisolone daily given intravenously for three successive days. Mobility and pain were recorded before, during, and after treatment. Significant pain relief and improvement of mobility of the spine for at least six weeks were clearly demonstrated (p less than 0.05). Finger to floor distance and chin manubrium distance improved significantly for at least six months (p less than 0.05). We conclude that intravenous MPPT is a useful treatment in patients with active AS when NSAID is insufficient. PMID:4042697

Ejstrup, L; Peters, N D

1985-08-01

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Juvenile ankylosing spondylitis in Turner syndrome.  

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Juvenile ankylosing spondylitis (JAS) is a chronic autoimmune disorder which causes considerable morbidity when left untreated; it occurs predominantly in men. We describe an Asian Indian woman who had JAS with phenotypic features of Turner syndrome (TS) and was found to be a mosaic for 45, X/46, X, psu idic (X) (p11) by karyotyping and fluorescence in situ hybridization (FISH) studies of peripheral blood. The absence of Y chromosome material was confirmed by FISH. Haplo-insufficiency of the X chromosome can predispose to autoimmunity. To the best of our knowledge, this is the first report of JAS in association with mosaic Turner syndrome. This case highlights the possible effects of gene dosage in development of an autoimmune disease. PMID:25073991

Sandhya, P; Danda, Debashish; Danda, Sumita; Srivastava, Vivi M

2013-01-01

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Ankylosing spondylitis. Not just another pain in the back.  

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Full Text Available OBJECTIVE: To review recent developments in diagnosis and treatment of ankylosing spondylitis (AS. QUALITY OF EVIDENCE: Level I evidence from three randomized placebo-controlled trials shows that AS is highly responsive to anti-tumour necrosis factor-alpha (anti-TNFalpha therapies when the standard approach of nonsteroidal anti-inflammatory drugs (NSAIDs and physical modalities fails. MAIN MESSAGE: Ankylosing spondylitis is associated with disability comparable to that of rheumatoid arthritis. Diagnosis should first focus on eliciting a history of nocturnal back pain, diurnal variation in symptoms with prolonged morning stiffness, and a good response to NSAID therapy. Physical examination is often unrevealing. Pelvic x-ray results are often normal in early disease. Magnetic resonance imaging is the most sensitive imaging technique for detecting early inflammatory lesions and should be considered when history supports the diagnosis but results of plain radiography are normal. When patients have failed at least two courses of NSAID therapy, anti-TNF(alphatherapies are of proven benefit. CONCLUSION: New magnetic resonance imaging techniques and highly effective therapies make AS more readily detectable and managable.

Maksymowych WP

2004-02-01

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Autoimmune thyroid disease in ankylosing spondylitis.  

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Although autoimmune thyroid disease is well known to be associated with primary Sjögren's syndrome (SjS) and with various autoimmune diseases, it is less clear whether a similar association also exists for ankylosing spondylitis (AS). Therefore, we investigated the frequency of autoimmune thyroid disease in patients with AS. In this cross sectional study, 80 patients with AS fulfilling the 1984 Modified New York Criteria and 80 healthy subjects, age and sex-matched with AS patients, were included. As the positive control group, 62 female patients with primary SjS were also studied. All cases underwent thyroid ultrasonography (USG) by a single endocrinologist. Thyroid function tests and thyroid autoantibodies were measured. The diagnosis of Hashimoto's thyroiditis (HT) was made if the patient had thyroid autoantibody positivity plus at least one of the following criteria: diffuse goiter with physical examination, abnormality in thyroid function tests, and parenchymal heterogeneity with USG. The chi-squared test and Fisher's exact test were used to compare cases and controls. The p values hypothyroidism was detected only in a single patient. Frequency of autoimmune thyroid disease was significantly higher in AS group, compared to healthy controls. Prospective studies are needed to see the clinical relevance of these findings and outcome in the long term. PMID:24384825

Emmungil, Hakan; Erdogan, Mehmet; Kalfa, Melike; Karabulut, Gonca; Kocanaogullar?, Hayriye; Inal, Vedat; Aksu, Kenan; Oksel, Fahrettin; Kabasakal, Yasemin; Keser, Gokhan

2014-07-01

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Ankylosant spondylitis association and diffuse idiopathic skeletal hyperostosis (DISH)  

International Nuclear Information System (INIS)

We are presenting a 66 year-old patient complaining of low back pain for the last 3 months and cervical pain for the last 45 days, Review of systems showed long standing lumbar and cervical stiffness, Radiological studies were compatible with ankylosing spondylitis and DISH (Diffuse idiopathic Skeletal Hyperostosis). Associations of those diseases are uncommon and reported only few times in the literature

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Effect of Pilates training on people with ankylosing spondylitis.  

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The objective of this study was to investigate the effects of Pilates on pain, functional status, and quality of life in patients with ankylosing spondylitis. The study was performed as a randomized, prospective, controlled, and single-blind trial. Fifty-five participants (30 men, 25 women) who were under a regular follow-up protocol in our Rheumatology Clinic with the diagnosis of AS according to the modified New York criteria were included in the study. The participants were randomly assigned into two groups: in group I, Pilates exercise program of 1 h was given by a certified trainer to 30 participants 3 times a week for 12 weeks, and in group II, designed as the control group, 25 participants continued previous standard treatment programs. In groups, pre-(week 0) and post treatment (week 12 and week 24) evaluation was performed by one of the authors who was blind to the group allocation. Primary outcome measure was functional capacity. Evaluation was done using the Bath Ankylosing Spondylitis Functional Index (BASFI). Exploratory outcome measures were Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Chest expansion, and ankylosing spondylitis quality of life (ASQOL) questionnaire. In group I, BASFI showed significant improvement at week 12 (P = 0.031) and week 24 (P = 0.007). In group II, this parameter was not found to have significantly changed at week 12 and week 24. Comparison of the groups showed significantly superior results for group I at week 24 (P = 0.023). We suggest Pilates exercises as an effective and safe method to improve physical capacity in AS patients. Our study is the first clinical study designed to investigate the role of Pilates method in AS treatment. We believe that further research with more participants and longer follow-up periods could help assess the therapeutic value of this popular physical exercise method in AS. PMID:21499876

Altan, L; Korkmaz, N; Dizdar, M; Yurtkuran, M

2012-07-01

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Comparison of X-ray, CT and MRI in detection of abnormal sacroiliac joint changes in patients with early stage of ankylosing spondylitis  

International Nuclear Information System (INIS)

Objective: To compare X-ray, CT, and MRI in detection of abnormal sacroiliac joint changes in patients with early stage of ankylosing spondylitis (AS). Methods: Fifty-three patients with clinical suspected early stage of AS underwent X-ray and MRI scan. MR scan sequences for the sacroiliac joints consisted of T1-weighted, T2-weighted, short time inversion recovery (STIR) and three dimensional balance turbo field echo with water selective excitation (3D-BTFE-WATS) in all patients. In 24 of the patients, fat-saturated contrast-enhanced T1-weighted was used. Twenty-five of 53 patients underwent CT scan. The Chi-square test was used to analyse the uniformity of bone erosions detected by X-ray, CT, and MRI. Results: Of the 106 sacroiliac joints in 53 patients, 16 sacroiliac joints with bone erosions were detected by X-ray and 63 sacroiliac joints by MRI. Of the 50 sacroiliac joints in 25 patients, 26 sacroiliac joints with bone erosions were found by CT. With regard to the detection of bone erosions, there was no difference between Cf and MRI (?2=0.16, P>0.05) and there was significant difference between CT and X-ray or MRI and X-ray (?2=14.44 and 17.36, P<0.05). 3D-BTFE-WATS was better than other sequences in detection of bone erosions. Acute inflammatory changes were determined by MRI, which included subchondral bone marrow edema in 32 patients, synovitis in 35 patients, fat depositions in 16 patients, enthesitis in 15 patients, capsulitis in 9 patients, and cartilaginous disruption in 31 patients. Conclusions: MRI can detect acute inflammatory changes that can not display by X-ray and CT. Compared with radiography and CT, MRI is more useful in detection of abnormal sacroiliac joint changes in patients with early stage of AS. (authors)

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Polyarthritis flare in patient with ankylosing spondylitis treated with infliximab  

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Full Text Available Over the last ten years, the treatment of seronegative spondyloarthropathies has changed dramatically with the introduction of the anti-tumor necrosis factor alpha (TNF? agents. Nevertheless, there is a growing number of studies describing several adverse reactions in patients treated with biological agents. In the present report we describe the case of a 22-year-old male patient with ankylosing spondylitis who developed a “paradoxic” adverse reaction, while receiving infliximab.

E. Filippucci

2011-06-01

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Ankylosing spondylitis in an athlete with chronic sacroiliac joint pain.  

Science.gov (United States)

Ankylosing spondylitis is a disease in which inflammation of joints, most often in the axial skeleton, can lead to reactive fibrosis and eventual joint fusion with associated immobility and kyphosis. The disease often involves extra-articular features, such as uveitis and aortic regurgitation, as well as associated inflammatory conditions of the intestines. Its etiology is unknown. Ankylosing spondylitis most commonly presents in young males (15-30 years old) as persistent low back pain and stiffness that is worse in the morning and at night and improves with activity. The authors report the case of a young male athlete whose symptoms were initially incorrectly diagnosed as sacroiliac joint instability and dysfunction and later as a sacroiliac stress fracture before further workup revealed a seronegative spondyloarthropathy and the diagnosis of ankylosing spondylitis. The patient was prescribed oral indomethacin daily by the attending rheumatologist and started on a slow progression of return to running, jumping, and weight lifting. Within 4 weeks of beginning this treatment, the patient had complete cessation of pain with the medication. At follow-up 1 year after graduation from his university, the patient was nearly symptom free and working in a non-heavy labor job. The purpose of this case report is to remind sports medicine physicians of the prevalence of rheumatologic diseases in general and ankylosing spondylitis in particular and of the various ways in which spondyloarthropathies may present in athletes. Increased suspicion may lead to earlier diagnosis and treatment, potentially reducing illness severity and duration and improving the performance of athletes with this condition. PMID:24679210

Miller, Timothy L; Cass, Nathan; Siegel, Courtney

2014-02-01

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99mTc-MDP scintigraphy in ankylosing spondylitis.  

Science.gov (United States)

99mTechnetium-MDP bone scintigrams in 11 patients with ankylosing spondylitis were reviewed. Increased activity in sacroiliac joints was present in five of 11 cases, all of whom had symptoms of less than 5 years duration. Patients with longstanding disease had normal or low sacroiliac joint activity. In the spine, appearances included diffuse symmetrical, unifocal or multifocal asymmetrical increased uptake involving the costovertebral, costotransverse and facet joints as well as the spinous processes. In advanced disease with extensive ankylosis, the lumbar spine was featureless on scintigraphy, except for focal increased activity at the site of previous fracture in one patient. Of six available views of the sternum, increased uptake was present in five at the manubriosternal joint and five at the sternoclavicular joints. Increased peripheral uptake was mainly in the hips and knees in advanced cases. Plain radiographic changes correlated poorly with scintigraphic changes, scintigraphy detecting considerably more lesions than radiography. Awareness of the scintigraphic appearances of ankylosing spondylitis may lead to diagnosis before the development of radiographic changes and avoid confusion with other pathology. Clinical indications for bone scintigraphy in ankylosing spondylitis are suggested. PMID:8293644

Collie, D A; Smith, G W; Merrick, M V

1993-12-01

 
 
 
 
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Atividade sexual na espondilite anquilosante / Sexual activity in ankylosing spondylitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Analisar a atividade sexual em pacientes com espondilite anquilosante, correlacionando com índices funcionais e de atividade da doença. PACIENTES E MÉTODOS: Foram analisados quanto a dor, fadiga, questionários de atividade de doença (Bath Ankylosing Spondylitis Disease Activity Index - BAS [...] DAI), funcionalidade (Bath Ankylosing Spondylitis Functional Index - BASFI) e atividade sexual (utilizando imagens de sete posições sexuais) 32 pacientes com diagnóstico de espondilite anquilosante e 32 controles saudáveis. Após a entrevista, os pacientes foram divididos em dois grupos: grupo A (com atividade sexual) e grupo B (sem atividade sexual). RESULTADOS: O grupo B apresentou associação estatística com maior duração da doença (P = 0,01), pior funcionalidade (P = 0,0007) e maior atividade de doença (P = 0,03). Não houve correlação entre idade e capacidade funcional. O homem deitado de costas e a mulher sobre ele foi a posição mais frequente, agradável e menos dolorosa. A figura com a mulher de costas e o homem deitado sobre ela foi a posição menos escolhida. Indivíduos-controle relataram maior frequência e duração mais longa das relações sexuais, menos fadiga e dor, embora a frequência de orgasmos tenha sido semelhante nos dois grupos. CONCLUSÃO: A natureza crônica da espondilite anquilosante, com pior capacidade funcional e maior atividade da doença, interferiu no comportamento sexual dos pacientes. Quando o sexo se tornou possível, orgasmo e satisfação sexual não diferiram dos controles saudáveis. Abstract in english OBJECTIVE: To assess the sexual activity of patients with ankylosing spondylitis, correlating it with disease activity and functional indices. PATIENTS AND METHODS: Thirty-two patients with ankylosing spondylitis and 32 healthy controls were assessed regarding pain, fatigue, sexual activity (by use [...] of pictures of seven sexual positions), disease activity (by use of Bath Ankylosing Spondylitis Disease Activity Index - BASDAI), and functional capacity (by use of Bath Ankylosing Spondylitis Functional Index - BASFI). After the interview, the patients were divided into two groups: group A (with sexual activity) and group B (no sexual activity). RESULTS: Group B showed statistical association with longer disease duration (P = 0.01), and higher BASFI (P = 0.0007) and BASDAI (P = 0.03) scores. No correlation was observed between age and functional capacity. Man lying on his back and woman on top was the most frequent, enjoyable and least painful position. The position with the woman on her back and a man lying on top was the least chosen. Control individuals reported a higher frequency of sexual activity, longer duration of intercourse, and less pain and fatigue; the reported frequency of orgasms, however, was similar in both groups. CONCLUSION: The chronic nature of ankylosing spondylitis, with poor functional capacity and higher disease activity, interferes with sexual intercourse. When sexual activity was possible, orgasm and sexual satisfaction did not differ from those of healthy controls.

Andrea Lopes, Gallinaro; Lilian Lie, Akagawa; Mariana Hissami Ichiba, Otuzi; Percival Degrava, Sampaio-Barros; Célio Roberto, Gonçalves.

2012-12-01

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Psoriasis induced by infliximab in a Saudi patient with ankylosing spondylitis.  

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Although the therapeutic uses of tumor necrosis factor alpha antagonists have added a highly effective treatment of ankylosing spondylitis and associated spondyloarthropathies, they are associated with many untoward effects. We describe a Saudi patient with ankylosing spondylitis who developed severe psoriatic lesions in treatment with infliximab. He had no personal, or family history of psoriasis, and no other triggering factors known to induce psoriasis.

Iehab B. Alabed

2010-09-01

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Adalimumab reduces pain, fatigue, and stiffness in patients with ankylosing spondylitis: results from the adalimumab trial evaluating long-term safety and efficacy for ankylosing spondylitis (ATLAS).  

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OBJECTIVE: To evaluate the effect of adalimumab on pain, fatigue, and stiffness in patients with active ankylosing spondylitis (AS). METHODS: The Adalimumab Trial Evaluating Long-Term Safety and Efficacy for Ankylosing Spondylitis (ATLAS) was an ongoing 5-year study that included an initial 24-week, randomized, placebo-controlled, double-blind period. Patients were randomized to adalimumab 40 mg or placebo by subcutaneous injection every other week. Pain was assessed by the bodily pain domain...

Revicki, Da; Luo, Mp; Wordsworth, P.; Wong, Rl; Chen, N.; Davis, Jc

2008-01-01

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Validation of the Italian versions of the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Dougados Functional Index (DFI) in patients with ankylosing spondylitis  

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Objectives: The Bath Ankylosing Spondylitis Functional Index (BASFI) and the Dougados Functional Index (DFI) are the most commonly used instruments to measure functioning in ankylosing spondylitis (AS). The aim of this study was to translate, adapt and validate these instruments into the Italian language. Methods: The BASFI and DFI questionnaires were translated into Italian by two independent bilingual physicians who were familiar with the medical aspects of AS and by one professional transl...

Grassi, W.; Carotti, M.; Silvestri, A.; Stancati, A.; Salaffi, F.

2011-01-01

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Espondilite anquilosante e uveíte: revisão / Ankylosing spondylitis and uveitis: overview  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O presente trabalho propõe uma revisão de epidemiologia, patogênese, quadro clínico, diagnóstico e tratamento da espondilite anquilosante e sua associação com alteração ocular com a devida condução da doença e suas manifestações. Os autores utilizaram em sua pesquisa os bancos de dados PubMed (MEDLI [...] NE), LILACS e Biblioteca do Centro de Estudos de Oftalmologia. A espondilite anquilosante é uma doença inflamatória crônica que acomete preferencialmente o esqueleto axial, podendo evoluir com rigidez e limitação funcional progressiva. Seu início costuma ocorrer por volta da segunda à terceira década de vida, preferencialmente em indivíduos do gênero masculino, caucasianos e HLA-B27-positivos. Sua etiologia e patogênese não são completamente elucidadas, e seu diagnóstico costuma ser tardio. O controle clínico e o tratamento são frequentemente satisfatórios.A uveíte anterior aguda é a manifestação extra-articular mais comum, ocorrendo em cerca de 20%-30% dos pacientes com espondilite anquilosante. Aproximadamente metade dos casos de uveíte anterior aguda está associada à presença do antígeno HLA-B27, podendo ser a primeira manifestação de uma doença reumatológica não diagnosticada, geralmente com boa resposta terapêutica e bom prognóstico. Concluímos que, para melhor avaliação e tratamento dos pacientes com uveíte, é importante maior integração entre oftalmologistas e reumatologistas. Abstract in english The present article reviews the epidemiology, pathogenesis, clinical features, diagnosis, and treatment of ankylosing spondylitis and its association with ocular changes. The authors used the PubMed (MEDLINE), LILACS, and Ophthalmology Library databases. Ankylosing spondylitis is a chronic inflammat [...] ory disease that usually affects the axial skeleton and can progress to stiffness and progressive functional limitation. Ankylosing spondylitis usually begins around the second to third decade of life, preferentially in HLA-B27-positive white males. Its etiology and pathogenesis are not completely understood, and its diagnosis is diffi cult. Clinical control and treatment are frequently satisfactory. Acute anterior uveíte is the most common extra-articular manifestation, occurring in 20%-30% of the patients with ankylosing spondylitis. Approximately half of the acute anterior uveíte cases are associated with the presence of the HLA-B27 antigen. It can be the first manifestation of an undiagnosed rheumatic disease, usually having a good prognosis and appropriate response to treatment. In conclusion, for better assessment and treatment of patients with uveitis, ophthalmologists and rheumatologists should work together.

Enéias Bezerra, Gouveia; Dório, Elmann; Maira Saad de Ávila, Morales.

2012-10-01

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Espondilite anquilosante e uveíte: revisão / Ankylosing spondylitis and uveitis: overview  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O presente trabalho propõe uma revisão de epidemiologia, patogênese, quadro clínico, diagnóstico e tratamento da espondilite anquilosante e sua associação com alteração ocular com a devida condução da doença e suas manifestações. Os autores utilizaram em sua pesquisa os bancos de dados PubMed (MEDLI [...] NE), LILACS e Biblioteca do Centro de Estudos de Oftalmologia. A espondilite anquilosante é uma doença inflamatória crônica que acomete preferencialmente o esqueleto axial, podendo evoluir com rigidez e limitação funcional progressiva. Seu início costuma ocorrer por volta da segunda à terceira década de vida, preferencialmente em indivíduos do gênero masculino, caucasianos e HLA-B27-positivos. Sua etiologia e patogênese não são completamente elucidadas, e seu diagnóstico costuma ser tardio. O controle clínico e o tratamento são frequentemente satisfatórios.A uveíte anterior aguda é a manifestação extra-articular mais comum, ocorrendo em cerca de 20%-30% dos pacientes com espondilite anquilosante. Aproximadamente metade dos casos de uveíte anterior aguda está associada à presença do antígeno HLA-B27, podendo ser a primeira manifestação de uma doença reumatológica não diagnosticada, geralmente com boa resposta terapêutica e bom prognóstico. Concluímos que, para melhor avaliação e tratamento dos pacientes com uveíte, é importante maior integração entre oftalmologistas e reumatologistas. Abstract in english The present article reviews the epidemiology, pathogenesis, clinical features, diagnosis, and treatment of ankylosing spondylitis and its association with ocular changes. The authors used the PubMed (MEDLINE), LILACS, and Ophthalmology Library databases. Ankylosing spondylitis is a chronic inflammat [...] ory disease that usually affects the axial skeleton and can progress to stiffness and progressive functional limitation. Ankylosing spondylitis usually begins around the second to third decade of life, preferentially in HLA-B27-positive white males. Its etiology and pathogenesis are not completely understood, and its diagnosis is diffi cult. Clinical control and treatment are frequently satisfactory. Acute anterior uveíte is the most common extra-articular manifestation, occurring in 20%-30% of the patients with ankylosing spondylitis. Approximately half of the acute anterior uveíte cases are associated with the presence of the HLA-B27 antigen. It can be the first manifestation of an undiagnosed rheumatic disease, usually having a good prognosis and appropriate response to treatment. In conclusion, for better assessment and treatment of patients with uveitis, ophthalmologists and rheumatologists should work together.

Enéias Bezerra, Gouveia; Dório, Elmann; Maira Saad de Ávila, Morales.

27

Adherence to treatment in patients with ankylosing spondylitis.  

Science.gov (United States)

This study aims to determine the level of adherence to treatment in ankylosing spondylitis (AS) patients and to identify possible factors associated to lack of adherence. We included consecutive AS patients (NY modified criteria). Sociodemographic and clinical data were collected. Patients answered auto-reported questionnaires: Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life, and Center for Epidemiological Studies Depression scale. Patients with rheumatoid arthritis (RA) (ACR'87 criteria) were assessed as the control group. The adherence of the studied groups to medical treatment and exercises was measured by means of two questionnaires: Compliance Questionnaire on Rheumatology (CQR) and Exercise Attitude Questionnaire-18 (EAQ-18). The study included 59 patients with AS and 53 patients with RA. Of the AS patients, 43 (72.9%) were male, median age 47 years (interquartile range (IQR) 33-57) and median disease duration of 120 months (IQR 33-57). Of the RA patients, 37 (69.8%) were female, had a median age of 56 years (IQR 43.5-60) and a median disease duration of 156 months (IQR 96-288). There were no significant differences in the results of the adherence questionnaires between both groups, with a total median of 68.42 for the CQR in both groups and of 40.7 in AS vs. 42.6 in RA for the EAQ. When dichotomizing patients as adherent and non-adherent, taking as good adherence a cut value in the CQR and EAQ higher than 60, adherence to pharmacological treatment was significantly higher in RA vs. AS (92.5 vs. 74.6%, p = 0.01) and there were no differences in the EAQ. On the uni- and multivariate analysis, lack of adherence to treatment was not associated to sex, age, disease duration, education, health insurance, depressive status, and disease activity parameters in neither group of patients. AS have an acceptable adherence to pharmacological treatment, although it is lower than RA patients; nonetheless, both groups show a lack of adherence to exercise. PMID:23515597

Arturi, Pablo; Schneeberger, Emilce Edith; Sommerfleck, Fernando; Buschiazzo, Emilio; Ledesma, César; Maldonado Cocco, José Antonio; Citera, Gustavo

2013-07-01

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Coexisting Ankylosing Spondylitis and Gouty Arthritis Case Report  

Directory of Open Access Journals (Sweden)

Full Text Available Coexsisting ankylosing spondylitis (AS and gouty arthritis have rarely been reported in the literature previously. We present a 43-year-old male patient with AS who had been diagnosed as having gout based on some clinical and laboratory findings. In this paper, the clinical features of both rheumatic diseases are discussed in light of the recent literature. The gouty arthritis should be considered in the differential diagnosis of acute peripheral arthritis in patients with AS. Turk J Phys Med Rehab 2011;57:111-3.

Necmettin Y?ld?z

2011-06-01

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Espondilite anquilosante e uveíte: revisão Ankylosing spondylitis and uveitis: overview  

Directory of Open Access Journals (Sweden)

Full Text Available O presente trabalho propõe uma revisão de epidemiologia, patogênese, quadro clínico, diagnóstico e tratamento da espondilite anquilosante e sua associação com alteração ocular com a devida condução da doença e suas manifestações. Os autores utilizaram em sua pesquisa os bancos de dados PubMed (MEDLINE, LILACS e Biblioteca do Centro de Estudos de Oftalmologia. A espondilite anquilosante é uma doença inflamatória crônica que acomete preferencialmente o esqueleto axial, podendo evoluir com rigidez e limitação funcional progressiva. Seu início costuma ocorrer por volta da segunda à terceira década de vida, preferencialmente em indivíduos do gênero masculino, caucasianos e HLA-B27-positivos. Sua etiologia e patogênese não são completamente elucidadas, e seu diagnóstico costuma ser tardio. O controle clínico e o tratamento são frequentemente satisfatórios.A uveíte anterior aguda é a manifestação extra-articular mais comum, ocorrendo em cerca de 20%-30% dos pacientes com espondilite anquilosante. Aproximadamente metade dos casos de uveíte anterior aguda está associada à presença do antígeno HLA-B27, podendo ser a primeira manifestação de uma doença reumatológica não diagnosticada, geralmente com boa resposta terapêutica e bom prognóstico. Concluímos que, para melhor avaliação e tratamento dos pacientes com uveíte, é importante maior integração entre oftalmologistas e reumatologistas.The present article reviews the epidemiology, pathogenesis, clinical features, diagnosis, and treatment of ankylosing spondylitis and its association with ocular changes. The authors used the PubMed (MEDLINE, LILACS, and Ophthalmology Library databases. Ankylosing spondylitis is a chronic inflammatory disease that usually affects the axial skeleton and can progress to stiffness and progressive functional limitation. Ankylosing spondylitis usually begins around the second to third decade of life, preferentially in HLA-B27-positive white males. Its etiology and pathogenesis are not completely understood, and its diagnosis is diffi cult. Clinical control and treatment are frequently satisfactory. Acute anterior uveíte is the most common extra-articular manifestation, occurring in 20%-30% of the patients with ankylosing spondylitis. Approximately half of the acute anterior uveíte cases are associated with the presence of the HLA-B27 antigen. It can be the first manifestation of an undiagnosed rheumatic disease, usually having a good prognosis and appropriate response to treatment. In conclusion, for better assessment and treatment of patients with uveitis, ophthalmologists and rheumatologists should work together.

Enéias Bezerra Gouveia

2012-10-01

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Surgical treatment of lumbar hyperextension injury in ankylosing spondylitis.  

Science.gov (United States)

Ankylosing spondylitis (AS) is a chronic systemic and inflammatory rheumatic disease with a variable course of the axial skeleton. Spinal involvement may accompany ossification of the ligaments, intervertebral disc, end-plates and apophyseal structures, and seems to be "bamboo spine". Because of these natures of the spine in AS, a spinal fracture can be occurred with minor trauma or spontaneously. The fracture of the AS can cause neurological complications extremely high, so special attention to prevent neurological deterioration. Operative management of the injured spine with AS is difficult, and associated with a high complication rate. Extreme care must be taken for surgery to prevent secondary neurological deterioration. PMID:24757488

Lee, Jung Keun; Park, Ki Seok; Park, Moon Sun; Kim, Seong Min; Chung, Seung Young; Lee, Do Sung

2013-09-01

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Efficacy and safety of adalimumab in ankylosing spondylitis  

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Full Text Available Aziza Mounach, Abdellah El MaghraouiRheumatology Department, Military Hospital Mohammed V, Rabat, MoroccoAbstract: Ankylosing spondylitis (AS is the most common and most severe subtype of spondyloarthritis. It also may be an outcome of any of the other spondyloarthritis subtypes. AS preferentially affects the sacroiliac joints and the tip of the column, with a tendency to later ankylosis. Peripheral joints, enthesis, and other extra-articular involvement may be observed. Tumor necrosis factor (TNF inhibitors are now well-established, effective drugs in the treatment of AS symptoms. Adalimumab, which is a fully human monoclonal antibody that binds to and neutralizes TNF, has demonstrated efficacy in treating AS symptoms, including axial involvement, peripheral arthritis, enthesitis, uveitis, gut involvement, and psoriasis. Furthermore, adalimumab has showed an overall acceptable safety profile. In this paper, we review the efficacy and safety profile of adalimumab in the treatment of AS, and discuss its differences from the other anti-TNF drugs reported in the literature.Keywords: ankylosing spondylitis, spondyloarthritis, adalimumab, tumor necrosis factor-?

Mounach A

2014-08-01

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Magnetic resonance imaging for ankylosing spondylitis; Magnetresonanztomographie bei ankylosierender Spondylitis (Morbus Struempell-Marie-Bechterew)  

Energy Technology Data Exchange (ETDEWEB)

Ankylosing spondylitis (AS) is the prototypical form of the spondyloarthropathies, which at a prevalence of 2% is among the most frequent rheumatic diseases. Spondyloarthropathy comprises the following five disorders: AS, reactive arthritis, psoriatic arthritis, enteropathic arthritis in Crohn's disease, and ulcerosing colitis as well as undifferentiated spondyloarthropathy. In 99% of the patients with AS initial abnormal findings affect the sacroiliac joints. The radiographic changes required for diagnosing AS occur as late as 5-9 years after the onset of clinical symptoms. MRI of the sacroiliac joints reliably demonstrates both chronic inflammatory changes (erosions, sclerotic changes, bone bridges) and acute inflammatory changes (synovitis, capsulitis, osteitis) and allows for grading the chronicity and acuity of such changes. Enthesitis of the interosseous ligaments of the retroarticular space is a manifestation of AS. Spondylodiscitis (Andersson 1937) may occur as an inflammatory or non-inflammatory process (transdiscal fatigue fracture). Inflammations of the facet and costospinal joints developing into ankylosis are typical of AS. Changes of the vertebral bodies occur as anterior (Romanus 1952), posterior, and marginal spondylitis. All forms of spondyloarthropathies are furthermore characterized by asymmetrical synovitis of the large joints, particularly of the legs (gonarthritis, coxitis, tarsitis, peripheral oligoarthritis), rheumatic fibroosteitis (pelvic enthesitis, rheumatic calcaneopathy), and peri- and synchrondritis of the public symphisis and sternal synchondrosis. Since early inflammatory changes of the spinal column and of the extravertebral localizations in AS are demonstrated by MRI before they become apparent on radiographs, and thereby the diagnostic gap could be closed, the early use of MRI for diagnostic and follow-up is commendable, when new therapeutical options like the so-called 'biologicals' are employed. (orig.) [German] Die ankylosierende Spondylitis (AS) gilt als Prototyp der Spondylarthropathien, welche mit einer Praevalenz von 2% zu den haeufigsten rheumatischen Erkrankungen gerechnet werden. Die Spondylarthropathie umfasst die 5 Entitaeten AS, reaktive Arthritis, Psoriasis arthropathica, enteropathische Arthritis bei Morbus Crohn und Colitis ulcerosa und die undifferenzierte Spondylarthropathie. Bei 99% der Patienten mit AS sind die ersten pathologischen Befunde an den Sakroiliakalgelenken zu finden. Die zur Diagnose einer AS geforderten Roentgenbefunde treten erst mit einer Latenz von 5-9 Jahren nach Beginn der klinischen Symptome in Erscheinung. Mit Hilfe der MRT der Sakroiliakalgelenke lassen sich sowohl chronisch-entzuendliche Veraenderungen (Erosionen, Sklerosierungen, Knochenbruecken) als auch akut-entzuendliche Veraenderungen (Synovitiden, Kapsulitiden, Osteitiden) sicher nachweisen und bezueglich ihrer Chronizitaet und Akuitaet graduieren. Enthesitiden der Ligamenta interossea des Spatium retroarticulare gehoeren zum Bild der AS. Eine Spondylodiszitis (Andersson 1937) kann als entzuendliche und als nichtentzuendliche Form (transdiskaler Ermuedungsbruch) auftreten. Zur Ankylosierung fuehrende Entzuendungen der Facetten- und der kostospinalen Gelenke sind fuer die AS typisch. Veraenderungen der Wirbelkoerper finden sich als Spondylitis anterior (Romanus 1952), posterior und marginalis. Charakteristisch fuer alle Spondylarthropathien sind darueberhinaus asymmetrische Synovitiden an den grossen Gelenken vor allem der unteren Extremitaet (Gonarthritis, Coxitis, Tarsitis, periphere Oligoarthritis), die Fibroostitis rheumatica (pelvine Enthesitis, Calcaneopathia rheumatica) und die Peri- und Synchondritiden der Symphysis pubica und der Synchondrosis sternalis. Da sich bei der AS fruehe entzuendliche Veraenderungen an der Wirbelsaeule und an den extravertebralen Manifestationsorten in der MRT vor deren Auftreten im Roentgenbild nachweisen lassen und damit die diagnostische Luecke geschlossen werden konnte, empfiehlt sich bei neuen therapeutischen Optionen mit den sogenannt

Bollow, M. [Augusta-Kranken-Anstalt, Inst. fuer Radiologie, Bochum (Germany)

2002-12-01

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Searching for optimal rating scales in the Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).  

Science.gov (United States)

The comparison of the performance of the numerical rating scale (NRS) versus visual analog scale (VAS) in the Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) showed that the 11-point NRS is psychometrically superior to the 10-cm VAS. This finding is in agreement with previous studies and the recommendation by the Assessment of SpondyloArthritis international Society. To illustrate the functioning of the response categories of both BASFI and BASDAI, we analyzed the rating scales (using the Rasch rating scale model) in patients with ankylosing spondylitis. Our results have shown that the 11 categories available in the 0-10 NRS version of both BASFI and BASDAI exceed the number of levels of a construct that participants can discriminate. This indicates the need for improving the metric quality of both rating scales by appropriately reducing the number of categories. PMID:24212675

Franchignoni, Franco; Salaffi, Fausto; Ciapetti, Alessandro; Giordano, Andrea

2014-02-01

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A discrete event modelling framework for simulation of long-term outcomes of sequential treatment strategies for ankylosing spondylitis  

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Objective To develop a modelling framework which can simulate long-term quality of life, societal costs and cost-effectiveness as affected by sequential drug treatment strategies for ankylosing spondylitis (AS). Methods Discrete event simulation paradigm was selected for model development. Drug efficacy was modelled as changes in disease activity (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)) and functional status (Bath Ankylosing Spondylitis Functional Index (BASFI)), which w...

Tran-duy, A.; Boonen, A.; Laar, M. A. F. J.; Franke, A. C.; Severens, J. L.

2011-01-01

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Relapsing Polychondritis in a Patient with Ankylosing Spondylitis Using Etanercept  

Science.gov (United States)

Relapsing polychondritis (RP) is an autoimmune disease characterized by recurrent episodes of inflammation and progressive destruction of cartilaginous tissues, especially of the ears, nose, joints, and tracheobronchial tree. Its etiology is not well understood, but some studies have linked its pathophysiology with autoimmune disease and autoantibody production. We described a case of a 46-year-old male patient with ankylosing spondylitis who developed RP after the use of etanercept. Few similar cases have been described in the literature. However, they show a possible association between the use of biological inhibitors of tumor necrosis factor (anti-TNF?), which potentially produces autoantibodies, and the development of RP. The treatment was based on data in the literature and included the cessation of biological therapy and the addition of corticosteroids with substantial improvement.

Azevedo, Valderilio Feijo; Galli, Natalia Bassalobre; Kleinfelder, Alais Daiane Fadini; D'Ippolito, Julia Farabolini; Gulin Tolentino, Andressa; Paiva, Eduardo

2014-01-01

36

Late effects of x-ray treatment of ankylosing spondylitis  

International Nuclear Information System (INIS)

Following a single course of x-ray treatment, patients with ankylosing spondylitis have suffered a mortality rate from leukemia about five times higher than that of the general population. The peak risk occurs 3 to 5 years after irradiation and subsequently declines, such that by 20 years after exposure the risk may be near normal levels, though more data will be necessary to confirm this. There is no clear relationship between the excess risk of leukemia and the estimated mean bone marrow dose of radiation. The excess risk of a radiation-induced leukemia appears to be greater for patients irradiated at an older age compared to the risk experience by patients irradiated at a younger age (but it should be noted that children were not included in the study)

37

MR imaging features of foot involvement in ankylosing spondylitis  

Energy Technology Data Exchange (ETDEWEB)

Objective: To determine alterations of the soft tissue, tendon, cartilage, joint space, and bone of the foot using magnetic resonance (MR) imaging in ankylosing spondylitis (AS) patients. Materials and Method: Clinical and MR examination of the foot was performed in 23 AS patients (46 feet). Ten asymptomatic volunteers (20 feet) were studied on MR imaging, as a control group. MR imaging protocol included; T1-weighted spin-echo, T2-weighted fast-field echo (FFE) and fat-suppressed short tau inversion recovery (STIR) sequences in sagittal, sagittal oblique, and coronal planes using a head coil. Specifically, we examined: bone erosions, tendinitis (acute and chronic), para-articular enthesophyte, joint effusion, plantar fasciitis, joint space narrowing, soft tissue edema, bone marrow edema, enthesopathy in the Achilles tendon and plantar fascia attachment, subchondral signal intensity abnormalities (edema and sclerosis), tenosynovitis, retrocalcaneal bursitis, subchondral cysts, subchondral fissures, and bony ankylosis. Midfoot, hindfoot, and ankle were included in examined anatomic regions. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in 3 (13%) of the patients while frequency of involvement was 21 (91%) with MR imaging assessment. The MR imaging findings were bone erosions (65%), Achilles tendinitis (acute and chronic) (61%), para-articular enthesophyte (48%), joint effusion (43%), plantar fasciitis (40%), joint space narrowing (40%), subchondral sclerosis (35%), soft tissue edema (30%), bone marrow edema (30%), enthesopathy of the Achilles attachment (30%), subchondral edema (26%), enthesopathy in the plantar fascia attachment (22%), retrocalcaneal bursitis (22%), subchondral cysts (17%), subchondral fissures (17%), tendinitis and enthesopathy of the plantar ligament (13%), and bony ankylosis (9%). The most common involved anatomical region was the hindfoot (83%) following by midfoot (69% ) and ankle (22%). Conclusion: In our experience, MR imaging may detect inflammatory and/or erosive bone, soft tissue, cartilage, tendon, and joint abnormalities in AS patients, even if AS patients did not have clinical signs and symptoms of foot involvement. If these data prove to be confirmed in further MR studies, MR imaging may be of importance especially in early diagnosis of inflammatory changes in the foot.

Erdem, C. Zuhal E-mail: sunarerdem@yahoo.com; Sarikaya, Selda; Erdem, L. Oktay; Ozdolap, Senay; Gundogdu, Sadi

2005-01-01

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MR imaging features of foot involvement in ankylosing spondylitis  

International Nuclear Information System (INIS)

Objective: To determine alterations of the soft tissue, tendon, cartilage, joint space, and bone of the foot using magnetic resonance (MR) imaging in ankylosing spondylitis (AS) patients. Materials and Method: Clinical and MR examination of the foot was performed in 23 AS patients (46 feet). Ten asymptomatic volunteers (20 feet) were studied on MR imaging, as a control group. MR imaging protocol included; T1-weighted spin-echo, T2-weighted fast-field echo (FFE) and fat-suppressed short tau inversion recovery (STIR) sequences in sagittal, sagittal oblique, and coronal planes using a head coil. Specifically, we examined: bone erosions, tendinitis (acute and chronic), para-articular enthesophyte, joint effusion, plantar fasciitis, joint space narrowing, soft tissue edema, bone marrow edema, enthesopathy in the Achilles tendon and plantar fascia attachment, subchondral signal intensity abnormalities (edema and sclerosis), tenosynovitis, retrocalcaneal bursitis, subchondral cysts, subchondral fissures, and bony ankylosis. Midfoot, hindfoot, and ankle were included in examined anatomic regions. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in 3 (13%) of the patients while frequency of involvement was 21 (91%) with MR imaging assessment. The MR imaging findings were bone erosions (65%), Achilles tendinitis (acute and chronic) (61%), para-articular enthesophyte (48%), joint effusion (43%), plantar fasciitis (40%), joint space na), plantar fasciitis (40%), joint space narrowing (40%), subchondral sclerosis (35%), soft tissue edema (30%), bone marrow edema (30%), enthesopathy of the Achilles attachment (30%), subchondral edema (26%), enthesopathy in the plantar fascia attachment (22%), retrocalcaneal bursitis (22%), subchondral cysts (17%), subchondral fissures (17%), tendinitis and enthesopathy of the plantar ligament (13%), and bony ankylosis (9%). The most common involved anatomical region was the hindfoot (83%) following by midfoot (69% ) and ankle (22%). Conclusion: In our experience, MR imaging may detect inflammatory and/or erosive bone, soft tissue, cartilage, tendon, and joint abnormalities in AS patients, even if AS patients did not have clinical signs and symptoms of foot involvement. If these data prove to be confirmed in further MR studies, MR imaging may be of importance especially in early diagnosis of inflammatory changes in the foot

39

Enterobacterial involvement in the pathogenesis of secondary ankylosing spondylitis.  

Science.gov (United States)

Ankylosing spondylitis (AS) is closely associated with the histocompatibility antigen HLA-B27. Pathogenesis of AS is thought to involve interactions between B27 and certain enterobacterial antigens. However, this is uncertain and contested by some. The present paper argues that the presence of statistically raised specific serum IgA to a common enterobacterial heat modifiable major outer membrane protein (h-momp; Mr 35,000) in active AS (N = 25; IgA = 1485 +/- 20) in comparison to controls, most notably hospital patients without known arthropathies or gastrointestinal disease (N = 12; IgA = 548 +/- 59), supports an inductive contribution of enterobacterial antigens to the pathogenesis of secondary AS. Serum IgG and IgM did not statistically differ. Raised specific serum IgA to h-momp might indicate enterobacterial antigenic stimulation from the gastrointestinal tract. It does not necessarily imply direct involvement in the pathogenesis of primary AS. H-momp appears to be a convenient tool for serological studies of AS and at present is likely to be more suitable than other bacterial antigens, notably those with B27-like epitopes. Namely, the confirmed presence in AS of enterobacteria with freely accessible B27-like antigenic epitopes on their cell surface might induce unusual tolerance to these organisms in B27 positive hosts, thus causing chronic inflammation, initially sacroiliitis (and spondylitis) due to the proximity of presacral and para-aortic colon draining lymph nodes, later becoming more generalized (for reasons unclear) to include other lesions (e.g. peripheral arthritis, uveitis, enthesopathies). Thus, antibodies to B27-like antigenic epitopes need not be detectable or may be absent. Also, cellular immune responsiveness to these antigens might be involved. PMID:2456814

van Bohemen, C G; Weterings, E; Goei The, H S; Grumet, F C; Zanen, H C

1988-01-01

40

Identification of multiple risk variants for ankylosing spondylitis through high-density genotyping of immune-related loci  

Science.gov (United States)

Ankylosing spondylitis is a common, highly heritable inflammatory arthritis affecting primarily the spine and pelvis. In addition to HLA-B*27 alleles, 12 loci have previously been identified that are associated with ankylosing spondylitis in populations of European ancestry, and 2 associated loci have been identified in Asians. In this study, we used the Illumina Immunochip microarray to perform a case-control association study involving 10,619 individuals with ankylosing spondylitis (cases) and 15,145 controls. We identified 13 new risk loci and 12 additional ankylosing spondylitis–associated haplotypes at 11 loci. Two ankylosing spondylitis–associated regions have now been identified encoding four aminopeptidases that are involved in peptide processing before major histocompatibility complex (MHC) class I presentation. Protective variants at two of these loci are associated both with reduced aminopeptidase function and with MHC class I cell surface expression. PMID:23749187

Cortes, Adrian; Hadler, Johanna; Pointon, Jenny P; Robinson, Philip C; Karaderi, Tugce; Leo, Paul; Cremin, Katie; Pryce, Karena; Harris, Jessica; lee, Seunghun; Joo, Kyung Bin; Shim, Seung-Cheol; Weisman, Michael; Ward, Michael; Zhou, Xiaodong; Garchon, Henri-Jean; Chiocchia, Gilles; Nossent, Johannes; Lie, Benedicte A; F?rre, ?ystein; Tuomilehto, Jaakko; Laiho, Kari; Jiang, Lei; Liu, Yu; Wu, Xin; Bradbury, Linda A; Elewaut, Dirk; Burgos-Vargas, Ruben; Stebbings, Simon; Appleton, Louise; Farrah, Claire; Lau, Jonathan; Kenna, Tony J; Haroon, Nigil; Ferreira, Manuel A; Yang, Jian; Mulero, Juan; Fernandez-Sueiro, Jose Luis; Gonzalez-Gay, Miguel A; lopez-Larrea, Carlos; Deloukas, Panos; Donnelly, Peter; Bowness, Paul; Gafney, Karl; Gaston, Hill; Gladman, Dafna D; Rahman, Proton; Maksymowych, Walter P; Xu, Huji; Crusius, J Bart A; van der Horst-Bruinsma, Irene E; Chou, Chung-Tei; Valle-Onate, Raphael; Romero-Sanchez, Consuelo; Hansen, Inger Myrnes; Pimentel-Santos, Fernando M; Inman, Robert D; Videm, Vibeke; Martin, Javier; Breban, Maxime; Reveille, John D; Evans, David M; Kim, Tae-Hwan; Wordsworth, Bryan Paul; Brown, Matthew A

2013-01-01

 
 
 
 
41

Health and Labour Questionnaire: Turkish Adaptation for Ankylosing Spondylitis  

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Full Text Available Objective: The purpose of this study was to perform a cross-cultural adaptation of the Health and Labour Questionnaire (HLQ into Turkish. Materials and Methods: The cross-cultural adaptation was conducted according to the International Society for Pharmacoeconomics and Outcomes Research guideline which consists the following ten steps respectively: Preparation, forward translation, reconciliation, back translation, back translation review, harmonization, cognitive debriefing (pilot testing, review of cognitive debriefing test results and finalization, proofreading and final report. The pilot testing was performed with 20 volunteers with ankylosing spondylitis.Results: The consensus version was prepared for pilot testing after the harmonization step. The translations generally found to be understandable to the participants. Some modifications and additional explanations for some terms in the questions 1, 2, 3, 15, 16 and 17 were required during the pilot testing. Furthermore, the response choices about the education system for the 3rd question of the appendix were adapted to the national system. Conclusion: The Turkish adaptation of the HLQ was performed successfully and found to be understandable to the pilot group and the expert group. It was considered that the Turkish version of the HLQ would encourage further researches about productivity loss related to many chronic health problems. Turk J Phys Med Re­hab 2012;58:204-11.

Engin Çakar

2012-09-01

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The role of bone morphogenetic proteins in ankylosing spondylitis.  

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Ankylosing spondylitis (AS), the best-known form of spondyloarthritis (SpA), is a remodelling arthritis characterized by chronic inflammation and bone formation. Ankylosis of the axial skeleton and sacroiliac joints leads to an impairment of spinal mobility, progressive spinal fusion and an increased risk of spinal fractures. The nature of the relationship between inflammation and new bone formation in AS has been controversial and questions remain as to whether there is a direct relationship between inflammation and new bone formation. Like others, we have hypothesized that the molecular pathways underlying ankylosis recapitulate the process of endochondral bone formation and that bone morphogenetic proteins (BMPs) play a key role in this process in AS. Furthermore, we discuss the entheseal stress hypothesis, which proposes that inflammation and ankylosis are linked but largely independent processes, and consider observations from mouse models and other human diseases which also imply that biomechanical factors contribute to the pathogenesis of AS. As current therapeutics, such as tumour necrosis factor inhibitors do not impede disease progression and ankylosis in AS, it is the pathways discussed in this review that are the now the focus for the identification of future drug targets. PMID:22859928

Carter, Shea; Braem, Kirsten; Lories, Rik J

2012-08-01

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Long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis.  

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To date, anti-tumor necrosis factor alfa (anti-TNF-?) therapy is the only alternative to nonsteroidal anti-inflammatory drugs for the treatment of ankylosing spondylitis. Etanercept is a soluble TNF receptor, with a mode of action and pharmacokinetics different to those of antibodies and distinctive efficacy and safety. Etanercept has demonstrated efficacy in the treatment of ankylosing spondylitis, with or without radiographic sacroiliitis, and other manifestations of the disease, including peripheral arthritis, enthesitis, and psoriasis. Etanercept is not efficacious in inflammatory bowel disease, and its efficacy in the treatment of uveitis appears to be lower than that of other anti-TNF drugs. Studies of etanercept confirmed regression of bone edema on magnetic resonance imaging of the spine and sacroiliac joint, but failed to reduce radiographic progression, as do the other anti-TNF drugs. It seems that a proportion of patients remain in disease remission when the etanercept dose is reduced or administration intervals are extended. Etanercept is generally well tolerated with an acceptable safety profile in the treatment of ankylosing spondylitis. The most common adverse effect of etanercept treatment is injection site reactions, which are generally self-limiting. Reactivation of tuberculosis, reactivation of hepatitis B virus infection, congestive heart failure, demyelinating neurologic disorders, hematologic disorders like aplastic anemia and pancytopenia, vasculitis, immunogenicity, and exacerbation or induction of psoriasis are class effects of all the anti-TNF drugs, and have been seen in patients with ankylosing spondylitis. However, etanercept is less likely to induce reactivation of tuberculosis than the other anti-TNF drugs and it has been suggested that etanercept might be less immunogenic, especially in ankylosing spondylitis. Acute uveitis, Crohn's disease, and sarcoidosis are other adverse events that have been rarely associated with etanercept therapy in patients with ankylosing spondylitis. PMID:24101863

Senabre-Gallego, José Miguel; Santos-Ramírez, Carlos; Santos-Soler, Gregorio; Salas-Heredia, Esteban; Sánchez-Barrioluengo, Mabel; Barber, Xavier; Rosas, José

2013-01-01

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Is there a relationship between endothelial nitric oxide synthase gene polymorphisms and ankylosing spondylitis?  

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Full Text Available OBJECTIVE: Nitric oxide is produced by endothelial nitric oxide synthase, and its production can be influenced by polymorphisms of the endothelial nitric oxide synthase gene. Because candidate genes responsible for susceptibility to ankylosing spondylitis are mostly unknown and available data suggest that there may be problems related to the nitric oxide pathway, such as endothelial dysfunction and increased asymmetric dimethylarginine, this study aimed to assess the association of common endothelial nitric oxide synthase gene polymorphisms with ankylosing spondylitis. METHODS: One hundred ninety-four unrelated Turkish ankylosing spondylitis patients and 113 healthy without apparent cardiovascular disease, hypertension or diabetes mellitus were included. All individuals were genotyped by PCR-RFLP for two single-nucleotide polymorphisms, namely 786T>C (rs2070744, promoter region and 786 Glu298Asp (rs1799983, exon 7. Variable numbers of tandem repeat polymorphisms in intron 4 were also studied and investigated by direct electrophoresis on agarose gel following polymerase chain reaction analysis. The Bath ankylosing spondylitis metrology index of the patients was calculated, and human leukocyte antigen B27 was studied. RESULTS: All studied polymorphisms satisfied Hardy-Weinberg equilibrium. Sex distributions were similar between the patient and control groups. No significant differences were found in the distributions of allele and genotype frequencies of the studied endothelial nitric oxide synthase polymorphisms between patients and controls. There were no correlations between endothelial nitric oxide synthase polymorphisms, disease duration, Bath ankylosing spondylitis metrology index or human leukocyte antigen B27. CONCLUSION: The results presented in this study do not support a major role of common endothelial nitric oxide synthase polymorphisms in Turkish ankylosing spondylitis patients.

Ismail Sari

2013-01-01

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Pitfalls and complications in the treatment of cervical spine fractures in patients with ankylosing spondylitis  

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Patients with ankylosing spondylitis are at significant risk for sustaining cervical spine injuries following trauma predisposed by kyphosis, stiffness and osteoporotic bone quality of the spine. The risk of sustaining neurological deficits in this patient population is higher than average. The present review article provides an outline on the specific injury patterns in the cervical spine, diagnostic algorithms and specific treatment modalities dictated by the underlying disease in patients with ankylosing spondylitis. An emphasis is placed on the risks and complication patterns in the treatment of these rare, but challenging injuries. PMID:18538019

Heyde, Christoph-E; Fakler, Johannes K; Hasenboehler, Erik; Stahel, Philip F; John, Thilo; Robinson, Yohan; Tschoeke, Sven K; Kayser, Ralph

2008-01-01

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Double-blind Cross-over Trial of Flurbiprofen and Phenylbutazone in Ankylosing Spondylitis  

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A double-blind cross-over study in 35 patients with ankylosing spondylitis was carried out comparing flurbiprofen (150 mg daily)—a new non-steroidal anti-inflammatory agent—with phenylbutazone (300 mg daily) over a four-week period. Flurbiprofen was well tolerated and shown to have therapeutic efficacy approaching that of phenylbutazone. The results suggest that flurbiprofen may prove a valuable alternative in the treatment of ankylosing spondylitis, and longterm efficacy and tolerance studies are clearly indicated. PMID:4611579

Calin, A.; Grahame, R.

1974-01-01

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Unexpected Beneficial Response to Etanercept Therapy in a Hemodialysis Patient with Ankylosing Spondylitis  

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Full Text Available Erythropoietin (EPO defi ciency is the main cause of renal anemia. However, chronic infl ammation may be one of the important causes for EPO resistance in patients with renal anemia. Inhibition of erythropoiesis by cytokines such as tumour necrosis factor alpha (TNF-? may play an important role. Etanercept, a recombinant dimeric fusion protein consisting of a TNF-? receptor ligand-binding region linked to the Fc portion of human IgG, is approved for use in the treatment of ankylosing spondylitis. Here, we present an end-stage renal failure patient with ankylosing spondylitis treated by etanercept and observed no need for erythropoietin during etanercept treatment.

Mehmet Tu?rul SEZER

2014-01-01

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Response to anti-TNF-? treatment for secondary renal amyloidosis in a patient with ankylosing spondylitis  

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Full Text Available Renal amyloidosis is a complication of ankylosing spondylitis. A possible pathogenetic role is due to TNF-?, with a direct action on glomerular receptors TNFR2 and renal injury, secondary to deposition of amyloid fibrils. The most frequent clinical manifestation is proteinuria or nephrotic syndrome. Etanercept, a soluble receptor of TNF-?, binds this circulant cytokine with a progressive improvement of renal function and reduction of deposits of amyloid. Transient leukopenia, observed during ankylosing spondylitis, should not be considered a controindication to the use of Etanercept, but it requires a constant monitoring. The benefit observed in our patient can represent an indication to the use of Etanercept for the management of amyloidosis.

A. Gallo

2011-09-01

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Spinal changes in patients with ankylosing spondylitis on MRI: case series.  

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Magnetic Resonance Imaging appearances are described in three cases of Ankylosing Spondylitis (AS). The different appearances of AS on magnetic resonance imaging are described and their significance in relation to the pathology of this condition is discussed. MRI is increasingly used to detect changes in the spine of patients with AS. Spinal changes associated with spondyloarthritis are florid anterior spondylitis (Romanus lesion), florid discitis (Andersson lesion), ankylosis, insufficiency fractures of the ankylosed spine, syndesmophytes, arthritis of the apophyseal and costovertebral joints and enthesitis of the interspinal ligaments. PMID:21381626

Naqi, Rohana; Ahsan, Humera; Azeemuddin, Muhammad

2010-10-01

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Carotid Intima Media Thickness as a Marker of Atherosclerosis in Ankylosing Spondylitis  

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Aim. Increased cardiovascular morbidity and mortality have been observed in ankylosing spondylitis because of accelerated atherosclerosis. We measured carotid intima media thickness (CIMT) as a surrogate marker of atherosclerosis in this study. Methods. In this study 37 cases of AS and the same number of matched individuals were recruited. CIMT measurements were done using B-mode ultrasound. Disease activity was assessed using Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), and Bath ankylosing spondylitis metrological index (BASMI) scores and C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels. Results. Mean age of the study groups was 29.43?±?9.00 years. Average disease duration was 65.62?±?54.92 months. Twenty-eight (75.68%) of cases were HLA B-27 positive. A significantly increased CIMT was observed in cases as compared to control group (0.62?±?0.12 versus 0.54?±?0.04; P < 0.001). CIMT in the cases group positively correlated with age (r = 0.357;?P < 0.05), duration of disease (r = 0.549;?P < 0.01), and BASMI (r = 0.337;?P < 0.05) and negatively correlated with ESR (r = ?0.295;?P < 0.05). Conclusions. Patients of AS had a higher CIMT than those of the control group. CIMT correlated with disease chronicity. PMID:24803936

Gupta, Naveen; Goyal, Laxmikant; Agrawal, Abhishek; Bhargava, Rajat; Agrawal, Arun

2014-01-01

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Assessment of subclinical atherosclerosis in ankylosing spondylitis: correlations with disease activity indices  

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Full Text Available The aim of the study was to evaluate atherosclerosis in ankylosing spondylitis (AS through the assessment of morphological and functional measures of subclinical atherosclerosis. Twenty patients [M/F=12/8, age (median/range 43.5/28-69 years; disease duration (median/range 9.7/1-36 years] with AS classified according to modified New York criteria and twenty age and sex related healthy controls with negative past medical history for cardiovascular events were enrolled in the study. In all patients and controls, the intima-media thickness (IMT of common carotid artery, carotid bulb and internal carotid artery, and the flow-mediated dilatation (FMD of non-dominant arm brachial artery were determined, using a sonographic probe Esaote GPX (Genoa, Italy. Furthermore, we assess the main disease activity and disability indices [bath ankylosing spondylitis disease activity index, ankylosing spondylitis disease activity score-eritrosedimentation rate (ASDAS-ESR, ASDAS-C-reactive protein (CRP, bath ankylosing spondylitis metrology index, bath ankylosing spondylitis functional index and acute phase reactants. Plasmatic values of total cholesterol, low-density lipoprotein, high-density lipoprotein, triglyceride and homocysteine were carried out in all twenty patients. IMT at carotid bulb was significant higher in patients than in controls (0.67 mm vs 0.54 mm; P=0.03. FMD did not statistically differ between patients and controls (12.5% vs 15%; P>0.05. We found a correlation between IMT at carotid bulb and ESR (rho 0.43; P=0.04. No correlation was found between FMD and disease activity and disability indices. This study showed that in AS patients, without risk factors for cardiovascular disease, carotid bulb IMT, morphological index of subclinical atherosclerosis, is higher than in controls.

F.M. Perrotta

2013-07-01

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Focal spinal abnormalities on bone scans in ankylosing spondylitis: a clue to the presence of fracture or pseudarthrosis  

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Four cases of ankylosing spondylitis are presented in which radionuclide bone studies indicated focal abnormalities of the spine. In three patients, the area of abnormal nuclide uptake corresponded to a site of pseudarthrosis, and in the fourth an acute fracture was present. As such focal lesions on bone scans are unusual in cases of chronic ankylosing spondylitis in which a complication is not apparent, their presence can be a useful finding

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Focal spinal abnormalities on bone scans in ankylosing spondylitis: a clue to the presence of fracture or pseudarthrosis.  

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Four cases of ankylosing spondylitis are presented in which radionuclide bone studies indicated focal abnormalities of the spine. In three patients, the area of abnormal nuclide uptake corresponded to a site of pseudarthrosis, and in the fourth an acute fracture was present. As such focal lesions on bone scans are unusual in cases of chronic ankylosing spondylitis in which a complication is not apparent, their presence can be a useful finding. PMID:6262000

Resnick, D; Williamson, S; Alazraki, N

1981-05-01

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Perfil gestacional na espondilite anquilosante Pregnancy profile in ankylosing spondylitis  

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Full Text Available OBJETIVO: avaliar o perfil gestacional numa casuística de mulheres com espondilite anquilosante (EA acompanhadas em um hospital universitário de referência. MÉTODOS: estudo retrospectivo avaliando 40 mulheres com EA, segundo os critérios modificados de New York, acompanhadas no Ambulatório de Espondiloartropatias da FCM-UNICAMP no período entre 1990 e 2004. Foram avaliados os dados referentes ao número de gestações, partos e abortos, bem como o comportamento da doença durante a gestação naquelas pacientes que engravidaram após o início da EA. RESULTADOS: dentre as 40 mulheres avaliadas, 35 (87,5% eram brancas e 27 (67,5% eram HLA-B27 positivo, sendo que somente três (7,5% referiam história familiar de EA. A média de idade de início foi de 29,9 anos e o tempo médio de doença foi de 15,5 anos. Nove pacientes (22,5% nunca haviam engravidado, sendo que apenas uma paciente decidiu não engravidar por causa da EA. Trinta e uma pacientes apresentaram 83 gestações (média de 2,7 gestações/paciente, sendo sete após o início da doença. Ocorreram 71 partos e 12 abortos espontâneos (nenhum após o início da doença. Dentre as cinco pacientes que engravidaram após o início da EA, apenas uma apresentou piora da doença, associada ao comprometimento das coxofemorais. CONCLUSÕES: a análise do perfil gestacional da presente casuística indica que a fertilidade parece não ter sido afetada antes do início da EA e que a maioria das pacientes decide não engravidar após o início da doença.OBJECTIVE: To analyze the pregnancy profile in a group of female patients with ankylosing spondylitis (AS followed at a referral university center. METHODS: Retrospective study analyzing 40 women with the diagnosis of AS according to the New York modified criteria followed at the Spondyloarthropathies Outpatient Clinic of the State University of Campinas in the period between 1990-2004. The number of pregnancies, deliveries and miscarriages was investigated, as well as the disease behavior during the pregnancy in those patients that got pregnant after AS onset. RESULTS: Among the 40 AS patients, 35 (87.5% were Caucasians and 27 (67.5% were HLA-B27 positive; 3 patients (7.5% referred familial history of AS. The mean age of onset was 29.9 years old and the mean disease duration was 15.5 years. Nine patients (22.5% never got pregnant; just one patient decided not to get pregnant because of AS. Thirty-one patients presented 83 pregnancies (an average of 2.7 pregnancies/patient, being seven after disease onset. There were 70 deliveries and 12 spontaneous miscarriages, but no miscarriages after AS onset. Among the 5 patients that got pregnant after disease onset, just 1 patient referred worsening of AS, related to hip involvement. CONCLUSIONS: In the present casuistic, fertility seemed not to be affected before disease onset and most patients decided not to get pregnant after AS onset.

Percival Degrava Sampaio-Barros

2005-06-01

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Cerebral magnetic resonance imaging in a patient with ankylosing spondylitis and multiple sclerosis-like syndrome  

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Clinical and cerebral magnetic resonance imaging (MRI) findings in a patient with ankylosing spondylitis (AS) and multiple sclerosis-like (MS-like) syndrome are reported. Cerebral MRI demonstrated multiple, MS-like, scattered foci of signal abnormality, one of which showed contrast enhancement. Lesion dissemination in ''space and time'' is a hallmark for diagnosis of MS, and its demonstration by enhanced cerebral MRI prompted suspicion of coexistence of MS and AS in our patient. (orig.)

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Adalimumab in ankylosing spondylitis: an evidence-based review of its place in therapy  

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Stephanie Hennigan, Christoph Ackermann, Arthur KavanaughCenter for Innovative Therapy, Division of Rheumatology, Allergy and Immunology, University of California, La Jolla, California, USAIntroduction: Ankylosing spondylitis (AS) is an idiopathic chronic inflammatory disease that has prominent effects on the spine and peripheral joints. In addition, extraarticular manifestations such as enthesitis and acute anterior uveitis may be clinically important. In recent years, the therapy of AS has ...

Stephanie Hennigan; Christoph Ackermann; Arthur Kavanaugh

2008-01-01

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Discovertebral (Andersson) lesions in severe ankylosing spondylitis: a study using MRI and conventional radiography  

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The objective of this study is to investigate the prevalence of Andersson lesions (AL) in ankylosing spondylitis (AS) patients who will start anti-tumor necrosis factor (TNF) treatment. Radiographs and magnetic resonance imaging (MRI) of the spine were performed before therapy with anti-TNF. ALs were defined as discovertebral endplate destructions on MRI, associated with bone marrow edema and fat replacement or sclerosis, a decreased signal on T1, enhancement after contrast administration (ga...

Vries, M. K.; Drumpt, A. S.; Royen, B. J.; Denderen, J. C.; Manoliu, R. A.; Horst-bruinsma, I. E.

2010-01-01

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The role of HLA-B27 molecules in the pathogenesis of ankylosing spondylitis  

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Full Text Available Ankylosing Spondylitis (AS is characterised by the strongest association with an HLA antigen ever described for any disease. It represents therefore the ideal model for the understanding of the link between immune-mediated diseases and the HLA system. The role of HLA-B27 in the pathogenesis of AS will be discussed focusing on the recently described higher expression of these molecules in patients with AS compared with healthy controls.

R. Pala

2011-09-01

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Absence of impaired lymphocyte transformation to Klebsiella spp. in ankylosing spondylitis.  

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We have evaluated claims that impaired peripheral blood lymphocyte (PBL) transformation can occur with Klebsiella spp. in patients with ankylosing spondylitis (AS). PBL of four AS patients were cultured in vitro with autogenous faecal klebsiella, as were the PBL of age (+/- 3 years) and sex-matched pairs of 15-20 AS and normal controls cultured with heterogeneous AS-derived klebsiella and control bacterial isolates. Three of four AS patients responded to their own isolates, and no significant...

Kinsella, T. D.; Lanteigne, C.; Fritzler, M. J.; Lewkonia, R. M.

1984-01-01

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Ankylosing spondylitis in Ireland: patient access and response to TNF-? blockers.  

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To investigate a group of Irish ankylosing spondylitis patients: current prescription practice for TNF blockers and patient response. All patients presenting with ankylosing spondylitis (AS) and treated with TNF-alpha between January 2006 and 2008 in the midwestern region of Ireland were studied. Response was evaluated using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and CRP results at 6 months. A total of 47 AS patients (32 men: 15 women, mean age 37.7 years, median disease duration 20 years, 80% HLA B27 positive) were identified; 66% were on disease-modifying anti-rheumatic drugs (DMARDs) concomitantly. All patients satisfied BSR/ASAS disease severity criteria for TNF-alpha at baseline, and mean BASDAI was 6.2, BASFI 6.9, and CRP 27.5 mg/L. At 6 months, these had reduced to a mean BASDAI of 3.8, BASFI 4.6, and CRP of 8.9 mg/L. Patients with advanced AS (disease duration >10 years, mean BASFI 7.5) responded at least as well. No allergies or serious side effects were encountered, and one patient successfully switched TNF agent due to secondary failure. Initial good responses at 6 months were seen to be maintained in sub-group analysis at 12 months. Disease severity in patients gaining access to treatment for active AS with TNF blockers in Ireland is very high. Patients mainly satisfy international guidelines for the use of biologics (BSR, EULAR) with some minor exceptions. High disease activity and long disease duration may predict better treatment response. Response rates were good and treatment was well tolerated, and no differences in response were noted between the 3 agents employed. PMID:21286722

Saeed, Aamir; Khan, Mumtaz; Elmamoun, Musaab; Brady, Mary; Morrissey, Siobhan; Fraser, Alexander Duncan

2012-05-01

 
 
 
 
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Relationship Between Bone Mineral Density and Disease Activity in Patients with Ankylosing Spondylitis  

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Objective: This retrospective study was planned to determine the relationship between bone mineral density (BMD) and clinical, radiological and laboratory parameters in patients with ankylosing spondylitis (AS). Materials and Methods: The study group consisted of 28 patients with a mean disease duration of 11.9±6.1 years. In addition to clinical and demographic variables, lumbar and femoral BMD were evaluated with dual energy X-ray absorbtiometry. Lumbar spine score (LSS) and sacroiliac sco...

Hasan Ulusoy; Ayhan Bilgici; Ömer Kuru; Nebahat Sar?ca; ?ule Arslan; Ünal Erkorkmaz

2010-01-01

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Bone Mineral Density in Patients with Ankylosing Spondylitis: Incidence and Correlation with Demographic and Clinical Variables  

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Objective: To evaluate bone mineral density (BMD) in patients with ankylosing spondylitis (AS) and determine its correlation with the demographic and clinical characteristics of AS. Patients and Methods: Demographic, clinical and osteodensitometric data were evaluated in a cross-sectional study that included 136 patients with AS. Spine and hip BMD were measured by means of dual energy X-ray absorptiometry (DXA). Using the modified Schober’s test we assessed spine mobility. We examined the s...

Muntean, Laura; T?igan, S?tefan I.; Simon, Siao-pin; Bolos?iu, Ca?lin R.; S?tefan, Simona; Petcu, Ana; Rednic, Simona; Bolos?iu, Horat?iu D.

2009-01-01

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Assessment of Pulmonary Changes in Patients with Ankylosing Spondylitis with High Resolution Computed Tomography  

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Full Text Available Objective: In this study, our aim was to investigate the pleural and parenchymal changes and their frequency in patients with ankylosing spondylitis using high resolution computed tomography.Patients and Methods: A total of 23 patients with the diagnosis of ankylosing spondylitis were included in the study. In all patients high resolution computed tomography of the lung was performed after maximum inspiration and expiration. Previous pulmonary findings of 11 cases were used for the analysis of the images.Results: Pulmonary changes were detected in 13 (57% of 23 patients using high resolution computed tomography. No parenchymal changes were detected in the remaining 10 patients. The most frequently detected finding was parenchymal nodules seen in 11 (48% patients. This was followed by parenchymal band formation in 9 (39% patients. In addition, mosaic pattern in 6 (26% patients, bronchiectasis in 5 (22% patients, emphysema, interlobular septal thickening, pleural thickening and/or ground glass opacity in 3 (13% patients, bronchial wall thickening in 2 (9% patients and honeycomb lung in 1 (4% patient, were detected.Conclusion: High resolution computed tomography of the lung is an effective method in demonstrating the pulmonary changes in patients with ankylosing spondylitis.

Hasan Dursun

2008-06-01

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Tramadol/acetaminophen combination as add-on therapy in the treatment of patients with ankylosing spondylitis.  

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This study aimed to determine the safety and efficacy of tramadol 37.5 mg/acetaminophen 325 mg combination tablets (Ultracet®) in patients with ankylosing spondylitis (AS). This was a 12-week, randomized, double-blind, placebo-controlled study. Sixty patients with active AS according to the Modified New York Criteria were enrolled. Active disease was defined by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for more than 3 at randomization. Subjects were randomized equally into two groups: the treatment group received aceclofenac plus Ultracet® one tablet twice a day, and the control group received aceclofenac plus placebo for 12 weeks. The primary endpoint was a difference of Assessment in Ankylosing Spondylitis (ASAS20) response criteria between two groups at week 12. At week 12, ASAS20 was achieved by 53.3 % of the aceclofenac plus Ultracet group and 31 % of the aceclofenac alone group (p?=?0.047). For the pain visual analogue scale at week 12, there was a reduction of 45.6 % in aceclofenac plus Ultracet group and 25.7 % in the aceclofenac alone group (p?=?0.087). There was no statistically significant difference between two groups in BASDAI, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Global Index, Physician Global Assessment, spinal mobility, ESR, hs-CRP, and Ankylosing Spondylitis Quality of Life Questionnaire. A slight increase in total adverse events was noted with dizziness (7.5 vs 1.5 %), vertigo (4.5 vs 1.5 %), and nausea/vomiting (6 vs 0 %) in the Ultracet arm compared to placebo. The tramadol 37.5 mg/acetaminophen 325 mg combination tablet (Ultracet®) might has additional effect to nonsteroidal anti-inflammatory drugs in the treatment of patients with ankylosing spondylitis. It showed marginal benefit in pain and disease activity. However, a slight increase in minor adverse events was noted. PMID:23192419

Chang, Jhi-Kai; Yu, Chen-Tung; Lee, Ming-Yung; Yeo, Kj; Chang, I-Chang; Tsou, Hsi-Kai; Wei, James Cheng-Chung

2013-03-01

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Bloqueio cardíaco completo em espondilite anquilosante / Complete heart block in ankylosing spondylitis  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A espondilite anquilosante é uma doença reumática crônica de homens jovens que afeta principalmente o esqueleto axial e está associada ao HLA-B27 em 90% dos casos. A incidência de envolvimento cardiovascular em casos de espondilite anquilosante varia entre 10%-30%; foram descritos distúrbios de cond [...] ução em 1%-9% dos pacientes com a doença. A maior parte do grupo acometido demonstra uma relação com doença de longa data. Este é o primeiro relato de bloqueio cardíaco completo em espondilite anquilosante precoce de nosso conhecimento. Abstract in english Ankylosing spondylitis (AS) is a chronic rheumatic disease of young men that affects mainly the axial skeleton and is associated with HLA-B27 in 90% of the cases. Incidence of cardiovascular involvement in AS ranges between 10%-30%; conduction disturbances have been described in 1%-9% of the patient [...] s with AS. The majority of the series show a relationship with longstanding disease. To our knowledge, this is the first report of complete heart block in early AS.

Juan Pablo, Restrepo; María Del Pilar, Molina.

2012-10-01

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Predictive factors for partial remission according to the Ankylosing Spondylitis Assessment Study working group in patients with ankylosing spondylitis treated with anti-TNF? drugs.  

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The objective of this study was to evaluate the predictive factors for achieving partial remission (PR) in patients with ankylosing spondylitis (AS) treated with anti-TNF?. We longitudinally enrolled in a multi-center study 214 AS patients, classified according to New York criteria, treated with anti-TNF? drugs adalimumab (ADA), etanercept (ETA) and infliximab (INF) with at least 12 months of follow up. PR was reached when the score was psoriasis were associated with higher PR rate only at 12 months. Other parameters assessed before treatment, such as BASDAI, BASFI, peripheral arthritis, inflammatory bowel disease and uveitis were not associated with PR. Our long-term longitudinal study in a setting of clinical practice showed that inflammatory parameters (i.e. CRP, ESR) and disease duration represent the most important predictive variables to achieve PR with an anti-TNF? treatment. PMID:25376955

Perrotta, F M; Addimanda, O; Ramonda, R; D'Angelo, S; Lubrano, E; Marchesoni, A; Olivieri, I; Punzi, L; Salvarani, C; Spadaro, A

2014-01-01

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Effects of balneotherapy on the reactants of acute inflammation phase in Ankylosing spondylitis  

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Full Text Available Introduction. Ankylosing spondylitis (AS is a chronic inflammatory disease that affects sacroiliac joints, spinal column and peripheral joints. Beside medication therapy, physical and balneotherapy play an important role in its complex treatment. Objective. The aim of the research was to establish serum concentrations of C-reactive protein (CRP, ? 1-acid glycoprotein (? 1-AGP, ceruloplasmine (CP and erythrocyte sedimentation rate (SE before and after the balneotherapy in ankylosing spondylitis. Methods. The research included 50 AS patients according to the revised New York criteria, of mean age 43 years, who were treated for 14 days on the average at the Clinic for Rheumatology of the Institute 'Niška Banja'. All the patients received medications and balneotherapy (radioactive oligomineral baths, peloid, massage, kinesitherapy; the serum concentrations of CRP, ?1-AGP, CP and SE were measured before and after balneotherapy. Serum proteins were determined using original Nor Partigen plates Boehringer. Erythrocyte sedimentation rate was measured by Westergreen method. Balneotherapy was applied individually, intensively or mildly, depending on the AS stage and activity phase. Results. After dosed balneotherapy, a significant decrease in the concentrations of CP (p<0.05, ?1-AGP (p<0.01 and CRP (p<0.05 was registered in the serums of AS patients. ESR was not significantly reduced. Conclusion. The research proved that ? 1-acid glycoprotein, ceruloplasmine and C-reactive protein represent more sensitive inflammation markers as compared to erythrocyte sedimentation rate. The identification of acute phase reactants is important in the evaluation of dosed balneotherapy efficiency in the treatment of ankylosing spondylitis.

Stamenkovi? Bojana

2009-01-01

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Sugammadex use in difficult intubation due to ankylosing spondylitis and severe restrictive respiratory disease  

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Full Text Available We describe anesthesia management of a 50-year-old man scheduled for thoracic spinal reconstruction, presenting with severe restrictive respiratory disease and difficult airway due to ankylosing spondilitis. The patient was unable to extend his head, had difficulty in breathing and sleeping in supine position due to thoracal deformities. The patient was intubated using intubating laryngeal mask airway to overcome the difficulties of limited mouth opening and head extension. He was extubated following administration of sugammadex to obtain optimal conditions in terms of respiratory muscle function and to prevent hypersecretion and bronchospasm. J Clin Exp Invest 2012; 3 (3: 398-400Key words: Restrictive lung disease, airway management, laryngeal masks, sugammadex, ankylosing spondylitis

Yakup Tomak

2012-09-01

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Radon-therapy in ankylosing spondylitis reduces auto-antibody titers  

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Full Text Available Combined low-dose radon/hyperthermia therapy has been reported to improve pain and mobility in patients with rheumatic disorders. The key feature of inflammatory rheumatic diseases is the induction of autoimmune processes via the production of autoantibodies. As reducing the autoantibody level through administration of biologicals is described to correlate with delay of disease progression, we investigated the impact of combined low-dose radon/hyperthermia therapy on the serum levels of antibodies directed against cyclic citrullinated peptides in patients with ankylosing spondylitis. We found that levels of circulating anti-CCP antibodies is significantly reduced immediately after a 3 weeks of radon therapy regimen.

Angelika Moder

2011-11-01

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Phenotypic Study of Natural Killer Cell Subsets in Ankylosing Spondylitis Patients  

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It has been demonstrated that natural killer (NK) cells play a role in regulation of autoimmunity. They play a protective role in several rodent disease models. In this study we aimed to compare the immunophenotypic features of NK cells in Ankylosing Spondylitis (AS) with normal subjects with regard to CD56 and CD16 molecules. "nThis study was carried out on 30 AS patients and 33 normal volunteer donors. Peripheral Blood Mononuclear cells (PBMC) were tested by flow cytometry detecting the int...

Farhad Shahsavar; Nader Tajik; Maziar Moradi; Hadi Poormoghim; Tahereh Mousavi; Mahboobeh Soofi

2009-01-01

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Pulmonary sarcoidosis in a patient with ankylosing spondylitis treated with infliximab.  

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We present a case of a 34 year-old male diagnosed with ankylosing spondylitis. After two years of treatment with infliximab, the patient developed a clinical picture compatible with stage II thoracic sarcoidosis. These findings resulted in the interruption of infliximab therapy. The patient was not administered new treatment since respiratory function testing did not confirm harmful repercussions. After a follow-up of 1 year, the patient is asymptomatic and radiologic tests show complete resolution of pulmonary infiltrates and mediastinal and bilateral hilar lymphad- enopathy. PMID:17417999

Almodóvar, R; Izquierdo, M; Zarco, P; Javier Quirós, F; Mazzucchelli, R; Steen, B

2007-01-01

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Scintigraphic findings in ankylosing spondylitis. [/sup 99//super m/Tc tracer technique  

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A prospective study of bone scintigraphic findings has been carried out in 63 patients, firmly diagnosed as having ankylosing spondylitis. In addition to abnormal uptake of the radiotracer at the sacroiliac joints, a peripheral arthropathy has been a common finding, particularly in the proximal joints, occurring in up to 50 percent of patients. Increased uptake of radiotracer in the spine has also been found both diffusely and focally. Focal increases have been noted at the apophyseal joints in 40 percent of patients and in three patients with a sterile intervertebral diskitis, an unusual complication of this disease only diagnosed in two patients after bone scintigraphy.

Lentle, B.C.; Russell, A.S.; Percy, J.S.; Jackson, F.I.

1977-06-01

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Espondilite anquilosante: investigação familiar de aspectos clínicos, imunogenéticos e radiológicos / Ankylosing spondylitis: familial investigation of clinical, immunogenetic and radiological aspects  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: avaliar familiares de primeiro grau de pacientes portadores de espondilite anquilosante (EA), em relação a alterações clínicas, imunogenéticas e radiológicas. MÉTODOS: foram avaliados 14 pacientes portadores de EA, acompanhados no Hospital das Clínicas da FMRP-USP e 30 familiares de primei [...] ro grau destes pacientes, pela história clínica e exame físico, tipificação do antígeno HLA-B27 (por microlinfocitotoxicidade e por citometria de fluxo), radiografia simples das articulações sacroilíacas e, em oito familiares, ressonância magnética (RM) da mesma região. RESULTADOS: observou-se que 47% (14/30) dos familiares apresentavam dor lombar com característica inflamatória crônica e 20% deles (6/30) apresentavam evidências radiológicas de sacroiliite bilateral. O diagnóstico de espondilite anquilosante (EA) foi confirmado em 10% dos familiares (3/30). O antígeno HLA-B27 estava presente em 60% dos familiares testados pela técnica de linfocitotoxicidade ou por citometria de fluxo. A RM não se mostrou superior à radiologia convencional na detecção precoce de alterações sacrilíacas. CONCLUSÕES: a avaliação de familiares de primeiro grau de pacientes portadores de EA pode revelar formas paucissintomáticas ou subclínicas da doença em uma proporção significativa de sujeitos. Abstract in english OBJECTIVE: to evaluate first-degree relatives of ankylosing spondylitis (AS) patients regarding to clinical, immunogenetic and radiological aspects. METHODS: fourteen patients with AS followed at the University Hospital of the Ribeirão Preto Medical School, University of São Paulo, Brazil (FMRP-USP) [...] and thirty first-degree relatives were evaluated by clinical history, physical examination, HLA-B27 typing (by lymphocytotoxicity and flow cytometry), plain radiography and magnetic resonance imaging (MRI) of sacroiliacal joints. RESULTS: we found that 47% (14/30) of the relatives presented low back pain with inflammatory characteristics, 20% (6/30) fulfilled displayed radiological features of bilateral sacroiliitis, and 10% (3/30) fulfilled the criteria for ankylosing spondylitis. Sixty percent of the relatives were HLA-B27 positive, verified either by lymphocytotoxicity or flow cytometry. MRI was not more sensitive than conventional radiography in the detection of early changes of sacroiliitis. CONCLUSIONS: the evaluation of first-degree relatives of patients with ankylosing spondylitis may reveal oligosymptomatic and subclinical forms of the disease in a significant proportion of subjects.

Rejane Maria Rodrigues de Abreu, Vieira; Jorge, Elias Jr; Marcello Henrique Nogueira, Barbosa; Júlio César, Voltarelli.

2003-10-01

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Assessment of left ventricular function by tissue Doppler imaging in patients with ankylosing spondylitis  

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Full Text Available Ankylosing spondylitis (ASpis a chronic, inflammatory and systemic disease affecting pericardium, myocardium and the conduction system of the heart. In this study, we aimed to analyse left ventricular systolic and diastolic functions using tissue Doppler imaging (TDI. 30 patients with ASp and 30 healthy volunteers having the similar demographic characteristics were included. Left ventricular systolic and diastolic functions were assessed by using two dimensional (2D echocardiography, M-mode, pulsed-wave (PW and tissue Doppler echocardiography. The peak systolic velocity (Sm, early diastolic myocardial peak velocity (m, late diastolic myocardial peak velocity (Am, isovolumic acceleration (IVA, myocardial precontraction time (PCTm, myocardial contraction time (CTm, myocardial relaxation time (RTm, and myocardial performance index (MPI were measured at septal and lateral mitral annulus. In conventional echocardiography, end-diastolic interventricular septum and posterior wall diameters were higher in patients with ASp than the control group. The ratio of E/A was significantly lower and deceleration time was significantly prolonged in patients with ASp, but mitral E and A velocities, isovolumic relaxation time and MPI were similar in patient and control group (P>0.05. Left ventricular lateral and septal wall tissue Doppler echocardiography showed that Em, Em/Am ratio and CTm were significantly lower, IVRTm was longer and MPI was higher in patients with ASp. No significant differences were detected between the groups for IVA, Sm, Am, PCTm, PCTm/CTm ratio (P>0.05. We have demonstrated that in patients with ASp, diastolic functions were impaired but systolic functions were preserved by using TDI.

Engin Bozkurt

2012-01-01

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Exacerbation of Verruca Vulgaris Associated with Etanercept in A Case of Ankylosing Spondylitis  

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Full Text Available I have read with great interest the manuscript titled “Cervix Cancer in a Patient with Ankylosing Spondylitis Using Etanercept: A Case Report” authored by Doruk et al. (1 and would like to share my experience with regard to a patient develops severe exacerbation of verruca vulgaris under treatment with etanercept. Verruca vulgaris (common wart is an infectious disease caused by human papilloma virus (HPV that is an important risk factor for cervix cancer (2.A 20yearold male patient was diagnosed with ankylosing spondylitis (AS resistant to conventional therapy, three years ago. Treatment with subcutaneous etanercept (50 mg/week was initiated. The patient responded well to etanercept and this treatment was continued. When the patient last came to the outpatient clinic, he complained that he had numerous warts on his hands. The patient reported that, there was only one and small wart on his right hand before etanercept treatment. He had taken etanercept treatment for three years. During this period, the size and number of warts had increased. In the laboratory analyzes, routine biochemical, hematological, and urine tests were found to be within normal limits. Serology for HIV, hepatitis B and C viruses were negative. The chest Xray was evaluated as normal. The patient referred to a dermatologist for the evaluation of these skin lesions. He was diagnosed with verruca vulgaris, and etanercept treatment was discontinued.

MahmutAlpayc?

2013-05-01

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Bath ankylosing spondylitis functional index (BASFI) evaluation of postoperative patients with OPLL.  

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Although surgical decompression of the involved spinal cord achieves a good recovery of neurological conditions, one of the most important complaints of patients with ossification of the posterior longitudinal ligament (OPLL) is disability as a result of spinal immobility. The activities of daily living (ADL) of postoperative patients with OPLL were examined. To evaluate the ADL of postoperative patients with OPLL in the cervical spine, we utilized the Bath Ankylosing Spondylitis Functional Index (BASFI), one of the most widely used functional indexes for ankylosing spondylitis. We investigated consecutive cases that underwent surgery for OPLL of the cervical spine in our department from 1978 to 1998. The latest and postoperative scores were compared to the preoperative Japanese Orthopaedic Association (JOA) scores (range, 0-17) to assess neurological recovery. We also evaluated ADL at the latest follow-up, using BASFI scores. Significant recoveries of JOA scores were confirmed; however, 77% of patients complained of disability. In BASFI, questions that seemed to reflect spinal condition received low scores in the present study. BASFI scoring was not sufficient in the present form; however, it is one of the candidate functional indexes for evaluating ADL in postoperative patients with OPLL. Establishment of an ideal functional index for such evaluation is needed. PMID:14767700

Mori, Kanji; Hukuda, Sinsuke; Katsuura, Akitomo; Saruhashi, Yasuo; Matsusue, Yoshitaka

2004-01-01

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Health-related quality of life in patients with ankylosing spondylitis: a comprehensive review.  

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Ankylosing spondylitis (AS) is a complex systemic rheumatological disease which often causes severe disability and impaired quality of life (QoL). We searched the PubMed/MEDLINE electronic database for available literature on QoL and its predictors in patients with AS. Recent evidence indicates that AS patients have poorer QoL compared to the general population, but similar to that of patients with other rheumatological disorders. Disease activity is one of the most powerful predictors of QoL, however latest advances in pharmacological treatment (namely, anti-TNF-?) along with physical exercise can minimize the effects of AS on QoL. Psychological distress symptoms contribute to impaired QoL both directly and indirectly by influencing disease activity. The impact of other psychosocial variables, however, is less studied and more prospective investigations are necessary, which could eventually lead to the development of psychosocial interventions that are personalized to this patient population. PMID:25193010

Kotsis, Konstantinos; Voulgari, Paraskevi V; Drosos, Alexandros A; Carvalho, André F; Hyphantis, Thomas

2014-12-01

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Acute toxoplasmosis infection in a patient with ankylosing spondylitis treated with adalimumab: a case report  

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Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory disease that affects the axial skeleton, often beginning in the sacroiliac joints, but accompanied also by other signs, including enthesitis, lung fibrosis and eye involvement. AS generally occurs in the second or third decade of life with inflammatory low back pain and has a strong relation with HLA-B27. The objective of the treatment until the end of the 90’s was to ameliorate pain and stiffness and preserve function (1. Nonselective nonsteroidal antiinflammatory drugs (NSAIDs, cyclooxygenase-2 selective inhibitors, and nonpharmalogic interventions, such as physiotherapy, exercise, education, and lifestyle modifications were the basis of the management. Therapy with agents like sulphasalazine was administered for peripheral arthritis (1, 2...

M. de Almeida Santos Jr

2011-06-01

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Intestinal Behçet’s disease appearing during treatment with adalimumab in a patient with ankylosing spondylitis  

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Full Text Available Behçet’s disease (BD is a chronic inflammatory disease affecting multiple organ systems, such as the skin, joints, blood vessels, central nervous system, and gastrointestinal tract. Intestinal BD is characterized by intestinal ulcerations and gastrointestinal symptoms. The medical treatment of intestinal BD includes corticosteroids and immunosupressants. There have been several reports of tumor necrosis factor-? (TNF-? blockers being successful in treatment of refractory intestinal BD. Here, we report on a patient who was diagnosed with intestinal BD despite treatment with the fully humanized TNF-? blocker (adalimumab for underlying ankylosing spondylitis. This patient achieved clinical remission and complete mucosal healing through the addition of a steroid and azathioprine to the adalimumab regimen.

Sook Hee Chung

2013-01-01

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Gastric outlet obstruction due to gastric amyloidosis mimicking malignancy in a patient with ankylosing spondylitis.  

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Amyloidosis is a group of disorders characterized by the extracellular accumulation of insoluble, fibrillar proteins in various organs and tissues. It is classified, on the basis of the identity of the precursor protein, as primary, secondary, or familial amyloidosis. Gastrointestinal amyloidosis usually presents as bleeding, ulceration, malabsorption, protein loss, and diarrhea. However, gastric amyloidosis with gastric outlet obstruction mimicking linitis plastica is rare. We report a case of gastrointestinal amyloidosis with gastric outlet obstruction in a patient with ankylosing spondylitis. The patient was indicated for subtotal gastrectomy because of the aggravation of obstructive symptoms, but refused the operation and was transferred to another hospital. Three months later, the patient died of aspiration pneumonia during medical treatment. PMID:24340260

Seon, Choon Sik; Park, Young Sook; Jung, Yu Min; Choi, Jeong Ho; Son, Byoung Kwan; Ahn, Sang Bong; Kim, Seong Hwan; Jo, Yun Ju

2013-11-01

 
 
 
 
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Inefficacy or Paradoxical Effect? Uveitis in Ankylosing Spondylitis Treated with Etanercept  

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Ankylosing spondylitis (AS) is presented with axial and peripheral articular involvement. Uveitis is a severe and rather specific manifestation of AS. Biologics targeting tumor necrosis factor (TNF) ? are effective on both articular and ocular manifestations of disease. The occurrence of uveitis in patients that never had eye involvement or the relapse of uveitis is described during anti-TNF? treatment. The frequency of these events is slightly higher during therapy with etanercept. The available TNF? blockers show different pharmacokinetics and pharmacodynamics yielding different biological effects. There is an ongoing debate whether uveitis during anti-TNF? has to be considered as paradoxical effect or an inadequate response to therapy. Here, we present a case report and review what the evidences for the two hypotheses are. PMID:24991219

Ometto, Francesca; Botsios, Costantino; Punzi, Leonardo

2014-01-01

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Orthotic correction of postural unleveling in a patient with ankylosing spondylitis.  

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The authors describe the case of a patient with ankylosing spondylitis who was treated with orthotic devices for postural unleveling. The patient described specific pre-existing postural problems, both static and dynamic, that had been present for many years. A unilateral 9-mm gel heel lift was used, followed by custom-molded orthotic devices that incorporated the heel lift. The patient reported immediate resolution of these symptoms after orthotic treatment, as well as increased functionality and satisfaction in activities of daily living, which coincided with the leveling of his posture. The orthotic devices were used until the patient underwent total hip arthroplasty, at which point the orthotic treatment was discontinued. PMID:24481805

Lipton, James A; Mitchell, Lisa J

2014-02-01

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IgA antibody response to klebsiella in ankylosing spondylitis measured by immunoblotting.  

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IgA antibodies to Klebsiella pneumoniae var oxytoca and Proteus mirabilis were measured in 66 patients with ankylosing spondylitis (AS) and 31 with rheumatoid arthritis (RA) and in 51 healthy control subjects, using an immunoblotting technique. The number of antigenic bands to klebsiella on nitrocellulose membrane was higher in 28 patients with active AS than in 38 patients with inactive AS, 31 patients with RA, and 51 healthy control subjects; comparatively smaller increases were found against proteus. In two patients with AS the synovial fluid and the corresponding serum sample showed an identical antibody pattern. Increases in IgA antibodies to klebsiella in patients with AS confirm previous studies using other techniques. PMID:1550409

Shodjai-Moradi, F; Ebringer, A; Abuljadayel, I

1992-02-01

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Antibodies to Klebsiella and Proteus microorganisms in ankylosing spondylitis and rheumatoid arthritis patients measured by ELISA.  

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Antibodies to Klebsiella oxytoca and Proteus mirabilis in 21 active ankylosing spondylitis (AS), 13 active rheumatoid arthritis (RA), 19 inactive RA patients and 18 healthy controls were measured using enzyme-linked immunosorbent assay (ELISA). Elevated anti-Klebsiella antibodies were demonstrated in active AS patients compared to active RA (p less than 0.01), inactive RA patients (p less than 0.001) and controls (p less than 0.005). When measuring antibodies to Proteus, active RA patients showed higher levels of antibodies compared to active AS patients (p less than 0.005) and healthy controls (p less than 0.05). Further investigations are required to assess the role of Klebsiella and Proteus microorganisms in AS and RA respectively. PMID:3042078

Khalafpour, S; Ebringer, A; Abuljadayel, I; Corbett, M

1988-01-01

85

Relationship Between Bone Mineral Density and Disease Activity in Patients with Ankylosing Spondylitis  

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Full Text Available Objective: This retrospective study was planned to determine the relationship between bone mineral density (BMD and clinical, radiological and laboratory parameters in patients with ankylosing spondylitis (AS. Materials and Methods: The study group consisted of 28 patients with a mean disease duration of 11.9±6.1 years. In addition to clinical and demographic variables, lumbar and femoral BMD were evaluated with dual energy X-ray absorbtiometry. Lumbar spine score (LSS and sacroiliac score (SIS were calculated by grading of standard radiographs. Erythrocyte sedimentation rate (ESR and C-reactive protein (CRP level were determined as laboratory parameters.Results: The rate of osteoporosis and osteopenia were 7.1% and 25% at the lumbar spine, and 14.2% and 17.8% at the femoral neck, respectively. LSS was significantly correlated with lumbar BMD (r=0.70, p<0.001, but not with femoral neck BMD (r=-0.11, p=0.55. SIS was negatively correlated with femoral neck BMD (r=-0.79, p<0.001, but not correlated with lumbar BMD (r=0.19, p=0.32. While lumbar BMD was positively correlated with disease duration (r=0.37, p=0.05, femoral neck BMD showed negative correlation with disease duration (r=-0.46, p=0.01. The evaluation of clinical paramaters and BMD showed that morning stiffness, spinal pain, ESR and CRP were not correlated with BMD. Only modified Schober’s test was related to BMD on both lumbar spine and femoral neck.Conclusion: Ankylosing spondylitis patients are at risk for developing osteoporosis. In advanced disease, the lumbar BMD is misleadingly high because of paravertebral calcification and ossification. Therefore, it is more rational to evaluate the BMD at the femoral neck.

Hasan Ulusoy

2010-03-01

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Ankylosing Spondylitis  

Science.gov (United States)

... of time where the pain lessens. In the sacroiliac joints and spine, inflammation can cause pain and stiffness. Over time, bony outgrowths called syndesmophytes can develop that cause the vertebrae to grow together, or fuse. Fusion can also stiffen the rib cage, resulting in ...

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A parallel analysis of cancer mortality among atomic bomb survivors and patients with ankylosing spondylitis given X-ray therapy.  

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Radiation-induced cancer mortality rates among atomic bomb survivors with doses of at least 100 rad and patients with ankylosing spondylitis given X-ray therapy have been compared for the first time. The estimated average mean bone marrow dose for the spondylitics is more than twice that for atomic bomb survivors, and yet spondylitics experienced only half the risk of radiation-induced leukemia of atomic bomb survivors. For sites that were heavily irradiated in the spondylitics, provisional e...

Darby, Sc; Nakashima, E.; Kato, H.

1985-01-01

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Unilateral sternocostoclavicular hyperostosis in a patient with ankylosing spondylitis: A case report with color Doppler ultrasonogram findings.  

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Sternocostoclavicular hyperostosis is a chronic inflammatory disorder affecting the sternoclavicular joint and upper ribs. There is a strong association with seronegative spondyloarthropathy in which bilateral involvement is common. Ultrasonography and Color Doppler findings of this entity have not been described previously, to the best of our knowledge. We describe the findings in a patient of ankylosing spondylitis who was referred for unilateral sternoclavicular joint swelling. PMID:24347862

Mondal, Sumantro; Sinha, Debanjali; Nag, Arijit; Ghosh, Alakendu

2013-07-01

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Thoracic Fracture through a Prior Instrumented Arthrodesis in a Patient with Ankylosing Spondylitis without Hardware Loosening: A Case Report.  

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The objective of this article is to report a case of a patient with ankylosing spondylitis who sustained a fracture through a prior solid arthrodesis without loosening or changing posterior instrumentation. There have been few cases reported of a patient with ankylosing spondylitis suffering a fracture through a prior instrumented arthrodesis. None have noted the instrumentation remaining intact with the fracture through the middle of the construct. The surgeon must be aware of this possibility to avoid spinal instability that may lead to a neurological deficit. We retrospectively reviewed the case. A review of the literature was performed through a PubMed search. A patient was found to have a fracture within a prior construct despite the presence of a posterior instrumentation. The mechanism of failure was a three-column spine fracture with "bending" of the rods. This patient was treated with a revision posterior/anterior instrumentation and fusion with placement of larger-diameter rods for added stiffness. Fractures through a prior instrumented arthrodesis are rare but still can occur in the ankylosing spondylitis patient. Given the higher risk of epidural hematoma and neurological compromise in this patient population, the surgeon must keep this on the differential diagnosis when treating patients with a prior instrumented arthrodesis. PMID:24353934

Saldua, Nelson S; Harrop, James S

2011-12-01

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Fracture in ankylosing spondylitis after minor trauma: radiological pitfalls and treatment by percutaneous instrumentation. A case report.  

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Patients with ankylosing spondylitis may experience spinal fractures even after minor injuries. The diagnosis of non-dislocated spinal fracture is based on clinical symptoms and radiological findings. Difficulties in interpreting the imaging studies can result in considerable diagnostic delays. We describe the steps of the radiological diagnosis in a patient with a fracture of L2 that was not visible on standard lumbar spine radiographs. Magnetic resonance imaging (MRI) T2 STIR sequences allowed determining the location and showed signs of a recent fracture. Then, MRI T1 images and computed tomography provided a detailed evaluation of the fracture line. In patients with ankylosing spondylitis, fracture instability is common, making surgical treatment mandatory. Open surgery is associated with substantial rates of infection and implant loosening. Percutaneous instrumentation has not yet been evaluated for the treatment of spinal fractures in patients with ankylosing spondylitis. This minimally invasive surgical technique enables multilevel internal fixation and may constitute an interesting alternative to open surgery. PMID:23270725

Charles, Y P; Buy, X; Gangi, A; Steib, J-P

2013-02-01

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Radiography of the spine and sacro-iliac joints in ankylosing spondylitis and psoriasis  

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A grading system involving six stages of arthritis from grade O=normal joints to grade V=extensive bony ankylosis in the sacro-iliac joints and a scheme applicable for quantitative registration of the radiographic findings of the spine in ankylosing spondylitis (AS) are detailed. These radiographic grading systems were used in a study comprising 48 patients with psoriasis (group A), 19 patients with AS and psoriasis (group B), 103 patients with AS (group C) and 231 first-degree relatives of the patients belonging to groups B and C (group D). Radiographic abnormalities of the spine were found totally in 80 per cent of the patients belonging to groups B and C. In these groups sclerotic anterior borders of vertebrae (SABS) and/or straightened anterior surfaces of vertebrae were seen totally in 66 per cent. SABS were earlier findings than syndesmophyte formation which was found in 60 per cent of the patients belonging to groups B and C. Except for ankylosis of the apophyseal joints and ossified interspinous ligament most frequently found in the lower lumbar region in patients with duration of disease more than 20 years, all abnormalities of the spine were most frequent in the dorsolumbar junction. Grade V sacro-iliitis was associated with ankylosis of two or more segments of the spine. Such spinal changes were infrequently seen in patients with grade IV sacro-iliitis. This finding supports the previous notion that among patients fulfilling the criteria for AS, there is a group with a non-ankylosing disease. Thus two different subgroups of AS could be identified. Except for frequent unilateral sacro-iliitis and slight changes of the spine in group A no radiographic differences were found between the groups A, B and C. Sacro-iliitis was found in 22(9%) in group D, and 11 of those with sacro-iliitis had abnormalities of the spine compatible with AS. (orig.).

Dale, K.; Vinje, O.

92

ERAP1 structure, function and pathogenetic role in ankylosing spondylitis and other MHC-associated diseases.  

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The endoplasmic reticulum aminopeptidase 1 (ERAP1) is a multifunctional enzyme involved in the final processing of Major Histocompatibility Complex class I (MHC-I) ligands and with a significant influence in the stability and immunological properties of MHC-I proteins. ERAP1 polymorphism is associated with ankylosing spondylitis among HLA-B27-positive individuals and the altered enzymatic activity of natural variants has significant effects on the HLA-B27 peptidome, suggesting a critical pathogenetic role of peptides in this disease. Likewise, the association of ERAP1 with other MHC-I associated disorders and its epistasis with their susceptibility MHC alleles point out to a general role of the MHC-I peptidome in these diseases. The functional interaction between ERAP1 and HLA-B27 or other MHC-I molecules may be related to the processing of specific epitopes, or to a more general peptide-dependent influence on other biological features of the MHC-I proteins. In addition, from a consideration of the reported functions of ERAP1, including its involvement in angiogenesis and macrophage activation, a more complex and multi-level influence in the inflammatory and immune pathways operating in these diseases cannot be ruled out. PMID:23916068

Alvarez-Navarro, Carlos; López de Castro, José A

2014-01-01

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Effects of physical therapy for the management of patients with ankylosing spondylitis in the biological era.  

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Exercise is considered a fundamental tool for the management of ankylosing spondylitis (AS), in combination with pharmacological therapy that with the advent of biological therapy has improved dramatically the control of signs and symptoms of this challenging disease. Current evidence shows that a specific exercise protocol has not been validated yet. The purpose of this review is to update the most recent evidence (July 2010-November 2013) about physiotherapy in AS, analyzing the possible role and synergistic interactions between exercise and biological drugs. From 117 studies initially considered, only 15 were included in the review. The results support a multimodal approach, including educational sessions, conducted in a group setting, supervised by a physiotherapist and followed by a maintaining home-based regimen. Spa exercise and McKenzie, Heckscher, and Pilates methods seem promising in AS rehabilitation, but their effectiveness should be further investigated in future randomized controlled trials (RCTs). When performed in accordance with the American College of Sports Medicine guidelines, cardiovascular training has been proven safe and effective and should be included in AS rehabilitation protocols. Exercise training plays an important role in the biological era, being now applicable to stabilized patients, leading ultimately to a better management of AS by physiatrists and rheumatologists throughout the world. On the basis of the current evidence, further research should aim to determine which exercise protocols should be recommended. PMID:24797772

Giannotti, Erika; Trainito, Sabina; Arioli, Giovanni; Rucco, Vincenzo; Masiero, Stefano

2014-09-01

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Ankylosing spondylitis and multiple sclerosis in an HLA-B27 negative patient.  

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A 41-year-old man presented with vertigo and gait disturbance. He gave a 10-year history of definite ankylosing spondylitis with low back pain, limitation of spinal mobility, decreased chest expansion and radiological evidence of bilateral sacroiliitis. The vertigo attacks started 3 years before and he had insidious evolution of bilateral leg weakness, increased muscle tension and walking disability during the past 2 years. The HLA haplotypes of the patient were A2, A33, B14, B49, Bw4, Bw6, Cw7 and he was HLA-B27 negative. The axial and sagittal cranial magnetic resonance imaging (MRI) showed multiple foci of increased signal intensity in the periventricular white matter and cerebellar hemispheres, suggesting a demyelinating disease process. The MRI of the spine showed centromedullar high intensity lesions at C7, Th7-8, Th9-10 levels. The diagnosis was definite MS (primary progressive MS) as the patient had insidious neurological progression, CSF evidence of inthrathecal production of oligoclonal bands, conduction defects at VEP, multiple brain and additional spinal cord lesions on MRI and continued progression for more than 1 year. PMID:15742608

Tan, Funda Uysal; Tellio?lu, Serdar; Aydin, Gülümser; Erdemo?lu, Ali Kemal; Kele?, I?ik

2004-12-01

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Individual characterization of stably expanded T cell clones in ankylosing spondylitis patients.  

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Ankylosing spondylitis (AS) is commonly characterized by clonal expansions of T cells. However, these clonal populations are poorly studied and their role in disease initiation and progression remains unclear. Here, we performed mass sequencing of TCR V beta libraries to search for the expanded T cell clones for two AS patients. A number of clones comprising more than 5% of the corresponding TCR V beta family were identified in both patients. For the first time, expanded clones were shown to be stably abundant in blood samples of AS patients for the prolonged period (1.5 and 2.5 years for two patients, correspondingly). These clones were individually characterized in respect to their differentiation status using fluorescent cell sorting with CD27, CD28, and CD45RA markers followed by quantitative identification of each clone within corresponding fraction using real time PCR analysis. Stable clones differed in phenotype and several were shown to belong to the proinflammatory CD27 - /CD28 - population. Their potentially cytotoxic status was confirmed by staining with perforin-specific antibodies. Search for the TCR V beta CRD3 sequences homologous to the identified clones revealed close matches with the previously reported T cell clones from AS and reactive arthritis patients, thus supporting their role in the disease and proposing consensus TCR V beta CDR3 motifs for AS. Interestingly, these motifs were also found to have homology with earlier reported virus-specific CDR3 variants, indicating that viral infections could play role in development of AS. PMID:19657773

Mamedov, I Z; Britanova, O V; Chkalina, A V; Staroverov, D B; Amosova, A L; Mishin, A S; Kurnikova, M A; Zvyagin, I V; Mutovina, Z Y; Gordeev, A V; Khaidukov, S V; Sharonov, G V; Shagin, D A; Chudakov, D M; Lebedev, Y B

2009-09-01

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Drug survival rates of tumor necrosis factor inhibitors in patients with rheumatoid arthritis and ankylosing spondylitis.  

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We investigated the compliance of Korean patients using tumor necrosis factor (TNF) inhibitors to treat rheumatoid arthritis (RA) and ankylosing spondylitis (AS), and identified potential predictors associated with treatment discontinuation. The study population comprised 114 RA and 310 AS patients treated with TNF inhibitors at a single tertiary center for at least 1 yr from December 2002 to November 2011. Of the 114 RA patients, 64 (56.1%) discontinued their first TNF inhibitors with a mean duration of 18.1 months. By contrast, 65 of 310 patients (21.0%) with AS discontinued their first TNF inhibitors, with a mean duration of 84 months. Although the survival rate did not differ among the three TNF inhibitors in the AS patients, the etanercept group had a lower discontinuation rate than the infliximab group in the RA patients. In addition, RA patients who received corticosteroids in combination with TNF inhibitors were more likely to discontinue their TNF inhibitors. The independent predictors of drug discontinuation in AS patients were male gender and complete ankylosis on radiographs of the sacroiliac joint. Our results provide further evidence that real-life treatment outcomes of RA and AS patients may be different from those observed in randomized clinical trials. PMID:25246737

Kang, Ji-Hyoun; Park, Dong-Jin; Lee, Jeong-Won; Lee, Kyung-Eun; Wen, Lihui; Kim, Tae-Jong; Park, Yong-Wook; Lee, Shin-Seok

2014-09-01

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Mortality among patients with ankylosing spondylitis after a single treatment course with x-rays  

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Mortality was studied in 14,111 patients with ankylosing spondylitis given a single course of x-ray treatment during 1935-54. Mortality from all causes was 66% greater than that of the general population of England and Wales. The substantial excesses of deaths from non-neoplastic conditions appeared to be associated with the disease itself rather than its treatment. A nearly fivefold excess of deaths from leukaemia and a 62% excess of deaths from cancers of sites that would have been in the radiation fields (''heavily irradiated sites'') were likely to have been a direct consequence of radiation treatment. Excess death rate from leukaemia was greatest three to five years after treatment and close to zero after 18 years. Excess of cancers of heavily irradiated sites did not become apparent until nine or more years after irradiation continuing for a further 11 years. More than 20 years after irradiation the excess risk declined but the fall was not statistically significant. The number of cancers of sites not considered to be in the radiation beams was 20% greater than expected. This excess, although not statistically significant, may have been due to scattered radiation. The risk of a radiation-induced leukaemia or other cancer was related to age at treatment time. (author)

98

Common Mediterranean Fever (MEFV) Gene Mutations Associated with Ankylosing Spondylitis in Turkish Population  

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Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease. Mediterranean fever (MEFV) gene, which has already been identified as being responsible for familial Mediterranean fever (FMF), is also a suspicious gene for AS because of the clinical association of these two diseases. The aim of this study was to explore the frequency and clinical significance of MEFV gene mutations (M694V, M680I, V726A, E148Q and P369S) in a cohort of Turkish patients with AS. Genomic DNAs of 103 AS patients and 120 controls were isolated and genotyped using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) methods. There was a statistically significant difference of the MEFV gene mutation carrier rates between AS patients and healthy controls (p = 0.004, OR: 2.5, 95% CI: 1.32–4.76). This association was also observed in allele frequencies (p = 0.005, OR: 2.3, 95% CI: 1.27–4.2). A relatively higher frequency was observed for M694V mutation in AS patients than controls (10.7% versus 4.2% , p = 0.060). There were no significant differences between MEFV mutation carriers and non-carriers with respect to the clinical and demographic characteristics. The results of this study suggest that MEFV gene mutations are positively associated with a predisposition to develop AS. PMID:22960328

Yigit, Serbulent; Inanir, Ahmet; Karakus, Nevin; Kesici, Esra; Bozkurt, Nihan

2012-01-01

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Drug Survival Rates of Tumor Necrosis Factor Inhibitors in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis  

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We investigated the compliance of Korean patients using tumor necrosis factor (TNF) inhibitors to treat rheumatoid arthritis (RA) and ankylosing spondylitis (AS), and identified potential predictors associated with treatment discontinuation. The study population comprised 114 RA and 310 AS patients treated with TNF inhibitors at a single tertiary center for at least 1 yr from December 2002 to November 2011. Of the 114 RA patients, 64 (56.1%) discontinued their first TNF inhibitors with a mean duration of 18.1 months. By contrast, 65 of 310 patients (21.0%) with AS discontinued their first TNF inhibitors, with a mean duration of 84 months. Although the survival rate did not differ among the three TNF inhibitors in the AS patients, the etanercept group had a lower discontinuation rate than the infliximab group in the RA patients. In addition, RA patients who received corticosteroids in combination with TNF inhibitors were more likely to discontinue their TNF inhibitors. The independent predictors of drug discontinuation in AS patients were male gender and complete ankylosis on radiographs of the sacroiliac joint. Our results provide further evidence that real-life treatment outcomes of RA and AS patients may be different from those observed in randomized clinical trials. Graphical Abstract

2014-01-01

100

Clinical Use of Chest Expansion Corrected for Age and Sex in Patients with Ankylosing Spondylitis  

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Full Text Available Objective: The aim of this study was to investigate if the chest expansion corrected by age and sex was appropriate for clinical practice or not and to evaluate the relation of chest expansion with pulmonary functions and disease severity in patients with ankylosing spondylitis (AS.Metarials and Methods: Eighty-two patients with AS and 42 healthy controls were included in the study. The patients were divided into two groups according to chest expansion corrected by age and sex: restricted and non-restricted groups. Additional to the clinical evaluation, the Bath AS Disease Activity Index (BASDAI, Bath AS Functional Index (BASFI, and Bath AS Metrology Index (BASMI were used to evaluate disease activity, functional impairment, and mobility, respectively.Results: Forced vital capacity and forced expiratory volume in the first second were significantly decreased in the restricted group when compared to the non-restricted and control groups. Pain, BASFI, and BASMI scores were significantly higher in the restricted group compared to the non-restricted one. Chest expansion was significantly correlated with clinical parameters and pulmonary function tests.Conclusion: Chest expansion measurement corrected for age and sex is appropriate for clinical practice and chest expansion is associated with pulmonary functions and disease severity. Turk J Phys Med Re­hab 2011;57:128-33.

Bekir Durmu?

2011-09-01

 
 
 
 
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Phenotypic Study of Natural Killer Cell Subsets in Ankylosing Spondylitis Patients  

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Full Text Available It has been demonstrated that natural killer (NK cells play a role in regulation of autoimmunity. They play a protective role in several rodent disease models. In this study we aimed to compare the immunophenotypic features of NK cells in Ankylosing Spondylitis (AS with normal subjects with regard to CD56 and CD16 molecules. "nThis study was carried out on 30 AS patients and 33 normal volunteer donors. Peripheral Blood Mononuclear cells (PBMC were tested by flow cytometry detecting the intensity of CD56 and CD16 surface molecules. The percentage of positive cells and their subsets were then calculated and statistically analyzed using SPSS software. A significant increase was found in CD56+ CD16+ (P? 0.009, and also in the subset of CD56 dim CD16+ (P? 0.02, but not in CD56 bright CD16+ (P=0.3 NK cells in AS patients compared to controls. We conclude that these results may indicate that NK and their subset ratios play a role in AS pathogenesis. Moreover, determination of NK subsets in combination with clinical features may be useful for AS diagnosis. However, further studies using large samples together with determination of relevant cytokines are recommended to verify the exact role of NK in AS disease.

Farhad Shahsavar

2009-07-01

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Isolation of IgG Antibodies to Toxocara in Ankylosing Spondylitis Patients with Acute Anterior Uveitis  

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Purpose Since few reports had been published on the prevalence of toxocariasis in ankylosing spondylitis (AS) patients with acute non-granulomatous anterior uveitis (ANGAU), the aim of this work was to determine the presence of antibodies against Toxocara canis in AS patients with ANGAU. Methods Thirty-six patients (14 female and 22 male) with AS were enrolled in the study. The history of ANGAU was accepted only if diagnosed by an ophthalmologist. The detection of IgG antibodies to T. canis was determined by enzyme-linked immunosorbent assay. In addition, antibodies to Ascaris lumbricoides were also tested to verify non-specific reactions. Results The prevalence of ANGAU in the AS patients was 58% (21 / 36), and 38% (8 / 21) of the patients with ANGAU were positive for antibodies to Toxocara, while 7% (1 / 15) of AS patients without ANGAU were positive for T. canis (p = 0.038, two tails; mid-p exact). No antibodies were detected to A. lumbricoides antigens in the serum samples of patients with AS. Conclusions These data suggest that the seroprevalence of antibodies to T. canis is high in Mexican patients with AS-associated uveitis, suggesting a chronic asymptomatic toxocariosis, which could be associated with the pathogenesis of ANGAU; however, further larger-scale studies are needed to confirm this observation. PMID:24882953

Jimenez-Balderas, Francisco-Javier; Garcia-Jaimes, Janete; Rios, Rita; Zonana-Nacach, Abraham; Tapia-Romero, Raquel; Villanueva, Nayeli; Mendez-Samperio, Patricia

2014-01-01

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Antibody responses to gut bacteria in ankylosing spondylitis, rheumatoid arthritis, Crohn's disease and ulcerative colitis.  

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Specific immunoreactive anti-Klebsiella antibodies are found in patients with ankylosing spondylitis (AS), a significant proportion of whom have occult inflammatory bowel disease. Molecular mimicry between Klebsiella or other bacterial antigens and HLA-B27 has been suggested in the pathogenesis of AS. The specificity of increased immunoreactivity against Klebsiella remains to be assessed against the abundant anaerobic bacterial flora, present either in healthy controls or in patients with ulcerative colitis (UC) and Crohn's disease (CD). Total immunoglobulin (Ig; IgG, IgA, IgM) immunoreactivity was measured by ELISA against Klebsiella pneumoniae, Proteus mirabilis, Escherichia coli and ten anaerobic isolates of the predominant normal bowel flora in 35 patients with active AS, 60 patients with inflammatory bowel disease (30 CD, 30 UC), 60 patients with active rheumatoid arthritis (RA) and 60 healthy controls. Ig immunoreactivity to K. pneumoniae was significantly elevated in AS (P mirabilis was significantly elevated only in RA patients, compared with the other inflammatory groups (P Proteus in patients with RA. The specificity of these responses in some patients supported a possible role for enteric Klebsiella in the pathogenesis of AS and Proteus in RA. The role of Klebsiella in inflammatory bowel disease requires further study. PMID:9194209

Tiwana, H; Wilson, C; Walmsley, R S; Wakefield, A J; Smith, M S; Cox, N L; Hudson, M J; Ebringer, A

1997-01-01

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Tai Chi for Disease Activity and Flexibility in Patients with Ankylosing Spondylitis—A Controlled Clinical Trial  

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We investigated the effects of tai chi on disease activity, flexibility and depression in patients with ankylosing spondylitis (AS). We allocated 40 patients to either a tai chi treatment group or a no-treatment control group. The tai chi group performed 60 min of tai chi twice weekly for eight consecutive weeks and 8 weeks of home-based tai chi, after which the group showed significant improvement in disease activity and flexibility compared to the control group. All outcome measures were si...

Lee, Eun-nam; Kim, Young-hee; Chung, Won Tae; Lee, Myeong Soo

2008-01-01

105

Espondilite anquilosante e anestesia Espondilitis anquilosante y anestesia Ankylosing spondylitis and anesthesia  

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Full Text Available JUSTIFICATIVA E OBJETIVOS: A espondilite anquilosante (EA é uma doença inflamatória crônica das articulações, incluída no grupo das espondiloartropatias soronegativas. A característica principal dessa doença é a fusão óssea da coluna vertebral que leva à perda permanente da flexibilidade do dorso e do pescoço. Outras grandes articulações e tecidos conectivos poderão estar afetados pelo processo inflamatório. A EA acomete principalmente homens entre 20 e 40 anos; é rara após os 50 anos. As mulheres correspondem somente à minoria de pacientes. Há pouca informação sobre a EA na literatura anestésica. O objetivo deste artigo foi revisar aspectos da EA de interesse para o anestesiologista, permitindo um adequado manuseio perioperatório. CONTEÚDO: Estão definidas as características da espondilite anquilosante quanto à clínica e a conduta anestésica. CONCLUSÕES: Os pacientes com doenças crônicas da coluna vertebral apresentam desafios específicos para o anestesiologista. O manuseio da via aérea e o acesso ao neuroeixo poderão ser difíceis. Preferência tem sido dada à anestesia geral, mesmo com via aérea difícil reconhecida, evitando-se a anestesia no neuroeixo. O grau de envolvimento da coluna cervical determinará o quanto poderá ser difícil a intubação traqueal. Cuidado especial deve ser tomado para evitar a manipulação excessiva da coluna cervical, que poderia levar ao trauma da medula espinhal.JUSTIFICATIVA Y OBJETIVOS: La espondilitis anquilosante (EA es una enfermedad inflamatoria crónica de las articulaciones, incluida en el grupo de las espondiloartropatías soronegativas. La característica principal de esa enfermedad es la fusión ósea de la columna vertebral que conlleva a la pérdida permanente de la flexibilidad del dorso y del cuello. Otras grandes articulaciones y tejidos conectivos podrán estar afectados por el proceso inflamatorio. La EA acomete principalmente a hombres entre los 20 y 40 años; es rara después de los 50 años. Las mujeres corresponden solamente a la minoría de pacientes. Existe poca información sobre la EA en la literatura anestésica. El objetivo de este artículo fue revisar aspectos de la EA de interés para el anestesiólogo, permitiendo un adecuado manoseo perioperatorio. CONTENIDO: Están definidas las características de la espondilitis anquilosante en cuanto a la clínica y la conducta anestésica. CONCLUSIONES: Los pacientes con enfermedades crónicas de la columna vertebral presentan desafíos específicos para el anestesiólogo. El manoseo de la vía aérea y el acceso al neuro-eje podrán ser difíciles. La preferencia ha sido dada a la anestesia general, incluso con la vía aérea de difícil acceso, evitando la anestesia en el neuro-eje. El grado de involucración de la columna cervical determinará cuanto podrá ser difícil la intubación traqueal. Un cuidado especial debe tenerse para evitar la manipulación excesiva de la columna cervical, lo que podría conllevar al trauma de la médula espinal.BACKGROUND AND OBJECTIVES: Ankylosing spondylitis (AS is a chronic inflammatory disease of the joints, included in the group of seronegative spondyloarthropathies. Its main characteristic is the fusion of the bones in the spine, which causes loss of flexibility of the back and neck. Other large articulations and connective tissues can be affected by the inflammatory process. It affects mainly men between the ages of 20 and 40; it is rare after the age of 50. Women represent a minority of patients. There is little information about AS in the anesthetic literature. The objective of this article was to review the characteristics of AS pertaining anesthesiology for an adequate perioperative handling. CONTENTS: The clinical characteristics of ankylosing spondylitis pertaining to the anesthetic conduct are reviewed. CONCLUSIONS: Patients with chronic diseases of the spine represent specific challenges to the anesthesiologist. Handling of the airways and the access to the neuroaxis can be difficult. Most anesthesiologi

Carlos Rogério Degrandi Oliveira

2007-04-01

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{sup 18}F-Fluoride PET/CT for detection of sacroiliitis in ankylosing spondylitis  

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The aim of this study was to evaluate the performance of {sup 18}F-fluoride-PET/CT (PET/CT) for the diagnosis of sacroiliac joint (SIJ) arthritis in patients with active ankylosing spondylitis (AS). Included in the study were 15 patients with AS according to the modified New York criteria (AS group) and with active disease and 13 patients with mechanical low back pain (MLBP; control group) who were investigated with whole-body {sup 18}F-fluoride PET/CT. The ratio of the uptake in the SIJ and that in the sacrum (SIJ/S) was calculated for every joint. The mean SIJ/S ratio of 30 quantified joints in the AS group was 1.66 (range 1.10-3.07) with PET/CT, and the mean SIJ/S ratio of 26 quantified joints in the MLBP group was 1.12 (range 0.71-1.52). The area under the receiver operating characteristic curve for SIJ arthritis was 0.84. With plain radiography as a the gold standard and taking an SIJ/S ratio of >1.3 as the threshold, the sensitivity, specificity and accuracy on a per patient basis were 80%, 77% and 79%, respectively. On a per SIJ basis, the greatest sensitivity (94%) was found in grade 3 sacroiliitis (n = 16). Our results suggest that quantitative {sup 18}F-fluoride PET/CT may play a role in the diagnosis of sacroiliitis in active AS and is an alternative to conventional bone scintigraphy in times of molybdenum shortage. (orig.)

Strobel, Klaus [University Hospital, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Cantonal Hospital Lucerne, Nuclear Medicine, Lucerne (Switzerland); Fischer, Dorothee R.; Stumpe, Katrin D.M.; Schulthess, Gustav K. von [University Hospital, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Tamborrini, Giorgio; Kyburz, Diego; Michel, Beat A.; Ciurea, Adrian [University Hospital Zurich, Department of Rheumatology, Zurich (Switzerland); Hesselmann, Rolf G.X.; Johayem, A. [University Hospital Zurich, Radiopharmacy, Zurich (Switzerland)

2010-09-15

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18F-Fluoride PET/CT for detection of sacroiliitis in ankylosing spondylitis  

International Nuclear Information System (INIS)

The aim of this study was to evaluate the performance of 18F-fluoride-PET/CT (PET/CT) for the diagnosis of sacroiliac joint (SIJ) arthritis in patients with active ankylosing spondylitis (AS). Included in the study were 15 patients with AS according to the modified New York criteria (AS group) and with active disease and 13 patients with mechanical low back pain (MLBP; control group) who were investigated with whole-body 18F-fluoride PET/CT. The ratio of the uptake in the SIJ and that in the sacrum (SIJ/S) was calculated for every joint. The mean SIJ/S ratio of 30 quantified joints in the AS group was 1.66 (range 1.10-3.07) with PET/CT, and the mean SIJ/S ratio of 26 quantified joints in the MLBP group was 1.12 (range 0.71-1.52). The area under the receiver operating characteristic curve for SIJ arthritis was 0.84. With plain radiography as a the gold standard and taking an SIJ/S ratio of >1.3 as the threshold, the sensitivity, specificity and accuracy on a per patient basis were 80%, 77% and 79%, respectively. On a per SIJ basis, the greatest sensitivity (94%) was found in grade 3 sacroiliitis (n = 16). Our results suggest that quantitative 18F-fluoride PET/CT may play a role in the diagnosis of sacroiliitis in active AS and is an alternative to conventional bone scintigraphy in times of molybdenum shortage. (orig.)

108

Muscle activation patterns and gait biomechanics in patients with ankylosing spondylitis  

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Full Text Available Patients with ankylosing spondylitis (AS may experience a progressive spinal kyphosis, which induces a forward and downward displacement of the centre of mass (COM of the trunk with consequent use of mechanisms to compensate for the displacement of the trunk. The analysis of patterns of movement gives an important opportunity for follow-up of patients and is an useful tool to plan a therapeutic and rehabilitative program. Objective: The aim of our study was to contribute to the description of abnormalities of gait biomechanics in patients with AS and to individualize, if existing, a typical pattern of these patients. Methods: Five patients with AS (3 men, 2 women were evaluated by gait analysis. Each patient was assessed with dynamic electromyography, with survey of phases of gait cycle and 3D video-analysis of gait related to data of platform (Digivec ® which allows to display real time the force vector of reaction foot-ground overlapping the screen image of patient. Results: The dynamometric platform located the following problems: increasing of the medium-lateral component of the reaction force on the ground in the mild and terminal stance. The anterior-posterior reaction force is diminished in both the initial and the terminal component. The timing of activation of the tibialis anterior results prolonged while the timing of activation of the gastrocnemius medialis results delayed. Conclusion: The patients with AS prefer therefore an eccentric contraction of the tibial anterior in comparison to a concentric contraction of the gastrocnemius medialis, “opting” for a gait strategy that confers greater stability but limited power.

A. Caliri

2011-09-01

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Effect of aquatic exercise on ankylosing spondylitis: a randomized controlled trial.  

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Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that affects mainly the axial skeleton and causes significant pain and disability. Aquatic (water-based) exercise may have a beneficial effect in various musculoskeletal conditions. The aim of this study was to compare the effectiveness of aquatic exercise interventions with land-based exercises (home-based exercise) in the treatment of AS. Patients with AS were randomly assigned to receive either home-based exercise or aquatic exercise treatment protocol. Home-based exercise program was demonstrated by a physiotherapist on one occasion and then, exercise manual booklet was given to all patients in this group. Aquatic exercise program consisted of 20 sessions, 5× per week for 4 weeks in a swimming pool at 32-33 °C. All the patients in both groups were assessed for pain, spinal mobility, disease activity, disability, and quality of life. Evaluations were performed before treatment (week 0) and after treatment (week 4 and week 12). The baseline and mean values of the percentage changes calculated for both groups were compared using independent sample t test. Paired t test was used for comparison of pre- and posttreatment values within groups. A total of 69 patients with AS were included in this study. We observed significant improvements for all parameters [pain score (VAS) visual analog scale, lumbar flexion/extension, modified Schober test, chest expansion, bath AS functional index, bath AS metrology index, bath AS disease activity index, and short form-36 (SF-36)] in both groups after treatment at week 4 and week 12 (p social functioning (p water-based exercises produced better improvement in pain score and quality of life of the patients with AS compared with home-based exercise. PMID:24626605

Dundar, U; Solak, O; Toktas, H; Demirdal, U S; Subasi, V; Kavuncu, V; Evcik, D

2014-11-01

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Retraction: Psychometric characteristics of the ankylosing spondylitis quality of life questionnaire, short form 36 health survey, and functional assessment of chronic illness therapy-fatigue subscale  

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Full Text Available Abstract Retraction of Revicki DA, Rentz AM, Luo MP, Wong RL, Doward LC, McKenna SP: Psychometric characteristics of the ankylosing spondylitis quality of life questionnaire, short form 36 health survey, and functional assessment of chronic illness therapy-fatigue subscale. Health and Quality of Life Outcomes 2009, 7: 6.

Wong Robert L

2009-04-01

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Capacidad funcional y factores asociados en pacientes con espondilitis anquilopoyética / Functional capacity and associated factors in patients with ankylosing spondylitis  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Introducción: la limitación funcional y la discapacidad son las consecuencias fundamentales para los pacientes con espondilitis anquilopoyética, diversos factores han sido relacionados con la discapacidad y su repercusión en la calidad de vida de estos enfermos. Objetivo: evaluar la capacidad funcio [...] nal y determinar factores asociados en los pacientes con espondilitis anquilopoyética. Métodos: se realizó un estudio transversal, descriptivo que incluyó 80 pacientes de la Consulta de Protocolo de Espondiloartropatías atendidos de junio de 2007 a julio de 2009. Se obtuvieron datos demográficos, clínicos, radiológicos y de laboratorio. Se evaluó la capacidad funcional aplicando el índice Bath Ankylosing Spondylitis Functional Index (BASFI) y se determinaron las asociaciones existentes. Resultados: predominó el sexo masculino (66,3 %). La edad media fue 40,1 años. La edad de inicio de la enfermedad, mayor de 20 años (73,8 %), presentó mayor BASFI (p=0,01), la ocupación laboral mostró diferencia significativa (56,14 %, p=0,04). El tiempo de demora del diagnóstico mayor de 10 años resultó significativo (p=0,03). El segmento cervical, la sacroilitis y el Bath Ankylosing Spondylitis Activity Index (BASDAI) reflejaron incremento del BASFI, significación estadística (p=0,01), no así, los reactantes de fase aguda y el HLA-B27. Conclusiones: la capacidad funcional se asocia de forma significativa con la edad de inicio de la enfermedad, el tiempo de demora del diagnóstico, la afectación del segmento cervical, la ocupación laboral, la sacroilitis y la actividad de la enfermedad. Abstract in english Introducción: the functional limitation and the inability are the mayor consequences for patients presenting Ankylosing Spondylitis, Different factors have been related to inability and its repercussion in the quality of life of these patients. Objective: to assess the functional ability and to dete [...] rmine associated factors. Method: a cross-sectional and descriptive study was conducted including 80 patients from the Protocol Consultation of Spondylo-artropathies seen from June, 2007 to July, 2009. Demographic, clinical, radiological, and laboratory data were obtained. The functional ability was assessed applying BASFI rate (Bath Ankylosing Spondylitis Functional Index) and the existing associations were determined. Results: there was male sex predominance, (63.3 %). The mean age was 40,1 years. The disease onset period - older than 20 years old (73.8 %), had great BASFI (p=0 0.01); the occupation showed significant difference (56.14 %, p=0.04). The delay time from diagnosis, longer than 10 years, was significant (p=0.03). The cervical segment, sacroiliitis and BASDAI (Bath Ankylosing Spondylitis Activyt) showed a statistically significant BASFI increase (p=0.01), except the acute phase reactants and HLA-B27. Conclusions: the functional ability is significantly associated with the disease onset age, diagnosis delay time, involvement of cervical segment, occupation, sacroiliitis, and the disease activity.

Nelsa, Casas Figueredo; Jelsys, Vidal Rojas; Dionisio, Pérez Campos; Concepción, Castell Pérez; Ángela, Gutiérrez Rojas.

2014-03-01

112

Relationship Between Upper Extremity Muscle Strength and Functional Level and Mobility in Patients with Ankylosing Spondylitis  

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Full Text Available Objective: To assess muscle strength of upper extremity muscles in patients with ankylosing spondylitis (AS and analyze any association between muscle strength and mobility and functional level. Materials and Methods: 30 patients diagnosed as AS and 20 healthy controls were included into the study. Demographics such as age, gender, body mass index, disease duration, and physical activity level were recorded. Mobility parameters [occiput-wall (OWD, chin-sternum (CSD, finger-floor distances (FFD, modified Schober (MS, and chest expansion diameter (CED] were evaluated in both groups. Deltoid anterior, trapezius middle, rhomboid and biceps muscle strength were measured by manual upper extremity-trunk dynamometer. Bath AS Functional Index (BASFI and Bath AS Disease Activity Index (BASDAI were used to evaluate functional level. Groups were compared by Mann–Whitney U test. The relationship between muscle strength and mobilization parameters and functional level were analyzed by Spearman correlation coefficient. Results: Mean age of the patients was 34.8±9.1 and the mean disease duration was 8.4±8.3 years (9/21: female/male. The mean age of controls was 34.0±7.3 years (7/13: female/male. All assessed mobilization parameters except CSD and OWD and muscle strengths except rhomboid muscle were significantly lower in patients (p<0.05. In the patient group, biceps muscle strength was associated with MS (r=0.480, p=0.038, CED (r=0.472, p=0.011, and inversely with FFD (-0.628, p=0.000. Middle trapezius muscle strength was associated with MS (r=0.621, p=0.005 and inversely with FFD (r=-0.610, p=0.001. Anterior deltoid muscle strength was associated with MS (r=0.383, p=0.044, CED (r=0.513, p=0.005, and inversely with FFD (r=-0.645, p=0.000 and CSD (r=-0.498, p=0.008. Rhomboid muscle strength was associated with MS, CED (r=0.421, p=0.026, and inversely with FFD (r=-0.504, p=0.006. No correlation was found between measured muscle strength and BASFI and BASDAI scores. Conclusion: Upper extremity muscle strengths decrease in patients with AS. There is an association between upper extremity muscle strengths and mobility.

Duygu Geler Külcü

2009-06-01

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Vertebral Osteotomies in Ankylosing Spondylitis-Comparison of Outcomes Following Closing Wedge Osteotomy versus Opening Wedge Osteotomy: A Systematic Review.  

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Study Design?Systematic review. Study Rationale?To seek out and assess the best quality evidence available comparing opening wedge osteotomy (OWO) and closing wedge osteotomy (CWO) in patients with ankylosing spondylitis to determine whether their results differ with regard to several different subjective and objective outcome measures. Objective?The aim of this study is to determine whether there is a difference in subjective and objective outcomes when comparing CWO and OWO in patients with ankylosing spondylitis suffering from clinically significant thoracolumbar kyphosis with respect to quality-of-life assessments, complication risks, and the amount of correction of the spine achieved at follow-up. Methods?A systematic review was undertaken of articles published up to July 2012. Electronic databases and reference lists of key articles were searched to identify studies comparing effectiveness and safety outcomes between adult patients with ankylosing spondylitis who received closing wedge versus opening wedge osteotomies. Studies that included pediatric patients, polysegmental osteotomies, or revision procedures were excluded. Two independent reviewers assessed the strength of evidence using the GRADE criteria and disagreements were resolved by consensus. Results?From a total of 67 possible citations, 4 retrospective cohorts (class of evidence III) met our inclusion criteria and form the basis for this report. No differences in Oswestry Disability Index, visual analog scale for pain, Scoliosis Research Society (SRS)-24 score, SRS-22 score, and patient satisfaction were reported between the closing and opening wedge groups across two studies. Regarding radiological outcomes following closing versus opening osteotomies, mean change in sagittal vertical axis ranged from 8.9 to 10.8 cm and 8.0 to 10.9 cm, respectively, across three studies; mean change in lumbar lordosis ranged from 36 to 47 degrees and 19 to 41 degrees across four studies; and mean change in global kyphosis ranged from 38 to 40 degrees and 28 to 35 degrees across two studies. Across all studies, overall complication risks ranged from 0 to 16.7% following CWO and from 0 to 23.6% following OWO. Conclusion?No statistically significant differences were seen in patient-reported or radiographic outcomes between CWO and OWO in any study. The risks of dural tear, neurological injury, and reoperation were similar between groups. Blood loss was greater in the closing wedge compared with the opening wedge group, while the risk of paralytic ileus was less. The overall strength of evidence for the conclusions is low. PMID:24436696

Ravinsky, Robert A; Ouellet, Jean-Albert; Brodt, Erika D; Dettori, Joseph R

2013-04-01

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Espondilitis anquilosante primaria: patrones clínicos en pacientes cubanos Primary ankylosing spondylitis: clinical patterns in Cuban patients  

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Full Text Available Se estudiaron retrospectivamente 70 pacientes con diagnóstico de espondilitis anquilosante (EA primaria, según los criterios de Nueva York modificados, para investigar sus patrones clínicos en pacientes cubanos. Los datos demográficos, clínicos y radiológicos fueron comparados según sexo, raza, edad de inicio de la EA y status del antígeno HLA-B27. Se encontró predominio de pacientes del sexo masculino (80,0 %, de raza caucásica (82,9 %, de inicio de la EA en la adultez (90,0 %, y positivos de HLA-B27 (90,0 %. Los antecedentes familiares de EA se registraron en 17,1 % de los pacientes. La afectación axial pura se observó en 4,3 %; la entesopatía, en 81,4 %; y la artritis periférica, en 58,6 %. La uveítis anterior aguda fue la manifestación extraarticular más frecuente (17,1 %. El sexo masculino se asoció con insuficiencia aórtica y el femenino, con fibromialgia (p = 0,11; también el sexo se asoció con la ubicación de los pacientes, mientras los hombres procedieron del medio urbano, las mujeres lo hicieron del medio rural (p = 0,001. La raza no caucásica, a diferencia de la caucásica, fue sometida al reemplazo total de cadera (p = 0,027. Los pacientes con EA de inicio juvenil presentaron con mayor frecuencia artritis periférica (p = 0,019, y necesitaron reemplazo total de cadera (p = 0,003. Los pacientes positivos de HLA-B27 presentaron con mayor frecuencia, sacroileítis bilateral grados 3 y 4 (p = 0,009, dolor bajo de espalda (p = 0,023, entesopatía (p = 0,006, y un tiempo de duración más largo de la EA que los pacientes negativos para este alelo (8,1 y 3,6 años, p = 0,021. Se concluyó que el sexo marcó diferencias en las manifestaciones extraarticulares de la EA, la raza caucásica y la no caucásica presentaron manifestaciones clínicas similares, el inicio juvenil de la EA se caracterizó por la artritis periférica, y la presencia del HLA-B27 se asoció a manifestaciones axiales y entesopatía.70 patients with diagnosis of primary ankylosing spondylitis, according to the modified criteria of New York, were retrospectively studied aimed at investigating its clinical patterns in Cuban patients. The demographic, clinical and radiological data were compared by sex , race, age at the onset of AS, and status of the HLA-B27 antigen. There was a predominance of males (80.0 %, of individuals of the Caucasian race (82.90 %, of onset of the ankylosing spondylitis at adulthood (90.0 %, and of positive HLA-B27 (90.0 %. The familiy histories of AS were registered in 17.1 % of the patients. The pure axial affection was observed in 4.3 %, enthesopathy in 81.4 %, and peripheral arthritis in 58.6 %. The anterior severe uveitis was the most frequent extraarticular manifestation (17.1 %. The male sex was associated with aortic failure and the female sex with fibromyalgia (p=0.11. Sex was also associated with the location of the patients. Males came from urban areas, and females from rural areas (p=0.001. The non-Caucasian race differently from the Caucasian, was subjected to total hip replacement (p=0.027. Those patients with AS of juvenile onset presented peripheral arthirits more frequently (p=0.019, and needed total hip replacement (p =0.003. Bilateral grade 3 and 4 sacro-illitis (p = 0,009, low back pain (p=0.023, and enthesopathy were more common in the patients positive for HLA-B27 than in the patients negative for this allele. The time of duration of AS was also longer (8.1 y 3.6 years, p=0.021. It was concluded that the male sex marked differences in the extraarticular manifestations of AS, the Caucasian and the non-Caucasian races presented similar clinical manifestations, the juvenile onset of AS was characterized by peripheral arthritis, and that the presence of HLA-B27 antigen was associated with axial manifestations and enthesopathy.

Elena Kokuina

2007-03-01

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Criptosporidiose em paciente com espondilite anquilosante usando adalimumabe / Cryptosporidiosis in a patient with ankylosing spondylitis treated with adalimumab  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A criptosporidiose é uma doença parasitária causada pelo protozoário Cryptosporidium sp. Observou-se um aumento no número de diagnósticos realizados nos últimos vinte anos, principalmente em pacientes que apresentam imunodeficiências como a síndrome da imunodeficiência humana adquirida e as imunodef [...] iciências induzidas como em pacientes transplantados e nos que necessitam realizar hemodiálise frequentemente. Relata-se o caso de um jovem com espondilite anquilosante que, usando adalimumabe, apresentou diarreia devido à criptosporidiose. Abstract in english Cryptosporidiosis is a parasitic disease caused by a protozoan called Cryptosporidium sp. An increased number of diagnoses were made in the last 20 years, especially in patients with immunodeficiency like the acquired human immunodeficiency syndrome and induced immunodeficiency, such as in transplan [...] t patients and those who need frequent hemodialysis, has been observed. We report the case of a young patient with ankylosing spondylitis treated with adalimumab who developed chronic diarrhea secondary to cryptosporidiosis

Fernando Augusto, Chiuchetta.

2010-06-01

116

A new HLA-B*27 allele (B*2719) identified in a Lebanese patient affected with ankylosing spondylitis.  

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Eighteen different HLA-B*27 alleles (B*2701-B2718) have so far been recognized by the WHO Nomenclature Committee for Factors of the HLA System. Frequency and disease association of these alleles with spondyloarthropathies differ among ethnic groups. We describe here a novel HLA-B*27 subtype identified in a Lebanese patient suffering from ankylosing spondylitis (AS). This new variant differs from the common HLA-B*2705 DNA sequence at five different nucleotide positions. These nucleotide changes lead to three amino acid differences in the alpha2 domain; Thr to Ile at position 94, Leu to Ile at position 95 and Asn to Arg at position 97. Since this novel allele is encountered in an AS patient, the associated sequence changes are not expected to affect significantly neither the presentation of a putative arthritogenic peptide nor the conformation-dependent recognition by effector cells. PMID:11580853

Tamouza, R; Mansour, I; Bouguacha, N; Klayme, S; Djouadi, K; Laoussadi, S; Azoury, M; Dulphy, N; Ramasawmy, R; Krishnamoorthy, R; Toubert, A; Naman, R; Charron, D

2001-07-01

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Criptosporidiose em paciente com espondilite anquilosante usando adalimumabe Cryptosporidiosis in a patient with ankylosing spondylitis treated with adalimumab  

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Full Text Available A criptosporidiose é uma doença parasitária causada pelo protozoário Cryptosporidium sp. Observou-se um aumento no número de diagnósticos realizados nos últimos vinte anos, principalmente em pacientes que apresentam imunodeficiências como a síndrome da imunodeficiência humana adquirida e as imunodeficiências induzidas como em pacientes transplantados e nos que necessitam realizar hemodiálise frequentemente. Relata-se o caso de um jovem com espondilite anquilosante que, usando adalimumabe, apresentou diarreia devido à criptosporidiose.Cryptosporidiosis is a parasitic disease caused by a protozoan called Cryptosporidium sp. An increased number of diagnoses were made in the last 20 years, especially in patients with immunodeficiency like the acquired human immunodeficiency syndrome and induced immunodeficiency, such as in transplant patients and those who need frequent hemodialysis, has been observed. We report the case of a young patient with ankylosing spondylitis treated with adalimumab who developed chronic diarrhea secondary to cryptosporidiosis

Fernando Augusto Chiuchetta

2010-06-01

118

Duration of remission after halving of the etanercept dose in patients with ankylosing spondylitis: a randomized, prospective, long-term, follow-up study  

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Full Text Available Fabrizio Cantini, Laura Niccoli, Emanuele Cassarà, Olga Kaloudi, Carlotta NanniniDivision of Rheumatology, Misericordia e Dolce Hospital, Prato, ItalyBackground: The aim of this study was to evaluate the proportion of patients with ankylosing spondylitis maintaining clinical remission after reduction of their subcutaneous etanercept dose to 50 mg every other week compared with that in patients receiving etanercept 50 mg weekly.Methods: In the first phase of this randomized, prospective, follow-up study, all biologic-naïve patients identified between January 2005 and December 2009 as satisfying the modified New York clinical criteria for ankylosing spondylitis treated with etanercept 50 mg weekly were evaluated for disease remission in January 2010. In the second phase, patients meeting the criteria for remission were randomized to receive subcutaneous etanercept as either 50 mg weekly or 50 mg every other week. The randomization allocation was 1:1. Remission was defined as Bath Ankylosing Spondylitis Disease Activity Index < 4, no extra-axial manifestations of peripheral arthritis, dactylitis, tenosynovitis, or iridocyclitis, and normal acute-phase reactants. The patients were assessed at baseline, at weeks 4 and 12, and every 12 weeks thereafter. The last visit constituted the end of the follow-up.Results: During the first phase, 78 patients with ankylosing spondylitis (57 males and 21 females, median age 38 years, median disease duration 12 years were recruited. In January 2010, after a mean follow-up of 25 ± 11 months, 43 (55.1% patients achieving clinical remission were randomized to one of the two treatment arms. Twenty-two patients received etanercept 50 mg every other week (group 1 and 21 received etanercept 50 mg weekly (group 2. At the end of follow-up, 19 of 22 (86.3% subjects in group 1 and 19 of 21 (90.4% in group 2 were still in remission, with no significant difference between the two groups. The mean follow-up duration in group 1 and group 2 was 22 ± 1 months and 21 ± 1.6 months, respectively.Conclusion: Remission of ankylosing spondylitis is possible in at least 50% of patients treated with etanercept 50 mg weekly. After halving of the etanercept dose, remission is maintained in a high percentage of patients during long-term follow-up, with important economic implications.Keywords: ankylosing spondylitis, anti-tumor necrosis factor, etanercept, remission, dose reduction

Nannini C

2013-01-01

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Infliximab has no apparent effect in the inner ear hearing function of patients with rheumatoid arthritis and ankylosing spondylitis.  

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Animal studies suggest that tumor necrosis factor (TNF) alpha blockers may pass to the inner ear in adequate concentration. In this prospective study, we aimed to evaluate the effect of infliximab on the inner ear hearing function in patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA). The patients with high disease activity, who were planned to begin infliximab for therapy by physical medicine and rehabilitation department, were referred to ear-nose-throat clinic for consultation. After physical and otoscopic examination, audiological tests were performed. Air conduction thresholds between 250 and 8,000 Hz, bone conduction thresholds between 500 and 4,000 Hz, pure tone average, speech discrimination scores, distortion product otoacoustic emission (DPOAE) were used to evaluate the hearing function. The tests were repeated 2 and 6 months after the initiation of the drug "infliximab." A total of 44 ears of 22 patients (17 males and 5 females) were evaluated. Fifteen patients had a diagnosis of AS, and seven patients had RA. After initiation of infliximab therapy, statistically significant improvement was observed in disease activity scores [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for AS, Disease Activity Score 28 (DAS-28) for RA] after 2 and 6 months (p??0.05). Any problem about the balance, vertigo, or dizziness was not reported from the patients during the treatment period. As a result, our study showed that there was no notable change or deterioration in the hearing function of the patients with AS and RA who were treated with infliximab. Further studies with higher number of patients with AS and RA and also with different TNF alpha inhibitors are needed to make more valid conclusion. PMID:24770796

Toktas, H; Okur, E; Dundar, U; Dikici, A; Kahveci, O K

2014-10-01

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Golimumab: A novel human anti-TNF-? monoclonal antibody for the treatment of rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis  

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Full Text Available Jonathan Kay1, Mahboob U Rahman2,31Division of Rheumatology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA; 2Centocor Research and Development, inc., Malvern, PA, USA; 3University of Pennsylvania School of Medicine, Philadelphia, PA, USAIntroduction: The introduction of tumor necrosis factor-? (TNF-? inhibitors represented a significant advance in the management of rheumatoid arthritis (RA and other chronic inflammatory diseases. Although three TNF-? inhibitors have been approved for the treatment of RA by the US Food and Drug Administration (FDA and the European Medicinal Products Evaluation Agency (EMEA, not all patients achieve a satisfactory clinical improvement with these therapeutic agents. The mode of administration of these medications is inconvenient for some patients.Aims: Golimumab is a novel anti-TNF-? monoclonal antibody that is in clinical development for the treatment of RA, psoriatic arthritis (PsA, and ankylosing spondylitis (AS, either as a first-line biologic therapy or an alternative after other TNF-? inhibitors have been discontinued. This review summarizes the development of, and clinical evidence achieved with, golimumab.Evidence review: Golimumab has demonstrated significant efficacy in randomized, double-blind, placebo-controlled trials when administered subcutaneously once every four weeks. It has been generally well tolerated in clinical trials and demonstrates a safety profile comparable with currently available TNF-? inhibitors.Outcomes summary: Golimumab has been confirmed to be an effective treatment for patients with RA, PsA, and AS in phase III clinical trials as evaluated by traditional measures of disease activity, such as signs and symptoms, as well as measures of physical function, patient reported outcomes, and health economic measures. The efficacy and safety profile of golimumab in RA, PsA, and AS appears to be similar to other anti-TNF agents. However, golimumab has the potential advantage of once monthly subcutaneous administration and the possibility of both subcutaneous and intravenous administration.Keywords: golimumab, TNF-? inhibitors, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis

Jonathan Kay

2009-07-01

 
 
 
 
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Caracterização da uveíte na espondilite anquilosante / Characterization of uveitis in ankylosing spondylitis  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: analisar a apresentação clínica e a evolução da uveíte em uma população de 207 pacientes com espondilite anquilosante (EA). MÉTODOS: estudo retrospectivo (1988-2001) analisando 207 pacientes com o diagnóstico de EA segundo os critérios de Nova York modificados. Todos apresentavam investiga [...] ção clínica (envolvimento axial e periférico, entesopatias, manifestações extra-articulares) e radiológica (sacroilíaca, coluna lombar, dorsal e cervical) completas, além da pesquisa do HLA-B27 (com seus respectivos alelos, quando possível). Os dados foram comparados com a presença de uveíte durante o período de seguimento dos pacientes. RESULTADOS: trinta pacientes (14,5%) apresentaram 55 episódios de uveíte anterior aguda unilateral durante o seguimento ambulatorial. Vinte e sete pacientes encontravam-se em atividade articular da EA no momento da crise de uveíte, enquanto três pacientes encontravam-se inativos do ponto de vista articular. Um único paciente, em tratamento de tuberculose pulmonar, apresentou um episódio de uveíte posterior. Entre os pacientes com uveíte, houve predomínio de sexo masculino (82,6%), raça caucasóide (77,8%), início da EA na idade adulta (83,1%), HLA-B27 positivo (79,2%), sem história familiar de EA (84,5%). Houve associação estatística entre uveíte e idade de início juvenil (p = 0,0094) e entesopatias aquileana (p = 0,0003) e plantar (p = 0,0067). Nenhum paciente apresentou seqüela ocular grave da uveíte. Dezesseis pacientes fizeram uso de sulfassalazina (1,0 g/dia a 2,0 g/dia), por prazo mínimo de seis meses. CONCLUSÕES: a uveíte anterior aguda foi comum na evolução da EA nesta casuística, estando associada preferencialmente à EA de início juvenil e ao acometimento articular entesopático de membros inferiores. Abstract in english OBJECTIVE: To analyze the clinical picture and outcome of uveitis in a series of 207 patients with ankylosing spondylitis (AS). METHODS: Retrospective study (1988-2001) analyzing 207 patients with diagnosis of AS according to the modified New York criteria. All patients were submited to complete cli [...] nical (axial and peripheral involvement, heel enthesopathies, extra-articular manifestations) and radiological (sacroiliac, lumbar, dorsal and cervical spine) investigation, HLA-B27 evaluation (and respective alleles, whenever possible), were searched. These data were compared with the occurrence of uveitis during the follow-up of the AS patients. RESULTS: Thirty patients (14.5%) presented 55 episodes of acute unilateral anterior uveitis. Twenty seven patients had active articular disease at the moment of the uveitis crisis, while three patients were inactive. One patient, in treatment of lung tuberculosis, presented a single episode of posterior uveitis. Among the uveitis in AS patients, there was predominance of male sex (82.6%), Caucasoid race (77.8%), adult-onset AS (83.1%), positive HLA-B27 (79.2%) and absence of familial history of AS (84.5%). There was statistical association between uveitis and juvenile-onset AS (p = 0.0094) and achillean (p = 0.0003) and plantar (p = 0.0067) enthesopathies. No patient presented severe ophthalmologic sequelae of uveitis. Sulfasalazine (1 to 2 g, daily) was prescribed to 16 patients, for a minimum period of six months. CONCLUSIONS: Acute anterior uveitis was common in the follow-up of AS patients in this casuistic, associated to the juvenile-onset of the disease and to the enthesophatic involvement of the lower limbs.

Percival Degrava, Sampaio-Barros; Manoel Barros, Bértolo; Adil Muhib, Samara.

2003-12-01

122

Concomitância de fibromialgia em pacientes com espondilite anquilosante / Occurrence of fibromyalgia in patients with ankylosing spondylitis  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese INTRODUÇÃO: A Espondilite Anquilosante (EA) é uma doença inflamatória crônica que acomete o esqueleto axial. Cursa com dor e incapacidade funcional. Para medir o impacto da EA na vida dos pacientes são utilizados questionários que avaliam a atividade da doença (BASDAI); a incapacidade funcional (BAS [...] FI); e a qualidade de vida (ASQoL). A Fibromialgia (FM) é uma das causas mais comuns de dor generalizada e pode coexistir com outras doenças; pode ser avaliada por meio do questionário de impacto da Fibromialgia (FIQ). Há poucos estudos demonstrando correlações entre FM e EA. O presente estudo obteve dados referentes ao perfil epidemiológico de pacientes com EA e FM e avaliou a prevalência de FM em portadores de EA. Avaliou-se a interferência da FM nos escores dos testes BASDAI, BASFI e ASQoL. PACIENTES E MÉTODO: Foram incluídos 71 pacientes portadores de EA diagnosticados de acordo com os critérios modificados de Nova York. Avaliação clínica, funcional e aplicação dos testes BASDAI, BASFI e ASQoL foram realizados. Os pacientes com diagnóstico de FM foram avaliados com o FIQ. RESULTADOS: Onze pacientes preencheram os critérios para FM, observando-se assim uma prevalência de 15% de FM entre os pacientes com EA, sendo mais frequente entre as mulheres (3,8:1). A idade de início da doença (EA) foi de 27,5 anos. O antígeno HLA-B27 foi positivo na grande maioria (80,4%). Comparando-se as médias dos testes BASDAI, BASFI e ASQoL, verificou-se que os valores são significativamente superiores (P Abstract in english INTRODUCTION: Ankylosing spondylitis (AS) is a chronic inflammatory disease that affects the axial skeletal system, causing pain and functional incapacity. To measure the impact of AS on patient's life, questionnaires are used to assess disease activity (BASDAI); functional incapacity (BASFI); and q [...] uality of life (ASQoL). Fibromyalgia (FM) is one of the most common causes of generalized pain and can coexist with other diseases; it can be assessed by the Fibromyalgia Impact Questionnaire (FIQ). Few studies have demonstrated correlations between FM and AS. The present study obtained data regarding the epidemiologic profile of patients with AS and FM and evaluated the prevalence of FM in patients with AS. The FM influence on BASDAI, BASFI and ASQoL test scores was assessed. PATIENTS AND METHOD: A total of 71 patients with AS, diagnosed according to the modified New York criteria, were studied. Clinical and functional assessment was performed and BASDAI, BASFI and ASQoL tests were applied. Patients with a diagnosis of FM were evaluated through the FIQ. RESULTS: Eleven patients met the criteria for FM; thus a FM prevalence of 15% was observed among the patients with AS. FM was more prevalent among women (3.8:1). Age at disease onset (AS) was 27.5 years. The HLA-B27 antigen was positive in most of them (80.4%). When comparing BASDAI, BASFI and ASQoL test means, it was observed that values are significantly higher (P

Valderilio Feijó, Azevedo; Eduardo dos Santos, Paiva; Lúcio Ricardo Hiurko, Felippe; Ranieri Amorim, Moreira.

2010-12-01

123

Concomitância de fibromialgia em pacientes com espondilite anquilosante Occurrence of fibromyalgia in patients with ankylosing spondylitis  

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Full Text Available INTRODUÇÃO: A Espondilite Anquilosante (EA é uma doença inflamatória crônica que acomete o esqueleto axial. Cursa com dor e incapacidade funcional. Para medir o impacto da EA na vida dos pacientes são utilizados questionários que avaliam a atividade da doença (BASDAI; a incapacidade funcional (BASFI; e a qualidade de vida (ASQoL. A Fibromialgia (FM é uma das causas mais comuns de dor generalizada e pode coexistir com outras doenças; pode ser avaliada por meio do questionário de impacto da Fibromialgia (FIQ. Há poucos estudos demonstrando correlações entre FM e EA. O presente estudo obteve dados referentes ao perfil epidemiológico de pacientes com EA e FM e avaliou a prevalência de FM em portadores de EA. Avaliou-se a interferência da FM nos escores dos testes BASDAI, BASFI e ASQoL. PACIENTES E MÉTODO: Foram incluídos 71 pacientes portadores de EA diagnosticados de acordo com os critérios modificados de Nova York. Avaliação clínica, funcional e aplicação dos testes BASDAI, BASFI e ASQoL foram realizados. Os pacientes com diagnóstico de FM foram avaliados com o FIQ. RESULTADOS: Onze pacientes preencheram os critérios para FM, observando-se assim uma prevalência de 15% de FM entre os pacientes com EA, sendo mais frequente entre as mulheres (3,8:1. A idade de início da doença (EA foi de 27,5 anos. O antígeno HLA-B27 foi positivo na grande maioria (80,4%. Comparando-se as médias dos testes BASDAI, BASFI e ASQoL, verificou-se que os valores são significativamente superiores (P INTRODUCTION: Ankylosing spondylitis (AS is a chronic inflammatory disease that affects the axial skeletal system, causing pain and functional incapacity. To measure the impact of AS on patient's life, questionnaires are used to assess disease activity (BASDAI; functional incapacity (BASFI; and quality of life (ASQoL. Fibromyalgia (FM is one of the most common causes of generalized pain and can coexist with other diseases; it can be assessed by the Fibromyalgia Impact Questionnaire (FIQ. Few studies have demonstrated correlations between FM and AS. The present study obtained data regarding the epidemiologic profile of patients with AS and FM and evaluated the prevalence of FM in patients with AS. The FM influence on BASDAI, BASFI and ASQoL test scores was assessed. PATIENTS AND METHOD: A total of 71 patients with AS, diagnosed according to the modified New York criteria, were studied. Clinical and functional assessment was performed and BASDAI, BASFI and ASQoL tests were applied. Patients with a diagnosis of FM were evaluated through the FIQ. RESULTS: Eleven patients met the criteria for FM; thus a FM prevalence of 15% was observed among the patients with AS. FM was more prevalent among women (3.8:1. Age at disease onset (AS was 27.5 years. The HLA-B27 antigen was positive in most of them (80.4%. When comparing BASDAI, BASFI and ASQoL test means, it was observed that values are significantly higher (P < 0.01 among patients with FM. We concluded that the coexistence of FM can worsen AS activity aspects, as well as functional incapacity and quality of life

Valderilio Feijó Azevedo

2010-12-01

124

Long term mortality after a single treatment course with X-rays in patients treated for ankylosing spondylitis  

International Nuclear Information System (INIS)

Mortality to 1 January 1983 was studied in 14,106 ankylosing spondylitis patients after a single course of X-rays (1935-1954). For neoplasms other than leukaemia or colon cancer, mortality was 28% greater than the general population of England and Wales, proportional increase reaching a maximum 71% between 10.0 and 12.4 years post-irradiation. There was 7% mortality increase more than 25.0 years post-irradiation and only for oesophageal cancer was the relative risk significantly raised. Neither the relative risk, nor its post-irradiation temporal pattern, were greatly influenced by the patient's age. There was a threefold increase in leukaemia mortality, the relative risk highest between 2.5 and 4.9 years post-treatment, but not disappearing being nearly twice that of the general population more than 25 years post-treatment. There was evidence that acute myeloid, acute lymphatic and chronic myeloid leukaemia risks were increased, but no evidence of increase in chronic lymphatic leukaemia. The relative risk appeared greatest for acute myeloid leukaemia. Colon cancer mortality increased by 30%. Non-neoplastic conditions showed a 51% mortality increase, likely to be associated with the disease itself, and not confined to diseases associated with spondylitis. (UK)

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Prehistoria, historia y arte de la Reumatología Gota y espondilitis anquilosante Prehistory, history and arts of rheumatology. Gout and ankylosing spondylitis. Part II  

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Full Text Available En esta segunda parte analizamos los inicios y la evolución de la Gota y de la Espondilitis Anquilosante. Relatamos nuevamente la importancia del arte en el desarrollo del conocimiento de estas enfermedades reumáticas.In this second part, we analyzed the beginning and the evolution of the Gout and Ankylosing Spondylitis. We relate again the importance of art in the development of knowledge of this rheumatic diseases.

Antonio Iglesias-Gamarra

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Prehistoria, historia y arte de la Reumatología Gota y espondilitis anquilosante / Prehistory, history and arts of rheumatology. Gout and ankylosing spondylitis. Part II  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish En esta segunda parte analizamos los inicios y la evolución de la Gota y de la Espondilitis Anquilosante. Relatamos nuevamente la importancia del arte en el desarrollo del conocimiento de estas enfermedades reumáticas. [...] Abstract in english In this second part, we analyzed the beginning and the evolution of the Gout and Ankylosing Spondylitis. We relate again the importance of art in the development of knowledge of this rheumatic diseases. [...

Antonio, Iglesias-Gamarra; Gerardo, Quintana; José Félix, Restrepo Suárez.

2006-06-30

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Equilíbrio estático e dinâmico no indivíduo com espondilite anquilosante: revisão da literatura Static and dynamic balance in subjects with ankylosing spondylitis: literature review  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Com o objetivo de analisar as alterações musculoesqueléticas dos indivíduos com espondilite anquilosante (EA) e suas repercussões sobre o controle postural, realizou-se uma revisão bibliográfica nas bases de dados da BIREME e EBSCO HOTS e no site Pubmed com as palavras-chave: "ankylosing spondylitis", "postural balance" e "posture". Foram selecionados artigos envolvendo seres humanos e que analisavam o controle postural e a biomecânica dos indivíduos com EA, nos idiomas inglês e por...

José Eduardo Pompeu; Renata Sorroche Lourenço Romano; Sandra Maria Alvarenga Anti Pompeu; Sônia Maria Anti Loduca Lima

2012-01-01

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IgM, IgG and IgA class enterobacterial antibodies in serum and synovial fluid in patients with ankylosing spondylitis and rheumatoid arthritis.  

Science.gov (United States)

IgM, IgG and IgA class antibodies against three Klebsiella pneumoniae capsular types, Escherichia coli and Proteus mirabilis, as well as total immunoglobulin concentrations, were measured by enzyme immunoassay and radial immunodiffusion technique, respectively, in paired serum and synovial fluid samples from eight patients with ankylosing spondylitis and 10 with rheumatoid arthritis. No clear evidence for intra-articular antibody production against any of the studied microbes was found. PMID:9374920

Mäki-Ikola, O; Penttinen, M; Von Essen, R; Gripenberg-Lerche, C; Isomäki, H; Granfors, K

1997-10-01

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A Case of Juvenile Ankylosing Spondylitis associated with Familial Mediterranean Fever  

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An eight year old male who was detected to have homozygous M694V mutation in the examinations for recurrent abdominal pain and familial history of Familial Mediterranean Fever (FMF) and who was then diagnosed with Juvenile Ankylosing Spondilitis (JAS) upon examination for hip joint pain was presented. This case was presented to emphasize the importance of high suspicion for JAS in FMF cases with atypical joint findings.

Ayhan Sö?üt; Özge Y?lmaz; Hasan Yüksel; Deniz Özalp

2010-01-01

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Radiography of the spine and sacro-iliac joints in ankylosing spondylitis and psoriasis  

International Nuclear Information System (INIS)

ulfilling the criteria for AS, there is a group with a non-ankylosing disease. Thus two different subgroups of AS could be identified. Except for frequent unilateral sacro-iliitis and slight changes of the spine in group A no radiographic differences were found between the groups A, B and C. Sacro-iliitis was found in 22(9%) in group D, and 11 of those with sacro-iliitis had abnormalities of the spine compatible with AS. (orig.)

131

Functional Interaction of the Ankylosing Spondylitis-associated Endoplasmic Reticulum Aminopeptidase 1 Polymorphism and HLA-B27 in Vivo*  

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The association of ERAP1 with ankylosing spondylitis (AS)1 among HLA-B27-positive individuals suggests that ERAP1 polymorphism may affect pathogenesis by altering peptide-dependent features of the HLA-B27 molecule. Comparisons of HLA-B*27:04-bound peptidomes from cells expressing different natural variants of ERAP1 revealed significant differences in the size, length, and amount of many ligands, as well as in HLA-B27 stability. Peptide analyses suggested that the mechanism of ERAP1/HLA-B27 interaction is a variant-dependent alteration in the balance between epitope generation and destruction determined by the susceptibility of N-terminal flanking and P1 residues to trimming. ERAP1 polymorphism associated with AS susceptibility ensured efficient peptide trimming and high HLA-B27 stability. Protective polymorphism resulted in diminished ERAP1 activity, less efficient trimming, suboptimal HLA-B27 peptidomes, and decreased molecular stability. This study demonstrates that natural ERAP1 polymorphism affects HLA-B27 antigen presentation and stability in vivo and proposes a mechanism for the interaction between these molecules in AS. PMID:22918227

Garcia-Medel, Noel; Sanz-Bravo, Alejandro; Van Nguyen, Dung; Galocha, Begona; Gomez-Molina, Patricia; Martin-Esteban, Adrian; Alvarez-Navarro, Carlos; de Castro, Jose A. Lopez

2012-01-01

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Cardiovascular risk parameters in men with ankylosing spondylitis in comparison with non-inflammatory control subjects: relevance of systemic inflammation.  

Science.gov (United States)

Men with AS (ankylosing spondylitis) are at elevated risk for CHD (coronary heart disease) but information on risk factors is sparse. We compared a range of conventional and novel risk factors in men with AS in comparison with healthy controls and, in particular, determined the influence of systemic inflammation. Twenty-seven men with confirmed AS and 19 controls matched for age were recruited. None of the men was taking lipid-lowering therapy. Risk factors inclusive of plasma lipids, IL-6 (interleukin-6), CRP (C-reactive protein), vWF (von Willebrand factor), fibrin D-dimer, ICAM-1 (intercellular cell-adhesion molecule-1) and fibrinogen were measured, and blood pressure and BMI (body mass index) were determined by standard techniques. A high proportion (70%) of men with AS were smokers compared with 37% of controls (P = 0.024). The AS patients also had a higher BMI. In analyses adjusted for BMI and smoking, men with AS had significantly higher IL-6 and CRP (approx. 9- and 6-fold elevated respectively; P control risk factor differences, except pulse pressure, non-significant. In accordance with this finding, IL-6 correlated positively (r = 0.74, P < 0.001) with fibrinogen, but negatively (r = -0.46, P = 0.016) with total cholesterol concentration. In conclusion, men with AS have perturbances in several CHD risk factors, which appear to be driven principally by systemic inflammatory mediators. Inflammation-driven atherogenesis potentially contributes to the excess CHD risk in AS. PMID:15801904

Divecha, Hiren; Sattar, Naveed; Rumley, Ann; Cherry, Lynne; Lowe, Gordon D O; Sturrock, Roger

2005-08-01

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Associations between walking time, quadriceps muscle strength and cardiovascular capacity in patients with rheumatoid arthritis and ankylosing spondylitis.  

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The aim of this study was to examine whether there are any associations between walking time, quadriceps muscle strength and cardiovascular capacity in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Thirty-one patients with RA and 26 patients with AS belonging to Steinbrocker's functional class I-II were examined. Cardiovascular capacity was calculated from the expired air during a bicycle test and quadriceps muscle strength by the peak torque from an isokinetic dynamometer test. Walking time was the time it took to walk a distance of 160 m on a flat floor and to climb up and down a staircase. In patients with RA, flat floor walking and stair climbing times correlated inversely with quadriceps muscle strength and cardiovascular capacity. Similar results were seen in patients with AS, although the association between cardiovascular capacity and stair-climbing time was not statistically significant. Multiple regression analysis was performed for all patients with quadriceps muscle strength and cardiovascular capacity applied as independent variables in two separate models. Cardiovascular capacity explained 32% and quadriceps muscle strength 21% of the variance in flat floor walking time. Quadriceps muscle strength, together with diagnosis and age, explained 38% of the variance in stair-climbing time, and cardiovascular capacity together with age and pain explained 36% of the variance. In conclusion, in spite of cardiovascular capacity and quadriceps muscle strength being associated with walking times, the findings suggest that they play only a modest role in explaining rapid walking on flat floor and in stairs. PMID:15293089

Mengshoel, Anne Marit; Jokstad, Kari; Bjerkhoel, Frithjof

2004-08-01

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Peripheral blood T lymphocytes subpopulations in HLA-B7 related rheumatic diseases: ankylosing spondylitis and reactive synovitis.  

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The etiology of B lymphocyte hyperactivity in ankylosing spondylitis (AS) and in reactive synovitis is unknown and data available on the cellular immune system are controversial. We therefore evaluated peripheral blood T cell populations in AS patients and patients with reactive synovitis (RS) using monoclonal antibodies, previously shown to react with all T cells (OKT3), the inducer-helper T cell subset (OKT4) and the suppressor-cytotoxic T cell subset (OKT8). Results were compared with a normal control group and a group of rheumatoid arthritis (RA) patients. In AS an increase of OKT4+ cells was found, but the total number of T helper-inducer cells in peripheral blood was not different from the normal group and the group of patients with RS. Contrary to the results found in RA, where the helper-inducer/suppressor-cytotoxic ratio (OKT4+/OKT8+) was significantly increased, the immunoregulatory ratio in AS and in RS was normal suggesting another mechanism leading to B cell hyperactivity than in RA. PMID:6601710

Veys, E M; Verbruggen, G; Hermanns, P; Mielants, H; Van Bruwaene, P; De Brabanter, G; De Landsheere, D; Immesoete, C

1983-02-01

135

Raised serum IgA to common cell envelope antigens supports enterobacterial inductive contribution to pathogenesis of secondary ankylosing spondylitis.  

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Ankylosing spondylitis (AS) is closely associated with the histocompatibility antigen HLA-B27. Pathogenesis of AS is thought to involve interactions between B27 and certain enterobacterial antigens. However, enterobacterial involvement is uncertain and contested by some. The present paper demonstrates raised serum IgA to a common enterobacterial heat modifiable major outer membrane protein (h-momp; Mr 35,000) in active AS (N = 25; IgA = 1485 +/- 20) compared with controls, who were hospital patients without known arthropathies or gastro-intestinal disease (N = 12; IgA = 548 +/- 59). Serum IgG and IgM did not differ statistically. Raised serum IgA to h-momp might indicate enterobacterial antigenic stimulation from the gastro-intestinal tract and thus support an inductive contribution of enterobacterial antigens to the pathogenesis of secondary AS. It does not necessarily imply direct involvement in the pathogenesis of primary AS. H-momp appears to be a convenient tool for serological studies of AS and at present is likely to be more suitable than other bacterial antigens. PMID:3583323

van Bohemen, C G; Weterings, E; Nabbe, A J; Mulder, C J; Goei The, H S; Zanen, H C

1987-04-01

136

Testing the effect of different electrotherapeutic procedures in the treatment of canine ankylosing spondylitis  

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Full Text Available This paper presents the results of studies on the effects of suppression of chronic pain by currents with low (TENS, medium (Intf and high (MT frequencies, in dogs with ankylosing spondilytis. Prior to imaging diagnostics the dogs were clinically observed, trias was estimated, as well as habitus, neurological signs and degree of pain. After a 10 day treatment it was clear that all three treatments resulted in a significant decrease of pain at rest, during activity or during palpation. TENS currents have shown the highest degree of effect. All treated animals have shown improved motility after a few months of therapy. Despite the fact that all animals had an improved clinical picture none of the applied currents resulted in a complete loss of limping. Dogs treated with Intf currents displayed a decrease in muscular atrophy. Motility of the coxofemoural joint was most evident in the group treated with microwaves.

Krsti? Nikola

2010-01-01

137

Health-related Quality of Life Assessment on 100 Tunisian Patients with Ankylosing Spondylitis using the SF-36 Survey  

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Full Text Available Objectives: The main objective of the study was to examine the self reported health status in patients with ankylosing spondylitis (AS compared with the general population and the secondary objective (in the AS group was to study the association between health status, demographic parameters, and specific disease instruments in AS.Methods: A cross sectional study of 100 AS patients recruited between 2006 and 2009 at the Department of Rheumatology. Health status was assessed by using the SF-36 health questionnaire in patients with AS. Demographic characteristics and disease specific instruments were also examined by the questionnaire. A sample of 112 healthy individuals was also surveyed using the SF-36 health questionnaire.Results: This study showed a great impairment in the quality of life of patients with AS involving all scales. All male patients with AS reported significantly impaired health-related quality of life on all items of the SF-36 compared with the general population whereas female patients reported poorer health on three items only, namely physical functioning, general health and bodily pain. Mental health was mostly affected than physical role. The physical role was significantly higher in patients with high education level than in patients with low education level (p=0.01. Physical functioning was better in employed patients. All scales of SF-36 were correlated with BASFI, BASDAI and BAS-G. Only physical functioning and general health were correlated with BASMI.Conclusion: Impairment in the quality of life can be significantwhen suffering from AS, affecting mental health more than physicalhealth. Among disease parameters, functional impairment,disease activity, mobility limitation, and spinal pain were the most associated factors resulting to the deterioration of quality of life.

Wafa Hamdi

2012-11-01

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Leishmaniose tegumentar em paciente com espondilite anquilosante utilizando adalimumabe / Cutaneous leishmaniasis in a patient with ankylosing spondylitis using adalimumab  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A leishmaniose é uma antropozoonose causada por espécies de Leishmania e pode apresentar-se de diversas formas clínicas, dependendo da interação parasita-hospedeiro. O fator de necrose tumoral-α (TNF-α) é uma citocina essencial para o controle de infecções, especialmente contra parasitas intracelu [...] lares como a Leishmania. A terapia anti-TNF-α tem importante papel no tratamento de doenças reumáticas, mas o uso desses antagonistas está relacionado ao aumento de infecções. Relatamos o primeiro caso de leishmaniose cutânea no Brasil em uma paciente portadora de espondilite anquilosante em uso de adalimumabe e metotrexato. Acreditamos que neste caso não houve relação entre o uso de anti-TNF-α e a leishmaniose cutânea, pois a doença estava limitada a apenas uma úlcera, que cicatrizou completamente após o tratamento. Mais estudos, entretanto, são necessários para entender melhor a possível associação entre agentes anti-TNF-α e leishmaniose. Abstract in english Leishmaniasis is an anthropozoonosis caused by species of Leishmania and can have different clinical presentations, depending on the parasite-host relationship. Tumor necrosis factor-α (TNF-α) is a cytokine essential to infection control, especially against intracellular parasites such as Leishman [...] ia. Anti-TNF-α strategies have had a marked impact on the treatment of rheumatic diseases, but the clinical use of those antagonists has been accompanied by an increased report of infections. We report the first case of cutaneous leishmaniasis in a patient with ankylosing spondylitis treated with adalimumab and methotrexate in Brazil. We believe that, in this case, there was no association between the anti-TNF-α treatment and cutaneous leishmaniasis, because the disease was limited to only one ulcer that healed completely after treatment. More studies, however, are necessary to better understand the possible relationship between anti-TNF-α agents and leishmaniasis.

Kirla Wagner Poti, Gomes; André Nunes, Benevides; Francisco José Fernandes, Vieira; Maggy Poti de Morais, Burlamaqui; Marcos de Almeida e Pontes, Vieira; Lysiane Maria Adeodato Ramos, Fontenelle.

2012-06-01

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Ankylosing spondylitis in Danish and Norwegian twins: occurrence and the relative importance of genetic vs. environmental effectors in disease causation  

DEFF Research Database (Denmark)

OBJECTIVE: To estimate the influence of genetic effects in the aetiology and pathogenesis of ankylosing spondylitis (AS). METHODS: The study comprised one Norwegian and two Danish nationwide twin surveys. In 1994 and 2002, respectively, 37,388 and 46,331 Danish twin individuals were asked by questionnaire if they had AS. Similarly, in 1998, 12,718 Norwegian twins were asked if they had AS using a questionnaire phrased according to the Danish survey. Twins reporting AS were categorized according to the modified New York criteria. RESULTS: A total of 113 twin individuals reported AS, of whom 81 (72.3%) participated in validation of the diagnosis. After validation, 39 probands were diagnosed with AS. Subsequent invitation of co-twins resulted in 27 complete pairs. The point prevalence and the annual incidence of AS was 0.1% and 3/100,000 person-years (pyr) among the Danish twins. The positive predictive value of self-reported AS was 49.3%. Probandwise concordance rates on AS were (2/5) 40% in monozygotic (MZ) and (1/23) 4% in dizygotic (DZ) twins [difference 35% (95% CI 2.9-72.8), p = 0.26]. Heredity analysis including previously published and the present HLA-B27-positive twin pairs indicated that additive genetic effects account for 94% (95% CI 0.56-0.99) of the variance in the causation of AS. CONCLUSION: Self-reported AS needs careful validation. The occurrence of AS in a Danish twin population was 0.1% and accords well with previous studies on singletons in hospital settings. The present study adds to previous evidence of a major genetic effect in the pathogenesis of AS.

Svendsen, Anders JØrgen; Ejstrup, L

2008-01-01

140

Susceptibility to ankylosing spondylitis is independent of the Bw4 and Bw6 epitopes of HLA-B27 alleles.  

Science.gov (United States)

We have characterized HLA-B27 alleles in a sample of the population from the Azores (n=46) with the aim of investigating the contribution of different subtypes to ankylosing spondylitis (AS). The study was carried out using PCR-SSOP and in some samples genomic sequencing was conducted. Some significant new finding have arisen from this study. First, B*2705,B*2702,B*2703,B*2707 and B*2708 alleles were found to be represented in this population. The polymorphism of B27 alleles found in a sample of the population from the Azores is higher than the Caucasian groups described. B*2703 and B*2707 have not previously been described to be represented in Caucasians and this could indicate admixtures with different populations of the world. In addition, the B*2708 allele was found to be associated with AS in a large family from the Azores. This association has not been previously reported in either ethnic group and needs to be confirmed in other population studies. This is of considerable interest since has only been described as a rare subtype underrepresented in the British population and has not been previously found to be associated with AS. B*2708 carries the sequence specifying the Bw6 epitope in contrast to most B27 alleles which carry a Bw4 sequence. Differences in this region (residues 77-83) can alter the F-pocket and affect T-cell recognition. The importance that these molecular changes can play in the pathogenesis of AS is discussed. PMID:10203016

Armas, J B; Gonzalez, S; Martinez-Borra, J; Laranjeira, F; Ribeiro, E; Correia, J; Ferreira, M L; Toste, M; López-Vazquez, A; López-Larrea, C

1999-03-01

 
 
 
 
141

Comparison of rates of referral and diagnosis of axial spondyloarthritis before and after an ankylosing spondylitis public awareness campaign.  

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The objective of this research is to measure the effect of a national ankylosing spondylitis (AS) public awareness campaign on numbers of referrals for suspected AS and numbers of cases diagnosed with axial spondyloarthritis (SpA). A television advertising campaign was conducted by Arthritis New Zealand in 2011 to raise public awareness of AS. A retrospective analysis was made of referrals received by the three rheumatology services 3 months before the campaign started and 3 months after the campaign ended. The age, gender, number of referrals for suspected AS and number of referrals resulting in a diagnosis of axial SpA were recorded. Independent analysis showed that the awareness campaign reached 82 % of the primary target audience. In the 3 months after the awareness campaign, there was a significant increase in referrals for suspected AS compared with the 3 months before the campaign (54 vs. 88, 63 %, p?=?0.0056). Referrals for other conditions did not change. The number of referrals resulting in a diagnosis of axial SpA also increased (27 vs. 44, 63 %, p?=?0.0576). The mean ages of the patients referred and of those diagnosed with axial SpA did not change. The male/female ratio was 1:1 among the referrals for suspected AS and 2:1 in referrals diagnosed with axial SpA, before and after the campaign. The Arthritis New Zealand AS public awareness campaign was associated with a significant increase in referrals to rheumatology services for suspected AS and an increase in the diagnosis of axial SpA in clinics. PMID:24609715

Harrison, Andrew A; Badenhorst, Christoffel; Kirby, Sandra; White, Douglas; Athens, Josie; Stebbings, Simon

2014-07-01

142

Ankylosing spondylitis is associated with an increased risk of vertebral and nonvertebral clinical fractures : a population-based cohort study  

DEFF Research Database (Denmark)

The objective of this work was to study the associations between ankylosing spondylitis (AS) and clinical vertebral and nonvertebral fractures. Data from a large population-based public health database in Spain, Sistema d'Informació per al Desenvolupament de l'Investigació en Atenció Primària (SIDIAP), were used in this parallel cohort study. All participants registered in SIDIAP on January 1, 2006, were screened to identify those with a diagnosis of AS. Five age-matched, gender-matched, and general practice surgery-matched controls were selected for each patient with AS. All participants were followed until December 31, 2011, transfer out date, or death date. Fractures during this time were classified as vertebral or nonvertebral. Adjustment was made for potential confounders (tobacco smoking, alcohol consumption, body mass index, and use of oral steroids). Of 4,920,353 eligible patients in SIDIAP, 6474 AS patients with matched controls (n?=?32,346) were available. A higher proportion of patients with AS versus controls had clinical vertebral (0.86% versus 0.41%) and nonvertebral (3.4% versus 2.7%) fractures. Adjusted Cox regression models showed an increased risk of clinical vertebral (hazard ratio [HR] 1.93; 95% confidence interval [CI], 1.39 to 2.68; p?

Muñoz-Ortego, Juan; Vestergaard, Peter

2014-01-01

143

Pamidronato endovenoso en espondilitis anquilosante refractaria a antiinflamatorios no esteroideos (AINES) y sulfasalazina / Intravenous pamidronate in refractory ankylosing spondylitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Peru | Language: Spanish Abstract in spanish Objetivo: Evaluar la terapia con pamidronato, en pacientes con espondilitis anquilosante (EA) activa, con respuesta subóptima o falla a los antiinflamatorios no-esteroideos (AINES) y sulfasalazina. Diseño: Estudio clínico comparativo. Lugar: Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lim [...] a, Perú. Participantes: Pacientes con espondilitis anquilosante. Intervenciones. Se incluyó 9 pacientes con EA (6 varones), con enfermedad activa (BASDAI > o = 4), actividad axial y falta de respuesta a los Aines y sulfasalazina a dosis de 3g/d. Todos los pacientes recibieron 60 mg de pamidronato mensual, en infusión endovenosa, durante 6 meses, y continuaron tomando AINES y sulfasalazina. La mejoría clínica fue evaluada usando el ASAS 20. En forma secundaria se evaluó el ASAS 40, BASDAI 50, BASDAI, BASFI Y BASMI, a las 24 y 48 semanas (32 a 86 semanas). La diferencia entre el índice de pre y postratamiento fue evaluada usando la prueba de Wilcoxon. Principales medidas de resultados: Evaluación del ASAS 20. Resultados: El 67% alcanzó un Asas 20 a las 24 semanas y 78% a las 48 semanas; 33,3% y 55,6% tuvieron ASAS 40 y 33,3%; y 44,4% alcanzó BASDAI 50 a las 24 y 48 semanas, respectivamente. Un paciente recayó a la semana 20. Tres pacientes (33,3%) permanecieron sin cambios. A las 24 y 48 semanas, la media de BASDAI disminuyó en 45,1% (p=0,007) y en 52,1% (p=0,01), la media de BASFI en 38,2% (p=0,007) y en 52,3% (p=0,007), y la media de BASMI en 39,2% (p=0,01) y 39,2% (p=0,01), respectivamente. Los eventos adversos no fueron importantes con esta terapia. Conclusiones: El tratamiento con pamidronato demostró ser efectivo en este grupo de pacientes con EA, refractaria a AINES y a sulfasalazina. Abstract in english Objective: To determine the response of an aminobisphosphonate (pamidronate) in patients with ankylosing spondylitis (AS) who had suboptimal or no response to nonsteroidal anti-inflammatory drugs (NSAIDs) and sulfasalazine. Design: Comparative clinical study. Setting: Hospital Nacional Edgardo Rebag [...] liati Martins, EsSalud, Lima, Peru. Participants: Patients with ankylosing spondylitis. Intervenciones: Nine patients with AS (6 males), with active disease [BASDAI > or = 4] and no response to NSAIDs and sulfasalazine up to 3g/day entered the study. All patients received monthly infusions of 60 mg of pamidronate for 6 months and remained taking NSAID and sulfasalazine. Clinical improvement was evaluated using the Assessments in Ankylosing Spondylitis 20 (ASAS 20). Secondary evaluations included ASAS 40, BASDAI 50, BASDAI, BASFI, and BASMI at 24 weeks and at last observation [48 weeks (32 to 86 weeks)]. Differences between pre and post treatment distributions of all continuous indices were evaluated using the Wilcoxon signed rank test. Main outcome measures: Evaluated of ASAS 20. Results: Sixty-seven percent achieved ASAS 20 at 24 weeks and 78% at 48 weeks; 33,3% and 55,6% achieved ASAS 40 at 24 and 48 weeks, respectively, and 33,3% and 44,4% achieved BASDAI 50 at weeks 24 and 48, respectively. One patient relapsed at week 20. In three patients (33,3%) the scores remained unchanged. At weeks 24 and 48 mean BASDAI decreased by 45,1% (p=0,007) and by 52,1% (p=0,01), mean BASFI decreased by 38,2% (p=0,007) and by 52,3% (p=0.007), and mean BASMI decreased by 39,2% (p=0,01) and 39,2% (p=0,01), respectively. There were no significant adverse events with this therapy. Conclusions: Our data provide further evidence of pamidronate therapy effectiveness in patients with AS who are refractory to NSAIDs and sulfasalazine.

Augusto, García-Poma; Manuel, Montero-Jauregui; Henry, Terrazas; Tatiana, Miraval; Felipe, Becerra; María I, Segami.

2007-03-01

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Variáveis relacionadas com perda da produtividade no trabalho em pacientes com espondilite anquilosante / Variables related to work productivity loss in patients with ankylosing spondylitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A perda da produtividade no trabalho, como resultado da espondilite anquilosante, tem se tornado tema de interesse dado o seu impacto socioeconômico. Além das limitações físicas, outras variáveis parecem interferir na produtividade desses pacientes que muitas vezes são aposentados precocemente do me [...] rcado de trabalho. Assim, esse manuscrito de revisão buscou identificar artigos publicados na língua inglesa no período de janeiro de 2001 a dezembro de 2011 que discutissem essas variáveis por meio de estudos realizados com pacientes adultos com diagnóstico de espondilite anquilosante, de ambos os gêneros e que usaram instrumentos padronizados para a avaliação da atividade da doença e da capacidade produtiva no trabalho. Foram identificados 33 artigos atendendo aos critérios de inclusão e observou-se que a perda de produtividade no trabalho em pacientes com espondilite anquilosante é influenciada por variáveis demográficas, emocionais, socioculturais e ocupacionais e hábitos de vida. Compreender esses possíveis fatores de risco pode colaborar para a elaboração de estratégias preventivas para a manutenção de pacientes com espondilite anquilosante no mercado de trabalho. Abstract in english The work productivity loss due to ankylosing spondylitis (AS) has become subject of interest because of its socioeconomic impact. In addition to physical limitations, other variables seem to affect the productivity of those patients, who often withdraw early from the labor force. This review was aim [...] ed at identifying articles published in English, from January 2001 to December 2011, which assessed those variables in adult patients of both sexes diagnosed with AS, using standardized instruments to measure disease activity and work productivity. Thirty-three articles meeting the inclusion criteria were identified. The work productivity loss of patients with AS proved to be influenced by demographics, emotional, social, cultural, and occupational factors, and lifestyle. Understanding those potential risk factors may contribute to the development of preventive strategies to maintain patients with AS participating in the labor force.

Renata, Frauendorf; Marcelo de Medeiros, Pinheiro; Rozana Mesquita, Ciconelli.

2013-06-01

145

Combined Home Exercise Is More Effective Than Range-of-Motion Home Exercise in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial  

Science.gov (United States)

Home exercise is often recommended for management of patients with ankylosing spondylitis (AS); however, what kind of home exercise is more beneficial for patients with AS has not been determined yet. We aimed to compare the effectiveness of combined home exercise (COMB) and range-of-motion home exercise (ROM) in patients with AS. Nineteen subjects with AS completed either COMB (n = 9) or ROM (n = 10) program. The COMB program included range-of-motion, strengthening, and aerobic exercise while the ROM program consisted of daily range-of-motion exercise only. After exercise instruction, subjects in each group performed home exercise for 3 months. Assessment included cardiopulmonary exercise test, pulmonary function test, spinal mobility measurement, chest expansion, Bath Ankylosing Spondylitis Functional Index (BASFI), and other functional ability and laboratory tests. After exercise, the COMB group showed significant improvement in peak oxygen uptake (12.3%, P = 0.008) and BASFI (P = 0.028), and the changed score between pre- and postexercise data was significantly greater in the COMB group regarding peak oxygen uptake and BASFI. Significant improvement in finger-to-floor distance after 3-month exercise was found only in the COMB group (P = 0.033). This study demonstrates that a combined home exercise is more effective than range-of-motion home exercise alone in aerobic capacity and functional ability.

Chuang, Chih-Cheng; Tseng, Ching-Shiang; Wei, James Cheng-Chung; Hsu, Wei-Chun; Lin, Yi-Jia

2014-01-01

146

Effects of Pilates, McKenzie and Heckscher training on disease activity, spinal motility and pulmonary function in patients with ankylosing spondylitis: a randomized controlled trial.  

Science.gov (United States)

The optimal management of ankylosis spondylitis (AS) involves a combination of nonpharmacologic and pharmacologic treatment aiming to maximize health-related quality of life. The primary objective of our study was to demonstrate the benefits of an original multimodal exercise program combining Pilates, McKenzie and Heckscher techniques on pulmonary function in patients with AS, while secondary objectives were to demonstrate the benefits of the same program on function and disease activity. This is a randomized controlled study on ninety-six consecutive patients with AS (axial disease subset), assigned on a 1:1 rationale into two groups based on their participation in the Pilates, McKenzie and Heckscher (group I) or in the classical kinetic program (group II). The exercise program consisted of 50-min sessions performed 3 times weekly for 48 weeks. Standard assessments were done at week 0 and 48 and included pain, modified Schober test (mST) and finger-floor distance (FFD), chest expansion (CE) and vital capacity (VC), as well as disease activity Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional Bath Ankylosing Spondylitis Functional Index (BASFI) and metrology index Bath Ankylosing Spondylitis Metrology Index (BASMI). Groups were comparable at baseline; we demonstrated significant improvement between baseline and after 48 weeks of regular kinetic training for all AS-related parameters in both groups. However, significant improvement was found in pain, lumbar spine motility (mST, FFD), BASFI, BASDAI and BASMI in AS performing the specific multimodal exercise program at the end of study (p = 0.001). Although there were significant improvements in CE in both groups as compared to baseline (group I, p = 0.001; group II, p = 0.002), this parameter increased significantly only in group I (p = 0.001). VC measurements were not significantly changed at the end of the study (group I, p = 0.127; group II, p = 0.997), but we found significant differences within groups (p = 0.011). A multimodal training combining Pilates, McKenzie and Heckscher exercises performed regularly should be included in the routine management of patients with AS for better control of function, disease activity and pulmonary function. PMID:24071935

Ro?u, Mihaela Oana; ?opa, Ionu?; Chirieac, Rodica; Ancuta, Codrina

2014-03-01

147

Grupos educacionais para pacientes com espondilite anquilosante: revisão sistemática / Educational groups for ankylosing spondylitis patients: systematic review  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese JUSTIFICATIVA E OBJETIVOS: A espondilite anquilosante (EA) é uma doença inflamatória, crônica, que acomete as articulações sacroilíacas, em graus variáveis a coluna vertebral e, em menor extensão as articulações periféricas. Dentre as formas de tratamento não medicamentoso, os grupos educacionais tê [...] m sido recomendados como importante coadjuvante no tratamento da doença. O objetivo deste estudo foi rever na literatura as evidências científicas sobre grupos educacionais para pacientes com EA. MÉTODO: A revisão foi realizada nas Bases de dados LILACS, Medline, Web of Science e PEDro. Os termos para busca sistemática foram extraídos dos Descritores em Ciências da Saúde (DeCS). RESULTADOS: Foram localizados nove artigos científicos no período de 1990 a 2012. Na seleção e análise dos estudos foram utilizados critérios de inclusão e exclusão, incluído artigos científicos que abordassem principalmente os grupos educacionais como forma de tratamento para os pacientes com EA. CONCLUSÃO: A literatura a respeito dos grupos educacionais como coadjuvante no tratamento desses pacientes é escassa. Futuros estudos mostrando os formatos dos grupos, duração, quantidade e conteúdos das aulas devem ser realizados, bem como a avaliação de sua efetividade. Abstract in english BACKGROUND AND OBJECTIVES: Ankylosing spondylitis (AS) is a chronic inflammatory disease affecting sacroiliac joints, the spine in different degrees and in lesser extension peripheral joints. Among non-pharmacological treatments, educational groups have been recommended as major coadjuvants to treat [...] this disease. This study aimed at reviewing the literature on scientific evidences of educational groups for AS patients. METHOD: The following databases were reviewed: LILACS, Medline, Web of Science and PEDro. Words for systematic search were extracted from Health Sciences Keywords (HSC). RESULTS: Nine scientific articles were found between 1990 and 2012. Inclusion and exclusion criteria were used to select and analyze studies, including scientific articles especially addressing educational groups as treatment approaches for AS patients. CONCLUSION: Literature on educational groups as coadjuvant to treat such patients is scarce. Further studies are needed to show group formats, number and content of classes, in addition to evaluating their effectiveness.

Marcelo Cardoso de, Souza; Aline, Orlandi; Anamaria, Jones; Fábio, Jennings; Elisabeth, Biruel.

2012-09-01

148

Population pharmacokinetics of rhTNFR-Fc in healthy Chinese volunteers and in Chinese patients with Ankylosing spondylitis  

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Aim: To investigate the population pharmacokinetics of recombinant human tumor necrosis factor receptor-Fc fusion protein (rhTNFR-Fc) administered via subcutaneous (SC) injection in healthy Chinese volunteers and in Chinese patients with ankylosing spondylitis (AS). Methods: Thirty-two healthy volunteers were randomly assigned to receive a single SC injection of 12.5, 25, 37.5, or 50 mg of rhTNFR-Fc. Twenty male patients with moderate AS were randomly assigned to receive seven consecutive SC injections of rhTNFR-Fc at either 25 mg twice a week (BIW) or 50 mg once a week (QW). Population pharmacokinetic (PK) analysis was applied to obtain PK parameters of rhTNFR-Fc by the NONMEM method. Results: The data were best described by a one-compartment model with lag time. We found that gender had a significant effect on the apparent clearance (CL/F), with the male CL/F ratio being only 0.665 times the female ratio; the absorption coefficient (F) of multiple dosages of rhTNFR-Fc was only 0.674 times that of a single dosage. The outcome parameters were CL/F (female: 0.168 L/h, male: 0.110 L/h), the apparent volume of distribution (Vd/F: 15.5 L), the absorption rate constant (Ka) (single dosage: 0.0605 h?1, multiple dosage: 0.0408 h?1), and the lag time (Tlag: 1.03 h). The inter-individual variability in the CL/F, Vd/F, Ka, and Tlag were 33.3%, 42.7%, 55.6%, and 81.8%, respectively. Conclusion: Chinese females have a higher CL/F than Chinese males, and multiple dosings can significantly decrease the absorption of rhTNFR-Fc (SC). The population PK parameters of rhTNFR-Fc in healthy Chinese volunteers and patients with AS were similar to those reported for subjects in published American studies. PMID:20953211

Fang, Yi; Li, Lu-jin; Wang, Rui; Huang, Feng; Song, Hai-feng; Tang, Zhong-ming; Li, Yu-zhen; Guan, Hua-shi; Zheng, Qing-shan

2010-01-01

149

Decreased Frequencies of Circulating Follicular Helper T Cell Counterparts and Plasmablasts in Ankylosing Spondylitis Patients Naïve for TNF Blockers.  

Science.gov (United States)

Follicular helper T cells (Tfh), localized in lymphoid organs, promote B cell differentiation and function. Circulating CD4 T cells expressing CXCR5, ICOS and/or PD-1 are counterparts of Tfh. Three subpopulations of circulating CD4+CXCR5+ cells have been described: CXCR3+CCR6- (Tfh-Th1), CXCR3-CCR6+ (Tfh-Th17), and CXCR3-CCR6- (Tfh-Th2). Only Tfh-Th17 and Tfh-Th2 function as B cell helpers. Our objective was to study the frequencies of circulating Tfh (cTfh), cTfh subsets and plasmablasts (CD19+CD20-CD27+CD38high cells), and the function of cTfh cells, in patients with Ankylosing Spondylitis (AS). To this end, peripheral blood was drawn from healthy controls (HC) (n?=?50), AS patients naïve for TNF blockers (AS/nb) (n?=?25) and AS patients treated with TNF blockers (AS/b) (n?=?25). The frequencies of cTfh and plasmablasts were determined by flow cytometry. Cocultures of magnetically sorted CD4+CXCR5+ T cells with autologous CD19+CD27- naïve B cells were established from 3 AS/nb patients and 3 HC, and concentrations of IgG, A and M were measured in supernatants. We obseved that AS/nb but not AS/b patients, demonstrated decreased frequencies of circulating CD4+CXCR5+ICOS+PD-1+ cells and plasmablasts, together with a decreased (Tfh-Th17+Tfh-Th2)/Tfh-Th1 ratio. The amounts of IgG and IgA produced in cocultures of CD4+CXCR5+ T cells with CD19+CD27- B cells of AS/nb patients were significantly lower than observed in cocultures established from HC. In summary, AS/nb but not AS/b patients, demonstrate a decreased frequency of cTfh and plasmablasts, and an underrepresentation of cTfh subsets bearing a B helper phenotype. In addition, peripheral blood CD4+CXCR5+ T cells of AS/nb patients showed a decreased capacity to help B cells ex vivo. PMID:25203742

Bautista-Caro, María-Belén; Arroyo-Villa, Irene; Castillo-Gallego, Concepción; de Miguel, Eugenio; Peiteado, Diana; Plasencia-Rodríguez, Chamaida; Villalba, Alejandro; Sánchez-Mateos, Paloma; Puig-Kröger, Amaya; Martín-Mola, Emilio; Miranda-Carús, María-Eugenia

2014-01-01

150

Níveis de vitamina D na espondilite anquilosante: a deficiência corresponde à atividade da doença? / Vitamin D levels in ankylosing spondylitis: Does deficiency correspond to disease activity?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A espondilite anquilosante (EA) é um transtorno inflamatório que se apresenta com artrite da coluna vertebral, inclusive das articulações sacroilíacas. A vitamina D é um hormônio secosteroide com papel consagrado na homeostase do cálcio e do fosfato e na regulação da formação e reabsorção óssea. Atu [...] almente, sabe-se que a vitamina D desempenha um papel imunossupressivo no organismo, e ultimamente tem havido interesse no papel dessa vitamina em doenças autoimunes. A inflamação pode ser responsável por parte da perda da densidade mineral óssea observada em pacientes com EA. Revisamos a literatura em busca de estudos que avaliassem os níveis de vitamina D em pacientes com EA, em comparação com controles saudáveis. Quatro dos sete estudos chegaram a uma significativa correlação negativa entre os níveis de vitamina D e o instrumento Bath Ankylosing Spondylitis Index (BASDAI), velocidade de hemossedimentação (VHS) e proteína C reativa (PCR). Em uma revisão de oito estudos de caso-controle, o nível médio de 25-hidroxivitamina D3 foi 22,8 ± 14,1 ng/mL em 555 pacientes com EA versus 26,6 ± 12,5 ng/mL em 557 controles saudáveis. Quando comparados com um teste t para duas amostras, os níveis de vitamina D estavam significativamente mais altos em controles saudáveis (p Abstract in english Ankylosing spondylitis (AS) is an inflammatory disorder that presents with arthritis of the axial skeleton, including sacroiliac joints. Vitamin D is a secosteroid hormone with a long-established role in calcium and phosphate homeostasis, and in the regulation of bone formation and resorption. It is [...] now known that vitamin D plays an immunosuppressive role in the body, and there is interest of late in the role of vitamin D in autoimmune diseases. Inflammation may be responsible for some of the loss of bone mineral density seen in AS. We reviewed the literature for studies assessing vitamin D level as a marker of AS disease activity and those examining vitamin D levels in AS in comparison to healthy controls. Four of 7 studies found a significant negative correlation between vitamin D levels and Bath Ankylosing Spondylitis Index (BASDAI), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). In a review of 8 case-control studies, the mean level of 25-hydroxyvitamin D3 was 22.8 ± 14.1 ng/mL in 555 AS patients versus 26.6 ± 12.5 ng/mL in 557 healthy controls. When compared with a 2-sample t test, vitamin D levels were significantly higher in healthy controls (p

Gabriel G., Pokhai; Sabiha, Bandagi; Adriana, Abrudescu.

2014-07-01

151

Níveis de vitamina D na espondilite anquilosante: a deficiência corresponde à atividade da doença? / Vitamin D levels in ankylosing spondylitis: Does deficiency correspond to disease activity?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A espondilite anquilosante (EA) é um transtorno inflamatório que se apresenta com artrite da coluna vertebral, inclusive das articulações sacroilíacas. A vitamina D é um hormônio secosteroide com papel consagrado na homeostase do cálcio e do fosfato e na regulação da formação e reabsorção óssea. Atu [...] almente, sabe-se que a vitamina D desempenha um papel imunossupressivo no organismo, e ultimamente tem havido interesse no papel dessa vitamina em doenças autoimunes. A inflamação pode ser responsável por parte da perda da densidade mineral óssea observada em pacientes com EA. Revisamos a literatura em busca de estudos que avaliassem os níveis de vitamina D em pacientes com EA, em comparação com controles saudáveis. Quatro dos sete estudos chegaram a uma significativa correlação negativa entre os níveis de vitamina D e o instrumento Bath Ankylosing Spondylitis Index (BASDAI), velocidade de hemossedimentação (VHS) e proteína C reativa (PCR). Em uma revisão de oito estudos de caso-controle, o nível médio de 25-hidroxivitamina D3 foi 22,8 ± 14,1 ng/mL em 555 pacientes com EA versus 26,6 ± 12,5 ng/mL em 557 controles saudáveis. Quando comparados com um teste t para duas amostras, os níveis de vitamina D estavam significativamente mais altos em controles saudáveis (p Abstract in english Ankylosing spondylitis (AS) is an inflammatory disorder that presents with arthritis of the axial skeleton, including sacroiliac joints. Vitamin D is a secosteroid hormone with a long-established role in calcium and phosphate homeostasis, and in the regulation of bone formation and resorption. It is [...] now known that vitamin D plays an immunosuppressive role in the body, and there is interest of late in the role of vitamin D in autoimmune diseases. Inflammation may be responsible for some of the loss of bone mineral density seen in AS. We reviewed the literature for studies assessing vitamin D level as a marker of AS disease activity and those examining vitamin D levels in AS in comparison to healthy controls. Four of 7 studies found a significant negative correlation between vitamin D levels and Bath Ankylosing Spondylitis Index (BASDAI), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). In a review of 8 case-control studies, the mean level of 25-hydroxyvitamin D3 was 22.8 ± 14.1 ng/mL in 555 AS patients versus 26.6 ± 12.5 ng/mL in 557 healthy controls. When compared with a 2-sample t test, vitamin D levels were significantly higher in healthy controls (p

Gabriel G., Pokhai; Sabiha, Bandagi; Adriana, Abrudescu.

152

Equilíbrio estático e dinâmico no indivíduo com espondilite anquilosante: revisão da literatura Static and dynamic balance in subjects with ankylosing spondylitis: literature review  

Directory of Open Access Journals (Sweden)

Full Text Available Com o objetivo de analisar as alterações musculoesqueléticas dos indivíduos com espondilite anquilosante (EA e suas repercussões sobre o controle postural, realizou-se uma revisão bibliográfica nas bases de dados da BIREME e EBSCO HOTS e no site Pubmed com as palavras-chave: "ankylosing spondylitis", "postural balance" e "posture". Foram selecionados artigos envolvendo seres humanos e que analisavam o controle postural e a biomecânica dos indivíduos com EA, nos idiomas inglês e português, publicados no período entre 1999 e 2010. Do total de artigos encontrados, apenas quatro preencheram os requisitos. Desses, três compararam os resultados de pacientes com EA com os dados obtidos de indivíduos saudáveis, e um analisou apenas indivíduos com EA. Nenhum artigo continha o mesmo método de análise postural. Para avaliação do equilíbrio foram utilizadas a Escala de Equilíbrio de Berg, a Plataforma de Força e a Magnometria. Os principais desvios posturais encontrados foram aumento da cifose torácica e flexão do quadril, que levam a uma anteriorização do centro de gravidade corporal, apresentando flexão do joelho e plantiflexão do tornozelo como compensação para manter o equilíbrio. Apenas um autor encontrou piora do equilíbrio funcional nos sujeitos com EA. Todos os métodos de avaliação utilizados foram considerados capazes de mensurar o equilíbrio, não havendo uma escala específica para pacientes com EA.To analyze the musculoskeletal changes of individuals with ankylosing spondylitis (AS and their repercussions on postural control, a literature review was carried out in the BIREME and EBSCO HOTS databases and Pubmed site with the following keywords: "ankylosing spondylitis", "postural balance", and "posture". Articles involving human beings, assessing the postural control and balance of individuals with AS, written in English or Portuguese and published between 1999 and 2010, were selected. Of the total number of articles found, only four met the requirements. Of those, three compared the outcomes of patients with AS with data obtained from healthy individuals, and one article assessed individuals with AS. No article used the same method of postural analysis. To assess balance, Berg Balance Scale, Force Plate, and Magnometry were used. The major postural deviations found were increased thoracic kyphosis and hip flexion, which lead to a forward displacement of the body's center of gravity, with knee flexion and ankle plantar flexion as compensation to control balance. Only one author reported worsening of functional balance in subjects with AS. All assessment methods used were considered capable of measuring balance, and no specific scale for patients with AS exists.

José Eduardo Pompeu

2012-06-01

153

Equilíbrio estático e dinâmico no indivíduo com espondilite anquilosante: revisão da literatura / Static and dynamic balance in subjects with ankylosing spondylitis: literature review  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Com o objetivo de analisar as alterações musculoesqueléticas dos indivíduos com espondilite anquilosante (EA) e suas repercussões sobre o controle postural, realizou-se uma revisão bibliográfica nas bases de dados da BIREME e EBSCO HOTS e no site Pubmed com as palavras-chave: "ankylosing spondylitis [...] ", "postural balance" e "posture". Foram selecionados artigos envolvendo seres humanos e que analisavam o controle postural e a biomecânica dos indivíduos com EA, nos idiomas inglês e português, publicados no período entre 1999 e 2010. Do total de artigos encontrados, apenas quatro preencheram os requisitos. Desses, três compararam os resultados de pacientes com EA com os dados obtidos de indivíduos saudáveis, e um analisou apenas indivíduos com EA. Nenhum artigo continha o mesmo método de análise postural. Para avaliação do equilíbrio foram utilizadas a Escala de Equilíbrio de Berg, a Plataforma de Força e a Magnometria. Os principais desvios posturais encontrados foram aumento da cifose torácica e flexão do quadril, que levam a uma anteriorização do centro de gravidade corporal, apresentando flexão do joelho e plantiflexão do tornozelo como compensação para manter o equilíbrio. Apenas um autor encontrou piora do equilíbrio funcional nos sujeitos com EA. Todos os métodos de avaliação utilizados foram considerados capazes de mensurar o equilíbrio, não havendo uma escala específica para pacientes com EA. Abstract in english To analyze the musculoskeletal changes of individuals with ankylosing spondylitis (AS) and their repercussions on postural control, a literature review was carried out in the BIREME and EBSCO HOTS databases and Pubmed site with the following keywords: "ankylosing spondylitis", "postural balance", an [...] d "posture". Articles involving human beings, assessing the postural control and balance of individuals with AS, written in English or Portuguese and published between 1999 and 2010, were selected. Of the total number of articles found, only four met the requirements. Of those, three compared the outcomes of patients with AS with data obtained from healthy individuals, and one article assessed individuals with AS. No article used the same method of postural analysis. To assess balance, Berg Balance Scale, Force Plate, and Magnometry were used. The major postural deviations found were increased thoracic kyphosis and hip flexion, which lead to a forward displacement of the body's center of gravity, with knee flexion and ankle plantar flexion as compensation to control balance. Only one author reported worsening of functional balance in subjects with AS. All assessment methods used were considered capable of measuring balance, and no specific scale for patients with AS exists.

José Eduardo, Pompeu; Renata Sorroche Lourenço, Romano; Sandra Maria Alvarenga Anti, Pompeu; Sônia Maria Anti Loduca, Lima.

154

Equilíbrio estático e dinâmico no indivíduo com espondilite anquilosante: revisão da literatura / Static and dynamic balance in subjects with ankylosing spondylitis: literature review  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Com o objetivo de analisar as alterações musculoesqueléticas dos indivíduos com espondilite anquilosante (EA) e suas repercussões sobre o controle postural, realizou-se uma revisão bibliográfica nas bases de dados da BIREME e EBSCO HOTS e no site Pubmed com as palavras-chave: "ankylosing spondylitis [...] ", "postural balance" e "posture". Foram selecionados artigos envolvendo seres humanos e que analisavam o controle postural e a biomecânica dos indivíduos com EA, nos idiomas inglês e português, publicados no período entre 1999 e 2010. Do total de artigos encontrados, apenas quatro preencheram os requisitos. Desses, três compararam os resultados de pacientes com EA com os dados obtidos de indivíduos saudáveis, e um analisou apenas indivíduos com EA. Nenhum artigo continha o mesmo método de análise postural. Para avaliação do equilíbrio foram utilizadas a Escala de Equilíbrio de Berg, a Plataforma de Força e a Magnometria. Os principais desvios posturais encontrados foram aumento da cifose torácica e flexão do quadril, que levam a uma anteriorização do centro de gravidade corporal, apresentando flexão do joelho e plantiflexão do tornozelo como compensação para manter o equilíbrio. Apenas um autor encontrou piora do equilíbrio funcional nos sujeitos com EA. Todos os métodos de avaliação utilizados foram considerados capazes de mensurar o equilíbrio, não havendo uma escala específica para pacientes com EA. Abstract in english To analyze the musculoskeletal changes of individuals with ankylosing spondylitis (AS) and their repercussions on postural control, a literature review was carried out in the BIREME and EBSCO HOTS databases and Pubmed site with the following keywords: "ankylosing spondylitis", "postural balance", an [...] d "posture". Articles involving human beings, assessing the postural control and balance of individuals with AS, written in English or Portuguese and published between 1999 and 2010, were selected. Of the total number of articles found, only four met the requirements. Of those, three compared the outcomes of patients with AS with data obtained from healthy individuals, and one article assessed individuals with AS. No article used the same method of postural analysis. To assess balance, Berg Balance Scale, Force Plate, and Magnometry were used. The major postural deviations found were increased thoracic kyphosis and hip flexion, which lead to a forward displacement of the body's center of gravity, with knee flexion and ankle plantar flexion as compensation to control balance. Only one author reported worsening of functional balance in subjects with AS. All assessment methods used were considered capable of measuring balance, and no specific scale for patients with AS exists.

José Eduardo, Pompeu; Renata Sorroche Lourenço, Romano; Sandra Maria Alvarenga Anti, Pompeu; Sônia Maria Anti Loduca, Lima.

2012-06-01

155

The permanent improvement of proteinuria and renal failure with colchicine and enalapril in a leukemic patient with renal amyloidosis secondary to ankylosing spondylitis: a review of the literature.  

Science.gov (United States)

Acute leukemia has been reported as secondary to radiation therapy in patients with ankylosing spondylitis (AS). AA amyloidosis secondary to AS causes progressive organ failure. Although new therapeutic choices can be used, response to therapy in secondary amyloidosis is not good enough. In AA amyloidosis, clinical symptoms partially regress with colchicine. Here, we report a patient with acute leukemia and AS. After complete remission of acute leukemia, pulmonary tuberculosis, acute renal failure and nephrotic syndrome developed. After treatment of leukemia and tuberculosis, Colchicine and enalapril therapy resulted in an improvement of clinical symptoms. He was followed up for >15 years and is doing very well and has minimal symptoms related to AS. PMID:22975660

Paydas, Saime; Paydas, Semra; Balal, Mustafa

2013-01-01

156

Thoughts and perceptions of ankylosing spondylitis patients with regard to TNF inhibitors.  

Science.gov (United States)

The risk of infections and malignancies is the major area of concern with anti-tumor necrosis factor (anti-TNF) agents. The aim of this study was to investigate patients' views about their treatments and the factors that influence patients' treatment decisions concerning the use of anti-TNF-? drugs. This descriptive study was conducted in a single rheumatology unit. Patients using anti-TNF-? drugs for at least 3 months were included. Patients' thoughts and perceptions about their treatment were evaluated using a questionnaire. A total of 101 (94.1% male) patients were recruited. The patients described their feelings as hopeful, worried, happy, scared, desperate, and hopeless, with the order decreasing beginning with the first. Hope for healing and an expectation of increased quality of life were the most significant determinants for acceptance of treatment. After the drug information was given, patients described their feelings as follows: increase in anxiety, psychologically wearisome, and worrying about their condition worsening in the future. After anti-TNF-? treatment, patients described their experience as follows: "the most effective medicine that I have ever used," "it saved my life," "control procedures that were carried out before the treatment and once every 3 months after the treatment were essential," "I feel myself safe with these controls," and "I advised other people." This study, to our knowledge, is the first to evaluate the attitudes of patients concerning anti-TNF-? drugs from the stage of informed consent to the post-experience stage. We found that standard consent forms caused an increase in the level of anxiety among new users of anti-TNF-? drugs, although the aim was the exact opposite. The reasons for acceptance were the hope for healing, reliance on physicians, and advice of other patients. Most patients accepted follow-up control procedures, which aimed to diagnose adverse effects early. PMID:24374358

Cinar, Fatma Ilknur; Cinar, Muhammet; Yilmaz, Sedat; Simsek, Ismail; Erdem, Hakan; Pay, Salih

2014-07-01

157

What Is Ankylosing Spondylitis?  

Science.gov (United States)

... the body. Will Diet and Exercise Help? A healthy diet and exercise are good for everyone, and they may be very helpful if you have AS. There is no specific diet for people with AS, but keeping a healthy weight is important. It reduces stress on painful ...

158

GlideScope video laryngoscopy use tracheal intubation in patients with ankylosing spondylitis: a series of four cases and literature review.  

Science.gov (United States)

Airway management in patients with ankylosing spondylitis (AS) is a challenging problem for anesthesiologists. The GlideScope video laryngoscope (GVL) is designed to assist tracheal intubation for patients with a difficult airway. The aim of the study was to report the successful intubation by GVL of four AS patients, and to discuss the use of GVL for tracheal intubation in patients with AS by performing a review of the literature. Four patients with chronic, severe AS were evaluated preoperatively; all had features associated with a difficult direct laryngoscopy. We performed the necessary preparations for difficult airway and intubation. Patients were kept in supine position, with their head and neck supported on pillows. Following sufficient preoxygenation, patients received i.v. remifentanil at 1 ?g kg(-1), propofol at 2 mg kg(-1), and succinylcholine at 1 mg kg(-1). GVL intubation was provided after full muscle relaxation. GVL is reasonable alternative to awake fiberoptic bronchoscopy or any other device, as it appears that less training and skill is involved in the actual intubation process. Adequate laryngeal exposure was obtained in all patients were successfully intubated in the first attempt. As with any challenging airway management, it is essential to have a rescue strategy. We believe that GVL can be a good alternative for oral endotracheal intubation in patients with AS. This series is very small and the reader should be very cautious about drawing broad conclusions regarding the GVL and patients with AS. PMID:24046099

Saricicek, Vahap; Mizrak, Ayse; Gul, Rauf; Goksu, Sitki; Cesur, Mehmet

2014-04-01

159

HLA-B27 and ankylosing spondylitis geographic distribution as the result of a genetic selection induced by malaria endemic? A review supporting the hypothesis.  

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The geographic distribution of HLA-B27 shows a latitude-related gradient inverse to that of malaria endemic. An apparent exception occurs in New Guinea, a region where malaria is present, but where HLA-B27 frequency shows, however, an orographic gradient antithetic to that of malaria incidence. We therefore suggest that Plasmodium falciparum may have exerted a negative selection on this gene. This might be due to a higher susceptibility to severe forms of malaria, associated with HLA-B27 or other close gene(s). In addition, we suggest here that the same selective pressure that has contributed to reduce the HLA-B27 frequency in some regions has favoured the fixing of newly generated B27 subtypes included in more advantageous HLA haplotypes. In some cases, as for B*2709 in Sardinia and B*2706 in Southeast Asia, these haplotypes may harbour factors that protect from Ankylosing Spondylitis, an autoimmune disease strongly associated with HLA-B27, thus offering a novel, powerful tool to dissect disease pathogenesis, and to identify additional genetic factors of susceptibility. PMID:18486928

Mathieu, Alessandro; Cauli, Alberto; Fiorillo, Maria Teresa; Sorrentino, Rosa

2008-05-01

160

High bone turnover assessed by 18F-fluoride PET/CT in the spine and sacroiliac joints of patients with ankylosing spondylitis: comparison with inflammatory lesions detected by whole body MRI  

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BACKGROUND: This study compares the frequency and distribution of increased activity on 18?F-fluoride PET/CT with the presence of bone marrow edema on whole-body MR imaging in the spine and sacroiliac joints (SIJ) of patients with active ankylosing spondylitis (AS). METHODS: Ten patients (6 men and 4 women), between 30 and 58?years old (median 44) with active AS, were prospectively examined with both whole-body MRI and 18?F-fluoride PET/CT. Patients fulfilled modified NY criteria and ha...

Fischer, Dorothee R.; Pfirrmann, Christian W. A.; Zubler, Veronika; Stumpe, Katrin D. M.; Seifert, Burkhardt; Strobel, Klaus; Tamborrini, Giorgio; Von Schulthess, Gustav K.; Michel, Beat A.; Ciurea, Adrian

2012-01-01

 
 
 
 
161

Translation into Brazilian Portuguese, cross-cultural adaptation and validation of the Stanford presenteeism scale-6 and work instability scale for ankylosing spondylitis.  

Science.gov (United States)

Loss of productivity at work, as a result of health problems, is becoming an issue of interest due to the high burden it represents in society. The measurement of such phenomenon can be made using generic and specific scales for certain diseases such as the Stanford Presenteeism Scale (SPS-6) and the Work Instability Scale for Ankylosing Spondylitis (AS-WIS), specific for patients with ankylosing spondylitis (AS). The aim of this study was to translate and perform a cross-cultural adaptation of SPS-6 and AS-WIS into Portuguese and check their psychometric properties. The study also aimed to evaluate the relationship between the general scores of the scales and the main sociodemographic and clinical data, lifestyles, and absenteeism in patients with AS and correlate these variables with SPS-6 and AS-WIS scales. A sample of 120 patients with AS and 80 workers at a university hospital was evaluated. The processes for the translation and cross-cultural adaptation of the instruments followed preestablished steps and rules presented in the literature. For the evaluation of measurement properties and correlations between scales, intra-class correlation coefficient (reproducibility analysis), Cronbach alpha (internal consistency), and Pearson correlation coefficient (validity) were employed. The inter-observer (0.986) and intra-observer (0.992) reproducibilities of the AS-WIS were shown to be high as well as the internal consistency (0.995). Similarly, the inter-observer reliability of SPS-6 was considered good (0.890), although it showed a poorer performance when considering the same observer (Pearson correlation coefficient?=?0.675 and intra-class correlation?=?0.656). Internal consistency, for the total number of items, as measured by Cronbach alpha, was 0.889. The validity of the scales was evaluated thru the comparison of the achieved scores with the results of the WLQ, SF-36, ASQoL, BASFI, BASDAI, HAQ-S, and SRQ-20 instruments. Correlations between loss of productivity at work, worse quality of life, presence of emotional disturbances, and worse health conditions were positive. The process of translation, cross-cultural adaptation, and validation of the SPS-6 as a generic measurement for the loss of productivity at work and of the AS-WIS as a specific measurement for patients with AS are valid, reproducible, and specific instruments to be used in Brazil. In both scales, productivity at work was associated to advanced age, higher rate of absenteeism in the last month and year, presence of peripheral arthritis, and a larger number of comorbidities in patients with AS. The AS-WIS and SPS-6 showed a good correlation among them although they are not mutually exclusive but supplementary. PMID:24221505

Frauendorf, Renata; de Medeiros Pinheiro, Marcelo; Ciconelli, Rozana Mesquita

2014-12-01

162

A comparison of telephone and paper self-completed questionnaires of main patient-related outcome measures in patients with ankylosing spondylitis and psoriatic arthritis.  

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A cross-sectional study was performed to assess the correlation between telephone and self-administration of patient-related outcomes (PROs) used in the assessment of ankylosing spondylitis (AS) patients. Participants underwent a telephone interview in which the following measures were evaluated: numerical rating scales (NRSs) for global health, pain intensity, global pain, back pain, and back pain at night; BASDI, BASFI, Health Assessment Questionnaire (HAQ), ASQoL, EuroQol, SF-12, and Work Productivity and Activity Impairment (WPAI) questionnaire. Within 48 h after the telephone interview, patients were appointed for a clinical visit in which the same questionnaires and in the same order were self-administered. The degree of correlation of outcomes measures between telephone interview and self-administration was assessed with the intraclass correlation coefficient (ICC). The two modes of assessing PROs were highly reliable, with ICC of 0.81 for BASDAI, 0.82 for BASFI, and 0.75 for HAQ. NRSs for global health, global pain intensity, back pain, and back pain at night also showed ICCs between 0.51 and 0.70, and only NRS for global disease activity showed an ICC of 0.45. This results were similar in patients with AS and patients with psoriatic arthritis. Social functioning and mental health domains of the SF-12 as well as EuroQol had poor correlations. The ICCs for WPAI outcomes were very good or good. We conclude that PROs in AS patients are comparable in both self-administered paper questionnaires and via a telephone interview. Different modes of assessing PRO measures facilitate the assessment of patients with AS in routine practice. PMID:23793389

Ariza-Ariza, Rafael; Hernández-Cruz, Blanca; Navarro-Compán, Victoria; Leyva Pardo, Christian; Juanola, Xavier; Navarro-Sarabia, Federico

2013-11-01

163

Los anti-TNF y la progresión radiográfica en espondilitis anquilosante / The anti-TNF and the radiological progression in ankylosing spondylitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish Los agentes biológicos inhibidores del factor de necrosis tumoral alfa (anti-TNF) se constituyen en un avance muy significativo en el tratamiento de los pacientes con espondilitis anquilosante (EA), demostrando una notable mejoría de sus síntomas, de su función y de su calidad de vida. Sumado a esta [...] excelente respuesta clínica, se ha demostrado igualmente mejoría de la inflamación, demostrada mediante pruebas de laboratorio y estudios de resonancia nuclear magnética. A pesar de esta clara evidencia, la conexión entre actividad inflamatoria y progresión estructural no está tan claramente establecida como en artritis reumatoide (AR), y la evidencia de la eficacia de los anti-TNF en la prevención de la progresión del daño radiológico crónico en EA es deficiente. Se revisan las evidencias y las teorías actuales respecto a este crucial tema y se hace mención del importante papel de la proteína DKK-1, inhibidora de la vía Wnt. Esta proteína ha emergido recientemente como un regulador fundamental en la biología ósea y se constituye en una conexión clave entre inflamación, osteoporosis y remodelación articular. Abstract in english The anti-TNF biological agents constitute a major advance in the treatment of patients with ankylosing spondylitis (AS) showing a remarkable improvement in symptoms of patients, their function and quality of life. In addition to this excellent clinical response, it has also been clearly demonstrated [...] improvement of inflammation as evidenced by laboratory tests and MRI studies. Despite this clear evidence, the connection between inflammatory activity and structural progression is not as clearly established as in rheumatoid arthritis, and the evidence of anti-TNF therapy to prevent chronic EA radiological damage is poor. We review the evidence and current theories about this crucial issue and mention the important role of DKK-1 protein, an inhibitor of the Wnt pathway. This protein has recently emerged as a key regulator in bone biology and constitutes a key link between inflammation, osteoporosis and joint remodeling.

Mauricio, Restrepo Escobar; Carolina, Muñoz Grajales; Adriana Lucía, Vanegas García; Gloria María, Vásquez Duque; Luis Alonso, González Naranjo.

2012-01-01

164

Divergent perceptions in health-related quality of life between family members and patients with rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitis.  

Science.gov (United States)

The aim of this study was to assess whether family members perceive health-related quality of life (HRQoL) of family members with rheumatic illnesses differently from the perceptions of these patients themselves. Cross-sectional study of consecutive patients with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) attending two outpatient rheumatic clinics. HRQoL was assessed using the Spanish version of the World Health Organization Disability Assessment Scale (WHODAS-II) questionnaire; the "proxy" version is available for relatives. All patients and one proxy per patient separately answered the questionnaire at the clinic. Differences were determined by coefficients of determination (r (2)), Z scores, and meaningful differences of 30 %. Two hundred and ninety-one patients (111 SLE, 100 RA, and 80 AS) and their respective proxies were included. The mean age was 35 ± 13 years in SLE, 49.5 ± 14 years in RA, and 40 ± 14 years in AS patients. Divergent perceptions between patients and their proxies were found in 57 % of the SLE group, in 69 % of the RA group, and in 47 % of the AS group as per WHODAS-II global score. Stronger disagreement occurred for all the three groups in domains representing cognition and interaction with other people: around 60 % in the SLE group, 80 % in the RA group, and 40 % in the AS group. A substantial proportion of family members perceived the HRQoL of rheumatic family members differently from the perception of the patients themselves, most of the time biased toward underestimation, suggesting problems in the dynamics of efficient communication and social support. PMID:24859395

Ramos-Remus, Cesar; Castillo-Ortiz, José Dionisio; Sandoval-Castro, Carlos; Paez-Agraz, Francisco; Sanchez-Ortiz, Adriana; Aceves-Avila, Francisco Javier

2014-12-01

165

Los anti-TNF y la progresión radiográfica en espondilitis anquilosante The anti-TNF and the radiological progression in ankylosing spondylitis  

Directory of Open Access Journals (Sweden)

Full Text Available Los agentes biológicos inhibidores del factor de necrosis tumoral alfa (anti-TNF se constituyen en un avance muy significativo en el tratamiento de los pacientes con espondilitis anquilosante (EA, demostrando una notable mejoría de sus síntomas, de su función y de su calidad de vida. Sumado a esta excelente respuesta clínica, se ha demostrado igualmente mejoría de la inflamación, demostrada mediante pruebas de laboratorio y estudios de resonancia nuclear magnética. A pesar de esta clara evidencia, la conexión entre actividad inflamatoria y progresión estructural no está tan claramente establecida como en artritis reumatoide (AR, y la evidencia de la eficacia de los anti-TNF en la prevención de la progresión del daño radiológico crónico en EA es deficiente. Se revisan las evidencias y las teorías actuales respecto a este crucial tema y se hace mención del importante papel de la proteína DKK-1, inhibidora de la vía Wnt. Esta proteína ha emergido recientemente como un regulador fundamental en la biología ósea y se constituye en una conexión clave entre inflamación, osteoporosis y remodelación articular.The anti-TNF biological agents constitute a major advance in the treatment of patients with ankylosing spondylitis (AS showing a remarkable improvement in symptoms of patients, their function and quality of life. In addition to this excellent clinical response, it has also been clearly demonstrated improvement of inflammation as evidenced by laboratory tests and MRI studies. Despite this clear evidence, the connection between inflammatory activity and structural progression is not as clearly established as in rheumatoid arthritis, and the evidence of anti-TNF therapy to prevent chronic EA radiological damage is poor. We review the evidence and current theories about this crucial issue and mention the important role of DKK-1 protein, an inhibitor of the Wnt pathway. This protein has recently emerged as a key regulator in bone biology and constitutes a key link between inflammation, osteoporosis and joint remodeling.

Mauricio Restrepo Escobar

2012-01-01

166

Antinuclear, anti-dsDNA and anti-ENA antibodies in patients affected with rheumatoid arthritis or ankylosing spondylitis during treatement with infliximab  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: We evaluated the induction and clinical significance of ANA, anti-dsDNA and anti-ENA during infliximab therapy in patients with Rheumatoid Arthritis (RA or Ankylosing Spondylitis (AS. Methods: We tested sera from 30 RA and 30 AS patients before and during treatment with infliximab. ANA and antidsDNA were determined by indirect immunofluorescence and anti-ENA by an “in house” counterimmunoelectrophoresis. Statistical analysis was performed by X2 and McNemar’s tests and U-test of Mann-Whitney. Results: Eight of the 30 RA patients and 1 of the 30 AS patients were positive for ANA before treatment with infliximab. Eighteen of the 22 (81.8% negative patients with RA and 11 of the 29 (37.9% negative patients with AS became positive for ANA during infliximab treatment. No ANA positive patients became negative during the therapy. The difference between ANA before and after treatment resulted significant in both RA and AS patients (p=0.001. The frequency of anti-dsDNA and anti-ENA did not change significantly from baseline, in both RA and AS patients. Acquired ANA positivity was not associated with clinical signs of lupus syndrome and was not correlated with adverse events. The mean values of ESR and CRP in RA patients who became positive for ANA were significantly decreased (p=0.01 and p=0.02 respectively. Conclusions: Infliximab treatment induced a significant increase in the frequency of ANA in RA and AS patients. The significance of ANA development in these diseases is at present unknown. The significant decrease of ESR and CRP in RA patients who became positive for ANA after treatment should be investigated in a larger number of patients.

L. Punzi

2011-09-01

167

Concomitância de artrite reumatoide e espondilite anquilosante em um único paciente: importância dos novos critérios de classificação Concurrent rheumatoid arthritis and ankylosing spondylitis in one patient: the importance of new classification criteria  

Directory of Open Access Journals (Sweden)

Full Text Available Relatamos um caso de concomitância de espondilite anquilosante e artrite reumatoide em um paciente caucasiano de 65 anos, com achados clínicos de poliartrite simétrica com erosão de metacarpofalangeana ao raio X convencional e dor lombar infl amatória, HLA-B27+, associada à sacroiliíte. O paciente apresentou valores elevados de fator reumatoide e antipeptídeo citrulinado cíclico (anti-CCP. Realizamos uma revisão da literatura na qual as principais características de casos previamente reportados foram comparadas às deste caso. Este é o primeiro relato de caso de concomitância das duas doenças em que se utilizou teste laboratorial para dosagem do anti-CCP associado ao preenchimento das últimas versões dos critérios ASAS axial e ACR/EULAR para a classificação de espondilite anquilosante e artrite reumatoide, respectivamente.We report the case of concomitant ankylosing spondylitis and rheumatoid arthritis in a 65-year-old Caucasian male, who had symmetric polyarthritis with erosion of the metacarpophalangeal joint on conventional X-ray, infl ammatory low back pain with HLA-B27 positivity, and sacroiliitis. Laboratory analysis showed high levels of rheumatoid factor and anti-cyclic citrullinated peptide antibody (anti-CCP. Clinical features of previously reported cases were compared with those of our case. This is the first case report on the coexistence of both diseases in the same patient, for whom anti- CCP testing and the latest versions of axial ASAS criteria and ACR/EULAR criteria for the classification of ankylosing spondylitis and rheumatoid arthritis, respectively, were used.

Valderilio Feijó Azevedo

2013-02-01

168

Decreased Frequencies of Circulating Follicular Helper T Cell Counterparts and Plasmablasts in Ankylosing Spondylitis Patients Na?ve for TNF Blockers  

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Follicular helper T cells (Tfh), localized in lymphoid organs, promote B cell differentiation and function. Circulating CD4 T cells expressing CXCR5, ICOS and/or PD-1 are counterparts of Tfh. Three subpopulations of circulating CD4+CXCR5+ cells have been described: CXCR3+CCR6- (Tfh-Th1), CXCR3-CCR6+ (Tfh-Th17), and CXCR3-CCR6- (Tfh-Th2). Only Tfh-Th17 and Tfh-Th2 function as B cell helpers. Our objective was to study the frequencies of circulating Tfh (cTfh), cTfh subsets and plasmablasts (CD19+CD20-CD27+CD38high cells), and the function of cTfh cells, in patients with Ankylosing Spondylitis (AS). To this end, peripheral blood was drawn from healthy controls (HC) (n?=?50), AS patients naïve for TNF blockers (AS/nb) (n?=?25) and AS patients treated with TNF blockers (AS/b) (n?=?25). The frequencies of cTfh and plasmablasts were determined by flow cytometry. Cocultures of magnetically sorted CD4+CXCR5+ T cells with autologous CD19+CD27- naïve B cells were established from 3 AS/nb patients and 3 HC, and concentrations of IgG, A and M were measured in supernatants. We obseved that AS/nb but not AS/b patients, demonstrated decreased frequencies of circulating CD4+CXCR5+ICOS+PD-1+ cells and plasmablasts, together with a decreased (Tfh-Th17+Tfh-Th2)/Tfh-Th1 ratio. The amounts of IgG and IgA produced in cocultures of CD4+CXCR5+ T cells with CD19+CD27- B cells of AS/nb patients were significantly lower than observed in cocultures established from HC. In summary, AS/nb but not AS/b patients, demonstrate a decreased frequency of cTfh and plasmablasts, and an underrepresentation of cTfh subsets bearing a B helper phenotype. In addition, peripheral blood CD4+CXCR5+ T cells of AS/nb patients showed a decreased capacity to help B cells ex vivo. PMID:25203742

Bautista-Caro, Maria-Belen; Arroyo-Villa, Irene; Castillo-Gallego, Concepcion; de Miguel, Eugenio; Peiteado, Diana; Plasencia-Rodriguez, Chamaida; Villalba, Alejandro; Sanchez-Mateos, Paloma; Puig-Kroger, Amaya; Martin-Mola, Emilio; Miranda-Carus, Maria-Eugenia

2014-01-01

169

Concomitância de artrite reumatoide e espondilite anquilosante em um único paciente: importância dos novos critérios de classificação / Concurrent rheumatoid arthritis and ankylosing spondylitis in one patient: the importance of new classification criteria  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Relatamos um caso de concomitância de espondilite anquilosante e artrite reumatoide em um paciente caucasiano de 65 anos, com achados clínicos de poliartrite simétrica com erosão de metacarpofalangeana ao raio X convencional e dor lombar infl amatória, HLA-B27+, associada à sacroiliíte. O paciente a [...] presentou valores elevados de fator reumatoide e antipeptídeo citrulinado cíclico (anti-CCP). Realizamos uma revisão da literatura na qual as principais características de casos previamente reportados foram comparadas às deste caso. Este é o primeiro relato de caso de concomitância das duas doenças em que se utilizou teste laboratorial para dosagem do anti-CCP associado ao preenchimento das últimas versões dos critérios ASAS axial e ACR/EULAR para a classificação de espondilite anquilosante e artrite reumatoide, respectivamente. Abstract in english We report the case of concomitant ankylosing spondylitis and rheumatoid arthritis in a 65-year-old Caucasian male, who had symmetric polyarthritis with erosion of the metacarpophalangeal joint on conventional X-ray, infl ammatory low back pain with HLA-B27 positivity, and sacroiliitis. Laboratory an [...] alysis showed high levels of rheumatoid factor and anti-cyclic citrullinated peptide antibody (anti-CCP). Clinical features of previously reported cases were compared with those of our case. This is the first case report on the coexistence of both diseases in the same patient, for whom anti- CCP testing and the latest versions of axial ASAS criteria and ACR/EULAR criteria for the classification of ankylosing spondylitis and rheumatoid arthritis, respectively, were used.

Valderilio Feijó, Azevedo; Pedro Grachinski, Buiar.

2013-02-01

170

Concomitância de artrite reumatoide e espondilite anquilosante em um único paciente: importância dos novos critérios de classificação / Concurrent rheumatoid arthritis and ankylosing spondylitis in one patient: the importance of new classification criteria  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Relatamos um caso de concomitância de espondilite anquilosante e artrite reumatoide em um paciente caucasiano de 65 anos, com achados clínicos de poliartrite simétrica com erosão de metacarpofalangeana ao raio X convencional e dor lombar infl amatória, HLA-B27+, associada à sacroiliíte. O paciente a [...] presentou valores elevados de fator reumatoide e antipeptídeo citrulinado cíclico (anti-CCP). Realizamos uma revisão da literatura na qual as principais características de casos previamente reportados foram comparadas às deste caso. Este é o primeiro relato de caso de concomitância das duas doenças em que se utilizou teste laboratorial para dosagem do anti-CCP associado ao preenchimento das últimas versões dos critérios ASAS axial e ACR/EULAR para a classificação de espondilite anquilosante e artrite reumatoide, respectivamente. Abstract in english We report the case of concomitant ankylosing spondylitis and rheumatoid arthritis in a 65-year-old Caucasian male, who had symmetric polyarthritis with erosion of the metacarpophalangeal joint on conventional X-ray, infl ammatory low back pain with HLA-B27 positivity, and sacroiliitis. Laboratory an [...] alysis showed high levels of rheumatoid factor and anti-cyclic citrullinated peptide antibody (anti-CCP). Clinical features of previously reported cases were compared with those of our case. This is the first case report on the coexistence of both diseases in the same patient, for whom anti- CCP testing and the latest versions of axial ASAS criteria and ACR/EULAR criteria for the classification of ankylosing spondylitis and rheumatoid arthritis, respectively, were used.

Valderilio Feijó, Azevedo; Pedro Grachinski, Buiar.

171

Aterosclerose subclínica em pacientes com espondilite anquilosante: há um papel para a inflamação? / Subclinical atherosclerosis in ankylosing spondylitis: is there a role for inflammation?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVOS: Avaliar a prevalência de aterosclerose subclínica em pacientes com espondilite anquilosante (EA) em comparação com controles com fatores de risco cardiovasculares similares. MÉTODOS: Foram recrutados 42 pacientes consecutivos com EA e 42 controles equiparados para idade (43,3 ± 11,7 vs. 4 [...] 3,7 ± 11,3, P = 0,89), gênero, tabagismo, diabetes mellitus e hipertensão arterial. Qualquer participante seria excluído se estivesse presente uma história pessoal de doença cardiovascular (CV). Foi preenchido um questionário registrando dados demográficos e histórias médica e de medicação. Foram determinados: pressão arterial, circunferência abdominal, altura e peso. O perfil lipídico foi determinado em uma amostra de sangue com 12 horas em jejum. Foi realizada uma análise ultrassonográfica da artéria carótida comum por um observador desconhecedor da pesquisa. Foi medida a distância entre a interface lúmen-íntima e a borda de ataque da interface média-adventícia (EIM) e os participantes também foram avaliados para presença de placas. RESULTADOS: A análise comparativa dos fatores de risco demográficos e cardiovasculares entre pacientes com EA e controles não revelou diferenças estatisticamente significativas. Também não foram observadas diferenças significativas entre grupos para TC, HDL-C, T-C/ HDL-C, LDL-C, triglicerídeos ou frequência de dislipidemia. As medidas de EIM não foram diferentes em EA e controles (0,62 ± 0,09 vs. 0,61 ± 0,09, P = 0,39) e nem as frequências de placas (19% vs. 17%, P = 0,78). CONCLUSÕES: A aterosclerose subclínica avaliada por meio de imagens ultrassonográficas da carótida não foi mais prevalente no grupo EA, em comparação com os controles com riscos cardiovasculares similares. Nossas observações podem implicar que os fatores de risco CV podem ter mais influência no sistema CV versus a própria EA. Esses achados devem ser confirmados em uma população maior, por meio de um estudo prospectivo. Abstract in english OBJECTIVES: To evaluate the prevalence of subclinical atherosclerosis in patients with ankylosing spondylitis (AS) in comparison to controls with similar cardiovascular risk factors. METHODS: Forty-two consecutive patients with AS and 42 controls matched for age (43.3 ± 11.7 vs. 43.7 ± 11.3, P = 0.8 [...] 9), gender, smoking, diabetes mellitus and arterial hypertension were enrolled. Participants were excluded if a personal cardiovascular disease (CV) history was present. A questionnaire recording demographic data, medical and medication history was fulfilled. Blood pressure, abdominal circumference, height and weight were measured. Lipid profile was determined in a 12-hour fastened blood sample. Ultrasound analysis of the common carotid artery was performed by one blind observer. The distance between the lumen-intima interface and the leading edge of the media-adventitia interface (IMT) was measured and participants were also evaluated for the presence of plaques. RESULTS: The comparative analysis of demographic and cardiovascular risk factors between AS patients and controls did not reveal statistically significant differences. Also, no significant differences between groups were observed for TC, HDL-C, T-C/HDL-C, LDL-C, triglycerides, or dyslipidemia frequency. IMT measures were not different in AS and controls (0.62 ± 0.09 vs. 0.61 ± 0.09, P = 0.39) as well as plaques frequencies (19% vs. 17%, P = 0.78). CONCLUSIONS: Subclinical atherosclerosis assessed through carotid ultrasound imaging was not more prevalent in the AS group when compared to controls with similar cardiovascular risks. Our observations may imply that CV risk factors may have more influence on the CV system than AS itself. These findings should be confirmed in a larger population with a prospective study design.

Renato Leandro Mattar, Valente; Jamil Mattar, Valente; Gláucio Ricardo Werner de, Castro; Adriana Fontes, Zimmermann; Sonia Cristina de Magalhães Souza, Fialho; Ivânio Alves, Pereira.

2013-10-01

172

Aterosclerose subclínica em pacientes com espondilite anquilosante: há um papel para a inflamação? / Subclinical atherosclerosis in ankylosing spondylitis: is there a role for inflammation?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVOS: Avaliar a prevalência de aterosclerose subclínica em pacientes com espondilite anquilosante (EA) em comparação com controles com fatores de risco cardiovasculares similares. MÉTODOS: Foram recrutados 42 pacientes consecutivos com EA e 42 controles equiparados para idade (43,3 ± 11,7 vs. 4 [...] 3,7 ± 11,3, P = 0,89), gênero, tabagismo, diabetes mellitus e hipertensão arterial. Qualquer participante seria excluído se estivesse presente uma história pessoal de doença cardiovascular (CV). Foi preenchido um questionário registrando dados demográficos e histórias médica e de medicação. Foram determinados: pressão arterial, circunferência abdominal, altura e peso. O perfil lipídico foi determinado em uma amostra de sangue com 12 horas em jejum. Foi realizada uma análise ultrassonográfica da artéria carótida comum por um observador desconhecedor da pesquisa. Foi medida a distância entre a interface lúmen-íntima e a borda de ataque da interface média-adventícia (EIM) e os participantes também foram avaliados para presença de placas. RESULTADOS: A análise comparativa dos fatores de risco demográficos e cardiovasculares entre pacientes com EA e controles não revelou diferenças estatisticamente significativas. Também não foram observadas diferenças significativas entre grupos para TC, HDL-C, T-C/ HDL-C, LDL-C, triglicerídeos ou frequência de dislipidemia. As medidas de EIM não foram diferentes em EA e controles (0,62 ± 0,09 vs. 0,61 ± 0,09, P = 0,39) e nem as frequências de placas (19% vs. 17%, P = 0,78). CONCLUSÕES: A aterosclerose subclínica avaliada por meio de imagens ultrassonográficas da carótida não foi mais prevalente no grupo EA, em comparação com os controles com riscos cardiovasculares similares. Nossas observações podem implicar que os fatores de risco CV podem ter mais influência no sistema CV versus a própria EA. Esses achados devem ser confirmados em uma população maior, por meio de um estudo prospectivo. Abstract in english OBJECTIVES: To evaluate the prevalence of subclinical atherosclerosis in patients with ankylosing spondylitis (AS) in comparison to controls with similar cardiovascular risk factors. METHODS: Forty-two consecutive patients with AS and 42 controls matched for age (43.3 ± 11.7 vs. 43.7 ± 11.3, P = 0.8 [...] 9), gender, smoking, diabetes mellitus and arterial hypertension were enrolled. Participants were excluded if a personal cardiovascular disease (CV) history was present. A questionnaire recording demographic data, medical and medication history was fulfilled. Blood pressure, abdominal circumference, height and weight were measured. Lipid profile was determined in a 12-hour fastened blood sample. Ultrasound analysis of the common carotid artery was performed by one blind observer. The distance between the lumen-intima interface and the leading edge of the media-adventitia interface (IMT) was measured and participants were also evaluated for the presence of plaques. RESULTS: The comparative analysis of demographic and cardiovascular risk factors between AS patients and controls did not reveal statistically significant differences. Also, no significant differences between groups were observed for TC, HDL-C, T-C/HDL-C, LDL-C, triglycerides, or dyslipidemia frequency. IMT measures were not different in AS and controls (0.62 ± 0.09 vs. 0.61 ± 0.09, P = 0.39) as well as plaques frequencies (19% vs. 17%, P = 0.78). CONCLUSIONS: Subclinical atherosclerosis assessed through carotid ultrasound imaging was not more prevalent in the AS group when compared to controls with similar cardiovascular risks. Our observations may imply that CV risk factors may have more influence on the CV system than AS itself. These findings should be confirmed in a larger population with a prospective study design.

Renato Leandro Mattar, Valente; Jamil Mattar, Valente; Gláucio Ricardo Werner de, Castro; Adriana Fontes, Zimmermann; Sonia Cristina de Magalhães Souza, Fialho; Ivânio Alves, Pereira.

173

[The effect of Xinfeng capsule treatment on the number of BTLA(+)T cells and oxidative stress of patients with ankylosing spondylitis].  

Science.gov (United States)

Objective To investigate the changes of B and T lymphocyte attenuator (BTLA), reactive oxygen species (ROS), reactive nitrogen species (RNS), malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), total antioxidative capacity (TAOC) in the patients with ankylosing spondylitis (AS) and the effect of Xinfeng capsule (XFC) on them. Methods AS patients (n=140) were randomly divided into two groups, XFC group (3 tablets each time, tid, n=70) and salicylazosulfapyridine (SASP) group (4 pills each time, bid, n=70). Continuous treatment lasts 3 months. The study also enrolled 60 healthy volunteers as a control group. Flow cytometry was used to test BTLA expression. ELISA was performed to detect the oxidative stress indicators (ROS, RNS, MDA, SOD, CAT, TAOC) and cytokines (IL-4, IL-10, IL-1?, TNF-?). Western blotting was adopted to examine the blood sedimentation (ESR). HITACHI 7060 automatic biochemical analyzer was used to determine the level of high sensitive C-reactive protein (Hs-CRP). Results Clinical efficacy of XFC group was significantly better than that of SASP group (Pcontrol group, AS patients had significantly lower BTLA expression in CD3(+) T cells and CD4(+) T cells from the peripheral blood (P<0.01 or P<0.05), the decreased levels of SOD, CAT and TAOC, and significantly increased ROS, RNS and MDA values (P<0.01 or P<0.05). In addition, the levels of serum IL-1?, TNF-?, ESR and Hs-CRP were significantly higher (P<0.01) and IL-4, IL-10 were significantly lower in AS patients (P<0.01 or P<0.05). Compared with pre-treatment, both XFC and SASP significantly elevated the expressions of BTLA(+)CD3(+) T, BTLA(+)CD4(+) T, BTLA, SOD, TAOC, IL-4, SF-36 (PF, SF, RP, RE, BP, MH, VT, GH) eight dimension scores, and reduced ROS, MDA, TNF-?, ESR, Hs-CRP, VAS, BASDAI, BASFI and BAS-G in the peripheral blood (P<0.01 or P<0.05). The differences between XFC group and SASP group were statistically significant (P<0.01 or P<0.05). Pearson correlation analysis showed that BTLA expression level in the peripheral blood was positively correlated with SOD, RP, BP, SF and RE. BTLA(+)CD3(+) T cells and BTLA*CD4(+) T cells were significantly negatively correlated with ROS, MDA, IL-1?, TNF-?, ESR, VAS and BASDAI, and they were positively correlated with TAOC, IL-4 and IL-10. BTLA(+)CD3(+) T cells were significantly negatively correlated with RNS, Hs-CRP and BASFI; BTLA(+)CD4(+) T cells were positively correlated with CAT. Conclusion XFC can improve BTLA expression in the peripheral blood of AS patients and regulate negatively the activation and proliferation of T cells. PMID:25270214

Qi, Yajun; Liu, Jian; Zheng, Li; Cao, Yunxiang; Wan, Lei

2014-10-01

174

A randomised, double-blind, multicentre, parallel-group, prospective study comparing the pharmacokinetics, safety, and efficacy of CT-P13 and innovator infliximab in patients with ankylosing spondylitis: the PLANETAS study  

Science.gov (United States)

Objectives To compare the pharmacokinetics (PK), safety and efficacy of innovator infliximab (INX) and CT-P13, a biosimilar to INX, in patients with active ankylosing spondylitis (AS). Methods Phase 1 randomised, double-blind, multicentre, multinational, parallel-group study. Patients were randomised to receive 5?mg/kg of CT-P13 (n=125) or INX (n=125). Primary endpoints were area under the concentration-time curve (AUC) at steady state and observed maximum steady state serum concentration (Cmax,ss) between weeks 22 and 30. Additional PK, efficacy endpoints, including 20% and 40% improvement response according to Assessment in Ankylosing Spondylitis International Working Group criteria (ASAS20 and ASAS40), and safety outcomes were also assessed. Results Geometric mean AUC was 32?765.8??gh/ml for CT-P13 and 31?359.3??gh/ml for INX. Geometric mean Cmax,ss was 147.0 ??g/ml for CT-P13 and 144.8??g/ml for INX. The ratio of geometric means was 104.5% (90% CI 94% to 116%) for AUC and 101.5% (90% CI 95% to 109%) for Cmax,ss. ASAS20 and ASAS40 responses at week 30 were 70.5% and 51.8% for CT-P13 and 72.4% and 47.4% for INX, respectively. In the CT-P13 and INX groups more than one adverse event occurred in 64.8% and 63.9% of patients, infusion reactions occurred in 3.9% and 4.9%, active tuberculosis occurred in 1.6% and 0.8%, and 27.4% and 22.5% of patients tested positive for anti-drug antibodies, respectively. Conclusions The PK profiles of CT-P13 and INX were equivalent in patients with active AS. CT-P13 was well tolerated, with an efficacy and safety profile comparable to that of INX up to week 30. PMID:23687259

Park, Won; Hrycaj, Pawel; Jeka, Slawomir; Kovalenko, Volodymyr; Lysenko, Grygorii; Miranda, Pedro; Mikazane, Helena; Gutierrez-Ureña, Sergio; Lim, MieJin; Lee, Yeon-Ah; Lee, Sang Joon; Kim, HoUng; Yoo, Dae Hyun; Braun, Jürgen

2013-01-01

175

Safe re-administration of tumor necrosis factor-alpha (TNF?) inhibitors in patients with rheumatoid arthritis or ankylosing spondylitis who developed active tuberculosis on previous anti-TNF? therapy.  

Science.gov (United States)

There is no consensus on whether it is safe to re-administer tumor necrosis factor-alpha (TNF?) inhibitors in patients with rheumatoid arthritis (RA) or ankylosing spondylitis (AS) flared after withdrawal of TNF? inhibitors due to active tuberculosis (TB). We evaluated the safety of restarting anti-TNF? therapy in patients with TNF?-associated TB. We used data of 1,012 patients with RA or AS treated with TNF? inhibitors at Seoul St. Mary's Hospital between January 2003 and July 2013 to identify patients who developed active TB. Demographic and clinical data including the results of tuberculin skin tests (TST) and interferon-? releasing assays (IGRA) were collected. Fifteen patients developed active TB. Five cases were occurred in RA and 10 cases in AS. Nine of 15 patients had a negative TST or IGRA and 6 TST-positive patients had received prophylaxis prior to initiating anti-TNF? therapy. All patients discontinued TNF? inhibitors with starting the treatment of TB. Eight patients were re-administered TNF? inhibitors due to disease flares and promptly improved without recurrence of TB. TNF? inhibitors could be safely resumed after starting anti-TB regimen in patients with RA or AS. PMID:24431903

Suh, Young Sun; Kwok, Seung-Ki; Ju, Ji Hyeon; Park, Kyung-Su; Park, Sung-Hwan; Yoon, Chong-Hyeon

2014-01-01

176

Adaptação cultural cruzada e validação da versão do Índice Funcional de Espondilite Anquilosante de Bath (BASFI) para o português do Brasil / Cross-cultural adaptation and validation of the Brazilian-Portuguese version of the Bath Ankylosing Spondylitis Functional Index (BASFI)  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Conduzir uma adaptação cultural cruzada do Índice Funcional de Espondilite Anquilosante de Bath (BASFI, Bath Ankylosing Spondylitis Functional Index) para o português do Brasil e avaliar suas propriedades de medição. MéTODOS: O BASFI foi traduzido por quatro reumatologistas e três professo [...] res de língua inglesa. O questionário traduzido foi aplicado a pacientes com espondilite anquilosante por observadores treinados e autoaplicado em três momentos, dias 1, 2 e 14. A validade foi estimada analisando-se a associação do BASFI e as medidas de capacidade funcional (rotação cervical, distância intermaleolar, teste de Schober e distância occipito-parede). A consistência interna foi testada pelo coeficiente ? de Cronbach, e a confiabilidade pelo teste-reteste (coeficiente de correlação intraclasse [CCI]). RESULTADOS: Foram incluídos 60 pacientes com espondilite anquilosante: 85% do gênero masculino, com idade média de 47 ± 12 anos e duração média da doença de 20 ± 11 anos. A confiabilidade intraobservador no teste-reteste (intervalo de duas semanas) revelou alto ICC (0,999; 95% IC: 0,997-0,999), além de alta consistência interna (coeficiente ? de Cronbach: 0,86; 95% IC: 0,80-0,90). Considerando-se a validade, os índices do BASFI foram correlacionados com a rotação cervical (0,53; P Abstract in english OBJECTIVE: To conduct a cross-cultural adaptation of the Bath Ankylosing Spondylitis Functional Index (BASFI) into Brazilian-Portuguese language and to assess its measurement properties. METHODS: The BASFI was translated by four rheumatologists and three English teachers. The translated questionnair [...] e was applied to ankylosing spondylitis patients by trained observers, and self-administered in three moments: days 1, 2, and 14. The validity was assessed analyzing the association of BASFI and functional capacity measures (cervical rotation, intermalleolar distance, Schober's test and occiput-to-wall distance). The internal consistence was tested by Cronbach's ?coefficient and the reliability by testretest (intraclass correlation coefficient - ICC). RESULTS: A total of 60 patients with ankylosing spondylitis was included: 85% male, mean age 47 ± 12 years, and mean disease duration 20 ± 11 years. The intra-observer test-retest (two-week interval) reliability showed a high ICC (0.999, 95% CI: 0.997-0.999) and a high internal consistency (Cronbach's ? coefficient: 0.86, CI 95%: 0.80-0.90). Considering the validity, the BASFI indices were correlated with cervical rotation (0.53, P

Karla Garcez, Cusmanich; Sérgio Candido, Kowalski; Andréa Lopes, Gallinaro; Claudia, Goldenstein-Schainberg; Lilian Avila Lima e, Souza; Célio Roberto, Gonçalves.

2012-10-01

177

Duloxetina no tratamento da dor lombar inflamatória crônica em pacientes portadores de espondilite anquilosante: relato de casos / Duloxetine to treat chronic inflammatory low back pain in ankylosing spondylitis patients: case reports  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese JUSTIFICATIVA E OBJETIVOS: A espondilite anquilosante (EA) é uma doença inflamatória crônica de etiologia autoimune, cujo principal sintoma é a lombalgia crônica de caráter inflamatório, cujo tratamento e complicações representam um encargo considerável para a sociedade. Novas opções terapêuticas tê [...] m sido buscadas para o tratamento da dor lombar inflamatória refratária nos pacientes com EA. O objetivo foi apresentar dois pacientes portadores de EA com dor lombar refratária ao uso de anti-inflamatórios não esteroides (AINES), que apresentaram importante melhora clínica com a duloxetina. RELATO DOS CASOS: Dois pacientes do sexo masculino com EA e dor lombar crônica inflamatória refratária ao uso de AINES, que usaram duloxetina (60 mg/dia) e apresentaram melhora clínica importante do quadro doloroso. CONCLUSÃO: A duloxetina se mostrou eficaz para a redução da intensidade da dor lombar crônica inflamatória em pacientes portadores de EA. Abstract in english BACKGROUND AND OBJECTIVES: Ankylosing spondylitis (AS) is a chronic inflammatory autoimmune disease. Its major symptom is chronic inflammatory low back pain, which treatment and complications represent a considerable burden to society. New therapeutic options have been studied to treat refractory in [...] flammatory low back pain in AS patients. The objective was to present two AS patients with low back pain refractory to non-steroid anti-inflammatory drugs (NSAIDs), who presented important clinical improvement with duloxetine. CASE REPORTS: Two male patients with AS and chronic inflammatory low back pain refractory to NSAIDs, who used duloxetine (60 mg/day) and presented major clinical improvement. CONCLUSION: Duloxetine was effective to decrease chronic inflammatory low back pain intensity in AS patients.

Valderilio Feijó, Azevedo; Varlei, Serrato; Marco Aurélio Azevedo, Grande.

178

Early diagnosis of the Spondyloarthropathies  

International Nuclear Information System (INIS)

Spondyloarthropathies are a cluster of chronic inflammatory diseases that primarily include ankylosing spondylitis, reactive arthritis, psoriatic arthritis; arthritis associated with inflammatory bowel diseases and undifferentiated spondyloarthropathies. The most common subgroups of spondyloarthropathies are ankylosing spondylitis and undifferentiated spondyloarthropathy. The diagnosis of ankylosing spondylitis is mainly based on unequivocal radiographic sacroiliitis of at least grade 2 bilaterally or grade 3 unilaterally. How ever, in the early phase of disease, conventional radiographs are often too insensitive to show sacroiliitis and it usually takes several years for definite radiographic sacroiliitis to evolve. Thus, the diagnosis of ankylosing spondylitis is a commonly delayed by 8 to 11 years after the onset of symptoms. As a result, diagnosing axial spondyloarthropathy in the absence of radiographic sacroiliitis is very difficult to rheumatologists. In the early phase of disease, HLA B27 test and magnetic resonance imaging of sacroiliac joints may be helpful to the early diagnosis. In the presence of chronic low back pain the probability of axial spondyloarthropathy is about 5% and is about 14% if the back pain is inflammatory. The presence of = 3 features of spondyloarthropathy (heel pain, uveitis, dactylitis, positive family history, alternating buttock pain, psoriasis, inflammatory bowel disease, asymmetrical arthritis, positive response to anti-inflammatoitis, positive response to anti-inflammatory drugs) increase the probability of axial spondyloarthropathy to 90%. Both, the positive HLA B27 and magnetic resonance imaging with signs of sacroiliitis increase the probability of spondyloarthropathy, particularly in patients without spondyloarthropathies features or with only 1 or 2 features. Since ankylosing spondylitis in association with psoriasis and inflammatory bowel disease is often HLA B27 negative, this test is of limited value under theses circumstances. Is important to consider that usefulness of testing for HLA B27 and its subtypes differs among ethnic groups and its value for diagnosis depends on the individual pre-test probability in each case

179

Disease-modifying anti-rheumatic drugs til behandling af ankyloserende spondylitis  

DEFF Research Database (Denmark)

Ankylosing spondylitis (AS) is an inflammatory disorder affecting the axial skeleton, peripheral joints, entheses and extra-articular sites. Patients with early disease, a higher level of erythrocyte sedimentation rate and/or peripheral arthritis might benefit from sulfasalazine. Otherwise, there is no evidence that disease-modifying anti-rheumatic (DMARDs) have a therapeutic effect in AS. Clinical evidence that greater TNF-inhibitor effectiveness can be achieved by combining with a DMARD is lacking, but further studies should be performed. More research is needed to clarify the role of DMARDs in the treatment of AS. Udgivelsesdato: 2009-Aug

Madsen, Ole Rintek; Egsmose, Charlotte

2009-01-01

180

Spondylitis - spondylodiscitis  

International Nuclear Information System (INIS)

Inflammatory disorders of the spine usually develop in the medullary space of the vertebral bodies, and this clinical picture is identified as spondylitis. If the inflammation involves the intervertebral disk as well as adjacent vertebras, this lesion is defined as spondylodiscitis. Spondylitis may be brought about by several causes which should be diagnostically clearly defined in order to introduce a suitable therapy. In many cases, no conclusions can be drawn from the radiological structures alone with respect to the underlying disease, an additional bioptic investigation (e.g. by a needle puncture) ist therefore required. Most infections conditions of spondylitis represent histologically either an acute, purulent or a chronic, unspecific osteomyelitis. A determination of the causative germs will be obtained by performing a simultaneous bacteriological investigation. The biopsy material of specific spondylitis shows typical histological granulomas which, together with the bacteriological findings, will allow to establish a precise diagnosis. Both conditions of spondylitis and spondylodiscitis may also be produced by fungi that can be histologically identified. Parasites (e.g. Echinococci) may also be recognized histologically. In spondylitis of unknown etiology the histological structures do not have a pathognomonic appearance, and therefore clinical and radiological findings should be included in the diagnosis. Diagnostic problems will only be solved by considering y synopsis of all findings. (orig.)

 
 
 
 
181

MRI Findings of Brucellar Spondylitis: A Case Report  

Energy Technology Data Exchange (ETDEWEB)

Brucellosis is a systemic infectious disease, and musculoskeletal involvement is a frequent complication. Particularly, spondylitis is a common involvement. However, early diagnosis of brucellar spondylitis is often difficult due to non-specific clinical symptoms and long latent period. Especially in Korea, where tuberculosis is an endemic disease, differentiation between tuberculous and brucellar spondylitis is clinically and radiologically more challenging. A 59-year-old male cattle farmer, who presented with non-specific back pain, had spondylitis on magnetic resonance imaging (MRI), and serologic test finally confirmed brucellar spondylitis. Therefore, we report a case of a rather rare disease in Korea, brucellar spondylitis with a review of MRI findings.

Kim, Jin Woo; Kim, Myung Soon; Kim, Young Ju [Dept. of Radiology, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of)

2013-03-15

182

[The early diagnosis of spondyloarthritis].  

Science.gov (United States)

The most frequent early symptoms of spondyloarthritides are inflammatory back pain and asymetric peripheral arthritis. Currently the mean delay between the onset of first symptoms and diagnosing ankylosing spondylitis which is the frequent type of spondyloarthritis is over 5 years. The availability of effective therapies makes an early diagnosis mandatory. The clinical symptoms of inflammatory back pain, active inflamation on MR, and positivity for HLA-B27 are the most important parameters for an early diagnosis of spondyloarthritis, especially in combination. Moreover, the combination of clinical and laboratory parameters is necessary for the early diagnosis. PMID:22232947

Novak, Srdan

2011-01-01

183

Coexistence of Ankylosing Spondylosis with Benign Joint Hypermobility Syndrome. Are they Complementary to Each Other?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Objective: To present cases of co-existence of pathologically opposite conditions ankylosing spondylitis (AS) and benign joint hypermobility syndrome (BJHS).Design: Clinical findings of 25 cases of ankylosing spondylitis with overlapping clinical picture of benignjoint hypermobility syndrome were evaluated.Results: There were 23 males and 2 females with the mean age of 25.92 + 7.54 years (age range 17-41years). The mean duration of the disease was 6.25 + 6.72 years. The mean Beighton’s scor...

Nallegowda M; Singh U; Khanna M; Kumar R

2007-01-01

184

Infectious spondylitis in adults  

International Nuclear Information System (INIS)

In adults, infectious spondylitis is a rare but sever disease, caused by a bacterial thrombus in tissue of reduced resistance. In conventional radiographs initial findings are a narrowing of the intervertebral space, local osteoporosis and poorly defined erosive borders of the vertebral endplates. These changings can be found at least three to six weeks after the onset of disease. However, in Szintigraphy and MRT pathologic alterations are evident after ten to twelve days. Thus, early diagnosis and treatment becomes possible. In early stages of the disease of localized lysis surrounded by a reactive sclerosis appears in predisposed areas of the vertebral body (subchondral, anterobasal, ventral, central). Apparently, a soft tissue tumor is associated. Sclerosis and reduction of the soft tissue tumor are the first signs of repair processes. After at least 12 weeks, computed tomography can reveal typical sintering of the vertebral body and occasionally the development of a bony sequester. In addition, MRT as well as CT can be helpful in the detection and localization of complications as abscesses or affection of the vertebral canal. The tuberculous spondylitis can sometimes cause difficulties in differential diagnosis. Clinical findings, affection of several vertebral bodies, large soft tissue tumors with appearance of calcification as well as not typical locations are strongly suggestive of tuberculous spondylitis, but these findings are not specific of the disease. Degdings are not specific of the disease. Degenerative disorders such as erosive osteochondrosis or changings due ot chronic dialysis (e.g amyloid or crystal arthropathies) may cause even more problems in differential diagnosis. Typical for a blastomatous process is the integrity of the interverebral disc space, which is a rare finding in spondylitis. (orig.)

185

Infectious spondylitis and its differential diagnosis; Spondylitis und ihre Differenzialdiagnosen  

Energy Technology Data Exchange (ETDEWEB)

Infectious spondylitis can be diagnosed early and reliably by MRI, given that the most important diagnostic criteria are present. These criteria are bone marrow edema adjacent to two contiguous vertebral end plates, disk space of high signal intensity and enhancement of bone adjacent to two contiguous vertebral end plates and of the disk space. If not all of these criteria are present, diagnostic accuracy decreases. Erosive osteochondritis, spondylarthritis, osteoporotic fractures of two contiguous vertebral end plates, active Schmorl's nodes as well as neuropathic spine may mimic an infectious spondylitis. This paper presents typical and atypical morphologic patterns of infectious spondylitis as well as the differentiation criteria from the above mentioned diseases. (orig.)

Erlemann, Rainer [Helios St. Johannes Klinik, Duisburg (Germany). Inst. fuer Radiologie; Hoogeveen, Anja [AKH Viersen (Germany)

2012-06-15

186

Ankyloserende spondylitis er associeret med øget kardiovaskulær morbiditet og mortalitet  

DEFF Research Database (Denmark)

Ankylosing spondylitis is an inflammatory disorder primarily affecting the axial skeleton. The disease is associated with increased cardiovascular morbidity and mortality. Structural changes in the heart, and arteriosclerosis secondary to inflammation may be of importance. The role of traditional cardiovascular risk factors and of anti-inflammatory treatment is unclear. Tumor necrosis factor inhibitors seem to increase cholesterol levels. Evaluation of the cardiovascular risk in these patients should be considered. Cardiovascular risk factors should be managed according to ordinary guidelines.

Madsen, Ole Rintek; Lindhardsen, Jesper

2011-01-01

187

MRI characteristics of tuberculous spondylitis  

Energy Technology Data Exchange (ETDEWEB)

Spondylitis is the most common osseous manifestation of Mycobacterium tuberculosis infection. Although treatable, it continues to cause significant mortality and morbidity. Early diagnosis through familiarity with its imaging characteristics is essential to permit rapid treatment and prevent potential life-limiting consequences. In this review, we demonstrate the key magnetic resonance imaging features of this disease.

Currie, S. [Leeds and West Yorkshire Radiology Academy, Leeds General Infirmary, Great George Street, Leeds (United Kingdom); Galea-Soler, S., E-mail: sandro.galeasoler@uhb.nhs.uk [Queen Elizabeth Medical Centre, Edgbaston, Birmingham (United Kingdom); Barron, D. [Leeds and West Yorkshire Radiology Academy, Leeds General Infirmary, Great George Street, Leeds (United Kingdom); Chandramohan, M.; Groves, C. [Department of Musculoskeletal Radiology, Bradford Teaching Hospitals NHS Trust, Bradford (United Kingdom)

2011-08-15

188

Infectious spondylitis in adults; Infektioese Spondylitis beim Erwachsenen  

Energy Technology Data Exchange (ETDEWEB)

In adults, infectious spondylitis is a rare but sever disease, caused by a bacterial thrombus in tissue of reduced resistance. In conventional radiographs initial findings are a narrowing of the intervertebral space, local osteoporosis and poorly defined erosive borders of the vertebral endplates. These changings can be found at least three to six weeks after the onset of disease. However, in Szintigraphy and MRT pathologic alterations are evident after ten to twelve days. Thus, early diagnosis and treatment becomes possible. In early stages of the disease of localized lysis surrounded by a reactive sclerosis appears in predisposed areas of the vertebral body (subchondral, anterobasal, ventral, central). Apparently, a soft tissue tumor is associated. Sclerosis and reduction of the soft tissue tumor are the first signs of repair processes. After at least 12 weeks, computed tomography can reveal typical sintering of the vertebral body and occasionally the development of a bony sequester. In addition, MRT as well as CT can be helpful in the detection and localization of complications as abscesses or affection of the vertebral canal. The tuberculous spondylitis can sometimes cause difficulties in differential diagnosis. Clinical findings, affection of several vertebral bodies, large soft tissue tumors with appearance of calcification as well as not typical locations are strongly suggestive of tuberculous spondylitis, but these findings are not specific of the disease. Degenerative disorders such as erosive osteochondrosis or changings due ot chronic dialysis (e.g amyloid or crystal arthropathies) may cause even more problems in differential diagnosis. Typical for a blastomatous process is the integrity of the interverebral disc space, which is a rare finding in spondylitis. (orig.) [Deutsch] Die Spondylitis des Erwachsenen ist eine zwar seltene, aber vor allem bei verzoegerter Diagnose eine ernste und langwierige Erkrankung, die auf einen Bakterienembolus im resistenzgeschaedigten Gewebe beruht. Nativ-radiologische erste Basissymptome sind die Verschmaelerung des Bandscheibenraums, die lokale Osteoporose und die erosive Unschaerfe der Grund- und Deckplatte. Diese Veraenderungen sind mit einer Zeitverzoegerung von mindestens 3-6 Wochen nach Beginn der Spondylitis nachweisbar. Mittels Szintigraphie und/oder MRT sind pathologische Veraenderungen bereits nach 10-12 Tagen fassbar. Dadurch ist eine fruehe Diagnose und Therapieeinleitung moeglich. In der Folge zeigt sich an den praedisponierten Stellen im Wirbelkoerper (subchondral, anterobasal, ventral, zentral) eine lokale Lyse und umgebende reaktive Sklerose. Die Sklerosierung und Rueckbildung des Weichteiltumors sind als erste Heilungszeichen zu werten. Im CT kann es dabei zu einer typischen Sinterung kommen (meist 12 Wochen nach Krankheitsbeginn). In einzelnen Faellen kann es zur Ausbildung eines Knochensequesters kommen, der dann am besten mittels CT erfassbar ist. Weitere Komplikationen (Abszess, Wirbelkanaleinbruch etc.) lassen sich am besten mittels MRT oder CT abgrenzen. Die Differentialdiagnose einer spezifischen Spondylitis kann im Einzelfall sehr schwierig sein. Typische Klinik, Befall mehrerer Wirbelkoerper, grosse Weichteiltumore mit Verkalkung sowie atypische Lokalisation sind hinweisend, aber nicht beweisend. Die eigentlichen Roentgenbasissymptome treten mit noch groesserer Zeitverzoegerung und hoher Subtilitaet auf. Differentialdiagnostische Schwierigkeiten koennen auch degenerative Veraenderungen (erosive Osteochondrose) und Veraenderungen im Rahmen einer chronischen Dialyse (Amyloid, Kristallarthropathie) hervorrufen. Schliesslich ist die Intaktheit der Bandscheibe atypisch fuer die Spondylitis, aber typisch fuer blastomatoese Prozesse. (orig.)

Vorbeck, F. [Abt. fuer Osteologie, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria); Morscher, M. [Universitaetsklinik fuer Orthopaedie, Wien (Germany); Ba-Ssalamah, A. [Abt. fuer Osteologie, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria); Imhof, H. [Abt. fuer Osteologie, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

1996-10-01

189

Evidence-based recommendations for the management of ankylosing spondylitis: systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising rheumatologists  

DEFF Research Database (Denmark)

OBJECTIVE: Recommendations and/or guidelines represent a popular way of integrating evidence-based medicine into clinical practice. The 3E Initiatives is a multi-national effort to develop recommendations for the management of rheumatic diseases, which involves a large number of experts combined with practising rheumatologists addressing specific questions relevant to clinical practice. METHODS: Ten countries participated in three rounds of discussions and votes concerning the management of AS. A set of nine questions was formulated in the domains of diagnosis, monitoring and treatment, after a Delphi procedure. A literature search in MedLine was conducted. Predefined outcome parameters for the domains of diagnosis, monitoring and treatment were assessed. The evidence to support each proposition was evaluated and scored. After discussion and votes, the final recommendations were presented using brief statements by each national group, following which the final international recommendations were formulated. RESULTS: A total of 2699 papers were found and 467 were selected for analysis. Twelve key recommendations were developed: three in the domain of diagnosis addressing general diagnostic considerations, early AS diagnosis and general practitioners' referral recommendations; three concerning monitoring of AS disease activity, severity and prognosis; six concerning pharmacological treatment (except biologics): non-steroidal anti-inflammatory drugs/COX-II inhibitors, bisphosphonates and treatment of enthesitis. The compiled agreement among experts ranged from 72% to 93%. CONCLUSION: Recommendations for the management of AS were developed using an evidence-based approach followed by expert/physician consensus with high level of agreement. Involvement of a larger and more representative group of rheumatologists may improve their dissemination and implementation in daily clinical practice.

Sidiropoulos, P I; Hatemi, G

2008-01-01

190

Avaliação da aterosclerose subclínica e de níveis plasmáticos de LDL minimamente modificada em pacientes com espondilite anquilosante e sua correlação com a atividade da doença / Evaluation of sub-clinical atherosclerosis and plasma levels of minimally modified LDL in patients with ankylosing spondylitis and its correlation with disease activity  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese INTRODUÇÃO: A aterosclerose acelerada foi demonstrada em algumas doenças autoimunes, principalmente lúpus eritematoso sistêmico e artrite reumatóide. Embora a alta prevalência do uso de corticosteróides possa ser um fator complicador, por causa de seus efeitos prejudiciais em diversos fatores de ris [...] co, acredita-se que, nesses pacientes, a inflamação sistêmica per se desempenhe papel importante na aterogênese. MÉTODOS: Avaliamos a aterosclerose subclínica e os níveis plasmáticos de LDL eletronegativa circulante em pacientes com espondilite anquilosante (EA). Catorze pacientes que atendiam aos critérios de Nova York modificados para EA foram comparados com 13 controles equiparados. Avaliamos a espessura da íntima-média (EIM) na carótida por ultrassonografia bilateral da artéria carótida comum, artéria carótida interna e na bifurcação. Os grupos foram homogêneos, no que tange a fatores de risco cardiovasculares. Apenas um paciente no grupo de EA estava sendo medicado com corticosteróide. RESULTADOS: A presença de inflamação ativa foi demonstrada por BASDAI elevado e níveis mais elevados de PCR em pacientes versus controles (12,36 vs. 3,45 mg/dl, P=0,002). Não observamos diferença na EIM da carótida entre os dois grupos, em qualquer local da artéria. A média de EIM (6 mensurações em 3 locais pré-especificados, bilateralmente) foi 0,72 ± 0,28 no grupo de EA e 0,70 ± 0,45 mm nos controles (P=0,91). Também não observamos diferença significativa na LDL minimamente modificada entre pacientes e controles (14,03 ± 17,40 vs. 13,21 ± 10,21; P=0,88). CONCLUSÕES: Pacientes com EA não demonstraram aumento na EIM da carótida, em comparação com controles. Do mesmo modo, os níveis plasmáticos circulantes de LDL(-) não diferiram significativamente nos dois grupos. Abstract in english INTRODUCTION: Accelerated atherosclerosis has been shown in some autoimmune diseases, mainly in Systemic Lupus Erythematosus and Rheumatoid Arthritis. Although high prevalence of corticosteroids use may be a confounding factor due to their detrimental effects on several risk factors, systemic inflam [...] mation per se is supposed to play an important role in atherogenesis in these patients. METHODS: We have evaluated sub-clinical atherosclerosis and plasma levels of circulating electronegative LDL, which represents the fraction of LDL that is minimally modified, in patients with ankylosing spondylitis (AS). Fourteen patients who fulfilled the modified New York criteria for AS were compared with 13 paired controls. Carotid intimal-media thickness (IMT) was assessed by ultrasonography bilaterally in common carotid artery, internal carotid artery and in the bifurcation. Groups were homogeneous regarding cardiovascular risk factors. Only a single patient in AS group was in use of corticosteroid. RESULTS: The presence of active inflammation was demonstrated by elevated BASDAI and higher CRP levels and in patients versus controls (12.36 vs. 3.45 mg/dl, P = 0.002). No difference was found in carotid IMT between both groups, in any site of artery. Averaged IMT (6 measurements, at 3 pre-specified sites bilaterally) was 0.72 ± 0.28 in AS group and 0.70 ± 0.45 mm in controls (P = 0.91). Minimally modified LDL did not differ significantly either between patients and controls (14.03 ± 17.40 vs. 13.21 ± 10.21; P = 0.88). CONCLUSIONS: Patients with AS did not show increased carotid IMT in comparison to controls. In the same way, circulating plasma levels of LDL (-), did not differ significantly in both groups.

Fernanda Teles, Ceccon; Valderílio Feijó, Azevedo; Carlos A., Engelhorn; Dulcinéia S. P., Abdalla; Tanize E. S., Faulin; Luis Cesar, Guarita-Souza; Roberto, Pecoits-Filho; José Rocha, Faria-Neto.

191

Avaliação da aterosclerose subclínica e de níveis plasmáticos de LDL minimamente modificada em pacientes com espondilite anquilosante e sua correlação com a atividade da doença / Evaluation of sub-clinical atherosclerosis and plasma levels of minimally modified LDL in patients with ankylosing spondylitis and its correlation with disease activity  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese INTRODUÇÃO: A aterosclerose acelerada foi demonstrada em algumas doenças autoimunes, principalmente lúpus eritematoso sistêmico e artrite reumatóide. Embora a alta prevalência do uso de corticosteróides possa ser um fator complicador, por causa de seus efeitos prejudiciais em diversos fatores de ris [...] co, acredita-se que, nesses pacientes, a inflamação sistêmica per se desempenhe papel importante na aterogênese. MÉTODOS: Avaliamos a aterosclerose subclínica e os níveis plasmáticos de LDL eletronegativa circulante em pacientes com espondilite anquilosante (EA). Catorze pacientes que atendiam aos critérios de Nova York modificados para EA foram comparados com 13 controles equiparados. Avaliamos a espessura da íntima-média (EIM) na carótida por ultrassonografia bilateral da artéria carótida comum, artéria carótida interna e na bifurcação. Os grupos foram homogêneos, no que tange a fatores de risco cardiovasculares. Apenas um paciente no grupo de EA estava sendo medicado com corticosteróide. RESULTADOS: A presença de inflamação ativa foi demonstrada por BASDAI elevado e níveis mais elevados de PCR em pacientes versus controles (12,36 vs. 3,45 mg/dl, P=0,002). Não observamos diferença na EIM da carótida entre os dois grupos, em qualquer local da artéria. A média de EIM (6 mensurações em 3 locais pré-especificados, bilateralmente) foi 0,72 ± 0,28 no grupo de EA e 0,70 ± 0,45 mm nos controles (P=0,91). Também não observamos diferença significativa na LDL minimamente modificada entre pacientes e controles (14,03 ± 17,40 vs. 13,21 ± 10,21; P=0,88). CONCLUSÕES: Pacientes com EA não demonstraram aumento na EIM da carótida, em comparação com controles. Do mesmo modo, os níveis plasmáticos circulantes de LDL(-) não diferiram significativamente nos dois grupos. Abstract in english INTRODUCTION: Accelerated atherosclerosis has been shown in some autoimmune diseases, mainly in Systemic Lupus Erythematosus and Rheumatoid Arthritis. Although high prevalence of corticosteroids use may be a confounding factor due to their detrimental effects on several risk factors, systemic inflam [...] mation per se is supposed to play an important role in atherogenesis in these patients. METHODS: We have evaluated sub-clinical atherosclerosis and plasma levels of circulating electronegative LDL, which represents the fraction of LDL that is minimally modified, in patients with ankylosing spondylitis (AS). Fourteen patients who fulfilled the modified New York criteria for AS were compared with 13 paired controls. Carotid intimal-media thickness (IMT) was assessed by ultrasonography bilaterally in common carotid artery, internal carotid artery and in the bifurcation. Groups were homogeneous regarding cardiovascular risk factors. Only a single patient in AS group was in use of corticosteroid. RESULTS: The presence of active inflammation was demonstrated by elevated BASDAI and higher CRP levels and in patients versus controls (12.36 vs. 3.45 mg/dl, P = 0.002). No difference was found in carotid IMT between both groups, in any site of artery. Averaged IMT (6 measurements, at 3 pre-specified sites bilaterally) was 0.72 ± 0.28 in AS group and 0.70 ± 0.45 mm in controls (P = 0.91). Minimally modified LDL did not differ significantly either between patients and controls (14.03 ± 17.40 vs. 13.21 ± 10.21; P = 0.88). CONCLUSIONS: Patients with AS did not show increased carotid IMT in comparison to controls. In the same way, circulating plasma levels of LDL (-), did not differ significantly in both groups.

Fernanda Teles, Ceccon; Valderílio Feijó, Azevedo; Carlos A., Engelhorn; Dulcinéia S. P., Abdalla; Tanize E. S., Faulin; Luis Cesar, Guarita-Souza; Roberto, Pecoits-Filho; José Rocha, Faria-Neto.

2013-12-01

192

A profile of Irish physiotherapy services for ankylosing Spondylitis (AS)  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: Physiotherapy and exercise are main components in the non-pharmacological management of AS (Zochling et al 2006). A minority of the Irish AS population participate in regular exercise (Fitzpatrick et al 2006). No study has explored the physiotherapy services provided to AS patients in the Republic of Ireland (ROI). Objectives: Identify physiotherapy services provided to Irish AS patients. Ascertain if strategies are utilised to improve motivation to exercise. Determine the corr...

Larkin, Louise

2011-01-01

193

Spondylitis/spondylodiscitis; Spondylitis/Spondylodiszitis  

Energy Technology Data Exchange (ETDEWEB)

Spondylitis is an inflammation of the vertebral body. If the infection is manifested in the vertebral motor segment it is called spondylodiscitis, which can be divided into specific and nonspecific forms. It is clinically impressive that at the beginning of the disease, the patients who are quite often immunosuppressed suffer from localized, especially nocturnally exacerbated backache. The initial diagnostic work-up generally consists of clinical history, examination, laboratory tests, and (especially advanced) imaging findings. Although computed tomography still remains the most frequently used advanced imaging technique, magnetic resonance imaging is the golden standard for the diagnosis of spondylitis and spondylodiscitis. (orig.) [German] Die Spondylitis ist eine Osteomyelitis des Wirbelkoerpers. Wenn sich der inflammatorische Bereich im Bewegungssegment manifestiert, spricht man von einer Spondylodiszitis. Man unterscheidet zwischen spezifischen und unspezifischen Spondylitiden bzw. Spondylodiszitiden. Klinisch imponiert die Erkrankung, die v. a. immunsupprimierte Patienten betrifft, mit lokalen Rueckenschmerzen, die meistens naechtlich exazerbieren. Die Diagnostik schliesst Anamnese, Untersuchung, Bestimmung der Entzuendungsparameter und insbesondere moderne bildgebende Verfahren ein. Der Erregernachweis kann haeufig anhand von Blutkulturen oder eine in der Regel computertomographisch gesteuerten Biopsie erfolgen. Auch wenn die Computertomographie das am haeufigsten genutzte Schnittbildverfahren bleibt, ist die Magnetresonanztomographie der Goldstandard in der modernen Bildgebung von Spondylitis und Spondylodiszitis. (orig.)

Ahlhelm, F.; Naumann, N.; Grunwald, I.; Reith, W. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische- und Interventionelle Neuroradiologie, Homburg/Saar (Germany); Kelm, J. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Orthopaedische Universitaetsklinik; Shariat, K.; Nabhan, A. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer allgemeine und spezielle Neurochirurgie

2006-06-15

194

Lipopolysaccharide treatment suppresses spontaneously developing ankylosing enthesopathy in B10.BR male mice: The potential role of interleukin-10  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Ankylosing enthesopathy (ANKENT is an animal model of human ankylosing spondylitis. ANKENT is an inflammatory disease affecting the ankle and tarsal joints of the hind limbs in susceptible mouse strains. In the disease, the participation of intestinal microbiota components was suggested. Therefore, we attempted to increase the incidence of ANKENT by systemic administration of lipopolysaccharide (LPS, which is a component of bacterial cellular walls and stimulates inflammatory processes. Methods ANKENT occurrence, serum cytokine profiles, spleen cellular composition and in vitro cytokine response to LPS were analysed in LPS-treated and control LPS-untreated B10.BR male mice. Results Contrary to expectations, LPS treatment decreased the incidence of ANKENT in LPS-treated group compared to control LPS-untreated group. Flow cytometry analysis of splenocytes showed an increased percentage of macrophages, dendritic cells and neutrophils and a decreased percentage of B cells, T cells and T helper cells in LPS-treated males following LPS administration. In addition, LPS-treated males had significantly elevated IL-6 and IL-10 serum levels. At 20–22?weeks after the final LPS application, splenocytes from LPS-treated mice were more susceptible to in vitro LPS stimulation than those of the controls and produced significantly higher levels of TNF? and IL-6. Conclusions Repeated systemic stimulation with microbial component lipopolysaccharide in early adulthood significantly reduced the incidence of ANKENT in B10.BR mice and this finding can support the “hygiene hypothesis”. In LPS-treated mice, the innate immunity parameters and the level of anti-inflammatory IL-10 cytokine were significantly increased. Nevertheless, the immunological mechanism of the LPS protective effect remains unclear.

Capkova Jana

2012-06-01

195

Aspergillus Spondylitis involving the Cervico-Thoraco-Lumbar Spine in an Immunocompromised Patient: a Case Report  

Energy Technology Data Exchange (ETDEWEB)

Aspergillosis is a rare cause of spondylitis. Moreover, early diagnosis by MR imaging and adequate treatment can prevent the serious complications of fungal infection. To our knowledge, the MR findings of multilevel aspergillus spondylitis in the cervico-thoraco-lumbar spine have not been previously described. Here, we report the MR findings of aspergillus spondylitis involving the cervical, thoracic, and lumbar spine in a liver transplant recipient. spergillosis is a rare cause of spondylitis, and early diagnosis by MR imaging and adequate treatment are essential for a good outcome. Although the MR findings of bacterial spondylitis have been fully described, the findings of aspergillus spondylitis have been rarely described, and to the best of our knowledge multilevel involvement of cervico-thoraco-lumbar spine has not been previously reported. Here, we report the MR imaging findings of aspergillus spondylitis involving the cervico-thoraco-lumbar spine in a liver transplant recipient. In conclusion, aspergillus spondylitis should be considered in the differential diagnosis of immunocompromised patients with MR findings resembling those of tuberculous spondylitis.

Son, Jeong-Min; Jee, Won-Hee; Jung, Chan-Kwon; Kim, Sang-Il; Ha, Kee-Yong [The Catholic University of Korea, Seoul (Korea, Republic of)

2007-10-15

196

Aspergillus Spondylitis involving the Cervico-Thoraco-Lumbar Spine in an Immunocompromised Patient: a Case Report  

International Nuclear Information System (INIS)

Aspergillosis is a rare cause of spondylitis. Moreover, early diagnosis by MR imaging and adequate treatment can prevent the serious complications of fungal infection. To our knowledge, the MR findings of multilevel aspergillus spondylitis in the cervico-thoraco-lumbar spine have not been previously described. Here, we report the MR findings of aspergillus spondylitis involving the cervical, thoracic, and lumbar spine in a liver transplant recipient. spergillosis is a rare cause of spondylitis, and early diagnosis by MR imaging and adequate treatment are essential for a good outcome. Although the MR findings of bacterial spondylitis have been fully described, the findings of aspergillus spondylitis have been rarely described, and to the best of our knowledge multilevel involvement of cervico-thoraco-lumbar spine has not been previously reported. Here, we report the MR imaging findings of aspergillus spondylitis involving the cervico-thoraco-lumbar spine in a liver transplant recipient. In conclusion, aspergillus spondylitis should be considered in the differential diagnosis of immunocompromised patients with MR findings resembling those of tuberculous spondylitis

197

Spondylitis Web Info for Teens  

Science.gov (United States)

... Special Accommodations Transition to College Friends & family Friends & Family Relationships Stay Positive! Join Us Connect with us Your ... yourself? How does living with spondylitis affect your relationships with your family and friends? Does it affect your school life? ...

198

SAPHO syndrome associated spondylitis.  

Science.gov (United States)

The concept of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome has been well clarified, after Chamot et al. suggested this peculiar disorder in 1987. The most commonly affected site in SAPHO syndrome is the anterior chest, followed by the spine. However, the clinical course and taxonomic concept of SAPHO spinal lesions are poorly understood. This study was performed to analyze: (1) the detailed clinical course of spinal lesions in SAPHO syndrome, and (2) the relationship between SAPHO syndrome with spinal lesions and seronegative spondyloarthropathy. Thirteen patients with spondylitis in SAPHO syndrome were analyzed. The features of spinal lesions were a chronic onset with a slight inflammatory reaction, and slowly progressing non-marginal syndesmophytes at multi spinal levels, besides the coexistence of specific skin lesions. SAPHO syndrome, especially spinal lesions related to palmoplantar pustulosis, can be recognized as a subtype of seronegative spondyloarthropathy. PMID:18642032

Takigawa, Tomoyuki; Tanaka, Masato; Nakanishi, Kazuo; Misawa, Haruo; Sugimoto, Yoshihisa; Takahata, Tomohiro; Nakahara, Hiroyuki; Nakahara, Shinnosuke; Ozaki, Toshifumi

2008-10-01

199

Spondylitis ankylosans und Osteoporose  

Directory of Open Access Journals (Sweden)

Full Text Available Das Auftreten einer Osteoporose bei entzündlich rheumatischen Erkrankungen wurde vor allem in den letzten drei Jahrzehnten zunehmend beschrieben und war damit in der Folge Gegenstand entsprechender Untersuchungen. So wurde zum Beispiel bei der chronischen Polyarthritis neben der schon lange bekannten juxtaartikulären Osteoporose auch eine generalisierte Porose als eigenständiges Symptom registriert. Mit den in den letzten Jahren gegebenen Möglichkeiten, den Knochenumsatz z. B. durch die Bestimmung von Knochenmarkern näher zu charakterisieren, ist auch bei der Spondylitis ankylosans (Sp.a. die Osteoporose stärker in den Vordergrund gerückt. Allerdings fand schon 1877 Fagge bei der Autopsie eines Sp.a.-Patienten so weiche Wirbelkörper, "daß man sie leicht mit einem Messer schneiden konnte". Von diesem Autor wurden auch bereits Wirbelkörperfrakturen beschrieben und in weiterer Folge wiesen Buckley 1932 und Fischer und Vontz auf die Osteoporose der Wirbelkörper bei dieser Erkrankung hin. Von Wurm wurde schließlich schon 1955 eine eingehende pathologisch-anatomische Beschreibung der Knochenveränderungen gegeben.

Thumb N

2001-01-01

200

Coexistence of Ankylosing Spondylosis with Benign Joint Hypermobility Syndrome. Are they Complementary to Each Other?  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: To present cases of co-existence of pathologically opposite conditions ankylosing spondylitis (AS and benign joint hypermobility syndrome (BJHS.Design: Clinical findings of 25 cases of ankylosing spondylitis with overlapping clinical picture of benignjoint hypermobility syndrome were evaluated.Results: There were 23 males and 2 females with the mean age of 25.92 + 7.54 years (age range 17-41years. The mean duration of the disease was 6.25 + 6.72 years. The mean Beighton’s score for jointhypermobility syndrome was 6.36 + 1.32. Schobers test was positive in 13 patients and 23 patients werepositive for HLA-B27. ESR was elevated in 24 patients and 68% patients were with grade II sacroilitis.Cardiovascular, ophthalmologic complications were also observed in some patients. Ligament and menisciinjuries were observed in 3 patients. It was observed that many of the patients had contracures of majorjoints along with spinal deformity and simultaneously they had hypermobility in other major and smaller joints.Conclusion: Coexistence of these two opposite disorders causes confusion and thus delay in the diagnosis and management, leading to further disability. Hypermobility can be advantageous for a stiff spine and for major joints. By the care of the joints and spine with proper exercises programme further deformities and soft tissue injuries can be prevented.

Nallegowda M

2007-04-01

 
 
 
 
201

Clinical course of pyogenic spondylitis  

International Nuclear Information System (INIS)

As diagnosis of pyrogenic spondylitis, although which is rather easy by MRI even at an early stage, is often difficult in other departments than orthopaedics, this retrospective study was performed to evaluate its clinical cause for elucidating factors necessary for appropriate diagnosis and treatment. Subjects were 56 patients (M 37/F 19, mean age 65 y) with the disease at cervical (6 cases), thoracic (14) and lumbar (36) vertebrae, who had been treated in authors' department during the period 97-06. Follow-up was done in 43-3,532 (mean 813) days. Patients were divided in the normal (N) and compromised host (C, 30 cases) groups based on their process from crisis to diagnosis, complications, causal bacteria, treatments and clinical causes. Diagnosis was by X-ray (1 case), CT (6), MRI (47) and biopsy (2). Treatments involved the conservative treatment (34 cases) of curettage of the lesion and spinal decompression, CT-guided rinsing of abscess (2), and surgery (20) as well as antibiotic administration. Means of duration until negative CRP value were 38.1 and 60.6 days in N and C group, respectively, and until discharge, 48.7 and 84.2 days. Good prognosis (negative CRP without lumbar pain) was found in all N and 14 of C group. The C group resulting in poor prognosis required prolonged hospitalization and/or had unsatisfactory treatment because of their basic complications. Presented were the actual cases from each in N and C group. (R.T.)

202

Radiology for the diagnosis of infectious spondylitis; Radiologische Diagnostik der infektioesen Spondylitis  

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The data of studies performed in the 1980s, applying standard X-ray diagnostics sometimes supplemented by tomography, for the diagnosis of the most frequently occurring lesions caused by infectious spondylitis have been found to be better in diagnostic value than the information obtained by CT. Magnetic resonance imaging has been found to be clearly better than skeletal scintigraphy and X-ray diagnostics. The advantage of MR imaging basically is the more accurate anatomic localization and visualization of findings. In addition, MR imaging achieves good imaging of the paravertebral soft tissue and the vertebral canal. Degenerative and neoplastic lesions can be better distinguished from a vertebral osteomyelitis by means of the MRI, as compared to Tc-99m MDP scintigraphy, or X-ray diagnostics. Accumulations occurring after surgery at the invertebral disks in the region of the vertebral column cannot be distinguished by scintigraphy from inflammatory reactions. CT, on the other hand, detects minor abscess calcifications as a result of tuberculous spondylitis better than MR imaging. Early diagnosis of spondylitis is possible by scintiscanning and MRI, but cannot be expected from X-ray diagnostics. (orig./VHE) [Deutsch] Die klassischen Veraenderungen der infektioesen Spondylitis wurden in Studien von den 80er Jahren durch konventionelle Roentgenaufnahmen, gegebenenfalls ergaenzt mit einer Tomographie, besser erfasst als durch die Computertomographie. Im Vergleich zur Skelettszintigraphie und konventioneller Roentgendiagnostik ist die MR deutlich ueberlegen. Diese Vorteile beruhen im wesentlichen auf einer genaueren anatomischen Befundzuordnung durch die MR. Darueber hinaus erlaubt die MR eine gute Darstellung der paravertebralen Weichteile und des Spinalkanals. Degenerative und neoplastische Veraenderungen koennen durch die MR von einer vertebralen Osteomyelitis besser differenziert werden, als dies durch eine Tc{sup 99m}-MDP-Szintigraphie oder durch konventionelle Roentgenaufnahmen moeglich waere. Anreicherungen im Bereich der Wirbelsaeule nach Bandscheibenoperationen sind szintigraphisch nicht von entzuendlichen Reaktionen zu differenzieren. Kleine Abszessverkalkungen bei tuberkuloeser Spondylitis werden durch die CT im Gegensatz zu der MR-Untersuchung dargestellt. Waehrend durch konventionelle Roentgenaufnahmen eine Fruehdiagnostik der Spondylitis nicht moeglich ist, werden die Szintigraphie und MR deutlich frueher positiv. (orig./VHE)

Wikstroem, M. [Abt. Roentgendiagnostik, Radiologische Universitaetsklinik und Poliklinik, Univ. Ulm (Germany); Rilinger, N. [Abt. Roentgendiagnostik, Radiologische Universitaetsklinik und Poliklinik, Univ. Ulm (Germany); Vogel, J. [Abt. Roentgendiagnostik, Radiologische Universitaetsklinik und Poliklinik, Univ. Ulm (Germany); Rieber, A. [Abt. Roentgendiagnostik, Radiologische Universitaetsklinik und Poliklinik, Univ. Ulm (Germany); Diepers, M. [Rehabilitationskrankenhaus Ulm (Germany). Neurologische Abt.; Hartwig, E. [Abt. fuer Unfallchirurgie, Chirurgische Universitaetsklinik und Poliklinik, Univ. Ulm (Germany)

1996-04-01

203

Tuberculous spondylitis in elderly Japanese patients  

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tuberculous spondylitis. Tuberculous spondylitis should be considered a possibility in the differential diagnosis of back pain in the elderly, especially in countries with a significant history of tuberculosis in the population. (author)

204

Our experience with Ra-224 in the treatment of ankylosing spondylitis  

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The results of the treatment of Bechterew's disease on 39 patients aged between 32 und 74 are described. Treatment of these patients with common methods had failed or the conventional methods could not be applied therapeutic effect was determined with the help of clinical parameters such as pain, stiffness and mobility of the spine and biological examinations such as sedimentation of erythrocytes, blood count and sometimes thromboclastography and determination of the transaminases. The patients were given i.v. injections of 224Ra of intervals of 14 days either in increasing doses or with a total dose of 448 to 1,300 ?Ci or with constant doses with a total below 580 ?Ci. The results obtained in both groups were more or less the same; frequent relapses could be seen, however, in the group of patients who were given lower doses. Clinical and biological side effects were more frequent after higher doses. (MG)

205

Coexistence of Behçet’s disease with ankylosing spondylitis and familial Mediterranean fever: a rare occurrence  

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Behçet's disease (BD) and familial Mediterranean fever (FMF), which are two separate diseases sharing some clinical features, may also coexist in the same patient. Further investigations are needed to understand whether this coexistence is due to either chance or geographical distribution patterns of these diseases or to common etiopathogenetic characteristics. Spondylarthritis as part of the clinical picture in these two diseases has been questioned and probably it is not a prominent charac...

Habiba Bouhamed Chaabouni; Zouhir Bahloul; Neila Kaddour; Moez Jallouli; Manel Kechaou; Makram Frigui

2011-01-01

206

Suppression of Inflammation and Effects on New Bone Formation in Ankylosing Spondylitis  

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... fully understood. It is currently thought that the inflammation caused by AS can cause injury by releasing ... that actually damage the surrounding tissues. As the inflammation subsides, the lesions, which are injured areas, begin ...

207

A longitudinal study on an autoimmune murine model of ankylosing spondylitis  

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Background: Proteoglycan aggrecan (PG)-induced arthritis (PGIA) is the only systemic autoimmune murine model which affects the axial skeleton, but no studies have been performed characterising the progression of spine involvement.

Bardos, T.; Szabo, Z.; Czipri, M.; Vermes, C.; Tunyogi-csapo, M.; Urban, R.; Mikecz, K.; Glant, T.

2005-01-01

208

Spondylitis of thoracic spine: Case report  

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Full Text Available Introduction Spondylitis is a rare bone and joint infection. It is a disease with long clinical history. Often, it is difficult to recognise symptoms at a proper time, and, due to the complex clinical outcome of spondylitis, a clinician may think about other problems in the body. Case Outline A case report of a 59-year-old male patient with thoracic spine spondylitis is presented, formerly treated as pulmonary thromboembolism with pericarditis. Only after neurological disorder such as paraplegia and orthopaedic consultative examination, real diagnosis was established. After that, the patient was hospitalized and operated on. Conclusion A therapeutic approach to spondylitis is based on surgery, antibiotic drugs and symptomatic therapy. Due to the frequent occurrence of neurologic disorders, therapy could be prolonged and uncertain. .

Timotijevi? Sla?an

2008-01-01

209

[Magnetic resonance tomography in the diagnosis of tuberculous spondylitis].  

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The examination included 35 patients with clinical and X-ray signs of tuberculous spondylitis. Magnetic resonance tomography (MRT) was performed on a Maganview apparatus (Finland). MRT helped to diagnose an active process in 5 patients. The most manifested changes were found on T2-suspended tomograms to indicate an inflammatory reaction of the bone marrow. MRT was effective in detecting bone marrow compression, its early atrophy, hydromyelia and postoperative changes. MRT can obviously fully replace pneumomyelography and myelography with contrast substances. PMID:1603786

Kholin, A V

1992-01-01

210

Computed tomography and magnetic resonance imaging in tuberculous spondylitis. Review and own findings  

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Purpose. The findings of tuberculous spondylitis in MRT have been described extensively. Nevertheless, the diagnostic value of both methods in the diagnosis of this severe manifestation of the tuberculous disease was not yet defined definitely. Materials. We performed a review of the recent literature and a retrospective analysis of the findings in ten patients with proven tuberculous spondylitis. Here we evaluated 10 CT and 6 MRT. Results. Major findings in computed tomography (n=10) were osseous sequestration (8/10), subperiostal bone apposition (6/10), abscess of the surrounding tissue (8/10) and calcification of the masses (3/10). In all cases which were examined by MRT (n=6) marrow edema was seen. Affection of the soft tissue was described by means of MRT in 5/6 patients. All patients showed rim enhancement. Conclusions. MRT shows signs of infection (bone marrow edema) which is an early but rather unspecific finding. The commonness of osseous lesions in advanced tuberculous spondylitis suggests a benefit of computed tomography in the later stages. Both methods are complementary in the differential diagnosis of tuberculous and non-specific spondylitis. (orig.)

211

Parallel analysis of cancer mortality among atomic bomb survivors and patients with ankylosing spondylitis given X-ray therapy  

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ear modeling of the RR's and also by examination of the excess mortality rates. The level of agreement between the two studies was high; provided it is accepted that the reduced level of leukemia risk in the spondylitics is due to cell sterilization, no inconsistencies were found

212

Titanium luque SSI for rheumatoid spondylitis with myelopathy. Clinical results and postoperative magnetic resonance imaging  

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Nineteen rheumatoid patients suffering from rheumatoid spondylitis with myelopathy were surgically treated using Luque segmental spinal instrumentation (SSI). We studied 7 cases of patients who underwent postoperative magnetic resonance imaging (MRI) evaluation after being treated with titanium Luque SSI. Titanium implants were imaged safely and there was no evidence of implant migration or local tissue heating effect. MRI also allowed postoperative cervical spine imaging without significant image distortion. This titanium Luque SSI method affords rigid fixation, allows early mobilization and MRI serial imaging in the patient's lifelong medical care. (author)

213

Espondilitis anquilopoyética / Spondylite ankilopoiétique / Ankylopoietic spondylitis  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se presenta un caso de espondilitis anquilopoyética, de 6 años de evolución sin tratamiento adecuado, que llevó al paciente a una deformidad en flexión y limitación de los movimientos del raquis, por lo cual se decidió realizar el tratamiento quirúrgico para corregir la deformidad. Se realiza una re [...] visión bibliográfica sobre la enfermedad, como parte del estudio para definir y planificar el tratamiento quirúrgico. Se muestran además los resultados obtenidos con la técnica empleada (osteotomía de sustracción transpedicular), con la que se logró la corrección planificada y una fijación estable en un segmento mínimo de la columna lumbar. Abstract in english Authors present a 6-years course ankilopoietic spondylitis case without a appropriate treatment causing a flexion deformity and rachis movement limitations who was operated on to correct the deformity. A bibliographic review as carried out on disease as part of study to define and plan surgical trea [...] tment. Results obtained using this technique (osteotomy of transpedicular substraction) are showed achieving the planned correction and a stable fixation in a minimal segment of lumbar spine.

Carlos, Santos Coto; Rafael, Rivas Hernández; Ernesto, Fleites Marrero.

214

Espondilitis anquilopoyética / Spondylite ankilopoiétique / Ankylopoietic spondylitis  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se presenta un caso de espondilitis anquilopoyética, de 6 años de evolución sin tratamiento adecuado, que llevó al paciente a una deformidad en flexión y limitación de los movimientos del raquis, por lo cual se decidió realizar el tratamiento quirúrgico para corregir la deformidad. Se realiza una re [...] visión bibliográfica sobre la enfermedad, como parte del estudio para definir y planificar el tratamiento quirúrgico. Se muestran además los resultados obtenidos con la técnica empleada (osteotomía de sustracción transpedicular), con la que se logró la corrección planificada y una fijación estable en un segmento mínimo de la columna lumbar. Abstract in english Authors present a 6-years course ankilopoietic spondylitis case without a appropriate treatment causing a flexion deformity and rachis movement limitations who was operated on to correct the deformity. A bibliographic review as carried out on disease as part of study to define and plan surgical trea [...] tment. Results obtained using this technique (osteotomy of transpedicular substraction) are showed achieving the planned correction and a stable fixation in a minimal segment of lumbar spine.

Carlos, Santos Coto; Rafael, Rivas Hernández; Ernesto, Fleites Marrero.

2009-12-01

215

Apicotomy: surgical management of maxillary dilacerated or ankylosed canines.  

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This clinical article reports a technique, apicotomy, for managing dilacerated or ankylosed canines. The records of 3 patients successfully treated with apicotomy are presented. Orthodontists observe clinically significant incidences of impacted maxillary canines in their daily practices. Several procedures have been described to bring an ankylosed, impacted tooth into occlusion. Luxation is the most widely used solution, but there are risks involved with that approach, and the success rate is low. Surgical repositioning has also been used, but morbidity is high, and the aggressiveness of the procedure might also contraindicate it. Ankylosis might be related to the anatomic position of the canine's root apex and its adjacent anatomic structures. Apicotomy is a guided fracture of a canine root apex, followed by its orthodontic traction. It is a conservative surgical alternative for treating impacted canines with dilacerations or apical root ankylosis. PMID:24286914

Araújo, Eustáquio A; Araújo, Cristiana V; Tanaka, Orlando M

2013-12-01

216

Tuberculous spondylitis of vertebra with fracture, paraparesis and pleural empyema complications: Case report  

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Full Text Available Introduction. Spine tuberculosis is caused by Micobacterium tuberculosis. It is localized in the vertebral body or intervertebral disc. Its diagnosis is often delayed because of nonspecific symptoms and neglected presence of tuberculosis, which leads to serious complications. Case Report. This paper presents a case of tuberculous spondylitis, which was complicated with the fracture of vertebra, paraparesis of lower extremities and pleural empyema. The treatment with antituberculous drugs started after the fracture of 10th and 11th thoracic vertebras. The therapy brought some improvement but paraparesis of lower extremities remained. In the further course of disease, inflammatory process affected the pleura. Antibiotic and antitubercular therapy with puncture of pleura were not very effective. Operation was performed on December 20th 2011: Thoracotomia lat. dex. Decorticatio pulmonum lat.dex. Seven months after surgery, the patient was without symptoms. Conclusion. Tuberculous spondylitis occurs relatively frequently in clinical practice. Early diagnosis and adequate therapy of this disease can prevent the occurrence of its serious complications.

Dragojlovi?-Ruži?i? Radica

2013-01-01

217

Diferencias entre la espondilitis tuberculosa y la espondilitis brucelar / Differences between tuberculous spondylitis and brucellar spondylitis  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Identificar posibles diferencias en las características clínicas y analíticas entre la espondilits tuberculosa (ET) y la espondilitis brucelar (EB). Pacientes y métodos: Estudio retrospectivo de los pacientes diagnosticados de ET y EB en nuestro hospital entre enero de 1992 y diciembre de [...] 1998. Resultados: Diecisiete pacientes fueron diagnosticados de ET y 10 de EB. La ET se caracterizó en nuestra serie por un mayor tiempo de evolución de la clínica hasta el momento del diagnóstico (27,9 ± 24,6 vs. 16 ± 5,6 semanas, p= 0,02). Encontramos una mayor frecuencia, pero sin alcanzar la significación estadística, de inmunosupresión, de uno o varios abscesos paravertebrales y/o epidurales, de compresión medular, de anemia y de velocidad de sedimentación globular elevada en la ET, y una mayor frecuencia de fiebre/febrícula y de dolor vertebral residual en la EB. La localización lumbar fue la más frecuente en ambos grupos (58,8% en la ET y 70% en la EB). Conclusiones: Es posible que existan algunas diferencias en las características clínicas y analíticas de la ET y de la EB que puedan ser de ayuda en el diagnóstico diferencial de ambas entidades y orientar el tratamiento empírico en los casos sin un diagnóstico definitivo microbiológico o a la espera de la confirmación diagnóstica. Abstract in english Objective: To identify potential differences in the clinical and laboratory characteristics between tuberculous spondylitis (TS) and brucellar spondylitis (BS). Patients and methods: Retrospective study of patients with TS and BS diagnosed in our hospital between january 1992 and december 1998. Resu [...] lts: TS was diagnosed in 17 patients and BS in 10 patients. In our series, a higher delay in the diagnosis (27.9 ± 24.6 vs. 16 ± 5.6 weeks, p= 0,02) was found in TS. There was a higher frequency, but without stadistic significance, of immunosupression, one or several paravertebral or epidural abscesses, spinal cord compression, anemia and an elevated erythrocyte sedimentation rate in TS, and a higher frequency of fever/febricule and residual vertebral pain in BS. Lumbar location was the most frequent in both groups (58.8% in TS and 70% in BS). Conclusions: It is possible that there were some differences in the clinical and laboratory characteristics between TS and BS which may be an aid in the differential diagnosis of both entities and orient the empirical treatment in these cases without a definitive microbiological diagnosis or while awaiting the diagnostic confirmation.

J. M., Calvo Romero; J. L., Ramos Salado; F., García de la Llana; J. C., Bureo Dacal; P., Bureo Dacal; M., Pérez Miranda.

2001-06-01

218

Spondylitis Following Kyphoplasty: A Case Report and Review of Literature  

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Full Text Available A 79-year-old diabetic woman with a fresh T9 osteoporotic compression fracture, underwent percutaneous kyphoplasty using polymethyl methacrylate. About 2.5 months after the operation, the patient was readmitted because of increasing back pain, nocturnal sweating and subfebrile temperature. The diagnosis of pyogenic spondylitis was made using radiograph and magnetic resonance imaging. The patient was successfully treated with antibiotics for 2 month. Only five cases of infections after kyphoplasty have been described so far. Our case is probably the first post kyphoplasty spondylitis which was treated non-operatively.For the kyphoplasty patients with diabetes and older age, specific modifications to prophylactic antibiotic protocols such as using higher doses of cefazolin or broad-spectrum antibiotics should be considered.

Ömer AKAR

2012-06-01

219

Cervical spondylitis and spinal abscess due to Actinomyces meyeri  

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Full Text Available SciELO Brazil | Language: English Abstract in english Human actinomycosis with involvement of the spine is a rare condition although it has been first described a long time ago. It is probably underrecognized since its clinical presentation is often misleading and accurate bacteriological diagnosis is challenging. We herein report a rare case of cervic [...] al actinomycosis with paravertebral abscess and spondylitis imputed to an infection by Actinomyces meyeri in a 52-year-old immunocompetent Caucasian man. A. meyeri should be considered as a potential cause for subacute or chronic spondylitis, even in immunocompetent subjects. Modern diagnostic tools such as Matrix-Assisted Laser Desorption–Ionization Time of Flight mass spectrometry and 16S rRNA sequencing are efficient for accurate microbiological identification.

Alexandre, Duvignaud; Emmanuel, Ribeiro; Daniel, Moynet; Maite, Longy-Boursier; Denis, Malvy.

220

Cervical spondylitis and spinal abscess due to Actinomyces meyeri  

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Full Text Available SciELO Brazil | Language: English Abstract in english Human actinomycosis with involvement of the spine is a rare condition although it has been first described a long time ago. It is probably underrecognized since its clinical presentation is often misleading and accurate bacteriological diagnosis is challenging. We herein report a rare case of cervic [...] al actinomycosis with paravertebral abscess and spondylitis imputed to an infection by Actinomyces meyeri in a 52-year-old immunocompetent Caucasian man. A. meyeri should be considered as a potential cause for subacute or chronic spondylitis, even in immunocompetent subjects. Modern diagnostic tools such as Matrix-Assisted Laser Desorption–Ionization Time of Flight mass spectrometry and 16S rRNA sequencing are efficient for accurate microbiological identification.

Alexandre, Duvignaud; Emmanuel, Ribeiro; Daniel, Moynet; Maite, Longy-Boursier; Denis, Malvy.

2014-01-01

 
 
 
 
221

MR imaging manifestations and staging of pyogenic spondylitis  

International Nuclear Information System (INIS)

Objective: To investigate MRI features and staging of pyogenic spondylitis and to evaluate MRI value in the differential diagnosis of the disease. Methods: The MRI findings of 50 cases pathologically or clinically proven with pyogenic spondylitis were retrospectively analyzed. The features of intervertebral disc, centrum, appendix of vertebra, soft tissue of intraspinal and extra-vertebral canal were observed. All the cases were divided into 4 stages according to the findings of MRI and degree of destruction in centrum. Results: The lesion originated from the cervical vertebra (3 cases), thoracic vertebra (5 cases), Th 12/L1 (5 cases), lumbar vertebra (31 cases) and L5/S1 (6 cases). The disc was damaged in 43 cases, while no abnormal findings of intervertebral dics showed in 7 cases. The MRI findings of 50 patients were divided into the first stage (7 cases), second stage (18 cases), third stage (8 cases) and fourth stage (17 cases). There was abnormal signal in endplate in 42 cases. Abnormal signal of soft tissue was observed in 46 cases, including the parenchymal intensification (26 cases), microabscess (14 cases) and comparatively large abscess (7 cases). Granulation tissue and abscess were formed in spinal canal in 28 cases. 5 cases and 31 cases spreaded by longitudinal ligaments and intervertebral disc respectively. Conclusion: MRI examinations can provide characteristic features and helpful information for the clinical diagnosis and differential diagnosis of pyoiagnosis and differential diagnosis of pyogenic spondylitis. (authors)

222

Tuberculous spondylitis after percutaneous vertebroplasty: misdiagnosis or complication?  

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So far, there have been few previous reports of tuberculous spondylitis occurring after percutaneous vertebroplasty. We report an unusual case of tuberculous spondylitis diagnosed after percutaneous vertebroplasty in a patient who had a history of pulmonary tuberculosis for the first time. A 58-year-old woman, who had a history of complete recovery from pulmonary tuberculosis six years previously, was hospitalized due to severe back pain after a fall. Radiological studies revealed a fresh compression fracture at the T12 thoracic vertebra. The back pain improved dramatically, and the patient was discharged two days after the vertebroplasty. However, cold sweats and a low grade fever with severe back pain developed four weeks after the procedure. Magnetic resonance imaging revealed a severe kyphosis and the T11-T12 disc space had collapsed with heterogeneous signal intensity. The results of the culture of the biopsy specimens were negative, and did not lead to identification of the causative micro-organism. However, the polymerase chain reaction for Mycobacterium tuberculosis was positive. Treatment for tuberculous spondylitis was started and she underwent posterior fusion and instrumentation from T9-L2 after the markers for infection returned to normal. After surgical intervention, the pain improved and the kyphotic deformity was corrected. PMID:24757469

Kang, Jung Hoon; Kim, Hyun-Sook; Kim, Seok Won

2013-06-01

223

Weekly Teriparatide Therapy Rapidly Accelerates Bone Healing in Pyogenic Spondylitis with Severe Osteoporosis  

Science.gov (United States)

Pyogenic spondylitis is a frequently observed disease in orthopedics, and the number of cases is increasing. Some patients with pyogenic spondylitis suffer from vertebral destruction due to infection. The disease is typically treated with antibiotics, bed rest, spinal support, and lesion curettage; however, vigorous drug therapy against vertebral body destruction by pyogenic spondylitis has not been attempted. In this report, a case of pyogenic spondylitis with spinal destruction caused by infection and treated with once-weekly teriparatide administration is presented. Vertebral body erosion in cortical and cancellous areas by the infection was rapidly repaired after 6 weeks of once-weekly teriparatide treatment. Treatment with once-weekly teriparatide appears to be a new strategy for patients with severe osteoporosis suffering from pyogenic spondylitis. PMID:25187868

Ueno, Yutaka; Marumo, Keishi

2014-01-01

224

Weekly teriparatide therapy rapidly accelerates bone healing in pyogenic spondylitis with severe osteoporosis.  

Science.gov (United States)

Pyogenic spondylitis is a frequently observed disease in orthopedics, and the number of cases is increasing. Some patients with pyogenic spondylitis suffer from vertebral destruction due to infection. The disease is typically treated with antibiotics, bed rest, spinal support, and lesion curettage; however, vigorous drug therapy against vertebral body destruction by pyogenic spondylitis has not been attempted. In this report, a case of pyogenic spondylitis with spinal destruction caused by infection and treated with once-weekly teriparatide administration is presented. Vertebral body erosion in cortical and cancellous areas by the infection was rapidly repaired after 6 weeks of once-weekly teriparatide treatment. Treatment with once-weekly teriparatide appears to be a new strategy for patients with severe osteoporosis suffering from pyogenic spondylitis. PMID:25187868

Shinohara, Akira; Ueno, Yutaka; Marumo, Keishi

2014-08-01

225

Intertrochanteric Fracture of the Ankylosed Hip Joint Treated by a Gamma Nail: A Case Report  

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We herein report a rare case of an intertrochanteric fracture complicated with an ankylosed hip joint in a 76-year-old man. Generally, operative treatment is performed for elderly people with intertrochanteric fractures to prevent general complications, maintain mobility, and release pain. However, intertrochanteric fractures of ankylosed hip joints are rare, and the optimal surgery for this condition is unknown. In addition, surgical fracture repair is challenging because unusual instability...

Daichi Ishimaru; Satoshi Nozawa; Masato Maeda; Katsuji Shimizu

2012-01-01

226

The diagnostic use of MRT in cases of suspected spondylitis  

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In cases where MRT fails to reveal abscess formation or typical vertebral changes to confirm the preliminary diagnosis, further examinations are necessary to exclude diseases other than spondylitis. More remote possibilities like insufficiency fracture, rheumatic disorders and neoplasm can mostly be ruled out on the basis of conventional X-ray pictures. Conventional tomography and computed tomography should also be carried out in addition to MRT in the rare case of unconfirmed activated arthrosis or disc removal syndrome. In order to distinguish between infective and non-infective/reactive changes, contrast-enhanced repeat MRT following antibiotic treatment may be very helpful. (orig.)

227

The diagnostic usefulness of CT-guided needle biopsy or aspiration in infectious spondylitis  

International Nuclear Information System (INIS)

ungal spondylitis (n=1). Thirty-six unconfirmed cases were diagnosed as nonspecific inflammation (n=21), fibrosis involving cortical bone (n=1), necrotic material (n=5) and inadequate specimen without evidence of malignancy (n=9). Only one of the nine cases in which biopsy was repeated was confirmed as tuberculous spondylitis. Diagnosis was confirmed in 7 of 17 paravertebral abscesses (41%), 8 of 21 vertebral bodies (38%), 6 of 20 intervertebral discs (30%) and 1 of 8 psoas abscesses (13%). In infectious spondylitis, the overall diagnostic yield of CT-guided needle biopsy and/or aspiration is relatively low, but the procedure seems to be effective for excluding malignancy. In identifying the organisms involved in infectious spondylitis, a paravertebral lesion is in a more favoured location than a psoas lesion

228

Assessment of efficience of purification of chromic waster water with application of spondyle green clay  

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Full Text Available Results of conducted experiments on spondyle green clay applying as a natural ecologically safe coagulant for waste water purification from Cr ions was presented. Optimal quantity of coagulant that provides the maximum level of purification was defined.

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2010-02-01

229

A Case of Pyogenic Spondylitis after Surgery for Oral Floor Cancer  

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Full Text Available We report the case of a patient who developed pyogenic spondylitis after surgery for oral floor cancer. This 85-year-old man was evaluated at our hospital for a mass in the left floor of the mouth. Oral floor cancer (T2N0M0 was diagnosed. Surgical resection of the tumor was performed twice. On postoperative day 14, he developed sudden neck pain, followed by fever the next day and a gradual decrease in blood pressure. Septic shock was diagnosed, and echocardiography was performed, but no evidence of infective endocarditis was found. Findings on neck magnetic resonance imaging suggested pyogenic spondylitis, and ultimately pyogenic spondylitis causing septic shock was diagnosed. In patients with a compromised immune system after surgery who develop neck pain and fever, the possibility of pyogenic spondylitis as a complication should be kept in mind.

Takamitsu Mano

2014-05-01

230

Can a functional assay on cytokine kinetics be used for the identification of a disease-related role for Single Nucleotide Polymorphisms (SNPs) in Ankolysing spondylitis?  

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Interleukin 1? (IL-1?) is a proinflammatory cytokine that belongs to the IL-1 family. It is produced mainly by macrophages at sites of infection and regarded as an essential regulator of acute inflammation. IL-1? is synthesized as a 33 kDa precursor peptide that is cleaved by a calpain-like protease to a nuclear -associated 16 kDa propiece and a secreted 17 kDa mature IL-1? peptide. However, the full understanding of its dual function is missing. Recently, SNPs in the gene for IL-1? was also associated with the risk of developing ankylosing spondylitis (AS), a subgroup of the spondyloarthropathies. These findings lead us to produce antibodies towards the N- and C-terminal region of IL-1? to investigate IL-1? kinetics in human macrophages. This would eventually be used to asses any correlation between a defect in the production of the cytokine and a disease related SNP found in the IL-1? gene in patients suffering from AS. In the present study we generated human macrophages (Mf) from blood monocytes, stimulated the cells with lipopolysaccharide (LPS) and analysed the production and localization of IL-1? by use of monoclonal antibodies (MAbs) generated against recombinant precursor IL-1?. We obtained a MAb specific for the N-terminal propiece and for the C-terminal mature form of IL-1?, respectively. Assays, including DNA sequencing, immunofluorescence microscopy, qPCR and FACS are now available for the analysis of IL-1? kinetics in blood samples from AS patients.

Carlsen, Thomas Gelsing; Kjærsgaard, Pernille

2014-01-01

231

Experimental reproduction of enterococcal spondylitis in male broiler breeder chickens.  

Science.gov (United States)

There has been a recent emergence of epidemic spinal infections with necrosis causing lameness and mortality in male broilers and broiler breeders. Mortality in affected flocks may be as high as 15%. The disease has been called enterococcal spondylitis (ES), based on the frequent isolation of Enterococcus cecorum from the lesions and necrosis and inflammation observed in the free thoracic vertebrae (FTV) of affected birds. Male broiler breeders in an experimental setting were challenged with pure E. cecorum isolates obtained from ES-affected commercial flocks. Challenge routes included oral gavage (10(8)), intravenous (i.v.; 10(3)), and air sac (AS; 10(3)). Half the study birds in each group were chemically immunosuppressed with dexamethasone. Spinal lesions were observed grossly in birds challenged intravenously (2.9%) and birds challenged orally (6.1%). Microscopic spinal lesions consistent with ES were more frequently identified compared with gross lesions in the orally challenged group (30.3%). Chemical immunosuppression with dexamethasone was not associated with a greater incidence of ES in this study. By recreating the disease experimentally, the study design reported here may help in the further development of an experimental challenge model for future studies on risk factors, prevention, and therapeutic intervention of ES. PMID:21793445

Martin, Leslie T; Martin, Michael P; Barnes, H John

2011-06-01

232

Differential diagnosis of erosive osteochondrosis and bacterial spondylitis in MRI  

International Nuclear Information System (INIS)

Purpose: To evaluate retrospectively criteria in the differential diagnosis of erosive osteochondrosis (EO) and infectious spondylitis (IS) on the basis of MRI. Methods: T1-weighted sagittal images before and after Gd-DTPA application, T2-weighted TSE or T-STIR images of 23 patients with proven IS and 41 patients with EO were evaluated. Criteria for this evaluation were morphology and extension of bone marrow edema, visibility of the low-intensity vertebral endplate, contrast enhancement and signal intensity in the disc space on T2-weighted and T-STIR images. Results: Bone marrow edema was more extensive in IS than in EO. The mean rated value for bone marrow edema on a four-level scale (0-3) was for IS 2.91 (±0.29), for EO 1.32 (±0.76, p1-weighted images, in IS not in a single case (0%). On T2-weighted or STIR images signal intensity of the discs was decreased in 82.1% of EO, 82.6% of segments in IS had water-equivalent signal intensity (p<0.001). Conclusion: If all the criteria are taken into consideration differential diagnosis of EO and IS on the basis of MRI findings is possible. (orig.)

233

Reconstruction of ankylosed temporomandibular joint: Sternoclavicular grafting as an approach to management.  

Science.gov (United States)

A retrospective analysis of 15 cases of ankylosed temporomandibular joint (TMJ) reconstructed, with sternoclavicular joint graft (SCG), during the period 2002-2007 was undertaken. All cases were analyzed for functional adaptation of the graft, considering maximum interincisal opening, and protrusive and laterotrusive movement of the jaw. Significant improvement was noticed in all cases except one, although maximum improvement was seen 3-6 months postoperatively. Radiological evaluation was carried out at regular intervals for 2-3 years to assess the anatomical adaptation of the graft. No major postoperative complications were observed and all the cases showed complete regeneration of the clavicle during follow up. This finding indicates that reconstruction of ankylosed TMJ with sternoclavicular joint graft is a satisfactory method of treatment. PMID:21115326

Singh, V; Verma, A; Kumar, I; Bhagol, A

2011-03-01

234

{sup 18}F-FDG hybrid PET in patients with suspected spondylitis  

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This study investigated the value of fluorine-18 2'-deoxy-2-fluoro-D-glucose (FDG) imaging with a double-headed gamma camera operated in coincidence (hybrid PET) detection mode in patients with suspected spondylitis. Comparison was made with conventional nuclear medicine imaging modalities and magnetic resonance imaging (MRI). Sixteen patients with suspected spondylitis (nine male, seven female, mean age 59 years) prospectively underwent FDG hybrid PET (296 MBq) and MRI. For intra-individual comparison, the patients were also imaged with technetium-99m methylene diphosphonate (MDP) (555 MBq) (n=13) and/or gallium-67 citrate (185 MBq) (n=11). For FDG hybrid PET, two or three transverse scans were performed. Ratios of infected (target) to non-infected (background) (T/B) vertebral bodies were calculated. MR images were obtained of the region of interest. Patients found positive for spondylitis with MRI and/or FDG hybrid PET underwent surgical intervention and histological grading of the individual infected foci. Twelve out of 16 patients were found to be positive for spondylitis. Independent of the grade of infection and the location in the spine, all known infected vertebrae (n=23, 9 thoracic, 12 lumbar, 2 sacral) were detected by FDG hybrid PET. T/B ratios higher than 1.45{+-}0.05 (at 1 h p.i.) were indicative of infectious disease, whereas ratios below this value were found in cases of degenerative change. FDG hybrid PET was superior to MRI in patients who had a history of surgery and suffered from a high-grade infection in combination with paravertebral abscess formation (n=2; further computed tomography was needed) and in those with low-grade spondylitis (n=2, no oedema) or discitis (n=2, mild oedema). False-positive {sup 67}Ga citrate images (n=5: 2 spondylodiscitis, 1 aortitis, 1 pleuritis, 1 pulmonary tuberculosis) and {sup 99m}Tc-MDP SPET (n=4: 1 osteoporosis, 2 spondylodiscitis, 1 fracture) were equally well detected by FDG hybrid PET and MRI. No diagnostic problems were seen in the other patients (n=5). In this study, FDG hybrid PET was superior to MRI, {sup 67}Ga citrate and {sup 99m}Tc-MDP, especially in patients with low-grade spondylitis (as compared with MRI), adjacent soft tissue infections (as compared with {sup 67}Ga citrate) and advanced bone degeneration (as compared with {sup 99m}Tc-MDP). (orig.)

Gratz, S.; Behr, T.M.; Behe, M. [Department of Nuclear Medicine, Philipps University of Marburg (Germany); Department of Nuclear Medicine, Georg August University of Goettingen (Germany); Doerner, J. [Department of Orthopedics, Georg August University of Goettingen (Germany); Fischer, U.; Grabbe, E. [Department of Radiology, Georg August University of Goettingen (Germany); Altenvoerde, G.; Meller, J.; Becker, W. [Department of Nuclear Medicine, Georg August University of Goettingen (Germany)

2002-04-01

235

A case of SAPHO syndrome with destructive spondylodiscitis suspicious of tuberculous spondylitis.  

Science.gov (United States)

We report a rare case of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome in which the differential diagnosis included tuberculous spondylitis and the patient ultimately required reconstructive spinal surgery. The patient was a 60-year-old woman who presented with severe low-back and leg pain after treatment for tuberculosis. Roentgenography and magnetic resonance imaging of the lumbar spine revealed destructive changes suggestive of tuberculous spondylitis. [(18)F]-fluoro-2-deoxyglucose positron emission tomography/computed tomography showed uptake in the cervical spines, lumbar spines, and sacroiliac joints from which she was suspected of having SAPHO syndrome without skin manifestations. However, as her symptoms did not respond to conservative treatment, we performed reconstructive surgery of the lumbar spine. Spinal specimens obtained surgically showed nonspecific inflammation and fibrous hypertrophy of the bone marrow, confirming a diagnosis of the SAPHO syndrome. Her symptoms improved markedly after surgery, although she required occasional prednisolone for moderate polyarthralgia and leg pain. PMID:19830381

Nakamura, Jun-ichiro; Yamada, Katsutaka; Mitsugi, Naoto; Saito, Tomoyuki

2010-02-01

236

Lemierre's syndrome with spondylitis and pulmonary and gluteal abscesses associated with Mycoplasma pneumoniae pneumonia.  

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Lemierre's syndrome, a systemic anaerobic infection caused by Fusobacterium necrophorum, is characterized by an acute oropharyngeal infection, septic thrombophlebitis of the internal jugular veins, sepsis, and multiple metastatic infections. It commonly leads to pulmonary parenchymal abscesses and occasionally to septic arthritis, osteomyelitis, or liver or spleen abscesses. Reported here is a case of spondylitis and pulmonary and gluteal abscesses that occurred as part of a classic presentation of Lemierre's syndrome. Treatment with imipenem and clindamycin was successful. PMID:11399017

Abele-Horn, M; Emmerling, P; Mann, J F

2001-04-01

237

SAPHO syndrome with rapidly progressing destructive spondylitis: two cases treated surgically.  

Science.gov (United States)

The authors present two cases of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome with rapidly progressing destructive spondylitis treated surgically. The spinal lesions in SAPHO syndrome generally have a good prognosis and rarely cause the structural destruction or neurological deterioration. Case 1: a 63-year-old female had palmoplantar pustulosis for 2 years. At first, she only felt a pain in the nape with no inducing factor. Two months later, she had incomplete quadriplegia (ASIA scale C). Magnetic resonance imaging showed destruction of C4-C7, kyphotic deformity, and severe compression of the spinal cord. Decompression and reconstruction surgery using anterior and posterior approach improved her paralysis. Case 2: a 69-year-old female complained of persistent back pain. Magnetic resonance imaging revealed spondylitis of T7-T9. Although there were no typical skin lesions, we diagnosed SAPHO syndrome by hyperostosis of the sternocostoclavicular joint and sacral joint. Destruction with kyphotic deformity of the spine progressed gradually for 3 months. Curettage and reconstruction surgery using thoracic endoscope relieved her pain and prevented the destruction of the spine. The histopathology of the specimen obtained surgically showed non-specific inflammation in both cases. Spondylitis in SAPHO syndrome may cause severe destruction and kyphotic deformity followed by paralysis. PMID:18389286

Takigawa, Tomoyuki; Tanaka, Masato; Nakahara, Shinnosuke; Sugimoto, Yoshihisa; Ozaki, Toshifumi

2008-09-01

238

Reduktion des gastrointestinalen Risikos in Parallelität zur verminderten Schmerzmedikatin nach wiederholter Radonstollentherapie bei Spondylitis ankylosans - 12-Jahres-Follow-up einer kontrollierten prospektiven Studie  

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Ziel der vorliegenden kontrollierten prospektiven Untersuchung ist die Beobachtung des langfristigen Einflusses von wiederholter Radonstollentherapie bei Patienten mit Spondylitis ankylosans auf deren Verbrauch an NSAR und auf die Häufigkeit gastrointestinaler Komplikationen. 100 Probanden mit gesicherter Spondylitis ankylosans und wiederholten Reha-Behandlungen wurden im Rahmen eines Langzeit-Follow-ups über 12 Jahre zu NSAR-Verbrauch (Einnahmetage/Woche) und zu durchgemachten gastrointes...

Lind-Albrecht G; Rotheimer-Hering S

2007-01-01

239

Efficacy of CT-guided biopsies of the spine in patients with spondylitis – an analysis of 164 procedures  

International Nuclear Information System (INIS)

Objective: To evaluate efficacy of CT-guided spinal biopsy (CTSB) in patients with spondylitis considering patient characteristics, technical issues, antibiotic therapy, histopathological, and microbiological findings. Materials and methods: All CTSB procedures performed between 1995 and 2009 in patients with proven spondylitis were re-evaluated. Patient sex and age, antibiotic treatment, biopsy approach, number of specimens, length of needle path, laboratory results (CRP, WBC), and histopathological/microbiological findings were documented and compared to the final diagnosis of spondylitis. Statistical analysis was performed using Chi-square test and Student's t-test. The p-value was set to 5%. Results: 164 CTSB procedures were performed in 159 patients (mean age 65 years, 60% men) in which spondylitis was histopathologically verified in 95%. Neither patient sex nor age, positioning, localization of the spinal lesion, bioptic approach, number of specimens, or depth of the needle showed significant impact on the rate of positive histopathological findings. A causative germ was identified in 40/127 biopsies (32%) with Staphylococcus aureus being identified in 50%. Tuberculous spondylitis was diagnosed in ten cases (6%). CRP significantly correlated with bacterial growth (13.3 ± 12.2 mg/dl versus 8.8 ± 7.6 mg/dl; p = .015) whereas administration of antibiotics did not show any significant impact on bacterial growth (29% versus 36% in patients without antibiotics; p = 6% in patients without antibiotics; p = 0.428). Patients with histopathological signs of active spondylitis showed a significantly higher CRP (16.5 ± 15.8 mg/dl versus 8.9 ± 8.0 mg/dl, p < .001). Complication rate was 0.6% (one focal bleeding). Conclusion: CTSB of the spine in suspected spondylitis is an effective and safe procedure for establishing final histopathological diagnosis. However, microbiological yield is low regardless of technical issues and antibiotic therapy. Other than CRP values, laboratory investigations added little useful information to diagnose infection in our study group. CRP values significantly correlated with bacterial growth and with histopathological signs of active spondylitis.

240

Aortic insufficiency  

Science.gov (United States)

... Causes of aortic insufficiency may include: Ankylosing spondylitis Aortic dissection Congenital (present at birth) valve problems, such as bicuspid valve Endocarditis High blood pressure Marfan syndrome Reiter ...

 
 
 
 
241

21 CFR 343.80 - Professional labeling.  

Science.gov (United States)

... In clinical studies in patients with rheumatoid arthritis, juvenile rheumatoid arthritis, ankylosing spondylitis and osteoarthritis... Rheumatologic Disease Indications (Rheumatoid Arthritis, Juvenile Rheumatoid Arthritis,...

2010-04-01

242

Uveitis  

Science.gov (United States)

Iritis; Pars planitis; Choroiditis; Chorioretinitis; Anterior uveitis; Posterior uveitis ... Uveitis can be caused by autoimmune disorders , including rheumatoid arthritis or ankylosing spondylitis . It can also be ...

243

Kyphectomy for severe kyphosis with pyogenic spondylitis associated with myelomeningocele: a case report  

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Full Text Available Abstract A 32-year-old woman was referred to our hospital for a refractory ulcer on her back. She had a history of myelomeningocele with spina bifida that was treated surgically at birth. The ulcer was located at the apex of the kyphosis. An X-ray film revealed a kyphosis of 154° between L1 and 3 and a scoliosis of 60° between T11 and L5. Computed tomography, magnetic resonance imaging and laboratory data indicated the presence of a pyogenic spondylitis at L2/3. To correct the kyphosis and remove the infected vertebrae together with the skin ulcer, kyphectomy was performed. Pedicle screws were inserted from T8 to T12 and from L4 to S1. The dural sac was transected and ligated at L2, followed by total kyphectomy of the L1-L3 vertebrae. The spinal column was reconstructed by approximating the ventral wall of the T12 vertebral body and the cranial endplate of the L4 vertebra. Postoperatively, the kyphosis was corrected to 61° and the scoliosis was corrected to 22°. In the present case, we treated the skin ulcer and pyogenic spondylitis successfully by kyphectomy, thereby, preventing recurrence of the ulcer and infection, and simultaneously obtaining sufficient correction of the spinal deformity.

Chiba Kazuhiro

2011-04-01

244

[Case of pyogenic spondylitis and epidural abscess after chemoradiotherapy for hypopharyngeal cancer].  

Science.gov (United States)

Osteomyelitis is one of the most severe late complications of radiation therapy. The condition can arise from osteoradionecrosis and can be fatal if it occurrs in vertebrae. A 71-year-old woman, who had undergone chemoradiotherapy for hypopharyngeal cancer 6 months previously, presented with severe neck pain. An MRI examination revealed pyogenic spondylitis and an epidural abscess of the neck. Neurological disturbance in the extremities developed despite the administration of antibiotics for 5 days. Drainage and a laminectomy were performed to control the infection and to relieve spinal cord compression. The patient had no postoperative complications at 15 months after surgery. Previous case reports of osteomyelitis and epidural abscess following radiation therapy for head and neck cancer with surgical treatment tended to have a good clinical course. Severe neck pain and a limitation in the range of motion of the neck are considered to be serious clinical features of osteomyelitis. Since infection in the necrotic mucosa leads to pyogenic spondylitis, a repeated cultivation survey of the mucosa is nessesary for adequate antibiotics therapy. For osteomyelitis and epidural abscess following radiation therapy, immediate specific surgical treatment of the involved region is strongly suggested if antibiotics are not effective or spinal cord compression develops. PMID:24558949

Kuba, Kiyomi; Inoue, Hitoshi; Matsumura, Satoko; Minami, Kazuhiko; Takajo, Fumihiko; Morita, Kei; Nakahira, Mitsuhiko; Sugasawa, Masashi

2013-12-01

245

Treatment of tuberculous spondylitis at the cervicothoracic junction. Clinical impact of surgery by means of a sternotomy.  

Directory of Open Access Journals (Sweden)

The operative treatment of tuberculous spondylitis remains a challenge with regard to the surgical approach to the cervicothoracic junction. In addition, it is difficult to restore the resected vertebral bodies. Two cases of tuberculous spondylitis in this area are presented. The first case concerns a 25-year-old African patient suffering from the effects of tuberculous spondylitis: Destruction of vertebral bodies dorsal (D1, D2, and D3, kyphosis coupled with compression of the spinal cord, as well as incomplete motor and sensory paraplegia (Frankel grade C. The operative treatment of tuberculous spondylitis that is described, approached the cervicothoracic junction by means of a sternotomia. Corpectomy of vertebral bodies D1 through D3 were followed by their restoration with the help of a titanium cage. As a result, the paraplegia disappeared. Ventral decompression was followed by dorsal instrumentation. The results of the operation are decompression of the spinal cord, correction of the kyphosis, and stable fusion followed by restitution of the paraplegia. Primary stability was provided by the use of a titanium cage and dorsal instrumentation. There was no need for an external brace. There was no loss of correction 3 years after the operation. The 2nd case concerns a 49-year-old European patient suffering from thoracic pain radiating around the chest. A partial destruction of D2 and D3 with kyphosis and compression of the spinal cord because of a tuberculous spondylitis were detected, neurological deficits were not found. The corpectomy of D2 and D3 were proceeded by means of a sternotomy, the defect was restored with the help of a titanium cage. Due to the use of a ventral Morscher plate an additional dorsal instrumentation was not necessary. The patient was fixed in a minerva plaster for 3 months. There was no loss of correction 2 years after the operation. Both patients are manual workers and postoperatively adapted to their former work.

Stefan M. Knoeller

2002-11-01

246

Prehistoria, historia y arte de la Reumatología Inicios de las palabras reuma, artritis reumatoide, artritis juvenil, gota y espondilitis anquilosante / Prehistoric, historic and arts of rheumatology. Origin of words reuma, rheumatoid arthritis, juvenile rheumatoid arthritis, gout and ankylosing spondylitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish En esta primera parte del artículo hacemos una revisión completa sobre la prehistoria, la historia y la importancia del arte como ayuda para entender los orígenes de la artritis Reumatoide y de la artritis juvenil. [...] Abstract in english In this first part of the paper, we describe a complete review about prehistoric, historic findings as well as the importance of arts as a tool to understand the origin of the rheumatoid arthritis and juvenile arthritis. [...

Antonio, Iglesias-Gamarra; Gerardo, Quintana; José Félix, Restrepo Suárez.

247

Prehistoria, historia y arte de la Reumatología Inicios de las palabras reuma, artritis reumatoide, artritis juvenil, gota y espondilitis anquilosante Prehistoric, historic and arts of rheumatology. Origin of words reuma, rheumatoid arthritis, juvenile rheumatoid arthritis, gout and ankylosing spondylitis  

Directory of Open Access Journals (Sweden)

Full Text Available En esta primera parte del artículo hacemos una revisión completa sobre la prehistoria, la historia y la importancia del arte como ayuda para entender los orígenes de la artritis Reumatoide y de la artritis juvenil.In this first part of the paper, we describe a complete review about prehistoric, historic findings as well as the importance of arts as a tool to understand the origin of the rheumatoid arthritis and juvenile arthritis.

Antonio Iglesias-Gamarra

2006-03-01

248

[The effectiveness of BACTEC MGIT 960 system hit analysis of surgery material of patients with tubercular spondylitis].  

Science.gov (United States)

The article considers the comparison of effectiveness of cultivation of 290 surgery samples from focus of destruction in patients with tubercular spondylitis in liquid medium Middlebrook 7119 with fluorescent detection of growth and two dense egg medium -Levenschtein-Yensen and Finn-II. The sensitivity of methods of inoculation in liquid medium Middlebrook 7H9 and in dense egg mediums has no difference (38.2% and 43.1%, p = 0.271). The duration of growth consisted 2 +/- 2.3 days for liquid mediums and 40.6 +/- 3.2 days for dense mediums. The method of pre-inoculation processing of surgery material. In case of inoculation of 440 samples in liquid mediums contamination consisted 3.9%. In case of inoculation of bone fragments of focus of destruction in liquid medium Middlebrook 7119 the culture was isolated in 43.5% of samples of patients with tubercular spondylitis. PMID:24757865

Solov'eva, N S; Manicheva, O A; Steklova, L N; Ole?nik, V V; Shul'gina, M V

2013-12-01

249

HLA-B27 positive juvenile arthritis with cardiac involvement preceding sacroiliac joint changes  

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While cardiovascular disease develops in up to 50% of adult patients with ankylosing spondylitis, it is very uncommon in its juvenile counterpart. Regarding the early stage of the disease, before onset of sacroiliac joint changes, only two cases with aortic incompetence have been published while reports of mitral valve involvement are not available. A 13 year old boy is described with an HLA-B27 positive asymmetric oligoarthritis and enthesitis, without back pain or radiographic evidence of ...

Lee, S.; Im H, Y.; Schueller, W.

2001-01-01

250

Anti-TNF agents for the treatment of active non-radiographic axial spondyloarthritis  

Directory of Open Access Journals (Sweden)

Full Text Available The spondyloarthritis (SpA complex includes ankylosing spondylitis (AS, reactive arthritis, psoriatic arthritis, arthritis related to inflammatory bowel disease and forms that do not meet established criteria for these definite categories which are designated as undifferentiated SpA. In the early 1990s, two sets of classification criteria were suggested with the purpose to cover the whole clinical spectrum of SpA: the Amor criteria and the European Spondylarthropathy Study Group (ESSG criteria...

A. Padula

2013-03-01

251

Existence of pyogenic spondylitis in Modic type 1 change without other signs of infection: 2-year follow-up  

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The relationship of Modic change to pain and inflammation remains to be unclear. Recently, some authors have reported that Modic type 1 signals are closely related to infection. However, if the patients do not have severe back pain, fever, or an abnormal blood profile, it is difficult to distinguish between common Modic change and infection. The purpose of this study was to examine the prevalence of pyogenic spondylitis in patients who showed Modic type 1 change without other signs of infecti...

Ohtori, Seiji; Koshi, Takana; Yamashita, Masaomi; Yamauchi, Kazuyo; Inoue, Gen; Suzuki, Munetaka; Takaso, Masashi; Orita, Sumihisa; Eguchi, Yawara; Ochiai, Nobuyasu; Kishida, Shunji; Kuniyoshi, Kazuki; Nakamura, Junichi; Aoki, Yasuchika; Ishikawa, Tetsuhiro

2010-01-01

252

The Spondyloarthropathies  

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This book contains several chapters on advances in inflammation research. Some of the chapter titles are: Genetic Analysis of Ankylosing Spondylitis, Pathological Specificity of Ankylosing Spondylitis: Is it yet established., Acute Anterior Uveitis and the Fourteenth Chromosome, and Patterns of Spondyloarthropathies.

Ziff, M.; Cohen, S.B.

1985-01-01

253

Clinical and radiological comparison of tuberculous and pyogenic spondylitis. An analysis of 49 operated cases  

International Nuclear Information System (INIS)

Objective: To perform retrospective analysis of 49 operated patients with histologically proven spondylodiscitis of tbc and pyogenic origin. Patient histories, laboratory tests and radiographic findings were statistically compared between two groups. We estimated that in 16 cases (32.6%) origin of spondylodiscitis was tbc and 33 cases (67.4%) origin was pyogenic. All cases of tbc spondylitis (except one drug resistant tbc form) were with previously proved tbc diagnosis of different localisation. Radiological findings for the tbc cases were more than two-vertebra involvement and deformation of vertebral column axis. Pyogenic spondylodiscitis (33 cases) were derived from or after - 1. lumbal discectomies (7 cases), 2. operation on retroperitoneal cavity (6 cases) including 3 cases after prothesation of abdominal aorta, 3. closed spine trauma (4 cases), 4. hematogenic dissemination of pyogenic infection from different localisation - kidney, lung, sinuses (8 cases). In 8 cases we did not estimate potential cause of spondylodiscitis. Conclusion: A definite diagnosis of spondylodiscitis was established by means of biopsy, histological evidence and bacterial culture. There are not specific radiological findings to differentiate tbc spondylodiscitis from pyogenic spondylodiscitis. (Full text)

254

Ra-224 for internal radiation therapy of spondylitis ankylosans (Bechterew's disease) - an alternative for chemotherapy  

International Nuclear Information System (INIS)

For therapy of spondylitis ankylosans (Sp. a.) nowadays Ra-224 of high radionuclide purity in a dosage of 280 ?Ci total activity should be given a place beside the non-steroidal antirheumatic drugs. With comparable therapeutic efficacy and risk this substance has the advantage of improving the patients' quality of life without the relatively frequent and strained side effects of drug therapy. However, Ra-224 therapy has still a psychological disadvantage resulting from less positive experience with peteosthor therapy and application of external X-ray radiation. Ra-224 therapy is very safe concerning dosage by the physician, compared to drug therapy an overdosage by the patient is impossible. In future a comparison between Ra-224 therapy and peteosthor therapy performed with false indication and overdosage should be avoided. After careful examination of the type of the disease including a bone scan for evaluating the potential therapeutic success, up to now after application of Ra-224 of high radionuclide purity no severe side effects could be reported. (orig.)

255

Effectiveness of percutaneous catheter drainage for tuberculous iliopsoas abscess associated with tuberculous spondylitis  

International Nuclear Information System (INIS)

To evaluate the efficacy of percutaneous catheter drainage of tuberculous abscess associated with tuberculous spondylitis. In twelve patients (male: female=1:2; mean age, 37.3 years) tuberculous abscess was diagnosed, and was treated by percutaneous abscess drainage(PAD). All patients had either a psoas or iliopsoas abscess and in two, a paravertebral abscess was also present. Four had bilateral lesions, one, a unilateral lesion, and one, paravertebral abscesses and bilateral psoas. The size of abscesses ranged from 4x5x12cm to 6x9x30cm;four were septated and all were lobulated. Using an 8.5-14F catheter, 17 of 18 abscesses were percutaneously drained; Ultrasound guidance was used in 12 cases, and CT guidance in five. The volume of drainage mater ranged from 150 to 1200 cc(mean, 600cc), and the duration of catheter insertion was 6-48 (mean, 17.4) days. In no patient did significant complications arise during or after drainage, and in all cases, follow-up studies using ultrasound, CT or MRI were performed. The duration of follow-up ranged from 3 to 35 (mean, 15.4) months; during this time, no recurrence was noted. Chemotherapy alone is sufficient for treating a small tuberculous psoas or iliopsoas abscess, but for a large abscess, adjuvant drainage is necessary

256

Effectiveness of percutaneous catheter drainage for tuberculous iliopsoas abscess associated with tuberculous spondylitis  

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To evaluate the efficacy of percutaneous catheter drainage of tuberculous abscess associated with tuberculous spondylitis. In twelve patients (male: female=1:2; mean age, 37.3 years) tuberculous abscess was diagnosed, and was treated by percutaneous abscess drainage(PAD). All patients had either a psoas or iliopsoas abscess and in two, a paravertebral abscess was also present. Four had bilateral lesions, one, a unilateral lesion, and one, paravertebral abscesses and bilateral psoas. The size of abscesses ranged from 4x5x12cm to 6x9x30cm;four were septated and all were lobulated. Using an 8.5-14F catheter, 17 of 18 abscesses were percutaneously drained; Ultrasound guidance was used in 12 cases, and CT guidance in five. The volume of drainage mater ranged from 150 to 1200 cc(mean, 600cc), and the duration of catheter insertion was 6-48 (mean, 17.4) days. In no patient did significant complications arise during or after drainage, and in all cases, follow-up studies using ultrasound, CT or MRI were performed. The duration of follow-up ranged from 3 to 35 (mean, 15.4) months; during this time, no recurrence was noted. Chemotherapy alone is sufficient for treating a small tuberculous psoas or iliopsoas abscess, but for a large abscess, adjuvant drainage is necessary.

Shin, Kue Hee; Kim, Yun Hwan [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

1997-10-01

257

Existence of pyogenic spondylitis in Modic type 1 change without other signs of infection: 2-year follow-up.  

Science.gov (United States)

The relationship of Modic change to pain and inflammation remains to be unclear. Recently, some authors have reported that Modic type 1 signals are closely related to infection. However, if the patients do not have severe back pain, fever, or an abnormal blood profile, it is difficult to distinguish between common Modic change and infection. The purpose of this study was to examine the prevalence of pyogenic spondylitis in patients who showed Modic type 1 change without other signs of infection. Seventy-one patients with Modic type 1 change were evaluated (average age 55, 32 males and 39 females). X-ray and magnetic resonance imaging (MRI) were performed to investigate low-back pain and leg pain. Body temperature was measured and blood analysis (including white blood cell count and level of C-reactive protein) was conducted for all patents. All 71 patients with Modic type 1 change, but without other signs of infection were followed for 2 years. Low-back pain, X-ray, and blood analyses were performed every 3 months; and MRI was performed every year. Severe low-back pain or abnormal signs developed in four patients during the follow-up. Pyogenic spondylitis was diagnosed in three patients by symptoms, blood results, and imaging, and confirmed by biopsy. Two of the three patients were diabetic. A total of 4.2% of patients with Modic type 1 change, but without other signs of infection were diagnosed as having pyogenic spondylitis during the 2-year follow-up, therefore, it is important to consider this before treating Modic type 1 change. PMID:20213295

Ohtori, Seiji; Koshi, Takana; Yamashita, Masaomi; Yamauchi, Kazuyo; Inoue, Gen; Suzuki, Munetaka; Takaso, Masashi; Orita, Sumihisa; Eguchi, Yawara; Ochiai, Nobuyasu; Kishida, Shunji; Kuniyoshi, Kazuki; Nakamura, Junichi; Aoki, Yasuchika; Ishikawa, Tetsuhiro; Arai, Gen; Miyagi, Masayuki; Kamoda, Hiroto; Takahashi, Kazuhisa

2010-07-01

258

Differential diagnosis of erosive osteochondrosis and bacterial spondylitis in MRI; Differentialdiagnose der erosiven Osteochondrose und bakteriellen Spondylitis in der Magnetresonanztomographie (MRT)  

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Purpose: To evaluate retrospectively criteria in the differential diagnosis of erosive osteochondrosis (EO) and infectious spondylitis (IS) on the basis of MRI. Methods: T{sub 1}-weighted sagittal images before and after Gd-DTPA application, T{sub 2}-weighted TSE or T-STIR images of 23 patients with proven IS and 41 patients with EO were evaluated. Criteria for this evaluation were morphology and extension of bone marrow edema, visibility of the low-intensity vertebral endplate, contrast enhancement and signal intensity in the disc space on T{sub 2}-weighted and T-STIR images. Results: Bone marrow edema was more extensive in IS than in EO. The mean rated value for bone marrow edema on a four-level scale (0-3) was for IS 2.91 ({+-}0.29), for EO 1.32 ({+-}0.76, p<0.001). In 37/41 cases of EO and in 22/23 cases of IS Gd-DTPA enhancement was found in the disc space (n.s.). In EO the low intensity endplate was visible in all parts in 36/41 cases (87.8%) on T{sub 1}-weighted images, in IS not in a single case (0%). On T{sub 2}-weighted or STIR images signal intensity of the discs was decreased in 82.1% of EO, 82.6% of segments in IS had water-equivalent signal intensity (p<0.001). Conclusion: If all the criteria are taken into consideration differential diagnosis of EO and IS on the basis of MRI findings is possible. (orig.) [Deutsch] Ziel: Diese retrospektive Auswertung soll Kriterien zur Differentialdiagnose erosiver Osteochondrosen (EO) und infektioeser Spondylodiszitiden (SD) mit der MR-Tomographie ergeben. Methode: T{sub 1}-gewichtete Aufnahmen ({+-}GT-DTPA) und T{sub 2}-gewichtete TSE- oder T-STIR-Aufnahmen von 23 Patienten mit infektioeser SD und 41 Patienten mit EO wurden ausgewertet. Beurteilt wurden die Ausdehnung von Knochenmarkoedemen, die Abgrenzbarkeit der signalarmen Abschlussplatte, die Kontrastmittelanreicherung und die Signalintensitaet (SI) im Zwischenwirbelraum. Ergebnisse: Oedeme waren bei SD ausgepraegter als bei EO. Der Mittelwert der von 0 bis 3 klassifizierten Oedemauspraegung betrug bei SD 2,91 ({+-}0,29), bei EO 1,32 ({+-}0,76, p<0,001). In 37/41 Faellen von EO und in 22/23 Faellen von SD bestand eine Gd-Anreicherung im Zwischenwirbelbereich (n.s.). Im T{sub 1}-gewichteten Bild war die Abschlussplatte bei EO in 36/41 Faellen (87,8%) durchgehend abgrenzbar, bei SD in keinem Fall (0%). Bei EO zeigten die Bandscheiben in 82,1% ein erniedrigtes Signal auf T{sub 2}-gewichteten oder T-STIR-Aufnahmen, bei SD entsprach die SI in 82,6% der von Wasser (p<0,001). Schlussfolgerung: Durch eine abwaegende Beruecksichtigung aller Kriterien ist eine Abgrenzung erosiver Osteochondrosen von infektioesen Spondylitiden in der MRT moeglich. (orig.)

Staebler, A.; Baur, A.; Helmberger, T.; Reiser, M. [Univ. Muenchen, Grosshadern (Germany). Inst. fuer Radiologische Diagnostik; Krueger, A. [Univ. Muenchen, Grosshadern (Germany). Klinik und Poliklinik fuer Orthopaedie; Weiss, M. [Univ. Muenchen, Grosshadern (Germany). Pathologisches Inst.

1998-05-01

259

Adverse Drug Reactions of Long-term Intravenous Antibiotics in Patients with Pyogenic Spondylitis  

Science.gov (United States)

Objective The purpose of this study was to investigate the incidence, cause, and influence of the adverse drug reactions (ADRs) associated with long-term intravenous antibiotics in patients with pyogenic spondylitis (PS). Methods We retrospectively reviewed the medical records of 84 patients with PS who underwent intravenous antibiotic therapy in our hospital from January 2001 to December 2012. ADRs were categorized to drug eruption, acute renal failure (ARF), hematologic toxicity, toxic hepatitis, pseudomembranous colitis (PMC), drug fever, and neuronal toxicity. Incidence and onset time of each ADR after antibiotic therapy were analyzed with the incidence of ADRs according to types of antibiotics. Results ADRs occurred in 38 of the 84 patients (incidence: 45.2%). The use of antibiotics was longer in the patients with ADRs (62.7 days) than in the patients without ADRs (44.3 day). The incidence of drug eruption, ARF, hematologic toxicity, toxic hepatitis, PMC, drug fever, and neuronal toxicity were 22.6, 11.9, 11.9, 10.7, 7.1, 3.6%, and 1.2%, respectively. The duration of antibiotics administration was related to the occurrence of PMC (p=0.001). ADRs were more common in patients treated by glycopeptides including vacomycin and teicoplanin. Conclusion The incidence of ADRs due to long-term intravenous antibiotics was as high as 45.2% in patients with PS. Therefore, we speculate that the possibility of delayed ADRs should be considered after long-term use of the antibiotics. Furthermore, close observation is mandatory to identify and treat ADRs promptly, even though PS revealed the improvement after antibiotic therapy. PMID:25346755

Kim, Dong Hwan; Kim, Hwan Soo; Nam, Kyoung Hyup; Choi, Byung Kwan

2014-01-01

260

Coexistencia de espondiloartritis psoriática y gota: a propósito de un caso / Coexistence of psoriatic spondylitis and gout: a case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish A pesar de la asociación frecuentemente aceptada entre psoriasis e hiperuricemia existen pocos reportes de gota en pacientes con psoriasis y muchos menos frecuente el reporte de la coexistencia de gota y artritis psoriática. Reportamos el caso de un paciente con diagnósticos de artritis gotosa y art [...] ritis psoriática variedad espondiloartritis, y resaltamos que es la primera vez que se reporta esta asociación en la literatura. Abstract in english Despite the commonly accepted association between psoriasis and hyperuricemia there are few reports of gout in patients with psoriasis and many less frequent reporting the coexistence of gout and psoriatic arthritis. We report a patient diagnosed with gouty arthritis and psoriatic arthritis, spondyl [...] arthritis variety, and we emphasize that it is the first time that this association is reported in the literature.

Mauricio, Restrepo Escobar; Luis Alonso, González Naranjo; Gloria María, Vásquez Duque.

2011-07-01

 
 
 
 
261

Coexistencia de espondiloartritis psoriática y gota: a propósito de un caso / Coexistence of psoriatic spondylitis and gout: a case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish A pesar de la asociación frecuentemente aceptada entre psoriasis e hiperuricemia existen pocos reportes de gota en pacientes con psoriasis y muchos menos frecuente el reporte de la coexistencia de gota y artritis psoriática. Reportamos el caso de un paciente con diagnósticos de artritis gotosa y art [...] ritis psoriática variedad espondiloartritis, y resaltamos que es la primera vez que se reporta esta asociación en la literatura. Abstract in english Despite the commonly accepted association between psoriasis and hyperuricemia there are few reports of gout in patients with psoriasis and many less frequent reporting the coexistence of gout and psoriatic arthritis. We report a patient diagnosed with gouty arthritis and psoriatic arthritis, spondyl [...] arthritis variety, and we emphasize that it is the first time that this association is reported in the literature.

Mauricio, Restrepo Escobar; Luis Alonso, González Naranjo; Gloria María, Vásquez Duque.

262

Diffusion-weighted MR imaging of bone marrow in the spine: differentiations of metastatic compression fracture, benign compression fracture and spondylitis  

International Nuclear Information System (INIS)

To determine the findings of diffusion-weighted magnetic resonance (MR) imaging of acute and chronic benign compression fracture, metastatic compression fracture, and spondylitis, and to differentiate between them. Forty-nine cases with vertebral compression fractures (17 metastatic, 16 acute osteoporotic, 11 old osteoporotic, 5 acute traumatic) and seven with spondylitis (4 tuberculous, 3 pyogenic) underwent MR imaging. All cases were classified as belonging to one of four groups: A: acute osteoporotic and traumatic, B: metastatic, C: old osteoporotic, or D: spondylitic. For MR imaging, a 1.5-T scanner (Magnetom Vision, Siemens, Erlangen, Germany) was used, and the diffusion-weighted imaging sequence was based on reversed fast imaging with steady-state precession (PSIF) and a relatively low b value of about 150 sec/mm2. Signal intensity characteristics were evaluated in terms of the contrast ratio (CR) and signal-to-noise ratio (SNR) of bone marrow. Diffusion-weighted MR imaging showed that signal intensity in group A was hypointense to adjacent normal vertebral bodies, but in group B, hyperintensity was noted. In group C, signal intensity was variable, while in group D, hyperintensity was again noted. Diffusion-weighted imaging revealed that in group A, bone marrow CR had a negative value, while in groups B and D, this value was positive (p less than 0.01). The SNR of group D was lower than that of group B, but the difference was not statistically significant (p greater than 0.01). Diffusion-weighted MR imaging revealed that the signal intensity of metastatic compression fracture and spondylitis was hyperintense to adjacent normal vertebral bodies, that of acute benign compression fracture was hypointense, and that of chronic benign compression fracture was variable. This modality is therefore useful for differentiating between metastatic compression fracture, spondylitis and acute benign compression fracture. (author)

263

Reduktion des gastrointestinalen Risikos in Parallelität zur verminderten Schmerzmedikatin nach wiederholter Radonstollentherapie bei Spondylitis ankylosans - 12-Jahres-Follow-up einer kontrollierten prospektiven Studie  

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Full Text Available Ziel der vorliegenden kontrollierten prospektiven Untersuchung ist die Beobachtung des langfristigen Einflusses von wiederholter Radonstollentherapie bei Patienten mit Spondylitis ankylosans auf deren Verbrauch an NSAR und auf die Häufigkeit gastrointestinaler Komplikationen. 100 Probanden mit gesicherter Spondylitis ankylosans und wiederholten Reha-Behandlungen wurden im Rahmen eines Langzeit-Follow-ups über 12 Jahre zu NSAR-Verbrauch (Einnahmetage/Woche und zu durchgemachten gastrointestinalen Komplikationen mit der Folge eines stationären Krankenhausaufenthaltes befragt. Weiter wurden die gastrointestinale Diagnostik und die Einnahme von PPIs sowie diverse soziodemographische und weitere medizinisch relevante Parameter erfragt. Die Prüfgruppe mit 49 Probanden und die Kontrollgruppe mit 51 Probanden führten jeweils etwa 6 Reha-Maßnahmen in den vergangenen 12 Jahren durch, die Prüfgruppe erhielt dabei zusätzlich Radonstollentherapie. Die Häufigkeit der Einnahme von NSAR (inkl. Coxibe sank im Vergleich zum Ausgangspunkt vor 12 Jahren ausschließlich in der regelmäßig mit Radonstollentherapie behandelten Prüfgruppe (p 0,05. Der Prozentsatz von Probanden mit schweren gastrointestinalen Komplikationen mit der Folge des Krankenhausaufenthaltes war in der Kontrollgruppe mit 18 % deutlich höher als in der Prüfgruppe mit 5%. Blutungen des Magens oder Darms wurden ausschließlich in der Kontrollgruppe berichtet. Offensichtlich führt also die regelmäßig wiederholte Radonstollentherapie für Patienten mit Spondylitis ankylosans zu einer langfristig verminderten NSAR-Einnahme und konsekutiv reduzierter gastrointestinaler Komlaktionsrate.

Lind-Albrecht G

2007-01-01

264

MR spectroscopy findings in tuberculous spondylitis; comparison with Modic type-I end-plate changes and metastatic vertebral disease  

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Purpose: To define single-voxel proton magnetic resonance spectroscopy (MRS) findings of vertebral tuberculous spondylitis (TBS), Modic type-I end-plate changes (MTEC) and metastatic vertebral disease (MVD). Materials and methods: Fifteen patients with TBS, 15 with MTEC and 15 with MVD were included. MRS from the diseased vertebral body as well as normal vertebral body was examined. Water and lipid peak were measured, water-to-lipid ratio (WLR) and for each patient lesion water index (LWI, the ratio of WLRs from diseased to normal vertebrae) were calculated. Results: The mean WLR of normal and pathologic vertebra was 0.91 and 7.13 in TBS group, 0.84 and 3.49 in MTEC group and 0.65 and 3.17 in MVD group, respectively. The mean LWI was 10.68 in TBS, 6.04 in MTEC and 6.42 MVD groups. Statistical significance was not achieved between the WLR and LWI of the TBS, MTEC nor MVD group (p > 0.05). Conclusion: The mean values of WLR and LWI in the TBS group are relatively higher than MTEC and MVD groups, with the difference being statistically insignificant.

Anik, Yonca [Kocaeli University, School of Medicine, Department of Radiology, 41380 Umuttepe, Kocaeli (Turkey)], E-mail: yoncaanik@yahoo.com; Ciftci, Ercument; Sarisoy, Hasan Tahsin; Akansel, Guer; Demirci, Ali [Kocaeli University, School of Medicine, Department of Radiology, 41380 Umuttepe, Kocaeli (Turkey); Anik, Ihsan [Kocaeli University, School of Medicine, Department of Neurosurgery, 41380 Umuttepe, Kocaeli (Turkey); Buluc, Levent [Kocaeli University, School of Medicine, Department of Orthopedics and Traumatology, 41380 Umuttepe, Kocaeli (Turkey); Ilgazli, Ahmet [Kocaeli University, School of Medicine, Department of Chest Disease, 41380 Umuttepe, Kocaeli (Turkey)

2009-08-15

265

MR spectroscopy findings in tuberculous spondylitis; comparison with Modic type-I end-plate changes and metastatic vertebral disease  

International Nuclear Information System (INIS)

Purpose: To define single-voxel proton magnetic resonance spectroscopy (MRS) findings of vertebral tuberculous spondylitis (TBS), Modic type-I end-plate changes (MTEC) and metastatic vertebral disease (MVD). Materials and methods: Fifteen patients with TBS, 15 with MTEC and 15 with MVD were included. MRS from the diseased vertebral body as well as normal vertebral body was examined. Water and lipid peak were measured, water-to-lipid ratio (WLR) and for each patient lesion water index (LWI, the ratio of WLRs from diseased to normal vertebrae) were calculated. Results: The mean WLR of normal and pathologic vertebra was 0.91 and 7.13 in TBS group, 0.84 and 3.49 in MTEC group and 0.65 and 3.17 in MVD group, respectively. The mean LWI was 10.68 in TBS, 6.04 in MTEC and 6.42 MVD groups. Statistical significance was not achieved between the WLR and LWI of the TBS, MTEC nor MVD group (p > 0.05). Conclusion: The mean values of WLR and LWI in the TBS group are relatively higher than MTEC and MVD groups, with the difference being statistically insignificant.

266

38 CFR Appendix B to Part 4 - Numerical Index of Disabilities  

Science.gov (United States)

...Lumbosacral or cervical strain.5238 Spinal stenosis.5239 Spondylolisthesis...Ankylosing spondylitis.5241 Spinal fusion.5242 Degenerative arthritis...Diaphragm paralysis or paresis. 6841Spinal cord injury with respiratory...

2010-07-01

267

38 CFR Appendix B to Part 4 - Numerical Index of Disabilities  

Science.gov (United States)

...instability.5240 Ankylosing spondylitis.5241 Spinal fusion.5242 Degenerative arthritis.5243 Intervertebral...Varicose veins.7121 Post-phlebitic syndrome.7122 Cold injury residuals.7123 Soft tissue sarcoma.THE...

2010-07-01

268

Indomethacin  

Science.gov (United States)

Indomethacin is used to relieve moderate to severe pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis ... ankylosing spondylitis (arthritis that mainly affects the spine). Indomethacin is also used to treat pain in the ...

269

Early Algebra, Early Arithmetic  

Science.gov (United States)

This site offers a variety of early algebra resources for teachers in grades 1-6, parents, researchers, policy makers, administrators, and curriculum developers. Site includes early algebra activities, handouts and overheads in PDF format (requires Acrobat Reader), articles, short reviews of articles and books focusing on early math and early algebra, news and events, and more. A valuable source for pre algebra activities in the elementary classroom.

National Science Foundation (NSF); Terc

2007-12-12

270

Diagnosis of infective spondylitis. Value of bone marrow scintiscans using 99mTc-labelled monoclonal granulocyte antibodies in combination with 99mTc-DPD bone scintiscanning  

International Nuclear Information System (INIS)

The diagnostic detection of infective spondylitis can be difficult and requires a combination of clinical examinations, laboratory findings, and the findings of imaging methods. Nuclear medicine and magnetic resonance imaging are the most important methods. Nevertheless, conventional radiography is in first place on the list of applicable diagnostic methods. The study reported covers 24 consecutive patients (13 women and 11 men, aged between 30 and 86), accepted as in-patients for suspected infective spondylitis. The results show that the scintiscanning data revealing enhanced accumulation in bone scintiscans together with the corresponding cold lesion in bone marrow scans are reliable signs indicating an infection of the vertrebral disc and of the neighbouring vertebral bodies. The scintiscans are easy to perform and can be considered as an alternative modality of other nuclear-medicine methods or of MRI in patients with unknown localisation of infection, or suspected multiple infections. It also is a valuable alternative to MRI for patients who cannot be examined by MRI. (orig./MG)

271

Radiological observation of the tuberculous spondylitis - The relationship between the duration of the disease and the degree of the involvement of the vertebral body -  

International Nuclear Information System (INIS)

The spine is the most common site of skeletal tuberculosis. It is still common disease in our country although recent advanced therapy developed with the many preventive medicine. 49 cases of tuberculous spondylitis, proved at the Chosun University Hospital, during period of Aug. 1973 to Aug. 1979, were reviewed. The results were as follows: 1. The sex ratio between male to female was 1 : 1.4. Age distribution showed that the group below 10 years was 12%. 2. The ratio between urban and rural was 1 : 5. 3. The most frequent site of the involvement was lumbar spine (40.8%). The next was thoracic (28.6%), thoracolumbar (10.2%), lumbosacral (8.2%), sacroilia (8.2%), cervical (2.0%), and sacral (2.0%). 4. 51.0 percent was associated with pulmonary tuberculosis and 56.0 percent of them reveal active pulmonary tuberculosis. 5. The major roentgenographic findings were remarkable with destruction of the intervertebral body (91.1%), narrowing of the intervertebral space (81.6%), kyphosis (75.5%), collapse of the vertebral body (77.6%), cold abscess (65.3%), calcification of the adjacent area (18.4%), formation of the osteophyte (18.4%). 6. There was no relationship between the duration of the disease and the degree of the involvement of the vertebral body

272

Scintigraphy of sacroliac joints in acute anterior uveitis. A study of thirty patients  

Energy Technology Data Exchange (ETDEWEB)

HLA-B27 is a transplantation antigen found in a high proportion of patients with ankylosing spondylitis. Recently, an association has been shown to exist between HLA-B27 and acute uveitis, even in the absence of ankylosing spondylitis. We have examined the HLA antigen profile of 45 patients with acute nongranulomatous anterior uveitis and have confirmed this relation. In addition, using 90m technetium stannous pyrophosphate we have been able to demonstrate abnormal bone scan in 19 of 30 patients studied. Such abnormalities are limited to the sacroiliac joints but are otherwise the same as those seen in overt ankylosing spondylitis. Seven of the 19 patients did not have HLA-B27. These factors suggest that acute anterior uveitis may often represent a manifestation of a spondylitic diathesis even in the complete absence of any suggestive symptomatic or radiologic change and, in some cases, even through the antigenic marker HLA-B27 may be absent.

Russell, A.S.; Lentle, B.C.; Percy, J.S.; Jackson, F.I.

1976-11-01

273

Scintigraphy of sacroliac joints in acute anterior uveitis. A study of thirty patients  

International Nuclear Information System (INIS)

HLA-B27 is a transplantation antigen found in a high proportion of patients with ankylosing spondylitis. Recently, an association has been shown to exist between HLA-B27 and acute uveitis, even in the absence of ankylosing spondylitis. We have examined the HLA antigen profile of 45 patients with acute nongranulomatous anterior uveitis and have confirmed this relation. In addition, using 90m technetium stannous pyrophosphate we have been able to demonstrate abnormal bone scan in 19 of 30 patients studied. Such abnormalities are limited to the sacroiliac joints but are otherwise the same as those seen in overt ankylosing spondylitis. Seven of the 19 patients did not have HLA-B27. These factors suggest that acute anterior uveitis may often represent a manifestation of a spondylitic diathesis even in the complete absence of any suggestive symptomatic or radiologic change and, in some cases, even through the antigenic marker HLA-B27 may be absent

274

Instrumentação anterior da coluna em espondilite tuberculosa mal de pott: Relato de caso Anterior instrumentation in tuberculous spondylitis (Pott's disease: case report  

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Full Text Available Relatamos caso de tratamento cirúrgico com instrumentação anterior em espondilite tuberculosa (mal de Pott, em mulher de 71 anos, que se encontrava em tratamento para tuberculose na forma pulmonar e evoluiu com dor lombar, dificuldade progressiva para deambular, cifose e disfunção vesical. A ressonância magnética revelou lesão nos corpos vertebrais de T12 e L1 com abcesso paravertebral. A paciente foi tratada cirurgicamente por acesso tóraco-abdominal lateral. Os corpos vertebrais foram ressecados, foi instalado uma gaiola vertical (mesh cage e a coluna foi estabilizada com placa lateral (Z plate e parafusos fixados em T11 e L2. Essa técnica permite boa artrodese dos corpos vertebrais remanescentes e boa estabilidade da coluna, sem comprometer a eficácia dos tuberculostáticos. A paciente foi avaliada um ano após a operação e não apresentava déficit motor, dor residual e a cifose foi desfeita.We report a case of a surgical treatment with anterior instrumentation in tuberculous spondylitis (Pott's disease, in a 71 years old woman, that was in treatment for pulmonary tuberculosis, with lumbar pain, progressive disability to walk, kyphotic deformit and vesical dysfunction. Magnetic resonance image presents a lesion in the bodies of T12 and L1, with paravertebral abscess. The patient was treated surgically by transthoracic-abdominal approach. The vertebral bodies were cut off and the spine were instrumented anteriorly with a mesh cage and a Z plate. This procedure permits a good arthrodesis and a immediately stabilization of the spine, without any complication of the infection. The patient was seen a year after the surgery and is free of infection, without motor deficit, pain or reminiscent kyphosis.

Luciano Farage

2002-03-01

275

Early intervention.  

Science.gov (United States)

This paper provides an overview of the critical nced for early intervention services, the specific role of occupational therapists in early intervention settings, and the training implications for the preparation of occupational Therapists with expanded roles, responsibilities and skills. An intervention approach that is multidisciplinary, culturally relevant, and family centered in nature is proposed as one way of redefining the occupational therapist's contribution and strategy in early intervention settings. Recommendations are presented regarding the education and preparation of occupational thera ists for their new directions in early intervention and the potenliarincrease in demands for their services. PMID:23941481

Schaaf, R C; Gitlin, L N

1989-01-01

276

IMAGING OF PSORIATIC ARTHRITIS  

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Full Text Available Imaging of psoriatic arthritis (PsA is important for two reasons: the differential diagnosis from other arthritides and the assessment of structural damage that can be inhibited by the new drugs such as the anti-TNF? agents. Plain film radiographic findings of peripheral arthritis have been important in elaborating the concept of PsA as a separate disease entity. Characteristic aspects of psoriatic peripheral arthritis help the differentiation from rheumatoid arthritis. High-resolution ultrasonography (US, US combined with power Doppler (PDUS and magnetic resonance imaging (MRI can be used to image joint synovitis of PsA. Radiologic features of spondylitis associated with psoriasis are similar to spondylitis associated with reactive arthritis and differ from those of primary ankylosing spondylitis (AS and the spondylitis associated with inflammatory bowel disease. MRI is very sensitive for the early diagnosis of sacroiliitis. There have been no MRI studies on the spine of patients with PsA. In primary AS bone oedema in the vertebral bodies is an indicator of active disease and can ameliorate during anti-TNF? therapy. Historically, plain film radiography have played a pivotal role in defining enthesitis lesions of SpA. However, entheseal bone changes appear late. US and MRI have proved to be a highly sensitive and non invasive tools. Recent US and MRI studies on both finger and toe dactylitis have established that dactylitis is due to flexor tenosynovitis and marked adjacent soft tissue swelling with a variable degree of small joint synovitis. There is no evidence of enthesitis of the insertion of the flexor digitorum tendons and of the attachment of the caspsule of the digit joints. Key words: Enthesitis, dactylitis, spondyloarthritis, ultrasound, magnetic resonance, imaging

S. D'Angelo

2011-09-01

277

Value of contrast-enhanced ultrasound in rheumatoid arthritis  

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The purpose of this review is to describe the spectrum of sonographic findings in rheumatic diseases with respect to the diagnostic potential using US contrast media which prove activity or inactivity in synovial tissue where new treatment regimes target. Synovial activity can be found in non-erosive and erosive forms of primary and secondary osteoarthritis, and in inflammatory forms of joint diseases like rheumatoid arthritis and peripheral manifestations of spondyloarthritis including, ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis and enteropathic arthritis. It can also be present in metabolic and endocrine forms of arthritis, in connective tissue arthropathies like systemic lupus erythematosus or scleroderma and in infectious arthritis. Ultrasound should be used as first-line imaging modality in suspected early cases of RA and other forms of arthritis, whereas contrast-enhanced ultrasound (CEUS) can further enable for sensitive assessment of vascularity which correlates with disease activity.

Zordo, Tobias de; Mlekusch, Sabine P.; Feuchtner, Gudrun M. [Department of Radiology II, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria); Mur, Erich [Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria); Schirmer, Michael [Department of Internal Medicine, Hospital of the Elisabethines Klagenfurt, Voelkermarkter Strasse 15-19, 9020 Klagenfurt (Austria); Klauser, Andrea S. [Department of Radiology II, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria)], E-mail: andrea.klauser@i-med.ac.at

2007-11-15

278

Value of contrast-enhanced ultrasound in rheumatoid arthritis  

International Nuclear Information System (INIS)

The purpose of this review is to describe the spectrum of sonographic findings in rheumatic diseases with respect to the diagnostic potential using US contrast media which prove activity or inactivity in synovial tissue where new treatment regimes target. Synovial activity can be found in non-erosive and erosive forms of primary and secondary osteoarthritis, and in inflammatory forms of joint diseases like rheumatoid arthritis and peripheral manifestations of spondyloarthritis including, ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis and enteropathic arthritis. It can also be present in metabolic and endocrine forms of arthritis, in connective tissue arthropathies like systemic lupus erythematosus or scleroderma and in infectious arthritis. Ultrasound should be used as first-line imaging modality in suspected early cases of RA and other forms of arthritis, whereas contrast-enhanced ultrasound (CEUS) can further enable for sensitive assessment of vascularity which correlates with disease activity

279

Magnetic resonance imaging in spondyloarthritis--how to quantify findings and measure response  

DEFF Research Database (Denmark)

Sensitive and reliable tools for monitoring disease activity and damage, and for prognostication, are essential in the management of patients with spondyloarthritis, including ankylosing spondylitis and psoriatic arthritis. Magnetic resonance imaging (MRI) allows direct visualisation of inflammation in peripheral and axial joints, and peripheral and axial entheses, and has dramatically improved the possibilities for early diagnosis and objective monitoring of the disease process in spondyloarthritis. Truthful, discriminative and feasible scoring systems are available for the assessment of inflammatory activity in the spine and sacroiliac joints in axial spondyloarthritis and in the hands of patients with peripheral psoriatic arthritis. Various systems for assessment of damage in axial and peripheral joints are available, but further studies are needed to document their value in clinical trials and clinical practice. The present article reviews key aspects of the status and recent important advances in MRI in spondyloarthritis, focussing on available MRI tools for assessing activity and damage in peripheral and, particularly, axial joints.

Østergaard, Mikkel; Poggenborg, René Panduro

2010-01-01

280

Usefulness of postoperative hip irradiation in the prevention of heterotopic bone formation in a high risk group of patients  

International Nuclear Information System (INIS)

Heterotopic ossification is a complication of total hip arthroplasty in 14 to 30% of patients. Significant functional impairment will occur in up to 28% of patients with ectopic bone. The high risk group includes those with preexisting heterotopic bone in either hip, those suffering from hypertrophic osteoarthritis or ankylosing spondylitis and patients who have had multiple procedures on the hip. Fifty-eight patients (67 hips) were irradiated after surgical removal of ectopic bone (53 hips) or received radiation prophylaxis of heterotopic ossification (14 hips). Ninety-five percent of patients had either no bone visible or insignificant amounts of ectopic bone visible on postoperative hip X-rays. Only 5% of patients showed significant persistence of ectopic bone. Postoperative hip function was dramatically improved compared to preoperative function in all patients treated. The importance of early commencement of irradiation is emphasized

 
 
 
 
281

Magnetic resonance imaging of the joints: a revolution for the practicing rheumatologist  

Directory of Open Access Journals (Sweden)

Full Text Available In the last 15 years, new imaging techniques have changed the life of practicing rheumatologists in terms of both diagnostic approach and knowledge of disease mechanisms. Clinical symptoms, disease signs and the results of physical examination have been more closely related to their anatomical basis. In particular, magnetic resonance imaging allow diagnosis of disease in its early phase and its follow-up with a previously unknown sensitivity. Novel imaging studies have contributed to elucidate several pathogenetic mechanisms in musculoskeletal diseases, such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, polymyalgia rheumatica and osteoarthritis; allow evaluation of the real degree of joint inflammation, which is often uncoupled from clinical signs; and possibly reduce the need for large clinical trials. In conclusion, new imaging techniques and refinements of the established techniques have opened exciting perspectives in our understanding and treatment of many rheumatic diseases. Much attention should be paid to the training of new generations of rheumatologists in this field.

M.A. Cimmino

2011-09-01

282

Update on the use of etanercept across a spectrum of rheumatoid disorders  

Directory of Open Access Journals (Sweden)

Full Text Available Bernard CombeService d’Immuno-Rhumatologie, Montpellier, FranceAbstract: Etanercept is a soluble TNF receptor p75 fusion protein which is approved for subcutaneous use (50 mg weekly in the treatment of patients with active rheumatoid arthritis (RA, juvenile RA, ankylosing spondylitis, and psoriatic arthritis. Etanercept binds to both TNF? and lymphotoxin and has quite a short mean half-life (70 hours. Numerous randomized clinical trials have demonstrated its efficacy to improve signs and symptoms in early and established RA and other inflammatory arthritis. Furthermore, etanercept has shown its ability to prevent radiographic progression and to improve health-related quality of life in patients with RA and psoriatic arthritis. A combination of etanercept plus methotrexate was more efficacious than etanercept monotherapy in RA patients but there is currently no evidence that such rheumatic combination is better than monotherapy in other disorders. Etanercept was generally well tolerated both in controlled trials with withdrawal rates being similar to the comparator groups and in large observational studies. Infections and injection-site reactions were the most frequently reported events. Serious infections were slightly increased but the occurrence of tuberculosis seemed less frequent than with anti-TNF monoclonal antibodies (infliximab and adalimumab. The benefit-risk ratio of etanercept appeared to be very positive, and this drug has now emerged as a major therapy in patients with active inflammatory arthritis. Furthermore, it is more frequently considered as an emerging and valuable option in patients with early disease.Keywords: etanercept, TNF blockers, rheumatoid arthritis, juvenile rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis

Bernard Combe

2008-06-01

283

What epidemiology has told us about risk factors and aetiopathogenesis in rheumatic diseases  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This article will review how epidemiological studies have advanced our knowledge of both genetic and environmental risk factors for rheumatic diseases over the past decade. The major rheumatic diseases, including rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, systemic lupus erythematosus, scleroderma, osteoarthritis, gout, and fibromyalgia, and chronic widespread pain, will be covered. Advances discussed will include how a number of large pro...

Oliver, Jacqueline E.; Silman, Alan J.

2009-01-01

284

38 CFR 4.71a - Schedule of ratings-musculoskeletal system.  

Science.gov (United States)

...motion for each component of spinal motion provided in this note...root stretching. Fixation of a spinal segment in neutral position...5240Ankylosing spondylitis 5241Spinal fusion 5242Degenerative arthritis...is present in more than one spinal segment, provided that...

2010-07-01

285

The management of benign conditions  

International Nuclear Information System (INIS)

The author reviews in outline his experience with radiotherapy for the following benign conditions: ankylosing spondylitis, rheumatoid arthritis, relapsing polychondritis, minor musculoskeletal disorders, after hip-joint surgery ossification, polymyositis, menorrhagia, treatment of keloid, benign conditions of the cornea, haemangioma, epilation, herpes zoster, gynaecomastia, tuberculous lymph nodes, salivary fistula. (U.K.)

286

Drug: D10161 [KEGG MEDICUS  

Full Text Available D10161 Drug Sarilumab (USAN) C6388H9918N1718O1998S44 144073.5003 144162.2723 (Heavy chain) EVQLV ... L'88, L'134-L'194) Peptide Treatment of rheumatoid arthritis ... and ankylosing spondylitis Monoclonal antibody int ...

287

How early should psoriatic arthritis be treated with a TNF-blocker?  

LENUS (Irish Health Repository)

PURPOSE OF REVIEW: Psoriatic arthritis (PsA) is the second most commonly identified inflammatory arthropathy in early arthritis clinics. It is a complex multisystem disease involving the skin and joints, but may also present with inflammation of the spine - spondylitis, digits - dactylitis, eyes - uveitis and ligamentous insertions - enthesitis. The skin manifestations may be mild or patchy and often precede the joint inflammation. Joint erosions, however, may occur within the first 2 years in up to half of PsA patients and an erosion rate of 11% per annum has been reported suggesting it is not a benign disease as it was once regarded. RECENT FINDINGS: Therapy with mild anti-inflammatories is only beneficial in very mild or localized disease. In cases of more widespread joint involvement systemic therapy with disease-modifying antirheumatic drugs (DMARDs) such as methotrexate may be required and in the case of extra-articular or spinal disease, in which DMARDs have failed to show efficacy, biologic therapy may be highly effective. SUMMARY: The question of how early treatment should be instituted should be decided in a specialist rheumatology referral centre following appropriate assessment. Optimal therapy with combination DMARD and biologics may result in remission rates of up to 60%.

Harty, Leonard

2012-02-01

288

life in early times  

Life in Early Times The World Around Us Lets Explore Life in Early Times Life in Early Times The World Around Us Let's explore Life in Early Times Life in Early Times www.ni-environment.gov.uk www.ni-environment.gov.uk ...

289

Espondilitis tuberculosa en adultos: revisión de una serie de casos en un hospital de tercer nivel, Lima-Perú / Tuberculous spondylitis in adults: a case series from a reference hospital in Lima, Peru  

Scientific Electronic Library Online (English)

Full Text Available SciELO Peru | Language: Spanish Abstract in spanish Describimos las características clínicas y demográficas en pacientes adultos con espondilitis tuberculosa así como un análisis exploratorio que buscó establecer características que contribuyeron al desarrollo de esta enfermedad, en un hospital de tercer nivel de Lima. Realizamos un estudio tipo seri [...] e de casos y describimos 33 casos recolectados entre 1999-2009. 18 pacientes (55%) fueron varones, la media de edad fue 31 años (IQ 23 a 51 años) y un tiempo de enfermedad de 3 meses (IQ 1 a 8 meses). El principal síntoma fue lumbalgia en 28 (85%). Los segmentos más comprometidos fueron el torácico en 28 (60%) casos y lumbar en 13 (28%). Tuberculosis pulmonar se encontró en 14 (42%) casos. Veinticuatro (73%) recibieron esquema I. La duración de tratamiento fue 10,5 ± 4,2 meses . Las características clínicas, diagnósticas fueron similares a series nacionales previas e internacionales. Abstract in english We describe the demographic and clinical characteristics of adult patients with tuberculous spondylitis as well as an exploratory analysis that seeked to establish patient characteristics that contributed to the development of this disorder at a reference hospital in Lima. This is a case-series desc [...] riptive study where data collection from 33 medical records of patients from 1999 to 2009 was done. Eighteen (55%) were male. Median age was 31 years (IQR 23 to 51 years). Median time of symptoms was 3 months (IQR 1 to 8 months). The most frequent symptom was back pain in 28 (85%). The most frequently affected areas were the thoracic spine involved in 28 (60%) cases and lumbar spine in 13 (28%). Pulmonary tuberculosis was present in fourteen (42%) cases. Twenty four (73%) patients received first line treatment. Treatment duration was 10.5 ± 4.2 months. Clinical and diagnostic characteristics were similar to previous Peruvian case reports and current literature.

Manuel, Castillo-Angeles; Celso, De la Cruz Luque; Henry, Zelada; Ana Rosa, Vilela-Sangay; Frine, Samalvides; Germán, Málaga.

2011-06-01

290

Espondilitis tuberculosa en adultos: revisión de una serie de casos en un hospital de tercer nivel, Lima-Perú / Tuberculous spondylitis in adults: a case series from a reference hospital in Lima, Peru  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: Spanish Abstract in spanish Describimos las características clínicas y demográficas en pacientes adultos con espondilitis tuberculosa así como un análisis exploratorio que buscó establecer características que contribuyeron al desarrollo de esta enfermedad, en un hospital de tercer nivel de Lima. Realizamos un estudio tipo seri [...] e de casos y describimos 33 casos recolectados entre 1999-2009. 18 pacientes (55%) fueron varones, la media de edad fue 31 años (IQ 23 a 51 años) y un tiempo de enfermedad de 3 meses (IQ 1 a 8 meses). El principal síntoma fue lumbalgia en 28 (85%). Los segmentos más comprometidos fueron el torácico en 28 (60%) casos y lumbar en 13 (28%). Tuberculosis pulmonar se encontró en 14 (42%) casos. Veinticuatro (73%) recibieron esquema I. La duración de tratamiento fue 10,5 ± 4,2 meses . Las características clínicas, diagnósticas fueron similares a series nacionales previas e internacionales. Abstract in english We describe the demographic and clinical characteristics of adult patients with tuberculous spondylitis as well as an exploratory analysis that seeked to establish patient characteristics that contributed to the development of this disorder at a reference hospital in Lima. This is a case-series desc [...] riptive study where data collection from 33 medical records of patients from 1999 to 2009 was done. Eighteen (55%) were male. Median age was 31 years (IQR 23 to 51 years). Median time of symptoms was 3 months (IQR 1 to 8 months). The most frequent symptom was back pain in 28 (85%). The most frequently affected areas were the thoracic spine involved in 28 (60%) cases and lumbar spine in 13 (28%). Pulmonary tuberculosis was present in fourteen (42%) cases. Twenty four (73%) patients received first line treatment. Treatment duration was 10.5 ± 4.2 months. Clinical and diagnostic characteristics were similar to previous Peruvian case reports and current literature.

Manuel, Castillo-Angeles; Celso, De la Cruz Luque; Henry, Zelada; Ana Rosa, Vilela-Sangay; Frine, Samalvides; Germán, Málaga.

2011-06-01

291

Espondilitis tuberculosa en adultos: revisión de una serie de casos en un hospital de tercer nivel, Lima-Perú Tuberculous spondylitis in adults: a case series from a reference hospital in Lima, Peru  

Directory of Open Access Journals (Sweden)

Full Text Available Describimos las características clínicas y demográficas en pacientes adultos con espondilitis tuberculosa así como un análisis exploratorio que buscó establecer características que contribuyeron al desarrollo de esta enfermedad, en un hospital de tercer nivel de Lima. Realizamos un estudio tipo serie de casos y describimos 33 casos recolectados entre 1999-2009. 18 pacientes (55% fueron varones, la media de edad fue 31 años (IQ 23 a 51 años y un tiempo de enfermedad de 3 meses (IQ 1 a 8 meses. El principal síntoma fue lumbalgia en 28 (85%. Los segmentos más comprometidos fueron el torácico en 28 (60% casos y lumbar en 13 (28%. Tuberculosis pulmonar se encontró en 14 (42% casos. Veinticuatro (73% recibieron esquema I. La duración de tratamiento fue 10,5 ± 4,2 meses . Las características clínicas, diagnósticas fueron similares a series nacionales previas e internacionales.We describe the demographic and clinical characteristics of adult patients with tuberculous spondylitis as well as an exploratory analysis that seeked to establish patient characteristics that contributed to the development of this disorder at a reference hospital in Lima. This is a case-series descriptive study where data collection from 33 medical records of patients from 1999 to 2009 was done. Eighteen (55% were male. Median age was 31 years (IQR 23 to 51 years. Median time of symptoms was 3 months (IQR 1 to 8 months. The most frequent symptom was back pain in 28 (85%. The most frequently affected areas were the thoracic spine involved in 28 (60% cases and lumbar spine in 13 (28%. Pulmonary tuberculosis was present in fourteen (42% cases. Twenty four (73% patients received first line treatment. Treatment duration was 10.5 ± 4.2 months. Clinical and diagnostic characteristics were similar to previous Peruvian case reports and current literature.

Manuel Castillo-Angeles

2011-06-01

292

Nurses in early intervention.  

Science.gov (United States)

The number of children from ages birth to 3 in need of early intervention services has increased over the past decades. A family-centered approach to early intervention services is essential. The family-centered approach emerged from early intervention philosophy developed by professionals in response to the needs of children and families. The historical perspective of early intervention and family-centered care, the role of nurses in early intervention and suggested focus of future research are outlined. PMID:8700607

Collin, R M

1995-01-01

293

Early Childhood Systems: Transforming Early Learning  

Science.gov (United States)

In this seminal volume, leading authorities strategize about how to create early childhood systems that transcend politics and economics to serve the needs of all young children. The authors offer different interpretations of the nature of early childhood systems, discuss the elements necessary to support their development, and examine how…

Kagan, Sharon Lynn, Ed.; Kauertz, Kristie, Ed.

2012-01-01

294

Comments on radiology of the 'seronegative spondylarthritides'  

International Nuclear Information System (INIS)

Besides the common factors characterizing the diseases in the group of the seronegative spondylarthritides, a further radiological feature, namely, inflammatory enthesiopathy, is described. The article points to the problems connected with the radiological visualisation of the sacroiliac joints. An explanation of the radiological 'stepwise diagnosis' of the sacroiliac joints is given. The classification of the types of ankylosing spondylitis after Schilling is demonstrated. Comments are made on the chronic Reiter's syndrome (Reiter's disease), on spondylitis psoriatica, enteropathies, and on Behcet's syndrome. (orig./MG)

295

Comments on radiology of the 'seronegative spondylarthritides'  

Energy Technology Data Exchange (ETDEWEB)

Besides the common factors characterizing the diseases in the group of the seronegative spondylarthritides, a further radiological feature, namely, inflammatory enthesiopathy, is described. The article points to the problems connected with the radiological visualisation of the sacroiliac joints. An explanation of the radiological 'stepwise diagnosis' of the sacroiliac joints is given. The classification of the types of ankylosing spondylitis after Schilling is demonstrated. Comments are made on the chronic Reiter's syndrome (Reiter's disease), on spondylitis psoriatica, enteropathies, and on Behcet's syndrome.

Schacherl, M.; Stollenwerk, R.

1981-09-01

296

Early breast cancer  

International Nuclear Information System (INIS)

Breast cancer remains a common disease throughout the world. Here we review new knowledge about early breast cancer obtained during the past 5 years. The prognosis of early breast cancer is generally favorable. Especially, ductal carcinoma in situ has been regarded as a non-life-threatening disease. Therefore, early diagnosis and early onset of the treatment has been important. Early age at menarche, late age at first birth, and late age at menopause are related to breast cancer risk. Examination by mammography and ultrasonography is still the most effective means of detection for premenopausal and postmenopausal women, respectively. Additionally, there have been important advances in MRI, sentinel lymph node biopsy, breast-conserving surgery, partial breast irradiation, neoadjuvant systemic therapy, and adjuvant systemic therapy. Another approach to keeping the disease under control is the elucidation of breast cancer's molecular biological features. Assessment of potential molecular targets can lead to early diagnosis and molecular targeted treatment. (author)

297

Determination of the uptake rates of the bone for 99m-Tc-methylendiphosphonate by means of gamma-camera-scintiscanning and checking its diagnostic value for various skeleton diseases  

International Nuclear Information System (INIS)

A model of uptake of labelled phosphate in the bones was used to derive a method of calculating the uptake rates for 99m-Tc-MDP. The precondition was the measurement of the change in radioactivity by means of a gamma camera within the lumbal part of the spine over 1 hour. The method was applied on 49 patients (7 with healthy bones, 6 cases of hyperparathyreoidism, 10 of osteoprosis, 9 cases of osteomalacia, 1 case of hypoparathyreoidism, 10 cases of ankylosing spondylitis, 6 tumours affecting the skeleton). Osteomalacia, ankylosing spondylitis, tumours, and, in 50% of the cases, hyperparathyreoidism could be differentiated from normal findings more significantly than using conventional scintiscanning. The author's expectations were met by the method. It is suitable for diagnosing metabolic osteopathis and controlling therapy in circumscribed bone foci. (orig.)

298

Diagnosis and treatment of enthesitis-related arthritis  

Directory of Open Access Journals (Sweden)

Full Text Available Pamela F WeissDivision of Rheumatology and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Departments of Pediatrics and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA, USAAbstract: Juvenile idiopathic arthritis (JIA is a chronic, inflammatory disease of unknown etiology. The enthesitis-related arthritis (ERA JIA category describes a clinically heterogeneous group of children including some who have predominately enthesitis, enthesitis and arthritis, juvenile ankylosing spondylitis, or inflammatory bowel disease-associated arthropathy. ERA accounts for 10%–20% of JIA. Common clinical manifestations of ERA include arthritis, enthesitis, and acute anterior uveitis. Axial disease is also common in children with established ERA. Treatment regimens for ERA, many of them based on adults with rheumatoid arthritis and ankylosing spondylitis, include the use of nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, and biologic agents either individually or in combination.Keywords: juvenile arthritis, enthesitis, sacroillitis, epidemiology, therapy

Weiss PF

2012-06-01

299

Early-Late Gate.  

Science.gov (United States)

In a range error measuring systems, a high frequency double balanced mixer in conjunction with a bi-polar pulse input allows simplified early-late gate processing of incoming RF pulses. The early-late gate aids in sensing the time difference of the arriva...

R. T. Campbell

1979-01-01

300

Early College High Schools  

Science.gov (United States)

For at-risk students who stand little chance of going to college, or even finishing high school, a growing number of districts have found a solution: Give them an early start in college while they still are in high school. The early college high school (ECHS) movement that began with funding from the Bill and Melinda Gates Foundation 10 years ago…

Dessoff, Alan

2011-01-01

 
 
 
 
301

Rotation of early Universe  

International Nuclear Information System (INIS)

Evolution of rotation velocity of early Universe formed by vacuum polarization of quantum fields by gravitation field is studied. Possibility of the Planck rotaion velocity of early Universe is discussed. Exact solution for such cosmological rotational model is unknown (as compared to the de Sitter stage)

302

Early Intervention in Vietnam  

Science.gov (United States)

This essay describes the setting up of early intervention services in Vietnam. From the outset, there was a focus on developing staff training programmes alongside establishing model early intervention programmes to ensure that the work would be sustained at the end of the project funding and spread throughout the country. The success of this work…

Hodes, Marja

2007-01-01

303

Earthquake early warning videos  

Science.gov (United States)

This web page features videos of the early warning system in action, images of some professional poster presentations, and a description of an in-class kinesthetic activity about how the early warning system works. It also addresses some of the affective aspects of natural disasters.

D'Alessio, Matthew; California State University, Northridge

304

Early Seizures After Stroke  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: Stroke is an important and well known cause of epileptic seizures in adults especially after 50 years of age. Poststroke seizures are divided into two groups; early seizures and late seizures according to the stroke's temporal relationship with seizures. In general, seizures that occur during the first or second week after stroke are considered as early seizures. Material and Method: In this study, we evaluated the rate of early seizures in stroke patients, lesion and seizure types, and lesion localisations in patients with poststroke seizures. Results: Early seizures occured in 27 of 630 (4,3 % patients. Seizures were most often focal motor seizures and occured 39 % in MCA, 28 % in PCA, and 22 % in watershed area lesions. We observed that seizures occured mostly during the first days of the stroke. Conclusion: We did not find any statistically significant difference between haemorhagic and ischemic stroke patients with respect to early seizure occurence.

Aysu ?en

2005-01-01

305

Oxaprozin: Synthesis, SAR study, physico-chemical characteristics and pharmacology  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Oxaprozin (3-(4,5-difeniloksazol-2-yl)propanoic acid) is a nonsteroidal anti-inflammatory drug (NSAID) used in the treatment of numerous inflammatory musculoskeletal diseases, including rheumatoid arthritis, osteoarthritis, tendonitis, ankylosing spondylitis and bursitis. It is the first representative member of the diaryl-substituted heterocyclic compounds, which have found clinical use as selective cyclooxygenase-2 (COX-2) inhibitors. U.S. Food and Drug Administration (FDA) approved i...

Boži? Bojan ?.; Trišovi? Nemanja P.; Valenti? Nataša V.; Uš?umli? Gordana S.; Petrovi? Slobodan D.

2011-01-01

306

Antiinflammatory activity of tenoxicam gel on carrageenan-induced paw oedema in rats  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Tenoxicam is a nonsteroidal antiinflammatory drug, used in the treatment of inflammatory and degenerative disorders of the musculoskeletal system. It is from the oxicam group of nonsteroidal antiinflammatory agents. It is widely prescribed for the treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, gout, extra-articular disorders, bursitis, tendonitis, and nonarticular rheumatic condition. Tenoxicam has some side effects when taken orally, viz., epigastric pain, heartbu...

Gupta G; Gaud R

2006-01-01

307

Long-term use of adalimumab in the treatment of rheumatic diseases  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Charalampos Papagoras, Paraskevi V Voulgari, Alexandros A DrososRheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, GreeceAbstract: Adalimumab, a fully humanized monoclonal antibody against tumor necrosis factor-alpha (TNF?), has been evaluated in various randomized placebo-controlled trials in rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and juvenile idiopathic arthritis. In the short time frame of th...

Charalampos Papagoras; Voulgari, Paraskevi Amp Nbsp V.; Drosos, Alexandros A.

2009-01-01

308

The role of adalimumab in rheumatic and autoimmune disorders: comparison with other biologic agents  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Andreas M ReimoldDallas Veterans Affairs Medical Center and Rheumatic Diseases Division, University of Texas Southwestern Medical Center, Dallas, TX, USAAbstract: Adalimumab (ADA) is a biologic medication that dampens inflammatory pathways by binding to the cytokine tumor necrosis factor alpha. The US Food and Drug Administration has approved ADA as a medication for use in rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, psoriasis, and juvenile idiop...

Am, Reimold

2012-01-01

309

Adalimumab in the treatment of arthritis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Tumor necrosis factor (TNF) has been implicated in a number of arthritic disease states, including rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. Adalimumab is the first fully human, high-affinity, recombinant immunoglobulin G1 (IgG1) anti-TNF monoclonal antibody. Adalimumab in combination with methotrexate or standard antirheumatic therapies, or as monotherapy, is effective in the treatment of adults with active rheumatoid arthritis who have had an inadequate response...

Mease, Philip J.

2007-01-01

310

Proteomics in rheumatology: the dawn of a new era  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Most rheumatic autoimmune diseases are complex in terms of their genetic origins and underlying pathogenic processes. Non-hypothesis-driven scanning platforms are adding novel insights to our understanding of these multifactorial diseases. This review summarizes the handful of recent proteomic studies that have been executed using samples from patients with rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, osteoarthritis, or Sjogren’s syndrome. The candidate biomar...

Vanarsa, Kamala; Mohan, Chandra

2010-01-01

311

Epidemiological studies of radiation carcinogenesis and its biophysical basis  

International Nuclear Information System (INIS)

The three projects of the research program are aimed at the epidemiological study of long-term radiation effects in patients injected with radium-224. They are: late effects in 224Ra treated ankylosing spondylitis patients, late effects in 224Ra treated juvenile and adult patients, and epidemiology of radiation carcinogenesis. The data from these patients are a unique source of information for risk analysis of incorporated bone seeking radionuclides in man. (R.P.) 5 refs., 3 tabs

312

Determination of ANA specificity using multiplexed fluorescent microsphere immunoassay in patients with ANA positivity at high titres after infliximab treatment: preliminary results.  

Science.gov (United States)

To evaluate ANA specificity using the fully automated multiplexed fluorescent microsphere immunoassay in patients affected either by rheumatoid arthritis or ankylosing spondylitis who developed strong positivity for ANA as assessed by indirect immunofluorescent method on HEp-2 cells during infliximab treatment. Three men affected by ankylosing spondylitis and 12 women affected by rheumatoid arthritis who developed ANA positivity at high titres during infliximab treatment underwent the identification of ANA specificity by multiplexed fluorescent microsphere immunoassay; moreover anti-DNA and anti-ENA antibodies were tested by indirect immunofluorescence and ELISA method, respectively. In 4 out of 15 cases, the determination of ANA reactivity by multiplexed fluorescent microsphere immunoassay was also performed on the serum collected before infliximab administration. One patient affected by rheumatoid arthritis showed multiple ANA reactivities against SS-A, SS-B, RNP, Sm, Jo-1 and histones; one patient affected by ankylosing spondylitis resulted positive for the same autoantibodies, except for anti-Sm antibody. Moreover, two patients, one with rheumatoid arthritis and one with ankylosing spondylitis, showed single antibody specificity to SS-B and RNP, respectively. The remaining 11 cases did not show any positivity. Instead, all the patients resulted negative for anti-ENA antibodies by the ELISA method. In the four cases tested for ANA specificity by multiplexed fluorescent microsphere immunoassay before and after infliximab administration no difference was found. The search for anti-DNA antibody always resulted negative by both the traditional immunofluorescent assay and the novel technique. The use of multiplexed fluorescent microsphere immunoassay in patients treated with infliximab with ANA positivity at high titres allowed to find some ANA specificities which were not revealed by ELISA method. Nevertheless, the majority of patients resulted negative in spite of ANA positivity at high titres; the molecular target of ANA which develop after infliximab administration still remains to be identified. PMID:17136355

Caramaschi, Paola; Ruzzenente, Orazio; Pieropan, Sara; Volpe, Alessandro; Carletto, Antonio; Bambara, Lisa Maria; Biasi, Domenico

2007-05-01

313

Radioisotope binding capacity of serum for folic acid, vitamin B12 and ferritin in hematologic and rheumatologic patients  

International Nuclear Information System (INIS)

Folic acid, vitamin B12 and ferritin levels were determined by radioimmunoassay in patients suffering from hemic and rheumatic diseases, resp. Compared to the controls the folic acid levels were lower in some cases, the deficiency of folic acid absorption and distribution possibly being caused by the disease. Vitamin B12 was only slightly decreased. In ankylosing spondylitis the transferrin level was similar to that of the controls, but in rheumatoid arthritis and in patients suffering from various diseases it was increased

314

[Paroxysmal nocturnal hemoglobinuria revealed by hepatic vein thrombosis (Budd-Chiari syndrome) during Infliximab therapy].  

Science.gov (United States)

We report the case of a 41-Year-old man presenting with hepatic vein thrombosis (Budd-Chiari syndrome) during Infliximab therapy for ankylosing spondylitis. The systematic work-up revealed paroxysmal nocturnal hemoglobinuria. One Year later the patient was receiving anticoagulation therapy and was in good condition. The role of Infliximab in the development of thrombosis in this patient with rare underlying thrombophilia is discussed. PMID:15243394

Sobkeng Goufack, Enam; Mammou, Saloua; Scotto, Béatrice; De Muret, Anne; Maakaroun, Abdallah; Socie, Gérard; Bacq, Yannick

2004-01-01

315

Enhancement of Dissolution of Aceclofenac Film Coated Tablet by Micronisation Technique  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Aceclofenac is non-steroidal anti-inflammatory drug with marked anti-inflammatory and analgesic properties. It is indicated for the relief of pain and inflammation in osteoarthritis, rheumatoid arthritis and ankylosing spondylitis. Aceclofenac is BCS class II drug with low solubility and high permeability. Micronization technique is used to increase the solubility and thus dissolution of Aceclofenac. The micronization was done using jet mill micronizer. The initial particle size of drug is 29...

Soni, Nilam M.; Bhitre, Dr Milind J.; Prachi Trivedi

2013-01-01

316

Acceleration of coxarthrosis by an exostosis causing femoroacetabular impingement  

Directory of Open Access Journals (Sweden)

Full Text Available Here we describe a 28-year-old man with a history of right hip pain for the past 11 years and ankylosing spondylitis for the past 6 months. Imaging studies showed an exostosis in the femoral neck causing femoroacetabular imping- ement. The patient was diagnosed with coxar- throsis. This case report suggests that femoro- acetabular impingement may accelerate the degenerative process in the hip joint.

Murat Arikan

2010-04-01

317

Clinical and experimental studies of mechanisms of action, efficacy and tolerability of glucocorticoids in patients with inflammatory rheumatic diseases  

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Clinical and experimental studies of mechanisms of action, efficacy and tolerability of glucocorticoids in patients with inflammatory rheumatic diseases Part I Membrane glucocorticoid receptor expression on peripheral blood mononuclear cells in patients with ankylosing spondylitis BACKGROUND: Recently we have demonstrated for the first time the expression of membrane-bound glucocorticoid receptors (mGCR) on normal peripheral blood mononuclear cells (PBMC) and their up-regulation i...

Tryc, Anita Blanka

2010-01-01

318

Efficacy and tolerability of naproxen/esomeprazole magnesium tablets compared with non-specific NSAIDs and COX-2 inhibitors: a systematic review and network analyses  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Catherine Datto,1 Richard Hellmund,1 Mohd Kashif Siddiqui21AstraZeneca Pharmaceuticals LP, Wilmington, DE, USA; 2HERON PVT India, Chandigarh, UT, IndiaAbstract: Non-steroidal anti-inflammatory drugs (NSAIDs), such as non-selective NSAIDs (nsNSAIDs) or selective cyclooxygenase-2 (COX-2) inhibitors, are commonly prescribed for arthritic pain relief in patients with osteoarthritis (OA), rheumatoid arthritis (RA), or ankylosing spondylitis (AS). Treatment guidelines for chronic NSAID therapy incl...

Datto C; Hellmund R; Mk, Siddiqui

2013-01-01

319

Etanercept-induced cystic acne.  

Science.gov (United States)

Tumor necrosis factor ? antagonists are potent biologics used to treat a variety of autoimmune disorders such as rheumatoid arthritis, ankylosing spondylitis, Crohn disease, psoriasis, and psoriatic arthritis. These medications are known to have many side effects (eg, infusion reactions, cytopenia, risk for infection, heart failure); however, only a few cases of acne vulgaris have been associated with the use of these biologics, particularly infliximab and adalimumab. We report a rare case of etanercept-induced cystic acne. PMID:25101341

Kashat, Maria; Caretti, Katherine; Kado, Jessica

2014-07-01

320

Radiologically- detectable sacroiliac involvement in behcet's disease  

International Nuclear Information System (INIS)

he results of the unisexual cohorts revealed to significance either (p=O.68 for males, and p=O.64 for females). The age subdivisions (under- and over-30) again showed no significant difference (p=O.96 and p=O.69 for under- and over -30 patients, respectively). Conclusion: The presence of radiographic signs of sacroiliac joint involvement is not mandatory for the diagnosis of ankylosing spondylitis

 
 
 
 
321

Cancer risks from internally deposited radium and thorotrast  

International Nuclear Information System (INIS)

Elevated risks for specific types of cancer were reviewed for three populations irradiated internally by alpha-emitters: (a) German patients injected with short-lived 224Ra for the treatment of tuberculosis or ankylosing spondylitis; (b) American and British watch-dial luminizers who ingested long-lived 226Ra or 228Ra and (c) patients injected with colloidal thorium dioxide (Thorostrast) as a contrast material for diagnostic X-ray examination. (author)

322

Magnetic resonance imaging of sacroiliitis in patients with spondyloarthritis. Correlation with anatomy and histology  

Energy Technology Data Exchange (ETDEWEB)

Magnetic resonance imaging (MRI) of the sacroiliac joints (SIJs) has become established as a valuable modality for the early diagnosis of sacroiliitis in patients with inconclusive radiographic findings. Positive MRI findings have the same significance as a positive test for HLA-B27. Sacroiliitis is one of the key features of axial spondyloarthritis (SpA) in the classification proposed by the Assessments in Ankylosing Spondylitis (ASAS) group. Early signs of sacroiliitis include enthesitis of articular fibrocartilage, capsulitis, and osteitis. In more advanced disease, structural (chronic) lesions will be visible, including periarticular fatty deposition, erosions, subchondral sclerosis, and transarticular bone buds and bridges. In this article we describe magnetic resonance (MR) findings and provide histologic biopsy specimens of the respective disease stages. The predominant histologic feature of early and active sacroiliitis is the destruction of cartilage and bone by proliferations consisting of fibroblasts and fibrocytes, T-cells, and macrophages. Advanced sacroiliitis is characterized by new bone formation with enclosed cartilaginous islands and residual cellular infiltrations, which may ultimately lead to complete ankylosis. Knowledge of the morphologic appearance of the sacroiliac joints and their abnormal microscopic and gross anatomy is helpful in correctly interpreting MR findings. (orig.)

Hermann, K.G.A. [Charite Medical School, Campus Mitte, Berlin (Germany). Dept. of Radiology; Bollow, M. [Augusta Hospital, Bochum (Germany). Dept. of Diagnostic and Interventional Radiology and Nuclear Medicine

2014-03-15

323

Magnetic resonance imaging of sacroiliitis in patients with spondyloarthritis. Correlation with anatomy and histology  

International Nuclear Information System (INIS)

Magnetic resonance imaging (MRI) of the sacroiliac joints (SIJs) has become established as a valuable modality for the early diagnosis of sacroiliitis in patients with inconclusive radiographic findings. Positive MRI findings have the same significance as a positive test for HLA-B27. Sacroiliitis is one of the key features of axial spondyloarthritis (SpA) in the classification proposed by the Assessments in Ankylosing Spondylitis (ASAS) group. Early signs of sacroiliitis include enthesitis of articular fibrocartilage, capsulitis, and osteitis. In more advanced disease, structural (chronic) lesions will be visible, including periarticular fatty deposition, erosions, subchondral sclerosis, and transarticular bone buds and bridges. In this article we describe magnetic resonance (MR) findings and provide histologic biopsy specimens of the respective disease stages. The predominant histologic feature of early and active sacroiliitis is the destruction of cartilage and bone by proliferations consisting of fibroblasts and fibrocytes, T-cells, and macrophages. Advanced sacroiliitis is characterized by new bone formation with enclosed cartilaginous islands and residual cellular infiltrations, which may ultimately lead to complete ankylosis. Knowledge of the morphologic appearance of the sacroiliac joints and their abnormal microscopic and gross anatomy is helpful in correctly interpreting MR findings. (orig.)

324

Early career awards  

...awards Education and outreach awards Early career awards The Maxwell medal and prize The Moseley medal and prize The Paterson medal and prize Nominations ...procedure Phillips Award Honorary fellowship Additional awards IOP Awards dinner 2013 Early career awards The early career awards are awarded annually to physicists within ... Maxwell medal and prizeFor outstanding contributions to theoretical physics, mathematical or computational physics Moseley medal and prizeFor distinguished research in experimental physics ...Paterson medal and prizeFor distinguished research in applied physics Feedback Related information Eligibility for awards Those eligible for awards should have made a substantial ...

325

Safety and clinical efficacy of golimumab in the treatment of arthritides  

Directory of Open Access Journals (Sweden)

Full Text Available Ismail Simsek, Yusuf YaziciNew York University School of Medicine, NYU Hospital for Joint Diseases, New York, USAAbstract: Golimumab is a human anti-tumor necrosis factor (TNF-alpha monoclonal antibody that was recently approved for the treatment of patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. This review covers the published clinical trial data on the use of golimumab for the approved indications mentioned above with respect to efficacy and safety. The various ongoing trials for golimumab have yielded promising results in terms of efficacy and safety in methotrexate-naive and -resistant patients with rheumatoid arthritis, as well as in patients who were previously treated with other anti-TNF agents. In addition, the efficacy of golimumab in psoriatic arthritis and ankylosing spondylitis has also been demonstrated. The real safety information will be available only once the drug has been used in many more patients, who frequently have comorbid conditions.Keywords: arthritis, rheumatoid, psoriatic arthritis, ankylosing spondylitis

Ismail Simsek

2010-09-01

326

Biomarcadores en espondiloartropatías / Biomarkers for spondyloarthropathies. State of the art  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english Among rheumatic diseases and specifically spondyloarthropathies (SpA), the study of biomarkers, defined as molecules that reflect either biologic or specific pathological process, is an important and necessary area in basic and clinical research, being a consequence or the response of an interventio [...] n. Other markers provide information about the pathogenesis of this disease. Recently, HLA-B27 has been used as diagnostic criteria to detect SpA. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) are clinical scores used to assess disease activity. A new activity index, Ankylosing Spondylitis Disease Activity Score (ASDAS) considers erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) as biomarkers. This review describes the state of the art of research on SpA biomarkers. There are promising new candidates as biomarkers such as metallopro-teinase 3, Type II collagen neoepitopes (C2C and C1-2C), C-propeptide of Type II collagen (CPII), aggrecan 846 epitope, macrophage colony stimulating factor, serum amyloid A protein and interleukin-6, among others.

CONSUELO, ROMERO-SÁNCHEZ; JOHN, LONDOÑO; JULIETTE, DE AVILA; RAFAEL, VALLE-OÑATE.

327

Assessment of fatigue in a large series of 1492 Brazilian patients with Spondyloarthritis.  

Science.gov (United States)

Abstract Background. The aim of the present study was to analyze the score of fatigue in a large cohort of Brazilian patients with SpA, comparing different disease patterns and its association with demographic and disease-specific variables. Methods. A common protocol of investigation was prospectively applied to 1492 Brazilian patients classified as SpA according to the European Spondyloarthropathies Study Group (ESSG) criteria, attended at 29 reference centers. Clinical and demographic variables were recorded. Fatigue was evaluated using the first item of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) questionnaire. Results. The mean BASDAI fatigue score was 4.20 ± 2.99. There was no significant difference in the fatigue score between the different SpA. Fatigue was higher in female patients (p < 0.001), with mixed (axial + peripheral) involvement (p < 0.001) and in those who did not practice exercises (p < 0.001). Higher scores of fatigue were significantly associated with inflammatory low back pain (p = 0.013), alternating buttock pain (p = 0.001), cervical pain (p = 0.001), and hip involvement (p = 0.005). Fatigue presented a moderate positive statistical correlation with Bath Ankylosing Spondylitis Functional Index (BASFI) (0.469; p < 0.001) and Ankylosing Spondylitis Quality of Life (0.462; p < 0.001). Conclusion. In this large series of Brazilian SpA patients, higher fatigue scores were associated with female gender, sedentary, worse functionality, and quality of life. PMID:24884480

Bianchi, Washington A; Elias, Fernanda R; Carneiro, Sueli; Bortoluzzo, Adriana B; Gonçalves, Célio R; da Silva, José Antonio Braga; Ximenes, Antonio Carlos; Bértolo, Manoel B; Ribeiro, Sandra L E; Keiserman, Mauro; Skare, Thelma L; Menin, Rita; Azevedo, Valderílio F; Vieira, Walber P; Albuquerque, Elisa N; Bonfiglioli, Rubens; Campanholo, Cristiano; Carvalho, Hellen M S; Costa, Izaias P; Duarte, Angela P; Kohem, Charles L; Leite, Nocy H; Lima, Sonia A L; Meirelles, Eduardo S; Pereira, Ivânio A; Pinheiro, Marcelo M; Polito, Elizandra; Resende, Gustavo G; Rocha, Francisco Airton C; Santiago, Mittermayer B; Sauma, Maria de Fátima L C; Valim, Valéria; Sampaio-Barros, Percival D

2014-11-01

328

Tuberculous spondylitis presenting as severe chest pain  

Directory of Open Access Journals (Sweden)

Full Text Available This case report describes a 32-year-old male who presented to an emergency department with severe chest pain and a history of cough, fever, night sweats, loss of appetite and weight. Chest radiography revealed a left upper lobe consolidation and multiple compression deformities in the thoracic spine. Magnetic resonance imaging demonstrated significant kyphosis and vertebral plana at two thoracic levels. Anterior compression of the spinal cord and adjacent soft tissue masses were also noted.

Claude Pierre-Jerome

2012-03-01

329

Earth's early biosphere  

Science.gov (United States)

Understanding our own early biosphere is essential to our search for life elsewhere, because life arose on Earth very early and rocky planets shared similar early histories. The biosphere arose before 3.8 Ga ago, was exclusively unicellular and was dominated by hyperthermophiles that utilized chemical sources of energy and employed a range of metabolic pathways for CO2 assimilation. Photosynthesis also arose very early. Oxygenic photosynthesis arose later but still prior to 2.7 Ga. The transition toward the modern global environment was paced by a decline in volcanic and hydrothermal activity. These developments allowed atmospheric O2 levels to increase. The O2 increase created new niches for aerobic life, most notably the more advanced Eukarya that eventually spawned the megascopic fauna and flora of our modern biosphere.

Des Marais, D. J.

1998-01-01

330

Early Diagnosis, Timely Treatment  

Medline Plus

Full Text Available ... known for over 20 years that he has glaucoma. In fact, his high normal pressures have been ... Phillips Eye Institute in Minneapolis. Dr. Bhasvar: When glaucoma is detected early you have a very good ...

331

Breast Cancer: Early Detection  

Science.gov (United States)

... saved articles window. My Saved Articles » My ACS » Breast Cancer Early Detection Download Printable Version [PDF] » ( En español ) ... the factors that may affect your risk for breast cancer, and find out what you can do to ...

332

Overview of Early Intervention  

Science.gov (United States)

... delays or disability. You can use the Parent’s Record-Keeping Worksheet to keep track of this important information. ... single point of contact with the early intervention system. Screening and/or evaluation | One of the first ...

333

Classification and clinical assessment  

Directory of Open Access Journals (Sweden)

Full Text Available There are at least nine classification criteria for psoriatic arthritis (PsA that have been proposed and used in clinical studies. With the exception of the ESSG and Bennett rules, all of the other criteria sets have a good performance in identifying PsA patients. As the CASPAR criteria are based on a robust study methodology, they are considered the current reference standard. However, if there seems to be no doubt that they are very good to classify PsA patients (very high specificity, they might be not sensitive enough to diagnose patients with unknown early PsA. The vast clinical heterogeneity of PsA makes its assessment very challenging. Peripheral joint involvement is measured by 78/76 joint counts, spine involvement by the instruments used for ankylosing spondylitis (AS, dactylitis by involved digit count or by the Leeds dactylitis index, enthesitis by the number of affected entheses (several indices available and psoriasis by the Psoriasis Area and Severity Index (PASI. Peripheral joint damage can be assessed by a modified van der Heijde-Sharp scoring system and axial damage by the methods used for AS or by the Psoriatic Arthritis Spondylitis Radiology Index (PASRI. As in other arthritides, global evaluation of disease activity and severity by patient and physician and assessment of disability and quality of life are widely used. Finally, composite indices that capture several clinical manifestations of PsA have been proposed and a new instrument, the Psoriatic ARthritis Disease Activity Score (PASDAS, is currently being developed.

F. Cantini

2012-06-01

334

Expression of PADI4 during rheumatoid arthritis development  

Directory of Open Access Journals (Sweden)

Full Text Available Peptidyl deiminase 4 (PADI4 catalyzes peptidylarginine to citrulline. The gene encoding PADI4 is associated with rheumatoid arthritis (RA in some populations. The levels of PADI4, anti-CCP, and RF were measured in the blood of patients suffering from RA and osteoarthritis (OA for less than six months using ELISA. The levels were also measured in the blood of patients that have been diagnosed with RA for more than three years. As controls, samples from healthy subjects or patients with ankylosing spondylitis (AS, epidemic pleurodynia (EP, OA, psoriatic arthritis (PA, systemic lupus erythematosus (SLE, gouty arthritis (GA, or Still’s disease (ST were also assayed. Of patients with early RA, 68.7% had significantly higher levels of PADI4 than patients with early OA. Patients with RA for a longer period of time had a higher expression of PADI4 than patients with SLE, ST, and GA, but they were similar to healthy subjects or patients with AS, EP, OA, or PA. The level of PADI4 was significantly correlated to the levels of RF and anti-CCP in blood samples of RA, but not in the samples of other diseases and those of healthy subjects. The level of PADI4 relates to the disease activity and clinical performance.

Yunzhong Zhang

2009-06-01

335

Subclinical atherosclerosis in patients with psoriatic arthritis: a case-control study. Preliminary data  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: The aim of this study was to evaluate the prevalence of subclinical atherosclerosis in patients with psoriatic arthritis (PsA, correlated with some traditional risk factors of atherosclerosis and with PsA-related disease factors. Methods: Forty-one patients and 41 healthy subjects were evaluated for intima-media thickness (IMT and flow-mediated dilation (FMD, using carotid duplex scanning. IMT values were expressed like IMT mean (cumulative mean of all the IMT mean and M-MAX (cumulative mean of all the higher IMT. Subclinical atherosclerosis markers were correlated with age, body mass index (BMI and blood pressure in both groups, with duration of arthritis, duration of psoriasis, tender and swollen joints, BASDAI (Bath Ankylosing Spondylitis Disease Activity Index, BASFI (Bath Ankylosing Spondylitis Functional Index, erythrocyte sedimentation rate (ESR and C-reactive protein (CRP in patients. Results: IMT mean and M-MAX were both higher in PsA patients compared with controls (0.7±0.15 vs 0.62±0.09 mm; p<0.01 and 0.86±0.21 vs. 0.74±0.13 mm; p<0.01 respectively. FMD was smaller in patients than in controls (5.9±2 vs 7.5±2.8%; p<0.01. Univariate analysis showed a correlation between IMT mean and SBP (r=0.217; p=0.05 and a correlation between M-MAX and age (r=0.392; p<0.001, BMI (r=0.252; p<0.05, SBP (r=0.446; p<0.001 in both groups. In PsA patients M-MAX resulted correlated with ESR (r=0.338; p<0.05 and BASDAI (r=0.322; p<0.05. Conclusions: PsA patients exhibited endothelial dysfunctions which is an early marker of subclinical atherosclerosis, as well as an higher IMT. An interesting correlation between M-MAX and PsA activity index (ESR and BASDAI was found.

M. Zanon

2011-06-01

336

Earthquake Early Warning Systems  

Directory of Open Access Journals (Sweden)

Full Text Available Because of Taiwan’s unique geographical environment, earthquake disasters occur frequently in Taiwan. The Central Weather Bureau collated earthquake data from between 1901 and 2006 (Central Weather Bureau, 2007 and found that 97 earthquakes had occurred, of which, 52 resulted in casualties. The 921 Chichi Earthquake had the most profound impact. Because earthquakes have instant destructive power and current scientific technologies cannot provide precise early warnings in advance, earthquake prevention is crucial. The earthquake early warning system can provide seconds to tens of seconds of warning time before an earthquake strikes. This paper introduces the  earthquake early warning system build by Taiwan National Center for Research on Earthquake Engineering and a practice case happened in Yilan City, Taiwan.

Pei-Yang Lin

2011-12-01

337

GYNAECOLOGICAL DISORDERS: EARLY SCREENING  

Directory of Open Access Journals (Sweden)

Full Text Available The very simple studies of the gynecological disorder has been performed for screening of early disorder of menstrual cycle pattern is monitored with administering drugs (Oral Contraceptive Pill which inhibit pregnancy but the side effect is monitored, like weight gain, may be symptomatic or asymptomatic in most of the cases is asymptomatic because this is the safe studies as it is done early at home, simple monitoring of the patient is done, important care like pregnancy card test is important, Doctors advise was taken, for confirmation of the study, hospital based clinical trial is done with HIV Kits, ELISA micro plate reader.

Rajesh Laik

2013-06-01

338

Early Detection Research Network  

Science.gov (United States)

This initiative supports the creation of a national Network for early cancer detection with resources for translational research that will include laboratory science, clinical science, public health, biostatistics, informatics, and computer science. The goals of the Network are to discover and coordinate the evaluation of biomarkers and reagents for the earlier detection of cancer and for the assessment of risk.

339

Early breast cancer  

International Nuclear Information System (INIS)

The therapy of early breast cancer has been changing during the last decennium. It requires a multi-disciplinary approach and in each of these disciplines improvements have been implemented. The result is that treatment schedules can now be adapted to specific subgroups. In this review early breast cancer is defined as operable disease, using the criteria set out by Haagensen. Emphasis is given to describing the new developments in prognostic criteria, since these form the basis for creating subgroups for specific treatment schedules. Distinction is made between the factors relating to growth rate and those relating to metastatic potential. Data on screening promises a beneficial effect of the implementation of screening in national health care programs. Important shifts are seen in treatment schedules; the place of postoperative radiotherapy after classic ablative treatment is being challenged, whereas it plays a major role in the new breast conserving therapy schedules. The data mentioned in the review suggest that a large proportion of 'operable' cases can be treated with breast conservation but details in the technique of breast conserving therapy are still under investigation. They form a major part of the coming prospective studies in breast cancer. Improvements in reconstruction techniques, creating better cosmetic results, make reconstruction more competitive with breast conserving therapy. The use of chemotherapy and endocrine manipulation in early breast canendocrine manipulation in early breast cancer has now been clearly confirmed by the overview technique by the Peto-group, thanks to all efforts of individual trialists together. (orig.)

340

Early-Stage Caregiving  

Science.gov (United States)

... last for years. Learn more: Stages of Alzheimer's Life after Diagnosis Your role as care partner Free e-Learning Course This program, Living with ... Early-stage issues A diagnosis of Alzheimer's is life changing for both ... with the disease and the care partner. Here are some of the issues you may ...

 
 
 
 
341

Early Awareness Boot Camp.  

Science.gov (United States)

Describes an early awareness program by Alvernia College (Pennsylvania) aimed at fifth to seventh graders from low-income school districts. The students' day-long visit to campus uses a "boot camp" analogy and involves small-group visits to campus facilities, games, and a talk on careers, higher education, and financial aid. A list of suggested…

Heist, Vali G.

2000-01-01

342

Early 'smoker' meeting  

Science.gov (United States)

Early 'smoker' meeting at the Aircraft Engine Research Laboratory at Cleveland, Ohio, now known as the John H. Glenn Research Center at Lewis Field, on March 2, 1944. Edward R. Sharp developed these informal night sessions in which engineers and scientists engaged in freewheeling discussions about technical problems.

1944-01-01

343

Early vulvar carcinoma.  

Science.gov (United States)

Fifty-eight cases of early vulvar neoplasia were reviewed from the Tumor Registry at Magee-Womens Hospital, between 1947 and 1976. Twenty-three cases were carcinoma in situ; 16 were microinvasive, and 19 were occult carcinoma. All of the cases were treated surgically. The modality of surgical treatment varied from local excision to radical vulvectomy with inguinal lymph node dissection. Regardless of the surgical therapy, none of the patients died of the vulvar malignancy. It is recommended, as part of routine gynecologic surveillance, that more critical attention be given to examination for early epithelial neoplastic lesions of the vulva. This can be accomplished by simple inspection and the use of special diagnostic aids. Biopsy specimens should be reviewed histologically for depth of invasion and the treatment individualized to the patient with considerations for conservatism, especially in younger women. PMID:717465

Kunschner, A; Kanbour, A I; David, B

1978-11-15

344

PHOBOS, the Early Years  

Science.gov (United States)

The PHOBOS detector, one of the two small experiments at RHIC, focuses on measurements of charged particle multiplicity over almost the full phase space and identified particles near mid-rapidity. Results will be presented from the early RHIC gold--gold runs at nucleon--nucleon center of mass energies of 56 and 130 GeV as well as the recently concluded run at the full RHIC energy of 200 GeV.

Stephans, George S. F.; Back, B. B.; Baker, M. D.; Barton, D. S.; Betts, R. R.; Ballintijn, M.; Bickley, A. A.; Bindel, R.; Budzanowski, A.; Busza, W.; Carroll, A.; Decowski, M. P.; Garcia, E.; George, N.; Gulbrandsen, K.; Gushue, S.; Halliwell, C.; Hamblen, J.; Heintzelman, G. A.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Holynski, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Katzy, J.; Khan, N.; Kucewicz, W.; Kulinich, P.; Kuo, C. M.; Lin, W. T.; Manly, S.; McLeod, D.; Michalowski, J.; Mignerey, A. C.; Nouicer, R.; Olszewski, A.; Pak, R.; Park, I. C.; Pernegger, H.; Reed, C.; Remsberg, L. P.; Reuter, M.; Roland, C.; Roland, G.; Rosenberg, L.; Sagerer, J.; Sarin, P.; Sawicki, P.; Skulski, W.; Steadman, S. G.; Steinberg, P.; Stephans, G. S. F.; Stodulski, M.; Sukhanov, A.; Tang, J.-L.; Teng, R.; Trzupek, A.; Vale, C.; van Nieuwenhuizen, G. J.; Verdier, R.; Wadsworth, B.; Wolfs, F. L. H.; Wosiek, B.; Wozniak, K.; Wuosmaa, A. H.; Wyslouch, B.

2002-06-01

345

Early Teaching Experiences: Strategies  

Science.gov (United States)

PhysTEC suggests early teaching experience as both a mechanism for recruitment and to provide future teachers with a realistic view of their chosen career. Ways of providing this experience include becoming a learning assistant, exposing student teachers to a variety of grade levels, and inviting more experienced teachers to become involved with the teacher preparation program, either as mentors or as advisors in program development.

2008-05-20

346

PHOBOS, the Early Years  

International Nuclear Information System (INIS)

The PHOBOS detector, one of the two small experiments at RHIC, focuses on measurements of charged particle multiplicity over almost the full phase space and identified particles near mid-rapidity. Results will be presented from the early RHIC gold-gold runs at nucleon-nucleon center of mass energies of 56 and 130 GeV as well as the recently concluded run at the full RHIC energy of 200 GeV. (author)

347

Earthquake Early Warning Systems  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Because of Taiwan’s unique geographical environment, earthquake disasters occur frequently in Taiwan. The Central Weather Bureau collated earthquake data from between 1901 and 2006 (Central Weather Bureau, 2007) and found that 97 earthquakes had occurred, of which, 52 resulted in casualties. The 921 Chichi Earthquake had the most profound impact. Because earthquakes have instant destructive power and current scientific technologies cannot provide precise early warnings in advance, earthquak...

Pei-Yang Lin

2011-01-01

348

Early Intervention: Critical Roles of Early Childhood Service Providers.  

Science.gov (United States)

Reviews trends in service provision to children with special needs and demonstrates the research-based efficacy of early intervention in family-centered inclusive contexts in early educational and care settings. Argues that changing roles of early childhood teachers need to be strengthened, because teachers possess skills to coordinate and…

Talay-Ongan, Ayshe

2001-01-01

349

Performance of different criteria sets for inflammatory back pain in patients with axial spondyloarthritis with and without radiographic sacroiliitis.  

Science.gov (United States)

It is important to recognize inflammatory back pain (IBP) for an early diagnosis of ankylosing spondylitis (AS). Assessment of Spondyloarthritis International Society (ASAS) has recently published new criteria set for diagnosing IBP. In the present study, we evaluated the performance of the new ASAS IBP criteria and to compare the performance of IBP criteria sets in axial spondyloarthritis (axSpA) patients with and without radiographic sacroiliitis. The study sample included a total of 274 patients with a diagnosis of axSpA and 50 patients with a diagnosis of chronic (>3 months) mechanical back pain (MBP). A face-to-face interview by using a standardized questionnaire addressing all the components of IBP was performed. Data about HLA-B27 status and C-reactive protein levels were obtained from the patients' charts. There were significantly more male patients (P?30 min (Calin 30), the specificity improved (72.9 %), but at a price of loss in sensitivity (82.4 %). In this study, new ASAS criteria for IBP performed almost as good as but not better than the existing criteria sets. Performances of the criteria sets were quite comparable in the differentiation of IBP from MBP in patients with and without radiographic sacroiliitis. PMID:24770795

Solmaz, Dilek; Akar, Servet; Soysal, Ozgul; Akkoc, Ye?im; Can, Gercek; Gerdan, Vedat; Birlik, Merih; Onen, Fatos; Akkoc, Nurullah

2014-10-01

350

Spondyloarthropathy presenting at a young age: case report and review  

Energy Technology Data Exchange (ETDEWEB)

The diagnosis of juvenile spondyloarthritis (JSA) is rarely entertained in young children who present with back and leg pain. We present a case of a 6-year-old male who presented with a 3-year history of severe back and leg pain and a positive Gower's sign, and was given a presumed diagnosis of muscular dystrophy. Presenting serologic evaluation included a mildly elevated sedimentation rate and C-reactive protein (CRP). Computed tomography of the pelvis demonstrated large erosions affecting both sacro-iliac joints. Despite the unusually young age of this patient, ankylosing spondylitis seemed the most plausible diagnosis. Following rheumatological evaluation and treatment for JSA, he showed significant clinical improvement. His disease, however, has not entirely remitted with signs of enthesitis at the Achilles tendon and knees. We present this case to illustrate that JSA could account for symptoms at an early age and not considering it could lead to multiple medical visits and diagnoses. To our knowledge, based on a search of the World literature, this would appear to be the youngest case of JSA reported with demonstrable severe sacroiliitis. (orig.)

Hartman, Golda H.; Renaud, Deborah L.; Reed, Ann M. [Mayo Clinic and Mayo Foundation, Department of Pediatrics, Rochester, MN (United States); Sundaram, Murali [Mayo Clinic and Mayo Foundation, Department of Pediatrics, Rochester, MN (United States); Cleveland Clinic, Cleveland, OH (United States)

2007-02-15

351

X-ray observation of heterotopic ossification after total hip arthroplasty  

International Nuclear Information System (INIS)

Purpose: To study the incidence and X-ray findings of heterotopic ossification (HO) after total hip arthroplasty (THA). Methods: 333 cases (352 hip) after THA were followed by X-ray examination for 1-12 years. Evaluation of HO from X-ray films using broker's classification was made and X-ray findings were correlated with sex, age and operative causes. Results: In the study, HO after THA was noted in 69 cases on X-ray films. The incidence was 20.7%. Higher in the male than in female by 7.2%, but no significant correlation with the age (P>0.05). Most (85.5%) of HO happened within one year after operation but in one case as long as eight years after operation. In this group, 85.0% of the HO belonged to Grade I-III, the remaining was grade IV. Severe HO was most frequently noted in the patients operated for Ankylosing Spondylitis. On X-ray film, the calcifications were located on external side of hip joint in early stage, and later also seen on internal side, the former being the dominant side. Calcification usually took the form of stripe or patch. Conclusion: HO is a common post-operative complication. X-ray plain film is a simple tool on diagnosing this disease and planning clinical therapy

352

Synoviocyte apoptosis may differentiate responder and non-responder patients to methotrexate treatment in rheumatoid arthritis.  

Science.gov (United States)

We aimed to evaluate whether methotrexate (MTX) in vitro induces apoptosis in synoviocytes obtained from rheumatoid arthritis patients and whether the apoptosis inducing effect of MTX to synoviocytes is correlated with the clinical responsiveness to MTX in patients with rheumatoid arthritis (RA). We evaluated 18 patients with RA taking MTX 15-20 mg/week as the subject group (nine responders and nine non-responders) and ten patients with osteoarthritis (OA) and nine patients with ankylosing spondylitis (AS) as the control group. Synoviocytes, cultured from the synovial fluid of the knee joint of each subject, were used for experiments between passages 4 and 6, and were treated with MTX. The induction of apoptosis was determined by the quantification of DNA hypoploidy by flow cytometry, nuclear morphology, caspases activation, DNA electrophoresis, and mitochondrial membrane potential measurements. The viability of synoviocytes treated with MTX was different between the MTX responders and nonresponders. MTX induced apoptosis in cultured synoviocytes by mitochondria- and caspase-dependent manners in the MTX responders but did not in the MTX non-responder, OA, and AS patients. The apoptotic responsiveness of the synoviocytes to MTX predicts the sensitivity to MTX treatment and provides a method determine the early application of an anti-tumor necrosis factor-? agent in RA treatment. PMID:24988987

Lee, Sang Yeob; Park, Sun-Hee; Lee, Sung Won; Lee, Sang Hwa; Son, Min Kyeong; Choi, Yung Hyun; Chung, Won Tae; Yoo, Young Hyun

2014-10-01

353

Frequency of occurrence, mode of development, and significance or rice bodies in rheumatoid joints.  

Science.gov (United States)

The incidence of rice bodies (RB) in synovial effusions has been studied in 36 patients with rheumatoid arthritis (RA) and in 12 patients with seronegative inflammatory arthritis (7 cases of Still's disease, 3 of psoriatic arthritis, and 2 of ankylosing spondylitis). In the RA group 50 joints were aspirated before and after saline lavage with a specially designed wide-bore needle. RB were found in 72% overall of the joints studied in this group, 14% on initial simple aspiration and an additional 58% after lavage. In contrast no rice bodies were found in 31 aspirations with lavage by an identical technique in the 12 patients with seronegative synovitis. The RB in RA synovitis occurred both early and late in the course of the disease and were not related to the severity of clinical or radiological changes. However, removal of rice bodies was accompanied by clinical improvement and reduction of synovitis. Macroscopically RB varied in shape and size, some being so large as to preclude effective removal by needles of the gauge customarily employed for joint aspirations. Microscopically the majority of RB were composed of coarsely reticular material reacting immunologically with antifibrinogen and antifibronectin and containing mononuclear cells. Some showed vacuolation suggestive of fibrinolysis, but many showed organisation like that seen in established connective tissues, with the formation of mature collagen, reticulin, and elastin. These findings are discussed in relation to the origin, development, and significance of rice bodies in rheumatoid synovitis. PMID:6176192

Popert, A J; Scott, D L; Wainwright, A C; Walton, K W; Williamson, N; Chapman, J H

1982-04-01

354

Imaging the spine in arthritis-a pictorial review.  

Science.gov (United States)

Spinal involvement is frequent in rheumatoid arthritis (RA) and seronegative spondyloarthritides (SpA), and its diagnosis is important. Thus, MRI and CT are increasingly used, although radiography is the recommended initial examination. The purpose of this review is to present the typical radiographic features of spinal changes in RA and SpA in addition to the advantages of MRI and CT, respectively. RA changes are usually located in the cervical spine and can result in serious joint instability. Subluxation is diagnosed by radiography, but supplementary MRI and/or CT is always indicated to visualise the spinal cord and canal in patients with vertical subluxation, neck pain and/or neurological symptoms. SpA may involve all parts of the spine. Ankylosing spondylitis is the most frequent form of SpA and has rather characteristic radiographic features. In early stages it is characterised by vertebral squaring and condensation of vertebral corners, in later stages by slim ossifications between vertebral bodies, vertebral fusion, arthritis/ankylosis of apophyseal joints and ligamentous ossification causing spinal stiffness. The imaging features of the other forms of SpA can vary, but voluminous paravertebral ossifications often occur in psoriatic SpA. MRI can detect signs of active inflammation as well as chronic structural changes; CT is valuable for detecting fracture. PMID:22347946

Jurik, Anne Grethe

2011-04-01

355

History of early atomic clocks  

International Nuclear Information System (INIS)

This review of the history of early atomic clocks includes early atomic beam magnetic resonance, methods of separated and successive oscillatory fields, microwave absorption, optical pumping and atomic masers. (author)

356

Can Rhabdomyosarcoma Be Found Early?  

Science.gov (United States)

... Next Topic How is rhabdomyosarcoma diagnosed? Can rhabdomyosarcoma be found early? At this time, there are no ... any symptoms.) Still, some cases of RMS can be found at an early stage because they start ...

357

75 FR 20830 - Early Learning  

Science.gov (United States)

...DEPARTMENT OF EDUCATION Early Learning AGENCY: Office of...Secretary, Department of Education. ACTION: Notice of...Learning about Early Learning--Public Input Meetings...S. Department of Education, 400 Maryland...

2010-04-21

358

Expressive Education in Early Childhood.  

Science.gov (United States)

Presents a concise overview of early childhood music education in Japan. Japanese early childhood education stresses the natural development of childhood, as well as cultivation of expressive activities. Discusses teaching methods, creative activities, and educational guidelines (MJP)

Mori, Kimie

1996-01-01

359

History of early atomic clocks  

Energy Technology Data Exchange (ETDEWEB)

This review of the history of early atomic clocks includes early atomic beam magnetic resonance, methods of separated and successive oscillatory fields, microwave absorption, optical pumping and atomic masers. (author)

Ramsey, N.F. [Harvard Univ., Cambridge, MA (United States). Lyman Lab. of Physics

2005-06-01

360

Expenditures for Early Intervention Services  

Science.gov (United States)

What does it cost to provide early intervention services? Data collected as part of the National Early Intervention Longitudinal Study were used to determine expenditures for infants, toddlers, and their families receiving services through Part C programs. The study found that the national average total expenditure for early intervention services…

Hebbeler, Kathleen; Levin, Jesse; Perez, Maria; Lam, Irene; Chambers, Jay G.

2009-01-01

 
 
 
 
361

Early Childhood Education: Policy Issues.  

Science.gov (United States)

Policy issues in the area of early childhood education are discussed in this document prepared for the Chief State School Officers of the Northwest and Pacific. Particular attention is given to: (1) the scope of early childhood education; (2) academic, developmental, economic, and political purposes of early childhood education; (3) targeted…

Hansen, Kenneth H.

362

The early Universe  

International Nuclear Information System (INIS)

A review is given of some of the work presented at a week-long workshop which was the culmination of a six month program on the early Universe, held at the Institute for Theoretical Physics, University of California. The purpose of the program was to focus on the close relationship between cosmology and particle physics with especial reference to the study of grand unification schemes. Subjects covered in this review include; standard big-bang model, elementary particles and interactions, primordial nucleosynthesis, baryosynthesis, galaxy formation, exotic relics from the big bang, phase transitions, fundamental problems. (U.K.)

363

Artritis Temprana / Early Arthritis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Costa Rica | Language: Spanish Abstract in spanish Hasta la década de los años ochenta se consideraba a la artritis reumatoide (AR) como una enfermedad poco frecuente, de gravedad leve a moderada, que tenía una evolución lentamente, progresiva hacia el daño articular y la incapacidad. El aborde terapéutico convencional hasta ese momento, era el trat [...] amiento clásico de la pirámide. Abstract in english Until the early the eighties was considered rheumatoid arthritis to (RA) as a rare disease of mild to moderate severity, which had a slowly evolution towards joint damage and disability. The conventional therapeutic option until then, was the classic treatment of the pyramid. [...

364

Modeling Early Mars Climate  

Science.gov (United States)

Mars is presently cold and dry but geomorphological, sedimentary and mineralogical observations indicate the presence of liquid water on its surface [Baker, 2001; Squyres et al., 2004; Poulet et al., 2005]. Taking into account the expected dimmer early sun, an optically thick atmospheric greenhouse is required to reach a thermal balance optimal for the existence of liquid water on Mars. Infrared scattering by CO2 clouds [Kasting, 1991], compensates for their shortwave cooling effect [Forget and Pierrehumbert, 1997] but a variety of climate models, from simple one-dimensional radiative-convective columns to full global circulation models, still require several bars of CO2 to reach near-melting conditions [Forget et al., 2012; Wordsworth et al., 2012]. Yung et al. [1997] suggested that trace amounts of volcanically emitted SO2 would inhibit CO2 condensation, allowing a surface temperature increase capable of supporting liquid water. Halevy et al. [2007] modeled the coupled sulfur and carbon cycles to explore the effects of ppb to ppm levels of SO2 on the climate and surface chemistry of early Mars. Subsequent global climate model simulations [Johnson et al., 2008] support the suggestion that strong greenhouse warming by SO2 increased early surface temperatures. In addition to gases, the effect of various aerosols, such as mineral dust, organic hazes and sulfur-bearing particles, remains unexplored. We have developed a rapid 1-D radiative transfer code using correlated-k distributions of gaseous absorption, instead of a computationally demanding line-by-line model. The radiative transfer backbone of the model is based on the line-by-line model of Halevy et al. [2009], as well as the high-resolution absorption spectra used to generate the k-coefficients required for the new, efficient model. The model allows calculation of simultaneous absorption and multiple-scattering at all wavelengths and is, therefore, especially suitable for exploring the effect of atmospheric particles on the radiative transfer. With this model we explore a range of atmospheric compositions, which can maintain a climate capable of sustaining liquid water at the Martian surface. We also explore the effect that mineral dust may have had in Mars' early climate.

Ozak, Nataly; Halevy, Itay; Aharonson, Oded

2013-04-01

365

Artritis Temprana / Early Arthritis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Costa Rica | Language: Spanish Abstract in spanish Hasta la década de los años ochenta se consideraba a la artritis reumatoide (AR) como una enfermedad poco frecuente, de gravedad leve a moderada, que tenía una evolución lentamente, progresiva hacia el daño articular y la incapacidad. El aborde terapéutico convencional hasta ese momento, era el trat [...] amiento clásico de la pirámide. Abstract in english Until the early the eighties was considered rheumatoid arthritis to (RA) as a rare disease of mild to moderate severity, which had a slowly evolution towards joint damage and disability. The conventional therapeutic option until then, was the classic treatment of the pyramid. [...

2011-02-01

366

Artritis Temprana Early Arthritis  

Directory of Open Access Journals (Sweden)

Full Text Available Hasta la década de los años ochenta se consideraba a la artritis reumatoide (AR como una enfermedad poco frecuente, de gravedad leve a moderada, que tenía una evolución lentamente, progresiva hacia el daño articular y la incapacidad. El aborde terapéutico convencional hasta ese momento, era el tratamiento clásico de la pirámide.Until the early the eighties was considered rheumatoid arthritis to (RA as a rare disease of mild to moderate severity, which had a slowly evolution towards joint damage and disability. The conventional therapeutic option until then, was the classic treatment of the pyramid.

2011-02-01

367

Exploring the Early Americas  

Science.gov (United States)

When thinking about the early Americas, it's hard not to consider the stellar materials that make up the Jay I. Kislak Collection at the Library of Congress. Kislak amassed thousands of items related to early Florida, the Caribbean, and Mesoamerica, and subsequently donated over 3,000 of these items to the Library. This online exhibition affords interested parties a taste of these materials organized into three sections: "Pre-Contact America", "Explorations and Encounters", and "Aftermath of the Encounter". Within each section, visitors can read a brief introductory essay and then dive right into the artifacts and documents presented therein. One delightful section that should not be missed is the "Urban Landscapes" section within "Pre-Contact America". Here visitors can wonder over miniature village scenes from West Mexico and views of Tenochtitl'n and Cusco from 1572. That's far from all, as the site also has three "Interactive" presentations. They cover the famed Waldseem'ller Maps of 1507 and 1516 and a complete digitized version of Alexander Exquemelin's rousing 1678 work, "The Buccaneers of America".

368

[Early onset diabetes mellitus].  

Science.gov (United States)

Neonatal diabetes mellitus is a rare condition (1/90,000 to 1/260,000 live births) defined as mild-to-severe hyperglycemia within the first year of life. Permanent neonatal diabetes mellitus requires lifelong therapy, whereas transient form resolves early in life but may relapse later on. Two main physiopathological mechanisms may explain this disease: ? cell functional impairment or absence (pancreas agenesis or ? cells destruction). The main genetic causes of ? cells impairment are 6q24 abnormalities and mutations in ABCC8 or KCNJ11 potassium channel (KATP channel) genes. Compared to the KATP subtype, the 6q24 subtype had specific features: developmental defects involving the heart, kidneys, or urinary tract, intrauterine growth restriction, and early diagnosis. Remission of neonatal diabetes mellitus occurred in 51% of probands at a median age of 17 weeks. Recurrence was common at pubertal age, with no difference between the 6q24 and KATP-channel groups (82% vs 86%, p=0.36, respectively). Patients with mutations in ABCC8 or KCNJ11 genes had developmental delay with or without epilepsy but also developmental coordination disorder (particularly visual-spatial dyspraxia) or attention deficits in all of those who underwent in-depth neuropsychomotor investigations. PMID:24360362

Busiah, K; Vaivre-Douret, L; Yachi, C; Cavé, H; Polak, M

2013-12-01

369

Faculty Early Career Development (CAREER) Program  

Science.gov (United States)

Faculty Early Career Development (CAREER) Program Including the description of the NSF component ... Title: Faculty Early Career Development (CAREER) Program Synopsis of Program: The Faculty Early ...

370

Chopin Early Editions  

Science.gov (United States)

Over the past few years, the Special Collections unit of the University of Chicago Libraries has distinguished itself by creating a number of high-quality digital collections. The Chopin Collection is another such collection, as it brings together over 400 first and early printed editions of musical compositions by Frederic Chopin. This particular collection is quite compelling as it brings together a number of variant texts, originating from the different versions published concurrently in several countries. First-time visitors can begin by browsing the collection by title, uniform title or genre, such as scherzos, fantasias, or boleros. Lovers of Chopin will find this site quite enticing, as will musicologists, both amateur and professional. The site is rounded out by a section dedicated solely to providing information about the way in which the digital collection was created.

371

Early retirement for weaponeers?  

International Nuclear Information System (INIS)

Department of Energy's Lawrence Livermore Laboratory's once-vital nuclear weapons division is now in dire straits. The laboratory was established in 1952, during the titanic struggle over the hydrogen bomb, has grown steadily from $7 million to its peak of $1.1 billion in 1991. The future for key members of their most experienced weapons design team is uncertain. Over the past two years, Livermore's operating budget has fallen by 12.5 percent or $127.6 million. Nearly 750 employees, 10 percent of the work force, accepted early retirement offers last year. Further budget cuts will force another 300 to 600 personnel out by the end of 1995. The future resides in the U.S. Congress

372

Earth's early atmosphere.  

Science.gov (United States)

Ideas about atmospheric composition and climate on the early Earth have evolved considerably over the last 30 years, but many uncertainties still remain. It is generally agreed that the atmosphere contained little or no free oxygen initially and that oxygen concentrations increased markedly near 2.0 billion years ago, but the precise timing of and reasons for its rise remain unexplained. Likewise, it is usually conceded that the atmospheric greenhouse effect must have been higher in the past to offset reduced solar luminosity, but the levels of atmospheric carbon dioxide and other greenhouse gases required remain speculative. A better understanding of past atmospheric evolution is important to understanding the evolution of life and to predicting whether Earth-like planets might exist elsewhere in the galaxy. PMID:11536547

Kasting, J F

1993-02-12

373

High signal intensity of intervertebral calcified disks on T1-weighted MR images resulting from fat content  

International Nuclear Information System (INIS)

To explain a cause of high signal intensity on T1-weighted MR images in calcified intervertebral disks associated with spinal fusion. Magnetic resonance and radiological examinations of 13 patients were reviewed, presenting one or several intervertebral disks showing a high signal intensity on T1-weighted MR images, associated both with the presence of calcifications in the disks and with peripheral fusion of the corresponding spinal segments. Fusion was due to ligament ossifications (n=8), ankylosing spondylitis (n=4), or posterior arthrodesis (n=1). Imaging files included X-rays and T1-weighted MR images in all cases, T2-weighted MR images in 12 cases, MR images with fat signal suppression in 7 cases, and a CT scan in 1 case. Histological study of a calcified disk from an anatomical specimen of an ankylosed lumbar spine resulting from ankylosing spondylitis was examined. The signal intensity of the disks was similar to that of the bone marrow or of perivertebral fat both on T1-weighted MR images and on all sequences, including those with fat signal suppression. In one of these disks, a strongly negative absorption coefficient was focally measured by CT scan, suggesting a fatty content. The histological examination of the ankylosed calcified disk revealed the presence of well-differentiated bone tissue and fatty marrow within the disk. The high signal intensity of some calcified intervertebral disks on T1-weighted MR images can result from the presence of fatty marrow, probably related to a disk ossification process in ankylosed spines. (orig.)

374

Early events in ovarian oncogenesis  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Ovarian cancer represents the most lethal of the gynecological neoplasms. The molecular and genetic events associated with early ovarian oncogenesis are still largely unknown, thus contributing to the lack of reliable biomarkers for disease detection. Since the majority of ovarian tumors are diagnosed at an advanced stage, the availability of early ovarian cancer tissue samples for molecular analyses is very limited. In this review, problems encountered in the study of early ovarian cancer are presented, along with the controversies concerning precursor lesions and stepwise progression towards ovarian malignancy. Experimental modeling in the development of ovarian cancer is also described, as well as genetic and epigenetic alterations associated with early ovarian cancer. Lastly, examples of technological advances in the study of early ovarian cancer are discussed. Hopefully, the increasing knowledge about molecular and genetic events involved in the early stages of ovarian tumorigenesis will provide the basis for management of ovarian cancer in the future.

Cvetkovic Dusica

2003-10-01

375

Can imaging be used for inflammatory arthritis screening?  

DEFF Research Database (Denmark)

This article reviews the utility of imaging in the diagnostic work-up of suspected and undifferentiated axial and peripheral inflammatory arthritis. Radiographic findings, that is, late damage but not early inflammation, are part of the classification criteria for rheumatoid arthritis (RA), ankylosing spondylitis, spondyloarthritis (SpA), and psoriatic arthritis (PsA), and they are generally part of the early examination program in arthritis.Computed tomography visualizes calcified tissue with high resolution but is rarely used unless radiography is unclear and MRI unavailable.MRI and ultrasonography (US) allow sensitive visualization and assessment of peripheral inflammatory and destructive joint and soft tissue involvement, and MRI is by far the best available method for detecting inflammation in the spine and sacroiliac joints in early SpA. Thus MRI/US can contribute to an earlier diagnosis of RA, PsA, and SpA.MRI and US are part of the recent American College of Rheumatology/European League against Rheumatism 2010 classification criteria for RA (can be used to count involved joints), and MRI is part of the SpondyloArthritis International Society criteria for axial and peripheral SpA.Thus radiography, MRI, and/or US should be used in clinical practice to contribute to the diagnostic work-up in suspected, but not definite, inflammatory joint disease and early unclassified inflammatory joint