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Sample records for early ankylosing spondylitis

  1. Whole body MR imaging in ankylosing spondylitis: a descriptive pilot study in patients with suspected early and active confirmed ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Hodler Juerg

    2007-02-01

    Full Text Available Abstract Background Ankylosing spondylitis is a chronic inflammatory rheumatic disorder which usually begins in early adulthood. The diagnosis is often delayed by many years. MR imaging has become the preferred imaging method for detection of early inflammation of the axial skeleton in ankylosing spondylitis. The goal of this study was to assess the frequency and distribution of abnormalities on whole body MR imaging in patients with suspected early ankylosing spondylitis and with active confirmed ankylosing spondylitis. Methods Ten patients with suspected early ankylosing spondylitis and ten patients with confirmed ankylosing spondylitis were enrolled. On an 18-channel MR system, coronal and sagittal T1 weighted and STIR sequences were acquired covering the entire spine, sacrum, anterior chest wall, shoulder girdle, and pelvis. The total examination time was 30 minutes. Results In both groups inflammatory lesions of the lower thoracic spine were frequent (number of patients with suspected early/confirmed ankylosing spondylitis: 7/9. In confirmed ankylosing spondylitis the upper thoracic spine (3/6 and the lumbar spine (4/8 were more commonly involved. The inferior iliac quadrant of the sacroiliac joints was frequently altered in both groups (8/8. The superior iliac (2/5, inferior sacral (6/10 and superior sacral (3/6 quadrants were more frequently affected in confirmed ankylosing spondylitis. Abnormalities of the manubriosternal joint (2/4, the sternoclavicular joints (1/2 and hip joint effusion (4/3 were also seen. Conclusion In both suspected early ankylosing spondylitis and confirmed ankylosing spondylitis, whole body MR examinations frequently demonstrate inflammatory lesions outside the sacroiliac joints. These lesions are similarly distributed but occur less frequently in suspected early compared to confirmed ankylosing spondylitis. Due to the small sample size in this pilot study these results need to be confirmed in larger studies with this emerging technique.

  2. Use of static lung mechanics to identify early pulmonary involvement in patients with ankylosing spondylitis.

    OpenAIRE

    Aggarwal A; Gupta D; Wanchu A; Jindal S

    2001-01-01

    AIM: To assess if a detailed analysis of lung mechanics could help in early recognition of pulmonary abnormalities in patients with ankylosing spondylitis. METHODS: Static pulmonary mechanics were studied in 17 patients (16 men and one woman) of ankylosing spondylitis with no obvious clinical or radiological evidence of pulmonary involvement. Lung pressure-volume relationship was generated using a whole body plethysmograph, and a monoexponential equation fitted to this data. RESULTS: Total lu...

  3. Ankylosing spondylitis: an autoimmune disease?

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    Lakomek, H. J.; Plomann, M.; Specker, C.; Schwochau, M.

    1991-01-01

    Identification of several autoantibodies in serum samples from patients with ankylosing spondylitis or suspected ankylosing spondylitis is reported. Five antibodies associated with ankylosing spondylitis were identified by applying cytoimmunofluorescence and immunoblotting techniques to antigen pools from insect tissue. At least one of these antibodies was found in 82% of serum samples from patients with ankylosing spondylitis. A 36 kD drosophila antigen, which showed the most common and most...

  4. Pulmonary manifestations of ankylosing spondylitis.

    Science.gov (United States)

    Kanathur, Naveen; Lee-Chiong, Teofilo

    2010-09-01

    Ankylosing spondylitis, a chronic multisystem inflammatory disorder, can present with articular and extra-articular features. It can affect the tracheobronchial tree and the lung parenchyma, and respiratory complications include chest wall restriction, apical fibrobullous disease with or without secondary pulmonary superinfection, spontaneous pneumothorax, and obstructive sleep apnea. Ankylosing spondylitis is a common cause of pulmonary apical fibrocystic disease; early involvement may be unilateral or asymmetrical, but most cases eventually consist of bilateral apical fibrobullous lesions, many of which are progressive with coalescence of the nodules, formation of cysts and cavities, fibrosis, and bronchiectasis. Mycobacterial or fungal superinfection of the upper lobe cysts and cavities occurs commonly. Aspergillus fumigatus is the most common pathogen isolated, followed by various species of mycobacteria. Prognosis of patients with fibrobullous apical lesions is mainly determined by the presence, extent, and severity of superinfection. Pulmonary function test results are nonspecific and generally parallel the severity of parenchymal involvement. A restrictive ventilatory impairment can develop in patients with ankylosing spondylitis because of either fusion of the costovertebral joints and ankylosis of the thoracic spine or anterior chest wall involvement. Chest radiographic findings may mirror the severity of clinical involvement. Pulmonary parenchymal disease is typically progressive, and cyst formation, cavitation, and fibrosis are seen in advanced cases. No treatment has been shown to alter the clinical course of apical fibrobullous disease. Although several antiinflammatory agents, such as infliximab, etanercept, and adalimumab, are being used to treat ankylosing spondylitis, their effects on pulmonary manifestations are unclear. PMID:20692546

  5. Ankylosing Spondylitis: a Reflection and a Question

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    Annia Deysi Hernández Martín

    2014-07-01

    Full Text Available Ankylosing spondylitis is a chronic inflammatory disease that affects the synovial membrane, joint entheses and para-articular structures of the spine, including the sacroiliac joints and limbs. We present a case of ankylosing spondylitis that had evolved for 12 years despite the relatively early diagnosis and treatment, showing flexion deformity and limitation of spinal movements. On radiological examination an early evolution to ankylosis was observed, which motivated us to make a reflection and a question.

  6. Ankylosing spondylitis: an overview

    OpenAIRE

    Sieper, J.; Braun, J.; Rudwaleit, M.; Boonen, A.; Zink, A.

    2002-01-01

    Ankylosing spondylitis (AS) is a complex, potentially debilitating disease that is insidious in onset, progressing to radiological sacroiliitis over several years. Patients with symptomatic AS lose productivity owing to work disability and unemployment, have a substantial use of healthcare resources, and reduced quality of life. The pathogenesis of AS is poorly understood. However, immune mediated mechanisms involving human leucocyte antigen (HLA)-B27, inflammatory cellular infiltrates, cytok...

  7. Use of static lung mechanics to identify early pulmonary involvement in patients with ankylosing spondylitis.

    Directory of Open Access Journals (Sweden)

    Aggarwal A

    2001-04-01

    Full Text Available AIM: To assess if a detailed analysis of lung mechanics could help in early recognition of pulmonary abnormalities in patients with ankylosing spondylitis. METHODS: Static pulmonary mechanics were studied in 17 patients (16 men and one woman of ankylosing spondylitis with no obvious clinical or radiological evidence of pulmonary involvement. Lung pressure-volume relationship was generated using a whole body plethysmograph, and a monoexponential equation fitted to this data. RESULTS: Total lung capacity (TLC was reduced in one (5.9% and static lung compliance (Cst in nine (52.9% patients. Four (23.5% patients had normal TLC, yet Cst and shape constant (K were reduced. Five (29.4% patients had reduced TLC and Cst; four of them had low K. One (5.9% patient had normal TLC but elevated Cst and K. CONCLUSIONS: Pulmonary involvement in patients with ankylosing spondylitis is probably diffuse and begins much earlier than generally presumed. Evaluation of static lung mechanics can identify pulmonary involvement early in the course of disease in several of these patients.

  8. Andersson Lesion in Ankylosing Spondylitis

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    Manimegalai N, KrishnanKutty K, Panchapakesa Rajendran C, Rukmangatharajan S, Rajeswari S

    2004-04-01

    Full Text Available Andersson lesions are destructive foci that appear at the discovertebral junction in ankylosingspondylitis. We report three cases of ankylosing spondylitis with such lesions. These lesions simulatean infection and in our country, mimic spinal tuberculosis.

  9. Imaging in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Lambert, Robert G W

    2012-01-01

    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.

  10. [Physical Therapy in the early treatment of ankylosing spondylitis].

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    Mur, Erich

    2008-01-01

    The primary goals of physiotherapeutic interventions at the early phase of M. Bechterew are alleviation of pain and prevention of functional impairments in patients. In order to achieve these goals, measures that have proved effective at later stages of the disease can also be implemented early in the course of the disease. Movement therapy is of particular importance, and so are thermo- and electrotherapeutic interventions. Combined with adequate pharmacotherapy, established physiotherapeutic procedures can have a positive influence on the course of this disease. PMID:18500472

  11. Current radiodiagnostic concept of ankylosing spondylitis

    International Nuclear Information System (INIS)

    Nine radiodiagnostic rules are drawn from the X-rays of 2125 ankylosing spondylitis patients. The significance of early diagnosis of the 'multicolored' sacroiliac X-ray is looked onto; the syndesmophyte, squaring-phenomen, barrel-shaped vertebra, Romanus and Andersson lesions, and the ossification of ligaments are discussed. The changes at the apophyseal and the costovertebral joints, unimportant for early diagnosis, are explored. (orig.)

  12. [Diagnosis and approach in suspected ankylosing spondylitis].

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    Rentsch, H U; van der Linden, S; Gerber, N

    1991-05-21

    The time interval from first clinical symptoms to definite diagnosis of ankylosing spondylitis (Morbus Bechterew) is still too long. Thus, many years for essential therapeutic interventions are unequivocally lost. Therefore, it is most important to improve early diagnosis. To this aim the diagnostic criteria recently suggested by van der Linden are useful in relatively early stages of disease (table 1). Diagnosis is based on patient history, clinical examination and radiological signs of sacroiliitis. Blood examinations for ESR, rheumatoid factors and antinuclear antibodies are important with regard to differential diagnosis. The determination of the HLA-B27 haplotype as a diagnostic tool is irrelevant on terms of single cases, because at least 8% of ankylosing spondylitis patients are HLA-B27-negative and in middle europe at least 7% of normal controls exhibit this genetic marker. PMID:2052824

  13. Employment perspectives of patients with ankylosing spondylitis

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    Chorus, A.; Boonen, A.; Miedema, H.; Linden, S.

    2002-01-01

    Objectives: To assess the labour market position of patients with ankylosing spondylitis (AS) in relation to disease duration and to identify potential factors in relation to withdrawal from the labour force.

  14. Traumatic death in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Thomsen, Asser H; Jurik, Anne Grethe

    2010-01-01

    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.

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

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

    2008-02-18

    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

  16. Rehabilitation techniques in ankylosing spondylitis management: a case report

    OpenAIRE

    Henderson, Shawn

    2003-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disorder of the musculoskeletal system. Progressive complaints of axial stiffness and restriction in movement may not be addressed by general medical practitioners. While AS has a progressive natural history, chiropractors may play a significant role in early detection, patient education, and management. Early diagnosis and therapy may help to minimize future pain and disability. Chiropractic treatment methods coupled with individualized a...

  17. 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.)

  18. A simplified version of Ankylosing Spondylitis Disease Activity Score (ASDAS) in patients with ankylosing spondylitis.

    Science.gov (United States)

    Sommerfleck, Fernando A; Schneeberger, Emilce E; Buschiazzo, Emilio E; Maldonado Cocco, José A; Citera, Gustavo

    2012-11-01

    This study aimed to develop a simplified version of the Ankylosing Spondylitis Disease Activity Score (ASDAS). The study included consecutive patients with ankylosing spondylitis according to modified New York and/or Assessment in Ankylosing Spondylitis 2009 criteria. Sociodemographic data and characteristics of the disease (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Ankylosing Spondylitis Quality of Life (ASQoL)) and erythrocyte sedimentation rate (ESR) were collected. ASDAS simplified version (SASDAS) was calculated as the simple linear sum of the five components of ASDAS which include: patient global assessment using visual analogue scale, back pain (BASDAI question no. 2), peripheral pain and swelling (BASDAI question no. 3), morning stiffness (BASDAI question no. 6), and ESR in millimeters per hour, divided by 10 so as to make it equivalent to the other scale's components. Eighty-six patients were included: 69 (80.2 %) were men with a median age of 46 years and median disease duration of 19 years. SASDAS showed an excellent correlation with the ASDAS (r?=?0.93). SASDAS also showed a good correlation with night pain (r?=?0.60), global pain (r?=?0.69), ASQoL (r?=?0.70), BASFI (r?=?0.75), and BASDAI (r?=?0.96). Using ASDAS cut-off values previously suggested, the corresponding cut-off values for SASDAS were as follows: from 0 to 7.8 (inactive disease), from 7.9 to 13.8 (moderate disease activity), from 13.9 to 27.6 (high disease activity), and above 27.6 (very high disease activity) with optimum sensitivity and specificity. SASDAS showed an excellent correlation with conventional clinical measures of disease activity, and it can be easily calculated and is simple to use in daily clinical practice. PMID:22895877

  19. Foraminal Synovial Cyst Associated with Ankylosing Spondylitis

    OpenAIRE

    Kim, Heyun Sung; Ju, Chang Il; Kim, Seok Won

    2011-01-01

    Ankylosing spondylitis (AS) is frequently associated with inflammatory lesions of the spine and continuous fatigue stress fractures; however, an association with an intraspinal synovial cyst has not been previously reported. A 55-year-old man with a five year history of AS who presented with back pain and a right radiculopathy was admitted to the hospital. Five years previously, he underwent a percutaneous vertebroplasty for an osteoporotic L1 compression fracture, and was diagnosed with AS a...

  20. Ankylosing spondylitis in two Zaïrian brothers.

    Science.gov (United States)

    Mbuyi-Muamba, J M; Malonda, N; Yuma, O

    1993-06-01

    Ankylosing spondylitis has never been described in Zaïre and is considered to be rare in black African populations. We report two cases observed in the University Hospital of Kinshasa. The two patients are brothers. The diagnosis is based on anaemnestic, clinical and radiological findings. We therefore demonstrate the existence of this disease in Zaïre and presume that other similar cases may be diagnosed. PMID:8358992

  1. Update on the treatment of ankylosing spondylitis

    OpenAIRE

    Maksymowych, Walter P.

    2007-01-01

    Non-steroidal anti-inflammatory agents (NSAIDs) remain the mainstay of treatment for ankylosing spondylitis (AS) though one recent trial suggests that continuous as opposed to on-demand use may be superior in preventing progression of structural damage. One particular NSAID, which is a highly selective cyclo-oxygenase 2 inhibitor, etoricoxib, may be superior to standard NSAIDs for AS. Second-line agents typically used for rheumatoid arthritis appear to lack efficacy. Salazopyrin is only moder...

  2. Cutaneous vasculitis and IgA glomerulonephritis in ankylosing spondylitis.

    OpenAIRE

    De Beauvais, C.; Kaplan, G; Mougenot, B.; C.; Michel; Marinho, E

    1993-01-01

    Two patients with ankylosing spondylitis were found to have IgA nephropathy and leucocytoclastic cutaneous vasculitis. Immunofluorescence showed perivascular deposition of IgA in the skin of one patient and in the mesangium of both patients. Such an association has been reported only once before. This supports the concept of abnormal IgA immune stimulation in the pathogenesis of ankylosing spondylitis.

  3. Rosuvastatin improves endothelial dysfunction in ankylosing spondylitis.

    Science.gov (United States)

    Garg, Nidhi; Krishan, Pawan; Syngle, Ashit

    2015-06-01

    Enhanced cardiovascular risk in ankylosing spondylitis (AS) provides a strong rationale for early therapeutical intervention. In view of the proven benefit of statins in atherosclerotic vascular disease, we aimed to investigate the effect of rosuvastatin on endothelial dysfunction (ED) and inflammatory disease activity in AS. In a single-blind, placebo-controlled, parallel study, 32 AS patients were randomized to receive 24 weeks of treatment with rosuvastatin (10 mg/day, n?=?17) and placebo (n?=?15) as an adjunct to existing stable antirheumatic drugs. Flow-mediated dilatation (FMD) was assessed by AngioDefender™ (Everest Genomic Ann Arbor, USA). Inflammatory measures (BASDAI, BASFI, CRP and ESR) and pro-inflammatory cytokines (tumour necrosis factor-alpha [TNF-?], interleukin-6 [IL-6] and interleukin-1 [IL-1]) were measured at baseline and after treatment. Lipids and adhesion molecules (intracellular adhesion molecule [ICAM-1] and vascular cell adhesion molecule [VCAM-1]) were estimated at baseline and after treatment. At baseline, inflammatory measures, pro inflammatory cytokines and adhesion molecules were elevated among both groups. After treatment with rosuvastatin, FMD improved significantly (p?disease activity and ED in AS. Rosuvastatin lowers the proinflammatory cytokines, especially IL-6 and TNF-?, which downregulates adhesion molecules and CRP production which in turns improves ED. Improvement in ED in AS occurs through both cholesterol-independent and cholesterol-dependent pathways. Rosuvastatin can mediate modest but clinically apparent anti-inflammatory effects with modification of vascular risk factors in the context of high-grade autoimmune inflammation of AS. PMID:25771851

  4. Dermatoglyphic analysis of patients with ankylosing spondylitis.

    Science.gov (United States)

    Wisniewska, H

    1985-01-01

    Dermatoglyphic features on fingers and palms were assayed in 50 male patients with ankylosing spondylitis (AS) and in 36 families (184 family members, 1st degree male relatives). In patients significantly higher occurrence of whorls and arches on finger tips was found. Loops were significantly less frequent when compared to standard population patterns. Decreasing number of palmar patterns was found in AS patients. Distal position of triradius, as well as more frequent occurrence of t', t" make the difference between AS patients and Polish population. Main lines D, C, B, A in AS patients tend to end in areas of lower numbers (9,7,5,4). That makes a significant difference with results obtained from population studies (p less than 0.01). The main line D in the area 9 occurs more frequently in AS patients expressing HLA-B27 antigen than in patients not showing it (p less than 0.01). PMID:3879949

  5. Ankylosis in ankylosing spondylitis: current concepts.

    Science.gov (United States)

    Haroon, Nigil

    2015-06-01

    Ankylosing spondylitis (AS) is the most common form of spondyloarthritis and is characterized by both inflammation and new bone formation. Despite many years of arduous efforts, we still do not clearly understand the pathogenesis of AS. The mechanisms behind new bone formation have been especially challenging to decipher due to the difficulty in obtaining tissue from spinal joints. The link between inflammation and bone formation looks obvious, but how inflammation drives spinal fusion is not evident. There are now two genes linked to prostaglandins (PG) that could be involved in AS pathogenesis. The first one is PTGER4 that codes for the EP4 receptor for PGE2 and the other one is PTGS1 that codes for prostaglandin-endoperoxide syntase 1 or cyclogenase 1. The bone morphogenic protein and Wnt signaling pathways could be important in signaling increased bone formation in AS. The disease-modifying potential of anti-inflammatories and tumor necrosis factor alpha inhibitors is discussed. PMID:25935456

  6. Chronic otitis media: a new extra-articular manifestation in ankylosing spondylitis?

    OpenAIRE

    Camilleri, A E; Swan, I R; Murphy, E.; Sturrock, R.D.

    1992-01-01

    Following a study reporting a fourfold increase in the occurrence of chronic otitis media in patients with ankylosing spondylitis, this prospective study examines this association with respect to severity, duration of disease, and acute phase in ankylosing spondylitis. Forty two consecutive patients with classical ankylosing spondylitis seen at the rheumatology clinic of a teaching hospital where the features of ankylosing spondylitis were recorded had an otological examination by an otolaryn...

  7. Ankylosing Spondylitis Associated With Bilateral TMJ Ankylosis

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ju Seop; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Chonbuk National University, Iksan (Korea, Republic of)

    2000-09-15

    A 31-year-old male with severe limitation of mouth opening was referred to our department of Chonbuk National University Hospital. The physical status of the patient was hyposthenic. Extraoral examination showed no condylar movement of the both temporomandibular joints, no pain, no faical swelling or paresthesia. Intraoral examination showed several cervical caries on the upper anterior teeth, and gingival swelling on the whole dentition. Transcranial view showed no condylar movement, and narrowing of joint spaces. Chest P-A view showed straightening of thoracic, lumbar spine, and squaring of vertebrae of the same spines. Conventional lateral radiograph of cervical spine showed calcification of the intervertebral ligament. Computed tomograph showed extensive bone formation between temporal bone and the both condylar heads. Labortory findings showed positive reaction on HLA-B27 histocompatibility antigen and increased level of IgA, IgG, ESR. Based on the clinical, radiographic, and the labortary findings, final diagnosis was made as bony ankylosis of the both temporomandibular joints secondary to ankylosing spondylitis.

  8. 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

  9. Symptom modifiers in therapy for ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Vladimir Vasilyevich Badokin

    2010-06-01

    Full Text Available Based on the data available in the literature, the author gives information on the prevalence of ankylosing spondyloarthritis. The clinical picture and pathogenesis of this disease and the principles of its diagnosis and treatment are described. Particular emphasis is placed on the use of etoricoxib, a nonsteroidal anti-inflammatory drug, in ankylosing spondyloarthritis. The available data strongly prove that etoricoxib is an alternative in the treatment of inflammatory diseases of the joints and vertebral column, ankylosing spondyloarthritis in particular.

  10. Sequential appearance of ankylosing spondylitis, retroperitoneal fibrosis and achalasia: Coincidental association or evidence of autoimmunity?

    Directory of Open Access Journals (Sweden)

    . Katsinelos P.

    2007-03-01

    Full Text Available SUMMARY The association of idiopathic achalasia with ankylosing spondylitis and retroperitoneal fibrosis, to our knowledge not previously reported, is described in a 54 year old woman. We suggest that the consecutive occurrence of ankylosing spondylitis and retroperitoneal fibrosis, two well-known autoimmune disorders, before the presence of achalasia, reinforces the theory of autoimmunity in etiopathogenesis of achalasia. Key words: Achalasia, Ankylosing spondylitis, Retroperitoneal fibrosis, Autoimmunity

  11. Juvenile Ankylosing Spondylitis and Juvenile Rheumatoid Arthritis: Differentiation on the Basis of Joint Involvement

    OpenAIRE

    Heydari, B.(B.); Z Nowroozi

    1999-01-01

    Juvenile-onset Ankylosing Spondylitis (JAS), commonly present as an acute peripheral Arthritis, may be included in Juvenile Rheumatoid Arthritis (JRA) patients. Distinction of the 2 diseases. On the basis of radiological findings, may last several years. Many investigations have tried to determine early clinical data of JAS and differentiate it from JRA. The present study aim to distinct early JAS findings and to compare them with JRA. During the previous 5 years 17 cases of JRA were diagnose...

  12. MRI of the axial skeletal manifestations of ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Levine, D.S.; Forbat, S.M.; Saifuddin, A. E-mail: asaifuddin@aol.com

    2004-05-01

    Magnetic resonance imaging (MRI) is a valuable tool in the imaging and assessment of patients with ankylosing spondylitis. MRI can demonstrate the acute and chronic changes of sacroiliitis, osteitis, discovertebral lesions, disc calcifications and ossification and arthopathic lesions, which characterize the disease, as well as the complications, which include fracture and the rare cauda equina syndrome. This article reviews the range of MRI findings commonly seen within the axial skeleton in patients with this condition.

  13. X-ray therapy in the treatment of ankylosing spondylitis

    International Nuclear Information System (INIS)

    The results of the treatment of a randomly selected series of 277 patients is presented and some consideration is given to the complications and sequelae of the X-ray therapy here described. There is particular reference to the risk of leukaemogenesis, the decline in the use of X-ray therapy and the present position in Britain of the management of ankylosing spondylitis. (orig./MG)

  14. Effects of Glossopharyngeal Insufflation in Ankylosing Spondylitis: A Pilot Study

    OpenAIRE

    Brodin, Nina; Lindholm, Peter; Lennartsson, Claudia; Nygren-bonnier, Malin

    2014-01-01

    In Ankylosing Spondylitis (AS), thoracic range of motion is often greatly limited. The objective of the study was to describe the effects of 12 weeks of Glossopharyngeal Insufflation (GI) training in patients with AS. Dynamic spirometry included vital capacity, forced expiratory volume, and peak expiratory flow. Thoracic and lumbar range of motion was assessed by tragus-to-wall distance, modified Schober test, and tape measure. Disease activity, activity limitation, and health perception were...

  15. Investigation of Spatial Clusters of Patients with Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Özge PAS?N

    2014-10-01

    Full Text Available Objective: The Geographic Information System (GIS, in health area studies especially topics such as the distribution, clustering and mapping of disease, the geographic location of health services and the determination of healthcare distribution, are frequently used. Limited regional studies on these subjects are available in our country. The aim of this work is to investigate the distribution and clustering status of ankylosing spondylitis disease in Duzce by the GIS based global spatial clustering methods. Materials and Methods: 52 patients with ankylosing spondylitis who admitted to Physical Therapy and Rehabilitation polyclinic in Duzce University Researching and Training Hospital on various dates for diagnosis or treatment were included in study. With the help of the patient data collected from reports in 2013 year, spatial clusters of the disease were examined by Nearest neighbor, Moran I, Getis ORD, and Ripley's K function methods. The study was conducted in ArcGIS program. Results: With the examined global spatial clustering methods, in the center of Duzce the distribution of ankylosing spondylitis patients was obtained and it was determined a significant spatial cluster for this disease. However, thence a few collected data set and the used only the data of a health center, due to the rarity of ankylosing spondylitis disease, clustering may not reflect the truth. Because the health center where data is collected is the largest and most comprehensive in Duzce, it should not be ignored that results are important like a preliminary study. Conclusion: To raise the level of public health and to improve remedial policies it is recommended to examine the clustering structures in the issues such as the distribution and location of disease, staff, health center which have important role in the planning, protection, and the diagnosis-treatment process.

  16. MRI manifestations of lumbar active inflammation in ankylosing spondylitis

    International Nuclear Information System (INIS)

    Objective: To study the MRI manifestations of lumbar active inflammation in ankylosing spondylitis (AS), and its relationship with CT grade of sacroiliitis. Methods: 64 cases of AS accepted lumbar MR scan with sagittal STIR/SPIR and T1-weighted fat suppressed sequences after administration of GD-DTPA. MR manifestations of lumbar active inflammation including active spondylitis, spondylodiskitis, arthritis of the facet joints and enthesitis were studied. Spondylitis was especially analyzed by Berlin method. 40 cases accepted CT scan of sacroiliac joints simultaneously, classed by modified New York criteria. Correlation: analysis was made between lumbar involvement and Berlin method. Results: There were 42 cases of active spondylitis, 6 of spondylodiskitis, 37 of arthritis of the facet joints, 32 of enthesitis in all 64 cases. The positive rate of lumbar involvement in AS was 85.9%. Positive rate of Spondylitis was 65.6%. L1/2 was 34.4%, which accounted for the most in all lumbar vertebral units, but there was not statistically significance between L1/2 and other Vertebral Units (P>0.05). The mean score of L5/S1 was 1.23, which was the highest in vertebral units involved, and there was statistically significance between L5/S1 and T12/L1, L1/2, L2/ 3 (P0.05) between lumbar active inflammation and the CT grades of sacroiliitis. Conclusions: Lumbar involvement of AS is common, mostly manifested as spondylitis, common, mostly manifested as spondylitis, arthritis of the facet joints and enthesitis, with spondylodiskitis the least. In spondylitis, L1/2 is the most. There maybe no correlation between lumbar involvement and degree of spondylitis and grade of sacroiliitis. (authors)

  17. Nursing and safety of silver needle diathermy treating ankylosing spondylitis.

    Science.gov (United States)

    Ning, Huaxiu; Wang, Yun; Yuan, Yiwen; Ning, Huaying

    2015-03-01

    This paper aims to discuss the nursing and safety of silver needle diathermy in the treatment for ankylosing spondylitis. We nursed 46 patients with ankylosing spondylitis treated with silver needle diathermy. Specific nursing was focused on physical condition evaluation and mental nursing before treatment, observation during and after treatment, diet nursing, needle eye nursing, functional training and propaganda and education when discharged. The result suggested that all the patients received mental nursing, diet guide, skin care, health education, functional training and follow-up visit from the nurse and all of them could endure silver needle diathermy as discomfort or drug allergy was barely found, so were slight scald and skin infection nearby the needle eye caused by fainting during acupuncture, accidental puncture or overheat. Follow-up visit showed that no patient suffered obvious untoward effect and the pain, joint range of motion and living condition were distinctly improved a week after discharging. In conclusion, during the treatment for ankylosing spondylitis applying silver needle diathermy, the nursing before, during and after the treatment can obviously reduce the complication, accelerate the recovery, which is highly safe. PMID:25796147

  18. Epicardial adipose tissue thickness in patients with ankylosing spondylitis.

    Science.gov (United States)

    Resorlu, Hatice; Akbal, Ayla; Resorlu, Mustafa; Gokmen, Ferhat; Ates, Can; Uysal, Fatma; Adam, Gurhan; Aylanc, Nilufer; Arslan, Muhammet; ?nceer, Besir Sahin

    2015-02-01

    The purpose of our study was to measure epicardial adipose tissue (EAT) thickness as a novel indicator of atherosclerosis and cardiovascular risk factor in ankylosing spondylitis (AS) patients and to show the relationship with clinical parameters and inflammatory markers. Forty AS patients (42.75?±?12.43 years) and 40 healthy individuals with no cardiovascular risk factor as the control group (43.02?±?14.78 years) were included in the study. Carotid intima-media thickness (CIMT) and EAT thickness were measured in AS patients and the control group. Total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, glucose, erythrocyte sedimentation rate, urea, and blood pressure were investigated in both groups. In addition, the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were used to evaluate the association between clinical findings and CIMT and EAT in the patient group. CIMT and EAT thickness were higher in the AS patients compared to the control group. CIMT was 0.76?±?0.19 and 0.57?±?0.12 mm (p?EAT thickness was 4.35?±?1.56 and 3.03?±?0.94 mm (p?EAT thickness and CIMT. Triglyceride level, patient age, blood pressure, and duration of disease were correlated with both CIMT and EAT thickness. Increased CIMT and EAT thickness in AS patients compared to the control group shows a risk for subclinical atherosclerosis and cardiovascular disease. PMID:24647981

  19. Atividade sexual na espondilite anquilosante Sexual activity in ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Andrea Lopes Gallinaro

    2012-12-01

    Full Text Available 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 - BASDAI, 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.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.

  20. Atividade sexual na espondilite anquilosante / Sexual activity in ankylosing spondylitis

    Scientific Electronic Library Online (English)

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

    2012-12-01

    Full Text Available 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.

  1. Cancer mortality following X-ray treatment for ankylosing spondylitis.

    OpenAIRE

    Weiss, Ha; Darby, Sc; Doll, R.

    1994-01-01

    Mortality has been studied in 15,577 ankylosing spondylitis (AS) patients diagnosed between 1935 and 1957 in the UK, of whom 14,556 received X-ray treatment. By January 1, 1992 over half of the cohort had died. Among the irradiated patients, cancer mortality was significantly greater than expected from the national rates for England and Wales, with a ratio of observed deaths to expected (relative risk, RR) of 1.30, and significant increases individually for leukaemia, non-Hodgkin's lymphoma, ...

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

    Scientific Electronic Library Online (English)

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

    2012-10-01

    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 (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.

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

    Directory of Open Access Journals (Sweden)

    Enéias Bezerra Gouveia

    2012-10-01

    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.

  4. Ankylosing spondylitis in North India: a clinical and immunogenetic study.

    OpenAIRE

    Prakash, S.; Mehra, N. K.; Bhargava, S.; Vaidya, M. C.; Malaviya, A. N.

    1984-01-01

    Fifty-one North Indian patients with ankylosing spondylitis (AS) are described with mean age of onset 21.2 years and male to female ratio of 16:1. AS began with peripheral arthritis in 47%, low back pain in 41%, acute anterior uveitis in 10%, and heel pain in 2% of the patients. 76% of 51 patients had one of the extra-axial features of AS: peripheral arthritis (61%), heel pain (24%), anterior uveitis (22%), urethritis (12%), kidney disease (10%), mucosal ulcerations (6%), aortic incompetence ...

  5. Contribution of functional KIR3DL1 to ankylosing spondylitis

    OpenAIRE

    Zvyagin, Ivan V.; Mamedov, Ilgar Z.; Britanova, Olga V.; Staroverov, Dmitriy B.; Nasonov, Evgeni L.; Bochkova, Anna G.; Chkalina, Anna V.; Kotlobay, Alexei A.; Korostin, Dmitriy O.; Rebrikov, Denis V.; Lukyanov, Sergey; Lebedev, Yuri B.; Chudakov, Dmitriy M.

    2010-01-01

    Increasing evidence points to a role for killer immunoglobulin-like receptors (KIRs) in the development of autoimmune diseases. In particular, a positive association of KIR3DS1 (activating receptor) and a negative association of KIR3DL1 (inhibitory receptor) alleles with ankylosing spondylitis (AS) have been reported by several groups. However, none of the studies analyzed these associations in the context of functionality of polymorphic KIR3DL1. To better understand how the KIR3DL1/3DS1 gene...

  6. Higher prevalence of peripheral arthritis among ankylosing spondylitis patients.

    OpenAIRE

    Lee, Ji-hyun; Jun, Jae-bum; Jung, Sungsoo; Bae, Sang-cheol; Yoo, Dae-hyun; Kim, Think-you; Kim, Seong Yoon; Kim, Tae-hwan

    2002-01-01

    This study was performed to define the clinical spectrum and disease manifestations of ankylosing spondylitis (AS) in a referral hospital setting. We identified the differences in clinical manifestations according to the sex, the age at onset, the presence of peripheral arthritis and the presence of HLA B27. A total 412 patients (357 males, 55 females) were recruited. Eighty-seven percent were men and 155 out of 412 patients (35%) were juvenile-onset. HLA B27 was detected in 385 patients (93%...

  7. ICF based comparison of disease specific instruments measuring physical functional ability in ankylosing spondylitis

    OpenAIRE

    Sigl, T; Cieza, A; van der Heijde, D.; Stucki, G

    2005-01-01

    Objectives: To link validated and widely used instruments measuring physical functional ability in ankylosing spondylitis to the International Classification of Functioning, Disability, and Health (ICF) and to compare their contents, based on the results of the linking process.

  8. Infliximab in combination with methotrexate in active ankylosing spondylitis: a clinical and imaging study

    OpenAIRE

    Marzo-Ortega, H; McGonagle, D; Jarrett, S; Haugeberg, G.; Hensor, E; O'Connor, P.; A. Tan; Conaghan, P; Greenstein, A; Emery, P.

    2005-01-01

    Objective: To examine the efficacy and safety of infliximab combined with methotrexate compared with methotrexate alone in the treatment of ankylosing spondylitis (AS) using MRI and DXA to monitor its impact on bone.

  9. Nonsteroidal anti-inflammatory drugs: a basis for the treatment of ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    A A Godzenko

    2011-12-01

    Full Text Available The paper describes the pathomorphological aspects of ankylosing spondylitis (AS and the value of nonsteroidal anti-inflammatory drugs in its therapy. Clinical trials demonstrate the high efficacy of aceclofenac (aertal in AS.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-12-01

    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

  11. [Correct and incorrect paths in the history of ankylosing spondylitis].

    Science.gov (United States)

    Fellmann, J

    1991-05-21

    This article retraces the history of ankylosing spondylitis. While the first part takes into consideration the paleopathological aspects of illness, the second part retains the main stages of the research on the subject from the 16th to the 19th century. This part refers to B.O. Connor, who in 1694 was the first to give a complete description of a characteristic skeleton. This part also mentions Benjamin Brodie who in 1850 wrote the first complete clinical description and Charles Fagge who in his work was the first to combine clinical and anatomical elements. The scientific discussion at the end of the 19th century between Adolf Strümpell. Wladimir von Bechterew and Pierre Marie is also part of this paragraph. The last part shows the important discoveries of the 20th century, specially useful for a better understanding of the pathogenesis of the disease. PMID:2052821

  12. Normal anti-Klebsiella lymphocytotoxicity in ankylosing spondylitis

    International Nuclear Information System (INIS)

    We compared in vitro lymphocytotoxicity (LCT) of peripheral blood lymphocytes (PBL), obtained from patients with ankylosing spondylitis (AS) and normal controls (NC). Assays were performed with antibacterial antisera prepared from AS- and NC-derived Klebsiella and coliforms Escherichia coli. LCT assessed by eosin staining was not significantly different in PBL of 12 AS patients and 28 controls when reacted with 3 Klebsiella and 1 E coli antisera. LCT assessed by 51Cr release was not significantly different for PBL of 20 age- and sex-matched pairs of AS patients and NC when reacted with 3 Klebsiella and 1 E coli antisera. Similarly, LCT-51Cr of PBL of 15 matched AS and NC pairs was not significantly different for anti-K21, a serotype putatively implicated in Klebsiella-HLA-B27 antigenic cross-reactivity. Our results do not support the notion of molecular mimicry between Klebsiella and B27 in the pathogenesis of primary AS

  13. 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

  14. MRI of cervical spine injuries complicating ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Koivikko, Mika P.; Koskinen, Seppo K. [Helsinki Medical Imaging Center, Helsinki University Central Hospital, Toeoeloe Hospital, Department of Radiology, Helsinki (Finland)

    2008-09-15

    The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed. A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during 6.2 years revealed 33 ankylosed spines studied for suspected acute cervical spine injury complicating AS. Of these, 20 patients also underwent MRI. On MRI, of these 20 patients, 19 had a total of 29 cervical and upper thoracic spine fractures. Of 20 transverse fractures traversing both anterior and posterior columns, 7 were transdiskal and exhibited less bone marrow edema than did those traversing vertebral bodies. One Jefferson's, 1 atlas posterior arch (Jefferson's on MDCT), 2 odontoid process, and 5 non-contiguous spinous process fractures were detectable. MRI showed 2 fractures that were undetected by MDCT, and conversely, MDCT detected 6 fractures not seen on MRI; 16 patients had spinal cord findings ranging from impingement and contusion to complete transection. Magnetic resonance imaging can visualize unstable fractures of the cervical and upper thoracic spine. Paravertebral hemorrhages and any ligamentous injuries should alert radiologists to seek transverse fractures. Multiple fractures are common and often complicated by spinal cord injuries. Diagnostic images can be obtained with a flexible multipurpose coil if the use of standard spine array coil is impossible due to a rigid collar or excessive kyphosis. (orig.)

  15. The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations : a nationwide register study

    DEFF Research Database (Denmark)

    Exarchou, Sofia; Lindström, Ulf

    2015-01-01

    INTRODUCTION: Prevalence estimates of ankylosing spondylitis vary considerably, and there are few nationwide estimates. The present study aimed to describe the national prevalence of clinically diagnosed ankylosing spondylitis in Sweden, stratified according to age, sex, geographical, and socio-economic factors, and according to subgroups with ankylosing spondylitis-related clinical manifestations and pharmacological treatment. METHODS: All individuals diagnosed with ankylosing spondylitis according to the World Health Organization International Classification of Disease codes, between 1967 and 2009, were identified from the National Patient Register. Data regarding disease manifestations, patient demographics, level of education, pharmacological treatment, and geographical region were retrieved from the National Patient Register and other national registers. RESULTS: A total of 11,030 cases with an ankylosing spondylitis diagnosis (alive, living in Sweden, and 16 to 64 years old in December 2009) were identified in the National Patient Register, giving a point prevalence of 0.18% in 2009. The prevalence was higher in northern Sweden, and lower in those with a higher level of education. Men had a higher prevalence of ankylosing spondylitis (0.23% versus 0.14%, P?ankylosing spondylitis of 0.18%. It revealed phenotypical and treatment differences between the sexes, as well as geographical and socio-economic differences in disease prevalence.

  16. Biomechanical assessment of balance and posture in subjects with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Sawacha Zimi

    2012-08-01

    Full Text Available Abstract Background Ankylosing spondylitis is a major chronic rheumatic disease that predominantly affects axial joints, determining a rigid spine from the occiput to the sacrum. The dorsal hyperkyphosis may induce the patients to stand in a stooped position with consequent restriction in patients’ daily living activities. The aim of this study was to develop a method for quantitatively and objectively assessing both balance and posture and their mutual relationship in ankylosing spondylitis subjects. Methods The data of 12 healthy and 12 ankylosing spondylitis subjects (treated with anti-TNF-? stabilized, with a mean age of 51.42 and 49.42?years; mean BMI of 23.08 and 25.44?kg/m2 were collected. Subjects underwent a morphological examination of the spinal mobility by means of a pocket compass needle goniometer, together with an evaluation of both spinal and hip mobility (Bath Ankylosing Spondylitis Metrology Index, and disease activity (Bath Ankylosing Spondylitis Disease Activity Index. Quantitative evaluation of kinematics and balance were performed through a six cameras stereophotogrammetric system and a force plate. Kinematic models together with a test for evaluating balance in different eye level conditions were developed. Head protrusion, trunk flexion-extension, pelvic tilt, hip-knee-ankle flexion-extension were evaluated during Romberg Test, together with centre of pressure parameters. Results Each subject was able to accomplish the required task. Subjects’ were comparable for demographic parameters. A significant increment was observed in ankylosing spondylitis subjects for knee joint angle with the target placed at each eye level on both sides (p? Conclusions Our findings confirm the need to investigate both balance and posture in ankylosing spondylitis subjects. This methodology could help clinicians to plan rehabilitation treatments.

  17. Core set of recommendations for patients with ankylosing spondylitis concerning behaviour and environmental adaptations.

    Science.gov (United States)

    Feldtkeller, Ernst; Lind-Albrecht, Gudrun; Rudwaleit, Martin

    2013-09-01

    Advice concerning behaviour and adaptations of living and working environment is considered an unmet need by patients with ankylosing spondylitis (AS). The aim of this study was to develop a core set of recommendations to be given to patients by their rheumatologists. A systematic literature research of scientific and patient-oriented literature revealed 70 raw recommendations. These recommendations were evaluated and ranked at a meeting of the Ankylosing Spondylitis International Federation (ASIF, 26 participants including 19 patients with AS, 5 rheumatologists and 2 physiotherapists from 13 countries) in November 2011. Thereafter, the 59 remaining recommendations were extensively discussed, supplemented, reworded, condensed and voted on during a meeting of local branch leaders of the AS patient organisation in Germany (Deutsche Vereinigung Morbus Bechterew, DVMB) with 80 participants (95 % of whom with AS), 2 rheumatologists and 1 occupational therapist in March 2012. The core set of final recommendations comprises (1) a general statement regarding living with AS which was considered highly important by patients and (2) the following domains: sitting position, walking, sleeping, at work, exercises, sports and recreational activities, diet and lifestyle, sexuality and pregnancy, fall prevention, car driving and advantages of membership in an AS-specific patient organisation. Most recommendations are relevant already in early disease, others concern advanced AS (e.g. fall prevention and car driving). The selected recommendations received high agreements (80-100 %). A first core set of recommendations for the behaviour and environmental adaptations of patients with AS was established under participation of many patients. PMID:23539272

  18. High-dose thalidomide increases the risk of peripheral neuropathy in the treatment of ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Hong-xia Xue

    2015-01-01

    Full Text Available Thalidomide is an effective drug for the treatment of ankylosing spondylitis but might induce peripheral neuropathy. This major adverse reaction has attracted much concern. The current study aimed to observe the incidence of thalidomide-induced peripheral neuropathy among ankylosing spondylitis patients for 1 year after treatment. In this study, 207 ankylosing spondylitis cases received thalidomide treatment, while 116 ankylosing spondylitis cases received other treatments. Results showed that the incidence of thalidomide-induced peripheral neuropathy in the thalidomide group was higher than that in the non-thalidomide group. There was no significant difference in the incidence of neuropathy between the < 6 months medication and ? 6 months medication groups. There were no differences in the mean age, gender, or daily dose between the two groups. The incidence of peripheral neuropathy among patients receiving 25, 50, 75, or 100 mg thalidomide per day was 4.6%, 8.5%, 17.1%, 21.7%, respectively. The incidence was significantly different between the groups receiving 25 mg and 100 mg thalidomide. In conclusion, thalidomide can induce peripheral neuropathy within 1 year after treatment of ankylosing spondylitis; however, age and gender have no obvious impact on the incidence of peripheral neuropathy. The incidence of peripheral neuropathy is associated with increasing daily doses of thalidomide.

  19. Cervical spine fracture in a patient with ankylosing spondylitis causing a C2-T9 spinal epidural hematoma- Treatment resulted in a rapid and complete recovery from tetraplegia: Case report and literature review

    Science.gov (United States)

    Wong, Albert Sii Hieng; Yu, Denis Hee youg

    2015-01-01

    Full recovery from tetraplegia is uncommon in cervical spine injury. This has not being reported for cervical spine fracture in a patient with ankylosing spondylitis causing spinal epidural hematoma. We report on a case of cervical spine fracture in a patient with ankylosing spondylitis who came with tetraplegia. He underwent a two stage fixation and fusion. He had a complete recovery. Two hours after the operation he regained full strength in all the limbs while in the Intensive Care Unit. He went back to full employment. There are only two other reports in the literature where patients with ankylosing spondylitis and extradural hematoma who underwent treatment within 12 h and recovered completely from tetraparesis and paraplegia respectively. Patient with ankylosing spondylitis has a higher incidence of spinal fracture and extradural hematoma. Good outcome can be achieved by early diagnosis and treatment. This can ensure not only a stable spine, but also a rapid and complete recovery in a tetraplegic patient. PMID:25767586

  20. Psychometric evaluation of the Moroccan version of the Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for use in patients with ankylosing spondylitis.

    Science.gov (United States)

    Rostom, Samira; Benbouaaza, Karima; Amine, Bouchra; Bahiri, Rachid; Ibn Yacoub, Yousra; Ali Ou Alla, Sanae; Abouqal, Redouane; Hajjaj-Hassouni, Najia

    2010-07-01

    The objectives of this study are to translate, adapt in the Moroccan cultural context, and validate in patients with ankylosing spondylitis (AS) the Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The cross-cultural adaptation of the BASFI and BASDAI was obtained in accordance with the guidelines for translation of the health status measures. Eighty-five patients with AS were included in the study. The test-retest reliability and the internal consistency were analyzed, and both questionnaires were assessed for external construct validity. Structural validity was analyzed with correlation matrix. Twenty-four-hour test-retest reliability was good: BASFI intraclass correlation coefficient (ICC) = 0.96 (confidence interval (CI) at 95%, 0.93-0.97), BASDAI ICC = 0.93 (CI at 95%, 0.90-0.95). Cronbach's alpha was 0.90 for the BASFI and 0.86 for BASDAI. The construct validity of the instruments was evaluated. The BASFI showed a strong validity when correlating its results with Schober's test (r = -0.56), occipital wall distance (r = 0.46), chest expansion (r = -0.46), BASDAI (r = 0.54), Bath Ankylosing Spondylitis Metrology Index (r = 0.70), Bath Ankylosing Spondylitis Global Score (BAS-G; r = 0.58), Bath Ankylosing Spondylitis Radiology Index (r = 0.61), and the radiological changes in sacroiliac joints (r = 0.54). A good correlation was observed between the BASDAI and the spinal pain (r = 0.53), the number of nocturnal awakenings (r = 0.57), the morning stiffness (r = 0.65), the enthesic index (r = 0.47), the BAS-G (r = 0.53), the BASFI (r = 0.54), and the erythrocyte sedimentation rate (r = 0.41; for all p Moroccan version of the BASFI and the BASDAI showed adequate reliability and validity. These instruments can be used in the clinical evaluation of Moroccan and Arabic-speaking patients with AS. PMID:20383548

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

    Scientific Electronic Library Online (English)

    Ismail, Sari; Yusuf Ziya, Igci; Gercek, Can; Ali, Taylan; Dilek, Solmaz; Bulent, Gogebakan; Servet, Akar; Zeynep, Eslik; Giray, Bozkaya; Nurullah, Akkoc.

    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 sugges [...] t 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.

  2. Multidetector Computed Tomography of Cervical Spine Fractures in Ankylosing Spondylitis

    International Nuclear Information System (INIS)

    Purpose: To analyze multidetector computed tomography (MDCT) cervical spine findings in trauma patients with advanced ankylosing spondylitis (AS). Material and Methods: Using PACS, 2282 cervical spine MDCT examinations requested by emergency room physicians were found during a period of 3 years. Of these patients, 18 (16 M, aged 41-87, mean 57 years) had advanced AS. Primary imaging included radiography in 12 and MRI in 11 patients. Results: MDCT detected one facet joint subluxation and 31 fractures in 17 patients: 14 transverse fractures, 8 spinous process fractures, 2 Jefferson's fractures, 1 type I and 2 type II odontoid process fractures, and 1 each: atlanto-occipital joint fracture and C2 laminar fracture plus isolated transverse process and facet joint fractures. Radiographs detected 48% and MRI 60% of the fractures. MRI detected all transverse and odontoid fractures, demonstrating spinal cord abnormalities in 72%. Conclusion: MDCT is superior to plain radiographs or MRI, showing significantly more injuries and yielding more information on fracture morphology. MRI is valuable, however, in evaluating the spinal cord and soft-tissue injuries. Fractures in advanced AS often show an abnormal orientation and are frequently associated with spinal cord injuries. In these patients, for any suspected cervical spine injuries, MDCT is therefore the imaging modality of choice

  3. Men's Experiences of Living with Ankylosing Spondylitis : A Qualitative Study

    DEFF Research Database (Denmark)

    Madsen, Mette; Jensen, Kim Vilbek

    2014-01-01

    BACKGROUND: The majority of patients with ankylosing spondylitis (AS) are male, although potential gender differences have not been investigated in relation to disease management. Moreover, men's perceptions of experiencing AS have not been reported in the literature. AIMS: This study sought to develop an understanding of how men experience AS and the challenges related to living with AS as a chronic disease. METHODS: A purposive sample of 13 men diagnosed with AS, with a median age of 44?years (range 32-58) was recruited from a rheumatology outpatient clinic. The median duration of disease was 12?years (range 0.3-28 years), and the median time from the first symptom to final diagnosis was seven years (range 2-20 years). Semi-structured interviews were conducted using an interview guide, and the interviews were analysed using content analysis inspired by Graneheim qualitative methodology. RESULTS: The analysis revealed four categories: (1) 'Approaching a diagnosis'; (2) 'Ill in a social context'; (3) 'Challenged as a man'; and (4) 'The importance of remaining physically well'. Based on these categories, the overall category of 'An invisible companion for life' emerged, which captures the experience of living with an invisible, life-long disease. CONCLUSIONS: These findings demonstrate that AS impacts men's perceptions of themselves as men, relationships as a partner and father, social lives, and masculine identity. Physical activity was highlighted as an important part of being a man, and not being able to exercise challenged the men's masculine identity. Copyright © 2014 John Wiley & Sons, Ltd.

  4. Risk and effect of radium-224 therapy of ankylosing spondylitis

    International Nuclear Information System (INIS)

    A total of 1426 patients suffering from Bechterew's disease who had formerly been treated with 224-Ra (up to 30 years ago), were included in an epidemiological study. The mean skeletal alpha dose amounted to 65 rad, the mean observation period was 16 years. Among the 363 mortalities recorded 3 were due to tumours in the skeletal region; of these, 2 were observed in the haemopoietic system. The types of the tumours detected deserve to be given particular attention: whereas osteosarcomas were almost the only tumours observed in a group of patients studied by Spiess, who had been treated with higher doses, no such tumour was revealed in the study population investigated here. Among the 3 tumours seen in this study group 2 were detected in the haemopoietic system as compared to 1 out of 55 tumours observed by Spiess. In contrast to this finding there was a remarkably high incidence of tumours of haemopoietic organs among the victims of Hiroshima. These results show that the relative benefits and disadvantages of the drug 224-Ra once again must be carefully considered. None of the chemical agents used in the treatment of ankylosing spondylitis is free from side-effects. A comparison of the latter with the risks involved in the use of 224-Ra leads to the conclusion that - according to the experience gained so far - 224-Ra is very useful in the treatment of this disease, if there is an absolute indication. (orig./MG)

  5. Effects of glossopharyngeal insufflation in ankylosing spondylitis: a pilot study.

    Science.gov (United States)

    Brodin, Nina; Lindholm, Peter; Lennartsson, Claudia; Nygren-Bonnier, Malin

    2014-01-01

    In Ankylosing Spondylitis (AS), thoracic range of motion is often greatly limited. The objective of the study was to describe the effects of 12 weeks of Glossopharyngeal Insufflation (GI) training in patients with AS. Dynamic spirometry included vital capacity, forced expiratory volume, and peak expiratory flow. Thoracic and lumbar range of motion was assessed by tragus-to-wall distance, modified Schober test, and tape measure. Disease activity, activity limitation, and health perception were assessed using the BAS-Indices, and tension in the thoracic region during GI was assessed using the Borg CR-10 scale. Adherence to training was recorded in an activity log, along with any remarks on the training. Ten patients were recruited and six male patients fulfilled the study protocol. Three patients were able to learn GI by exceeding their maximal vital capacity with 5% using GI. A significant increase in thoracic range of motion both on costae IV (P = 0.04) and at the level of the xiphoid process (P = 0.04) was seen. Thus, patients with AS can practice GI, it is safe if maximal exertion is avoided, and patients with some mobility in the chest can increase their lung function substantially by performing GI during 12 weeks. PMID:25506364

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

    Directory of Open Access Journals (Sweden)

    Tschoeke Sven K

    2008-06-01

    Full Text Available Abstract 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.

  7. Delayed Traumatic Diaphragm Hernia after Thoracolumbar Fracture in a Patient with Ankylosing Spondylitis

    Science.gov (United States)

    Lee, Hyoun-Ho; Kim, Sang Woo; Jung, Young Jin

    2015-01-01

    Traumatic diaphragm hernia can occur in rare cases and generally accompanies thoracic or abdominal injuries. When suffering from ankylosing spondylitis, a small force can develop into vertebral fracture and an adjacent structural injury, and lead to diaphragm hernia without accompanying concomitant thoracoabdominal injury. A high level of suspicion may be a most reliable diagnostic tool in the detection of a diaphragm injury, and we need to keep in mind a possibility in a patient with ankylosing spondylitis and a thoracolumbar fracture, even in the case of minor trauma. PMID:25733996

  8. Cervix Cancer in a Patient With Ankylosing Spondylitis Using Etanercept: A Case Report

    Directory of Open Access Journals (Sweden)

    P?nar Doruk

    2012-06-01

    Full Text Available Tumor necrosis factor-alpha inhibitors (anti TNF-alpha are agents that increasingly used in the treatment of ankylosing spondylitis resistant to classical disease-modifying treatment and they provide better functional outcome. However, these agents have serious side effects. Their safety has been questioned by several published reports of increased risk for malignancies. In this study, we present a patient with ankylosing spondylitis who developed cervix cancer after receiving anti TNF-alpha therapy for 19 months. Turk J Phys Med Re­hab 2012;58:162-4.

  9. The Relationship Between Bath Indexes and Osteoporosis in Male Patients with Axial Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Nurullah Akkoc

    2008-09-01

    Full Text Available Objective: Osteoporosis is a common complication of patients with ankylosing spondylitis (AS. There is no avaible data for the indications of bone mineral density (BMD measurement related to osteoporosis diagnosis at AS patients. The aim of this study is to investigate the relationship between Bath indexes and BMD in patients with AS.Materials and Methods: 45 male AS patients (mean age: 46.96±13.58 years and 41 healthy male controls (mean age: 48.93±6.86 years were enrolled in the study. Patients with AS were evaluated with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI, Bath Spondylitis Metrology Index (BASMI and Bath Ankylosing spondylitis Radiology Index (BASRI. The BMD of AS and control group patients were assessed at hip (femoral neck, Ward’s triangle and femur trochanter and lumbar area.Results: We have found a significant difference at the femoral ward triangle and lomber spine BMD and T scores in favour of AS patients (p<0.05. BASMI scores were negatively correlated with femoral neck and femoral ward triangle (p<0.05. BASDAI, BASFI scores were not correlated with BMD and T scores of any measured regions.Conclusion: We found that femur ward triangle may be appropriate to evaluate bone loss in patients with AS. BASMI score is a useful tool to determine BMD in patients with AS.

  10. IgA nephropathy associated with ankylosing spondylitis: occurrence in women as well as in men.

    OpenAIRE

    Lai, K. N.; Li, P. K.; Hawkins, B; Lai, F M

    1989-01-01

    Two patients (one male, one female) with ankylosing spondylitis (AS) and IgA nephropathy are described. The female patient is the first reported case to have AS and IgA nephropathy concurrently. Contrary to previously reported cases, her renal manifestation preceded her rheumatic symptoms. It is suggested that women with IgA nephropathy and AS may be overlooked as the severity of spondylitis and joint involvement is less than in men.

  11. Bilateral alloplastic prostheses for temporomandibular joint reconstruction in a patient with ankylosing spondylitis.

    Science.gov (United States)

    de Oliveira-Neto, Patrício Jose; Marchiori, Erica Cristina; de Almeida Lopes, Maria Candida; Moreira, Roger William Fernandes

    2014-06-01

    Ankylosing spondylitis (AS) or Bechterew disease is a chronic, usually progressive, systemic inflammatory joint disease, which predominantly affects the spine and sacroiliac joints. In these joints, early inflammatory changes are followed by lumbosacral pain and progressive restriction of spinal movement associated with radiologically visible intervertebral ossification. Peripheral joint involvement occurs in 10 to 30% of patients and shows a predilection for the shoulders, knees, ankles, feet, and wrists. Temporomandibular joint (TMJ) involvement has been described, and its reported frequency varies from 11 to 35%. However, ankylosis is uncommon with a single documented case utilizing an alloplastic prosthesis for total joint replacement. A case report of bilateral ankylosis of the jaw treated with alloplastic prostheses for total TMJ replacement using a Brazilian system in a patient with AS is presented. PMID:25050151

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

    Directory of Open Access Journals (Sweden)

    F.M. Perrotta

    2014-11-01

    Full Text Available 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 <20 mm (on a visual analogue scale of 0-100 mm in each of the following 4 domains: 1 patient global assessment (in the last week; 2 pain (spinal pain; 3 function [measured by the bath ankylosing spondylitis functional index (BASFI]; 4 inflammation [mean of intensity and duration of morning stiffness, from the bath ankylosing spondylitis disease activity index (BASDAI]. Two hundred fourteen AS patients (M/F=160/54; median age/range=43.2/19-78 years; median disease duration/ range=96/36-189 months were treated with ADA (15.8%, ETA (28.9% and INF (55.1%. At 12 and 24 months, high serum level of C reactive protein (CRP (?2 vs ?0.8 mg/dL were associated with higher rate of PR in AS patients treated with anti-TNF? drugs. At 24 months, PR was associated with shorter disease duration (?36 vs ?189 months and higher erythrosedimentation rate (ESR values (?45 vs ?17 mm/h. In male patients lower bath ankylosing spondylitis metrology index (BASMI (?2 vs ?6 and absence of 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.

  13. Lung parenchymal changes in patients with ankylosing spondylitis

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    Zehra Isik Hasiloglu

    2012-01-01

    Full Text Available AIM: To assess lung parenchymal changes in ankylosing spondylitis (AS using high resolution computed tomography (HRCT. METHODS: We included 78 AS patients whose average age was 33.87 (18-56 years with a ratio of 53 males to 25 females who were followed up for 3.88 (1-22 years on average. Pneumonia and tuberculosis were excluded. In a detailed examination of lung HRCT findings, we investigated the presence of parenchymal micronodules, parenchymal bands, subpleural bands, interlobular and intralobular septal thickening, irregularity of interfaces, ground-glass opacity, consolidation, mosaic pattern, bronchial wall thickening, bronchial dilatation, tracheal dilatation, pleural thickening, emphysema, thoracic cage asymmetry, honeycomb appearance, structural distortion, apical fibrosis and other additional findings. RESULTS: In detailed HRCT evaluations, lung parenchymal changes were found in 46 (59% of all patients. We found parenchymal bands in 21 (27% cases, interlobular septal thickening in 9 (12%, emphysema in 9 (12%, apical fibrosis in 8 (10%, ground-glass opacities in 7 (9%, parenchymal micronodules in 5 (6%, irregularity in interfaces in 3 (4%, bronchial dilatation in 3 (4%, mosaic pattern in 2 (3%, pleural thickening in 2 (3%, consolidation in 1 (1%, bronchial wall thickening in 1 (1% and a subpleural band in 1 (1% case. Furthermore, we detected subsegmental atelectasis in 2 patients and a cavitary lesion in 1 patient. CONCLUSION: Our study had the highest number of AS cases of all previous studies in evaluating lung parenchymal changes. The rate of lung parenchymal changes was slightly lower than that reported in recent literature.

  14. Instrumentos de avaliação em espondilite anquilosante / Outcome measures in ankylosing spondylitis

    Scientific Electronic Library Online (English)

    Themis Mizerkowski, Torres; Rozana Mesquita, Ciconelli.

    2006-06-01

    Full Text Available A espondilite anquilosante (EA) é uma doença inflamatória crônica caracterizada por acometimento predominante do esqueleto axial. Ocorre de forma insidiosa e é potencialmente debilitante, levando à redução na qualidade de vida dos indivíduos acometidos. A sua etiopatogenia ainda não está totalmente [...] esclarecida, dificultando estratégias no seu diagnóstico e manejo. O avanço da terapia com agentes biológicos veio reforçar discussões sobre a melhor forma de avaliação destes pacientes. Nesta revisão, discutimos os principais instrumentos utilizados para avaliar pacientes com EA e o consenso do grupo internacional (ASAS working group - Assessments in Ankylosing Spondylitis Working Group) determinado no OMERACT IV (Outcome Measures in Rheumatology). Abstract in english Ankylosing spondylitis is a chronic and progressive disease involving predominantly the axial skeleton. It is insidious and potentially debilitating, compromising the quality of life of patients suffering from the disease. The etiopathogenesis is still uncertain, which difficult strategies in its di [...] agnosis and treatment. Advances in biological therapies are reforcing discussions in the best way of managing the disease. In this paper, we revise the outcome instruments available for ankylosing spondylitis and the consensus from the ASAS working group (Assessments in Ankylosing Spondylitis Working Group) established at the OMERACT IV (Outcome Measures in Rheumatology).

  15. Instrumentos de avaliação em espondilite anquilosante Outcome measures in ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Themis Mizerkowski Torres

    2006-06-01

    Full Text Available A espondilite anquilosante (EA é uma doença inflamatória crônica caracterizada por acometimento predominante do esqueleto axial. Ocorre de forma insidiosa e é potencialmente debilitante, levando à redução na qualidade de vida dos indivíduos acometidos. A sua etiopatogenia ainda não está totalmente esclarecida, dificultando estratégias no seu diagnóstico e manejo. O avanço da terapia com agentes biológicos veio reforçar discussões sobre a melhor forma de avaliação destes pacientes. Nesta revisão, discutimos os principais instrumentos utilizados para avaliar pacientes com EA e o consenso do grupo internacional (ASAS working group - Assessments in Ankylosing Spondylitis Working Group determinado no OMERACT IV (Outcome Measures in Rheumatology.Ankylosing spondylitis is a chronic and progressive disease involving predominantly the axial skeleton. It is insidious and potentially debilitating, compromising the quality of life of patients suffering from the disease. The etiopathogenesis is still uncertain, which difficult strategies in its diagnosis and treatment. Advances in biological therapies are reforcing discussions in the best way of managing the disease. In this paper, we revise the outcome instruments available for ankylosing spondylitis and the consensus from the ASAS working group (Assessments in Ankylosing Spondylitis Working Group established at the OMERACT IV (Outcome Measures in Rheumatology.

  16. Chest Wall Motion during Speech Production in Patients with Advanced Ankylosing Spondylitis

    Science.gov (United States)

    Kalliakosta, Georgia; Mandros, Charalampos; Tzelepis, George E.

    2007-01-01

    Purpose: To test the hypothesis that ankylosing spondylitis (AS) alters the pattern of chest wall motion during speech production. Method: The pattern of chest wall motion during speech was measured with respiratory inductive plethysmography in 6 participants with advanced AS (5 men, 1 woman, age 45 plus or minus 8 years, Schober test 1.45 plus or…

  17. Resolution of inflammation following treatment of ankylosing spondylitis is associated with new bone formation

    DEFF Research Database (Denmark)

    Pedersen, Susanne J; Chiowchanwisawakit, Praveena

    2011-01-01

    To test the hypothesis that in patients with ankylosing spondylitis (AS) a vertebral corner inflammatory lesion (CIL) visible on magnetic resonance imaging (MRI) that completely resolves following treatment with anti-tumor necrosis factor-a (TNF-a) agents is more likely to develop into a de novo syndesmophyte visible on a radiograph as compared to a vertebral corner with no CIL.

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

    Directory of Open Access Journals (Sweden)

    Senabre-Gallego JM

    2013-09-01

    Full Text Available José Miguel Senabre-Gallego,1 Carlos Santos-Ramirez,2 Gregorio Santos-Soler,1 Esteban Salas-Heredia,1 Mabel Sánchez-Barrioluengo,3 Xavier Barber,4 José Rosas1 On behalf of the AIRE-MB group 1Rheumatology, Hospital Marina Baixa, Villajoyosa, 2Rheumatology, Hospital Marina Salud, Denia, 3INGENIO (Instituto de Gestión de la Inovación y del Conocimiento (CSIC [Consejo Superior de Investigaciones Científicas]-UPV [Universidad Politécnica de Valencia], Universitat Politècnica de València, Valencia, 4CIO (Centro de Investigación Operativa-UMH (Universidad Miguel Hernández, Universidad Miguel Henández, Elche, Spain Abstract: 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. Keywords: ankylosing spondylitis, etanercept, spondyloarthritis, efficacy, safety

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

    Directory of Open Access Journals (Sweden)

    F.M. Perrotta

    2013-07-01

    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.

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

    Science.gov (United States)

    Perrotta, F M; Scarno, A; Carboni, A; Bernardo, V; Montepaone, M; Lubrano, E; Spadaro, A

    2013-01-01

    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. PMID:23884025

  1. [Spinal claudication and malum perforans pedis. Late sequela of ankylosing spondylitis (Bechterew disease) with cystic lumbosacral arachnopathy].

    Science.gov (United States)

    Tesch, M

    1994-12-01

    Enlargement of the caudal sac with bony erosions of the spinal vertebrae may be a late sequel of ankylosing spondylitis. CT scans demonstrate typical changes. We report a case with spinal claudication and a neuropathic ulcer. PMID:7854510

  2. Both structural damage and inflammation of the spine contribute to impairment of spinal mobility in patients with ankylosing spondylitis

    OpenAIRE

    Machado, P; Landewé, R; Braun, J.; Hermann, KG; Baker, D.; van der Heijde, D.

    2010-01-01

    OBJECTIVE: To study the relationship between spinal mobility, radiographic damage of the spine and spinal inflammation as assessed by MRI in patients with ankylosing spondylitis (AS). METHODS: In this subanalysis of the Ankylosing Spondylitis Study for the Evaluation of Recombinant Infliximab Therapy cohort, 214 patients, representing an 80% random sample, were investigated. Only baseline data were used. MRI inflammation was assessed by the AS spinal MRI activity (ASspiMRI-a) score, struc...

  3. [Symptoms, effects on quality of life, judgement and expectations of treatment in active ankylosing spondylitis: the patient's view].

    Science.gov (United States)

    Falkenbach, A; Curda, B

    2001-10-01

    Symptoms, Effects on Quality of Life, Judgement and Expectations of Treatment in Active Ankylosing Spondylitis: The Patient's View.In ankylosing spondylitis uncertainty prevails among rheumatologists on how to define and measure activity. In the present study the patient's view of activity was evaluated. What does active ankylosing spondylitis mean for the patient? In a standardized interview the patient was asked to describe, from his own experience, what active ankylosing spondylitis means, what bothers him most, what helps most, and what he expects from therapy. For the patient, active ankylosing spondylitis means pain (99 responses), mobility restriction (19), muscle tension (10), inability to stay supine (6), restriction in chest mobility (5) and dyspnea (5). Fatigue was mentioned by two patients. In active states patients are mainly bothered by pain (77), mobility restriction (55), consequences for social life (20) and work (18), disturbed sleep (17) and difficult breathing (16). Drugs (84) and physical activity (42) were judged the best treatments during active ankylosing spondylitis. It was no surprise that pain and mobility restriction were cited most often by the patients. Breathing difficulties were cited rather often, whereas fatigue seems not to play an important role for most patients. The results suggest that modern rheumatology may have underestimated the relevance of difficult breathing and paid too much attention to fatigue. PMID:11579374

  4. Cardiovascular risk in patients with ankylosing spondylitis: the role of systemic inflammation and endothelial dysfunction

    Directory of Open Access Journals (Sweden)

    D.A. Poddubnyy

    2008-01-01

    Full Text Available Aim. To investigate the role of systemic inflammation and endothelial dysfunction as factors of cardiovascular risk in patients with ankylosing spondylitis.Material andMethods. 100 patients with ankylosing spondylitis were included into the study. Screening for arterial hypertension (HT and conventional cardiovascular risk factors (smoking, hyper- and dislipoproteinemia, body overweight, heredity and diabetes mellitus was performed in all patients. 10-year coronary disease risk (Framingham scale and 10-year risk of fatal cardiovascular event (SCORE scale was calculated. Additionally the follows cardiovascular risk factors were assessed: C-reactive protein level (CRP, fibrinogen level, platelet count, antithrombin III activity, plasma fibrinolytic activity, vonWillebrand factor (vWF activity, circulating endothelial cells (CEC count. Besides, endothelial functionwas evaluated by Doppler-ultrasonography of brachial artery in testswith reactive (endothelium-dependent or flow-mediated dilation and nitroglycerine (endotheliumindependent dilation hyperemia. 30 healthy patients were included into control group and were comparable with patients of studied group on sex and age.Results. 10-year coronary disease risk in patients with ankylosing spondylitis was significantly lower than this in patients of control group 4.0%(3,0; 7,5 vs 5.0%(3,0; 11,0,respectively (p<0,05. 10-year risk of fatal cardiovascular event in studied group was relatively low 1.0% (1.0; 2.0. However, analysis of the additional risk factors shown increased thrombogenic potential of blood, which was related to systemic inflammation activity: high platelets count, high fibrinogen activity, increased vWF activity, and decreased fibrinolytic activity. Moreover, signs of endothelial injury (increased level of CEC and vWF activity and endothelial dysfunction were found in patients with ankylosing spondylitis.Conclusion. Cardiovascular risk in patientswith ankylosing spondylitis estimated on the basis of conventional risk factors is not higher than this in general population. At the same time, these patients have signs of endothelial injure, dysfunction, and increased thrombogenic potential directly related to the systemic inflammation activity.We suppose these factors are responsible for the increased cardiovascular risk in patients with ankylosing spondylitis and, therefore, should be taken into account upon cardiovascular risk assessment.

  5. Enthesopathic erosive lesions of patella and tibial tuberosity in juvenile ankylosing spondylitis

    International Nuclear Information System (INIS)

    The authors report the case of a 20-year-old joiner suffering from ankylosing spondylitis, with recurrent knee effusions from the age of 11 and radiological evidence of sacro-iliac involvement. The patient presented with pain and bone erosions localized to the sites of tendinous attachments in the upper pole of the left patella and in tibial tuberosities. On both sides an inflammation of deep infrapatellar bursa was observed on anatomical examination. These destructive lesions are considered as rare forms of the erosive enthesopathy which has been described in anlylosing spondylitis, particularly on spine and calcanum. They could be considered as highly localized forms of algodystrophy. (orig.)

  6. Discriminant validity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) in patients with non-radiographic axial spondyloarthritis and ankylosing spondylitis: a cohort study.

    Science.gov (United States)

    Kilic, Erkan; Kilic, Gamze; Akgul, Ozgur; Ozgocmen, Salih

    2015-06-01

    The aim of this study was to assess discriminant validity of Ankylosing Spondylitis Disease Activity Score (ASDAS)-C-reactive protein (-CRP) and ASDAS-erythrocyte sedimentation rate (-ESR) and to compare with The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) as clinical tools for the measurement of disease activity in patients with non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS). Also, the cut-off values for ASDAS-CRP in nr-axSpA and AS is revisited. Patients with axSpA were recruited from Erciyes Spondyloarthritis Cohort (ESPAC) and were assessed for disease activity, quality of life and functional measures. The discriminatory ability of ASDAS-CRP and ASDAS-ESR was assessed using standardized mean differences and receiver operating characteristic (ROC) curves analysis. Optimal cut-off values for disease activity scores were calculated. Two hundred and eighty-seven patients with axSpA (nr-axSpA:132, AS:155) were included in this study. Two ASDAS versions and BASDAI had good correlations with patient's and physician's global assessment in both groups. Discriminatory ability of ASDAS-CRP, ASDAS-ESR and BASDAI were similar in patients with nr-axSpA and AS when the patients were assigned into low and high disease activity according to the ASAS partial remission, patient's and physician's global assessment scores (based on the comparison of ROC curves). ASDAS cut-off values are quite similar between groups indicating that ASDAS-CRP works similarly well in nr-axSpA and AS. The performance of ASDAS to discriminate low and high disease activity and cut-off values are quite similar in patients with AS and non-radiographic axial SpA. PMID:25366469

  7. Ankylosing spondylitis and HLA-B27: restriction fragment length polymorphism and sequencing of an HLA-B27 allele from a patient with ankylosing spondylitis.

    OpenAIRE

    1992-01-01

    Two groups of patients with ankylosing spondylitis (AS) from England and Poland were examined for restriction fragment length polymorphisms (RFLPs) associated with the disease. No preferential association was found between the 9.2 kb PvuII fragment in HLA-B27 positive patients with AS compared with HLA-B27 healthy subjects as had been previously reported. In the English group, however, a 14 kb PvuII fragment was more common in HLA-B27 positive subjects with AS than in normal controls. Also 4....

  8. [Magnetic resonance imaging in ankylosing spondylitis (Marie-Struempell-Bechterew disease)].

    Science.gov (United States)

    Bollow, M

    2002-12-01

    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 synchondritis of the pubic 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. PMID:12471519

  9. Scientists Gain New Insights into Genetic Mechanisms of Ankylosing Spondylitis

    Science.gov (United States)

    ... 2000 1999 Spotlight on Research 2012 January 2012 Scientists Gain New Insights into Genetic Mechanisms of Ankylosing ... and Musculoskeletal and Skin Diseases (NIAMS), has brought scientists a step closer to understanding the genetic mechanisms ...

  10. Perfil gestacional na espondilite anquilosante / Pregnancy profile in ankylosing spondylitis

    Scientific Electronic Library Online (English)

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

    2005-06-01

    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 Espon [...] diloartropatias 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. Abstract in english 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 Spondyloarthropath [...] ies 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.

  11. Perfil gestacional na espondilite anquilosante Pregnancy profile in ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Percival Degrava Sampaio-Barros

    2005-06-01

    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.

  12. Reducing work disability in Ankylosing Spondylitis – development of a work instability scale for AS

    OpenAIRE

    Helliwell Philip; Smyth M Glyn; Barkham Nick; Emery Paul; Gilworth Gill; Tennant Alan

    2009-01-01

    Abstract Background The Work Instability Scale for Rheumatoid Arthritis (RA-WIS) is established and is used by physicians to identify patients at risk of job loss for rapid intervention. The study objective was to explore the concept of Work Instability (a mismatch between an individual's abilities and job demands) in Ankylosing Spondylitis (AS) and develop a Work Instability Scale specific to this population. Methods New items generated from qualitative interviews were combined with items fr...

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

    OpenAIRE

    Bekir Durmu?; Altay, Zuhal; Baysal, O?zlem; Yüksel Ersoy; Hacievli?yagi?l, Su?leyman Savas?; Baysal, Tamer; Aytemur, Zeynep Ayfer; Erdal Do?an

    2011-01-01

    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 a...

  14. Prospects for the use of celecoxib in patients with ankylosing spondylitis: impact on retarding disease progression

    Directory of Open Access Journals (Sweden)

    Yulia Leonidovna Korsakova

    2012-09-01

    Full Text Available Ankylosing spondylitis (AS is one of the major inflammatory diseases that affect the vertebral column and joints. The first-line drugs for the treatment of this disease are now nonsteroidal anti-inflammatory drugs (NSAIDs that not only reduce painful sensations and rigidity, but also retard the radiological progression of AS. Celecoxib is one of the effective and safe NDAIDs that are promising for the treatment of AS.

  15. Ankylosing spondylitis monocytes show upregulation of proteins involved in inflammation and the ubiquitin proteasome pathway.

    OpenAIRE

    Wright, C.; Edelmann, M.; Digleria, K.; Kollnberger, S.; Kramer, H.; Mcgowan, S.; Mchugh, K.; Taylor, S.; Kessler, B.; Bowness, P.

    2009-01-01

    OBJECTIVES: To determine if peripheral blood monocytes from patients with ankylosing spondylitis (AS) differed in protein expression compared to rheumatoid arthritis (RA) and healthy controls (HC). METHODS: Monocyte protein expression was characterised by 2D gel electrophoresis and by label-free quantitative expression profiling, using nano-ultra performance liquid chromatography coupled to electrospray ionisation mass spectrometry (ESI-MS(E), where (E) refers to low/high collision energy swi...

  16. The information needs of people living with ankylosing spondylitis: a questionnaire survey

    OpenAIRE

    Cooksey Roxanne; Brophy Sinead; Husain Muhammad Jami; Irvine Elizabeth; Davies Helen; Siebert Stefan

    2012-01-01

    Abstract Background Today, health care is patient-centred with patients more involved in medical decision making and taking an active role in managing their disease. It is important that patients are appropriately informed about their condition and that their health care needs are met. We examine the information utilisation, sources and needs of people with Ankylosing Spondylitis (AS). Methods Participants in an existing AS cohort study were asked to complete a postal or online questionnaire ...

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

    International Nuclear Information System (INIS)

    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.)

  18. Withdrawal from labour force due to work disability in patients with ankylosing spondylitis

    OpenAIRE

    Boonen, A.; Chorus, A.; Miedema, H.; Heijde, D.; Landewe, R.; Schouten, H.; Tempel, H.; Linden, S.

    2001-01-01

    OBJECTIVE—To investigate withdrawal from the labour force because of inability to work owing to ankylosing spondylitis (AS) and to determine the characteristics of patients with no job because of work disability attributable to AS.?METHODS—A postal questionnaire was sent to 709 patients with AS aged 16-60 years followed up by a rheumatologist. Kaplan-Meier survival statistics were used to assess the time lapse between diagnosis and withdrawal from work. Standardised incidence ratios we...

  19. Faecal carriage of klebsiella by patients with ankylosing spondylitis and rheumatoid arthritis.

    OpenAIRE

    Warren, R. E.; Brewerton, D. A.

    1980-01-01

    In consecutive samples submitted to a clinical microbiology laboratory 22 out of 99 from outpatients and 23 out of 51 from inpatients yielded Klebsiella sp. A clinical reassessment of outpatients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA) who had not been inpatients within the last year was made for disease activity and drug requirements. 124 patients with AS and 92 with RA were requested at assessment to submit a stool specimen for klebsiella examination, this being carri...

  20. Fetuin-A is related to syndesmophytes in patients with ankylosing spondylitis: a case control study

    Scientific Electronic Library Online (English)

    Tugba, Tuylu; Ismail, Sari; Dilek, Solmaz; Didem Leyla, Kozaci; Servet, Akar; Necati, Gunay; Fatos, Onen; Nurullah, Akkoc.

    2014-12-01

    Full Text Available OBJECTIVES: New bone formation is one of the hallmark characteristics of ankylosing spondylitis, which is thereby associated with syndesmophytes. Fetuin-A is a molecule that is abundantly found in calcified tissues and it shows high affinity for calcium phosphate minerals and related compounds. Con [...] sidering the role of fetuin-A in the regulation of calcified matrix metabolism, we compared the fetuin-A levels in ankylosing spondylitis patients with syndesmophytes with those in patients without syndesmophytes and in healthy controls. We also studied other biomarkers that are thought to be related to syndesmophytes. METHODS: Ninety-four patients (49 patients without syndesmophytes, 67.3% male, 40.7±8.7 years; 45 patients with syndesmophytes, 71.1% M, 43.9±9.9 years) and 68 healthy controls (44.2±10.6 years and 70.6% male) were included in this study. Syndesmophytes were assessed on the lateral radiographs of the cervical and lumbar spine. The serum levels of fetuin-A, dickkopf-1, sclerostin, IL-6, high-sensitivity C-reactive protein and bone morphogenetic protein-7 were measured with an enzyme-linked immunosorbent assay. RESULTS: Patients with syndesmophytes had significantly higher levels of fetuin-A compared with patients without syndesmophytes and controls (1.16±0.13, 1.05±0.09 and 1.08±0.13 mg/ml, respectively). However, fetuin-A was not different between the patients without syndesmophytes and controls. Bone morphogenetic protein-7 was significantly lower; dickkopf-1 was significantly higher in patients with ankylosing spondylitis compared with controls. The sclerostin concentrations were not different between the groups. In regression analysis, fetuin-A was an independent, significant predictor of syndesmophytes. CONCLUSION: Our results suggest that fetuin-A may a role in the pathogenesis of bony proliferation in ankylosing spondylitis.

  1. Muscle activation patterns and gait biomechanics in patients with ankylosing spondylitis

    OpenAIRE

    CALIRI A.; P. Furfari; Balestrieri, A; L.G. De Filippis; A. Africa; Bagnato, G.

    2011-01-01

    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 ...

  2. Safety and Clinical Responses in Ankylosing Spondylitis after Three Months of Etanercept Therapy

    OpenAIRE

    Choi, Chan-bum; Kim, Tae-jong; Park, Hee-jin; Uhm, Wan-sik; Jun, Jae-bum; Bae, Sang-cheol; Yoo, Dae-hyun; Kim, Tae-hwan

    2008-01-01

    We aimed to evaluate the safety and clinical responses in Korean ankylosing spondylitis (AS) patients after three months of etanercept therapy. AS patients satisfying the Modified New York Criteria were enrolled. They were assessed for safety and clinical responses at enrollment and after three months of etanercept therapy. A total of 124 patients completed the study. After three months, the rate of ASsessment in AS International Working Group 20% improvement (ASAS 20) response was 79.8%. The...

  3. Disease activity assessment in ankylosing spondylitis in a Chinese cohort: BASDAI or ASDAS?

    Science.gov (United States)

    Au, Yuen Ling Elaine; Wong, Woon Sing Raymond; Mok, Mo Yin; Chung, Ho Yin; Chan, Eric; Lau, Chak Sing

    2014-08-01

    Recently, the Ankylosing Spondylitis Disease Activity Score (ASDAS), a new index, has been shown to be validated and highly discriminatory in assessing ankylosing spondylitis (AS) disease activity. This study is to evaluate the performance of ASDAS in a local Chinese cohort of AS in a cross-sectional setting and to compare it with the existing instrument, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Consecutive patients with AS were recruited from a local rheumatology clinic. Data, including BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI), Visual Analogue Scale (VAS) for spinal pain, and patient and physician global assessments were gathered during clinic visit. Inflammatory markers, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and high-sensitivity (hs)-CRP were collected. ASDAS was calculated accordingly. The discriminatory capacity of BASDAI and ASDAS was compared by: (1) standardized mean difference statistics, (2) R (2) in linear regressions, and (3) area under receiver operating characteristic curve (AUC) in logistic regression models. Both ASDAS and BASDAI showed satisfactory predictive value on disease activity with reference to patient and physician global assessment. R (2) in linear regression models ranged from 0.6-0.7. Both indices also demonstrated good discriminatory capacity as evidenced by a relatively high AUC (> 0.8) under the logistic regression models using either patient or physician global assessment score ?4 and ASDAS in the high inflammatory marker subgroup. ASDAS and BASDAI showed similarly good performance in a cross-sectional setting in a local Chinese AS cohort. ASDAS performed better in subgroup with raised inflammatory markers. PMID:24981160

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

    OpenAIRE

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

    2010-01-01

    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...

  5. HLA-DR4 in ankylosing spondylitis with different patterns of joint involvement.

    OpenAIRE

    Miehle, W.; Schattenkirchner, M.; Albert, D.; Bunge, M.

    1985-01-01

    Fifty patients with ankylosing spondylitis (AS) confined to the spine and sacroiliac joints were compared with 50 cases of AS complicated by various patterns of non-axial joint involvement. Radiological and clinical features were evaluated and HLA-DR4 typing was carried out. This antigen was found in 16% of 200 normal individuals in 18% of patients suffering from exclusively axial AS, and in 54% of patients with additional purely peripheral joint involvement (wrist, finger, ankle, toe). The p...

  6. The oxidative metabolism of circulating phagocytes in ankylosing spondylitis: determination by whole blood chemiluminescence

    OpenAIRE

    Ho, K.; Chen, P.; Chang, C.; Lu, F.

    2000-01-01

    OBJECTIVE—Superoxide anion radicals within the human body are regarded as a major cause of inflammation. However, their role in the pathogenesis of ankylosing spondylitis (AS) has not been well identified. This study aimed at investigating the relation between AS and the oxidative metabolism of phagocytes in whole blood.?METHODS—24 patients with classic AS were examined to determine their clinical status; complete blood count, erythrocyte sedimentation rate (ESR), and C reactive protein...

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

    OpenAIRE

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

    1984-01-01

    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...

  8. Relationship of environmental exposures and ankylosing spondylitis and spinal mobility: US NHAENS, 2009-2010.

    Science.gov (United States)

    Shiue, Ivy

    2015-06-01

    It was aimed to study the relationships of different sets of urinary environmental chemical concentrations and ankylosing spondylitis in a national and population-based setting. Data were extracted from United States National Health and Nutrition Examination Surveys, 2009-2010. Information on demographics was obtained by household interview and ankylosing spondylitis clinical measures and urines were taken at examination. People with abnormal occiput-to-wall distance were found to have higher urinary cadmium (OR 2.17, 95?% CI 1.34-3.52, p?=?0.004), antimony (OR 1.74, 95?% CI 1.15-2.62, p?=?0.012), tungsten (OR 1.91, 95?% CI 1.39-2.64, p?=?0.001), uranium (OR 1.49, 95?% CI 1.03-2.15, p?=?0.036), and trimethylarsine oxide (OR 5.01, 95?% CI 2.34-10.71, p?ankylosing spondylitis clinical measures, compared to those who resided in households that were built in 1990 or after. The odds were 1.74 for households built in 1978-1989 and 1.81 for those built in 1940 or earlier. PMID:25103950

  9. Long-term clinical investigation of patients with ankylosing spondylitis treated with /sup 224/Ra

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, E. (Universitatsklinik Friedrichsheim, Frankfurt, West Germany); Ruckbeil, C.; Wick, R.R.

    1983-01-01

    Between 1952 and 1980 about 250 patients with ankylosing spondylitis were treated with /sup 224/Ra at the Orthopaedic University Hospital of Frankfurt/M. In 1970, 119 of them were examined and X-rayed as was another group of 40 patients in 1980. The results of those examined could be compared with a group of 40 patients treated without /sup 224/Ra. Patients with /sup 224/Ra demonstrated a long-lasting period of subjective improvement after the treatment, with reduced consumption of antirheumatoid and analgesic drugs, on the average. Blood examinations show inflammatory activities. Nevertheless, the ankylosing spondylitis proceeded. In the final stages of the disease, neither the clinical aspects nor the X-rays showed any specific changes. We observed no case of malignant bone tumor. Of the 169 examined patients, 22 had a total of 32 children after the treatment with /sup 224/Ra. Among these was a set of twins with cerebral palsy and diabetes insipidus renalis. In conclusion, /sup 224/Ra in ankylosing spondylitis is a recommended treatment without higher risk compared to the common therapy with drugs.

  10. Health-related quality of life in Turkish patients with ankylosing spondylitis: impact of peripheral involvement on quality of life in terms of disease activity, functional status, severity of pain, and social and emotional functioning.

    Science.gov (United States)

    Y?lmaz, Ozlem; Tuto?lu, Ahmet; Garip, Ye?im; Ozcan, Esra; Bodur, Hatice

    2013-05-01

    Ankylosing spondylitis (AS) affects sacroiliac joints at early stages and may involve the axial skeleton at later stages of disease. Peripheral involvement usually occurs in lower extremities. When it develops early in the disease course, it is a predictor of more aggressive disease. The aim of this study is to evaluate health-related quality of life (HRQoL) in AS and to assess the impact of peripheral involvement on HRQoL domains in terms of disease activity, functional status, pain, and social and emotional functioning. Seventy-four AS patients were included. Peripheral involvement was present in 51.35 % of the patients. In 65.79 % of these cases the hips, in 31.58 % the knees, in 18.42 % the shoulders and in 13.16 % the ankles were affected. Patients were evaluated by Ankylosing Spondylitis Quality of Life (ASQoL), Short Form-36 (SF-36), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS) and Bath Ankylosing Spondylitis Functional Index (BASFI). ASQoL was strongly correlated with ASDAS, BASDAI, BASFI, and Bath Ankylosing Spondylitis Metrology Index (BASMI), severity of total pain, night pain, fatigue, morning stiffness and ESR. ASDAS and BASDAI showed the strongest correlation with ASQoL. Severity of total pain, functional status and severity of night pain followed it, respectively. Patients with peripheral involvement scored significantly lower in all subgroups of SF36 and significantly higher in ASDAS, BASDAI, BASFI, BASMI and ASQoL scores and levels of pain, night pain, fatigue and morning stiffness. Peripheral involvement is associated with more active disease and functional disability and has a negative influence on HRQoL including physical, social and emotional functioning. PMID:22955799

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

    Directory of Open Access Journals (Sweden)

    W. Grassi

    2011-09-01

    Full Text Available 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 translator. Two rheumatologists familiar with instrument validation, and who were aware of the purpose of the study, examined semantic, idiomatic and conceptual issues and produced by consensus unified versions of each instrument. English back-translations from the Italian were done by a professional translator unaware of the original version. Both English versions were compared, and where needed, modifications to the Italian versions were made. Results: A total of 95 patients were included: 77 males, age (mean±SD 47.9±9.3years, and disease duration 12.4±6.6 years, and 18 females, age 45.9±8.7 years, and disease duration 11.3±8.2 years. Reliability, measured in 23 patients participating a physiotherapy program, showed an acceptable one-week test-retest intraclass correlation coefficient (ICC - BASFI ICC: 0.91, 95% CI: 0,87-0.94 and DFI ICC: 0.86, 95% CI: 0.83-0.90. The internal consistency was 0.90 (Cronbach’s alpha for the BASFI and 0.87 for the DFI. For validity the functional indices were correlated with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, Bath Ankylosing Spondylitis Metrology Index (BASMI, Bath Ankylosing Spondylitis Patient Global Score (BAS-G, modified Health Assesment Questionnaire (HAQ-S, SF-36 physical component summary (SF-36 PCS, stiffness, pain, physician’s assessment of disease activity, Bath AS Radiology Index-total (BASRI-t, erythrocyte sedimentation rate (ESR, and C-reactive protein (CRP. The functional indices (BASFI and DFI were correlated with each other (p<0.0001 and with activity variables. There was no significant relationship between functional indices and BASRI-t and acute phase reactants. The receiver operating characteristic (ROC curve analysis indicated that the BASFI ranked superior compared to HAQ-S, (p = 0.019 and SF36 PCS (p = 0.002, but not respect to DFI (p = NS, in distinguishing between patients with high and low disease activity. Conclusions: The Italian versions of the BASFI and DFI showed adequate reliability and validity in patients with AS. Because of psychometric advantages, the BASFI may be preferred in clinical trial settings. However, sensitivity to changes due to drug therapy and/or rehabilitation remains to be determined.

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

    Directory of Open Access Journals (Sweden)

    Juan Pablo Restrepo

    2012-10-01

    Full Text Available 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 condução 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.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 patients 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.

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

    Scientific Electronic Library Online (English)

    Juan Pablo, Restrepo; María Del Pilar, Molina.

    2012-10-01

    Full Text Available 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.

  14. Assessment of functional disability and quality of life in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Mustur Dušan

    2009-01-01

    Full Text Available Introduction Ankylosing spondylitis is a chronic progressive autoimmune inflammatory disorder involving mainly the axial skeleton and larger peripheral joints that progressively limits spinal mobility and may lead to irreversible structural changes and consequently to impaired physical function and reduced quality of life. Objective The aim of this study was to assess functional disability and quality of life of patients with ankylosing spondylitis and determine the correlation between functional disability and quality of life. Methods The study enrolled 74 patients with ankylosing spondylitis (16 females and 58 males. The demographic data of the patients were collected. Functional disability was assessed with the Bath Ankylosing Functional Index (BASFI. Quality of life was assessed by the Short-Form 36 (SF-36 and the European Quality of Life Questionnaire (EuroQoL/EQ-5D. Results In our study, the mean age was 48.5±10.3 years. BASFI was negatively correlated with the SF-36 physical function subscale (p<0.001, physical role (p=0.002, bodily pain (p=0.003, general health (p<0.001, vitality (p=0.012 and mental health (p=0.010 subscale. There was a significantly inverse correlation between the BASFI score and the rating scale of EQ-5D (p=0.001. In the regression model, the BASFI score (p=0.000 showed an independent association with the physical function domain of SF-36. Conclusion In conclusion, the BASFI index was associated with physical function, physical role, bodily pain, general health, vitality and mental health domains of SF-36 and also with the rating scale of EQ-5D.

  15. Prevalence, clinical relevance and characterization of circulating cytotoxic CD4+CD28- T cells in ankylosing spondylitis

    OpenAIRE

    Duftner, Christina; Goldberger, Christian; Falkenbach, Albrecht; Würzner, Reinhard; Falkensammer, Barbara; Pfeiffer, Karl P.; Maerker-Hermann, Elisabeth; Schirmer, Michael

    2003-01-01

    Circulating CD3+CD4+CD28- cells exhibit reduced apoptosis and were found to be more enriched in patients with ankylosing spondylitis than in age-matched healthy control individuals (7.40 ± 6.6% versus 1.03 ± 1.0%; P < 0.001). Levels of CD4+CD28- T cells correlate with disease status as measured using a modified metrology score, but they are independent of age and duration of ankylosing spondylitis. CD4+CD28- T cells produce IFN-? and perforin, and thus they must be considered proinflammato...

  16. TREATMENT OF ANKYLOSING SPONDYLITIS BASED ON ALLOPATHIC AND AYURVEDIC SYSTEM OF MEDICINE

    Directory of Open Access Journals (Sweden)

    A.KRISHNA SAILAJA

    2015-01-01

    Full Text Available Ankylosing spondylitis previously known as Bechterew's disease and Marie-Strümpell disease. It is a chronic inflammatory disease of the axial skeleton with variable involvement of peripheral joints and nonarticular structures. AS is a form of spondyloarthritis, a chronic, inflammatory arthritis where immune mechanisms are thought to play a key role. It mainly affects joints in the spine and the sacroiliac joint in the pelvis and can cause eventual fusion of the spine. The treatment of ankylosing spondylitis typically involves the use of medications to reduce inflammation, suppress immunity to stop progression of the disease, physical therapy, and exercise. Medications decrease inflammation in the spine and other joints. Physical therapy and exercise help to improve posture, spine mobility, and lung capacity. Ayurveda offers excellent therapies for treating Ankylosing spondylitis. The treatment comprises of a series of purification procedures for Detoxification through world renowned Ayurveda Panchakarma therapies along with the administration of researched medicines internally In these article treatment strategies for western system of medicine and Indian system of medicine was explained in detail. The main mechanisms involved in treating the conditions such as fever, back pain, swelling at various joints, stiffness in neck and back bone was explained. Different medicines used for the treatment of symptoms and their mechanism of action was explained properly. Strict diet restrictions along with life style modification are essential parts of the therapy. Following the diet as advised not only helps in recovering fast but also in prevents further worsening of the condition. The importance of diet in treating the condition was also explained.

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

    Directory of Open Access Journals (Sweden)

    Stamenkovi? Bojana

    2009-01-01

    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.

  18. Possible protective role of HLA-B*2706 for ankylosing spondylitis.

    Science.gov (United States)

    Ren, E C; Koh, W H; Sim, D; Boey, M L; Wee, G B; Chan, S H

    1997-01-01

    HLA-B27 is strongly associated with ankylosing spondylitis (AS) but the role of the HLA molecule itself is still unclear. In this study on Singapore Chinese, we have subtyped 50 B27 positive AS patients and 45 B27 positive normals and found that the B*2706 allele has a significant negative association with disease (p = 0.047). Together with recent data indicating the existence of AS "protective" B27 alleles, our data shows that the HLA molecule itself plays a crucial role in disease development. PMID:9027969

  19. Circulating cytotoxic CD8+ CD28- T cells in ankylosing spondylitis

    OpenAIRE

    Schirmer, Michael; Goldberger, Christian; Würzner, Reinhard; Duftner, Christina; Pfeiffer, Karl-P; Clausen, Johannes; Neumayr, Günther; Falkenbach, Albrecht

    2001-01-01

    Circulating CD8+ CD28- T cells were found to be expanded more in patients with ankylosing spondylitis than in an age-matched healthy population (41.2 ± 17.7% versus 18.6 ± 7.6%). The level of CD8+CD28- T cells was dependent on the disease status, but was independent of age. Most of the CD8+ CD28- T cells produced perforin after stimulation in vitro, in contrast to their CD8+CD28+ counterparts. From the clinical perspective, the percentage of the cytotoxic CD8+ CD28- T cells reflected a more...

  20. HLA-E gene polymorphism associates with ankylosing spondylitis in Sardinia.

    OpenAIRE

    Paladini, F.; Belfiore, Francesca; Cocco, E.; Carcassi, Carlo; Cauli, Alberto; Vacca, Alessandra; Fiorillo, Mt; Mathieu, Alessandro; Cascino, Isabella; Sorrentino, Rosa

    2009-01-01

    INTRODUCTION: Ankylosing spondylitis (AS) is a severe, chronic inflammatory disease strongly associated with HLA-B27. The presence of additional HLA risk factors has been suggested by several studies. The aim of the current study is to assess the occurrence of an additional HLA susceptibility locus in the region between HLA-E and HLA-C in the Sardinian population. METHODS: 200 random controls, 120 patients with AS and 175 HLA-B27 positive controls were genotyped for six single nucleotide poly...

  1. HLA class I associations of ankylosing spondylitis in the white population in the United Kingdom.

    OpenAIRE

    Brown, Ma; Pile, Kd; Kennedy, Lg; Calin, A.; Darke, C.; Bell, J.; Wordsworth, Bp; Corne?lis, F.

    1996-01-01

    OBJECTIVE: To investigate the HLA class I associations of ankylosing spondylitis (AS) in the white population, with particular reference to HLA-B27 subtypes. METHODS: HLA-B27 and -B60 typing was performed in 284 white patients with AS. Allele frequencies of HLA-B27 and HLA-B60 from 5926 white bone marrow donors were used for comparison. HLA-B27 subtyping was performed by single strand conformation polymorphism (SSCP) in all HLA-B27 positive AS patients, and 154 HLA-B27 positive ethnically mat...

  2. Trial and error in producing ankylosing-spondylitis-selective antisera according to Andrew Geczy.

    Science.gov (United States)

    Beukelman, C J; Quarles van Ufford, H C; van Bree, F P; Aerts, P C; Nieuwenhoff, C; Reerink, G; van Leeuwen, A; van Dijk, H

    1990-01-01

    Geczy found that rabbit sera raised against Klebsiella strain K43 cross-reacted with the cells from HLA-B27 positive patients with ankylosing spondylitis (AS). Other laboratories failed to reproduce these results. After a series of unsuccessful attempts, however, we managed to prepare one selective antiserum, using E. coli, isolated from a Dutch Bechterew patient, in offspring of rabbits Geczy sent us. Ever since we obtained irreproducible results only. This paper reports about the many attempts we have made to produce a discriminating antiserum for use in a combined vital stain and dye-exclusion assay. PMID:2259890

  3. Increased levels of serum IgA as IgA1 monomers in ankylosing spondylitis.

    OpenAIRE

    Hocini, H; Iscaki, S.; Benlahrache, C; Vitalis, L; Chevalier, X.; Larget-Piet, B.; Bouvet, J P

    1992-01-01

    The various subsets of serum IgA were determined in 43 patients with ankylosing spondylitis to investigate the putative mucosal origin of increased IgA concentrations in this disease. Total IgA was shown to be increased and weakly correlated with the erythrocyte sedimentation rate (ESR). In contrast, although the mean concentration (but not the median) of secretory IgA (SIgA) was slightly increased, no correlation was found with total IgA nor the ESR. Moreover, molecular sieving of nine serum...

  4. Secretory IgA: immune defence pattern in ankylosing spondylitis and klebsiella.

    OpenAIRE

    Calguneri, M; Swinburne, L; Shinebaum, R; Cooke, E M; Wright, V

    1981-01-01

    Saliva secretory IgA (sIgA), secretory component (SC); serum immunoglobulins (IgG, IgA, IgM), complement (C3, C4), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were performed in 32 patients with ankylosing spondylitis and 29 normal controls. They were investigated for carriage in the faeces of Klebsiella spp. on 3 occasions over the previous months. Throat swabs and urine were cultured at the same time as immunological estimations were done. 24-hour urine sIgA specimens ...

  5. Allicin Attenuates Inflammation and Suppresses HLA-B27 Protein Expression in Ankylosing Spondylitis Mice

    OpenAIRE

    Xin Gu; Haishan Wu; Peiliang Fu

    2013-01-01

    Here we aimed to determine the therapeutic effect of allicin on ankylosing spondylitis (AS) and explore the mechanism(s) of action. AS mouse model was constructed by transferring the HLA-B2704 gene into Kunming mice and verified by RT-PCR and CT imaging. Verified AS mice were randomly divided into model group (n = 6) and allicin-treated groups (50, 100, and 200?mg/kg, resp., n = 6, p.o., for 2 months). Wild type mice were used as control (n = 6). The levels of AS-related inflammatory factor...

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

    OpenAIRE

    Perrotta, F. M.; Scarno, A.; Carboni, A.; Bernardo, V.; Montepaone, M.; Lubrano, E.; Spadaro, A.

    2013-01-01

    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 p...

  7. The Relationship Between Bath Indexes and Osteoporosis in Male Patients with Axial Ankylosing Spondylitis

    OpenAIRE

    Nurullah Akkoc; Servet Akar; Ismail Sari; Yesim Kiraz; Yesim Akkoc; Sibel Eyigor; Hale Karapolat

    2008-01-01

    Objective: Osteoporosis is a common complication of patients with ankylosing spondylitis (AS). There is no avaible data for the indications of bone mineral density (BMD) measurement related to osteoporosis diagnosis at AS patients. The aim of this study is to investigate the relationship between Bath indexes and BMD in patients with AS.Materials and Methods: 45 male AS patients (mean age: 46.96±13.58 years) and 41 healthy male controls (mean age: 48.93±6.86 years) were enrolled in the study...

  8. Relation of microscopic haematuria in ankylosing spondylitis to circulating IgA containing immune complexes.

    OpenAIRE

    Peeters, A.J.; van den Wall Bake, A W; Dalsen, A.D.; Westedt, M L

    1988-01-01

    Ankylosing spondylitis (AS) is associated with IgA nephropathy. To study the pathogenetic mechanism of this association the presence of haematuria and circulating IgA containing immune complexes (IgA ICs) in 70 patients with AS was determined. In this retrospective study haematuria was present in 15 patients and 25 patients had IgA ICs. Circulating IgA ICs were shown in 9/15 (60%) of the patients with haematuria and in 16/55 (29%) of those without haematuria. These results suggest that IgA IC...

  9. A New Cardiac Autonomic Function Predictor (Heart Rate Turbulence in Patients with Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Ersel Onrat

    2010-12-01

    Full Text Available Objective: Ankylosing spondylitis (AS is a chronic systemic disease. The risk of cardiovascular morbidity and mortality is high in patients with AS. Heart rate turbulence (HRT expresses ventriculophasic sinus arrhythmia and has been considered to reflect cardiac autonomic activity. It has been shown that HRT is an independent and powerful predictor of mortality. The aim of this study was to determine HRT changes in patients with AS in comparison with healthy controls. Materials and Methods: Thirty-seven patients with AS (28 men, 9 women; age: 42±2 years, range: 19-69 years according to the modified New York criteria and 37 age-and gender-matched healthy control subjects without obvious cardiovascular disease (mean age: 40±2 years, range: 23-68 years were included in this study. Mean duration of AS was 5±3 years (range: 1-20 years. All participants underwent 24-hour Holter ECG. HRT measurements, turbulence onset (TO and turbulence slope (TS were calculated with HRT View Version 0.60-0.1 software program. HRT was calculated in patients and healthy controls with at least one ventricular premature beat (VPB in their Holter recordings. TO is a measure of the early sinus acceleration and TS is the measure of the rate of sinus deceleration that follows the sinus acceleration after a VPB. Results: There were no significant differences in TO and TS between AS patients and control subjects (TO-AS: -0.0004±0.008, TO-Control: -0.118±0.006; TS-AS: 12.07±1.26, TS-Control: 10.39±1.26, respectively.Conclusion: Although cardiovascular manifestation (including increased morbidity and mortality of AS has been shown in various studies, HRT parameters, which determine the risk of sudden death, do not seem to be altered in this disease.

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

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    Engin Bozkurt

    2012-01-01

    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.

  11. No association of KIR3DL1 or KIR3DS1 or their alleles with ankylosing spondylitis.

    OpenAIRE

    Mccappin, J.; Harvey, D.; Wordsworth, Bp; Middleton, D.

    2010-01-01

    We determined the alleles of KIR3DL1 and KIR3DS1 in a cohort of British Caucasian ankylosing spondylitis (AS) patients and HLA-B27-positive controls. We found no association in frequencies of the alleles of these genes in AS. In addition, no differences were found when the patients and controls were differentiated by gender.

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

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    MahmutAlpayc?

    2013-05-01

    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.

  13. Whole Genome Expression Profiling and Signal Pathway Screening of MSCs in Ankylosing Spondylitis

    Science.gov (United States)

    Li, Yuxi; Wang, Peng; Xie, Zhongyu; Huang, Lin; Yang, Rui; Gao, Liangbin; Tang, Yong; Zhang, Xin; Ye, Jichao; Chen, Keng; Cai, Zhaopeng; Wu, Yanfeng; Shen, Huiyong

    2014-01-01

    The pathogenesis of dysfunctional immunoregulation of mesenchymal stem cells (MSCs) in ankylosing spondylitis (AS) is thought to be a complex process that involves multiple genetic alterations. In this study, MSCs derived from both healthy donors and AS patients were cultured in normal media or media mimicking an inflammatory environment. Whole genome expression profiling analysis of 33,351 genes was performed and differentially expressed genes related to AS were analyzed by GO term analysis and KEGG pathway analysis. Our results showed that in normal media 676 genes were differentially expressed in AS, 354 upregulated and 322 downregulated, while in an inflammatory environment 1767 genes were differentially expressed in AS, 1230 upregulated and 537 downregulated. GO analysis showed that these genes were mainly related to cellular processes, physiological processes, biological regulation, regulation of biological processes, and binding. In addition, by KEGG pathway analysis, 14 key genes from the MAPK signaling and 8 key genes from the TLR signaling pathway were identified as differentially regulated. The results of qRT-PCR verified the expression variation of the 9 genes mentioned above. Our study found that in an inflammatory environment ankylosing spondylitis pathogenesis may be related to activation of the MAPK and TLR signaling pathways. PMID:25544849

  14. The characteristics of patients having ankylosing spondylitis associated with Takayasu's arteritis.

    Science.gov (United States)

    Gan, Feng-ying; Fei, Yun-yun; Li, Meng-tao; Wang, Qian; Xu, Dong; Hou, Yong; Zeng, Xiao-feng; Zhang, Feng-chun

    2014-03-01

    Both ankylosing spondylitis (AS) and Takayasu's arteritis (TA) are infrequent, and their association is even more rare. Our objective was to assess their association and characteristics in our patients. We conducted retrospective analysis of our hospital inpatients from June 2000 to July 2011 who had both AS and TA. We used modified New York criteria for ankylosing spondylitis (1984) as AS diagnosis criterion and American College of Rheumatology Classification Criteria for Takayasu's Arteritis as TA diagnosis criterion. All clinical data, lab data, and radiological data were collected. Six patients were included in our study because they fulfilled our AS and TA criteria, four males and 2 females, aged from 18 to 35 years old. Four patients were HLA-B27 positive and 2 were negative. All patients' inflammatory markers such as erythrocyte sedimentation rate and C-reactive protein were high. The clinical characteristics of patients with both diseases did not seem to be different from that of patients with AS or TA alone in China. All patients were first diagnosed as AS, then found TA 3-20 years later. After diagnosed those patients having AS and TA, patients were given prednisone and cyclophosphamide and their symptoms improved gradually. Our study provides further evidence of the association of TA with AS. We should know that some AS patients can do have TA. To AS patients who have fever, bruit, or pulselessness, we should suspect that they have TA. PMID:24310108

  15. Efficacy of cyclo-oxygenase-2 inhibition by etoricoxib and naproxen on the axial manifestations of ankylosing spondylitis in the presence of peripheral arthritis

    OpenAIRE

    Gossec, L; van der Heijde, D.; Melian, A; Krupa, D.; M. James; Cavanaugh, P.; Reicin, A; Dougados, M

    2005-01-01

    Objective: The combined efficacy of selective and non-selective cyclo-oxygenase-2 (COX-2) inhibition on the axial manifestations of ankylosing spondylitis (AS) in the presence or absence of chronic peripheral arthritis was evaluated.

  16. Clinical response to discontinuation of anti-TNF therapy in patients with ankylosing spondylitis after 3 years of continuous treatment with infliximab

    OpenAIRE

    Baraliakos, Xenofon; Listing, Joachim; Brandt, Jan; Rudwaleit, Martin; Sieper, Joachim; Braun, Juergen

    2005-01-01

    We analyzed the clinical response and the time to relapse after discontinuation of continuous long-term infliximab therapy in patients with ankylosing spondylitis (AS). After 3 years of infliximab therapy, all AS patients (n = 42) discontinued treatment (time point (TP)1) and were visited regularly for 1 year in order to assess the time to relapse (TP2). Relapse was defined as an increase to a value ? 4 on the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and a physician's globa...

  17. [Scoring of disease activity using BASDAI and ASDAS method in ankylosing spondylitis].

    Science.gov (United States)

    Bobek, Dubravka; Zagar, Iva; Kova?-Durmiš, Kristina; Peri?, Porin; ?urkovi?, Božidar; Babi?-Nagli?, Ður?ica

    2012-01-01

    Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is the most frequently used ankylosing spondylitis activity assesment by which through 6 questions 5 basic diseases symptoms (fatigue, back pain, joint pain/swelling, enthesitic points, intensity and duration of morning stiffness) are being evaluated. In distinction from mentioned, Ankylosing Spondylitis Disease Activity Score (ASDAS) is the first validated index for the AS activity assessment with the patient's assessments of the disease symptoms (back pain, duration of the morning stiffess, activity of the disease, pains and swelling of the peripheral joints) includes the acute phase reactants (SE or CRP). We compared BASDAI and ASDAS indexes to the group of patients with the AS, in order to evaluate their congruence and to evaluate the inluence of SE, fatigue and back pain at obtained values. The cross-sectional study was performed in a group of 36 patients with the AS whose disease activity levels were evaluated by the BASDAI and ASDAS (SE) index. Statistical data analysis was performed by Student t-test and frequency tables for non-parameter data. As it has been expected the significant correlation between BASDAI and ASDAS indexes has been confirmed (r=0.796; p=0.00). BASDAI/ASDAS average value of all of the patients was 4.2/2.8. From 36 patients with the AS according to the BASDAI index 42% had mild active disease (BASDAI ASDAS index 44% patients had very active disease (ASDAS 2.1-.5.3). Higher activity of the disease according to ASDAS index is the result of the elevated sedimentation which is assessed only in ASDAS index. Patients with higher BASDAI index statistically have more significantly expressed fatigue and spinal pain without statistically significant difference in sedimentation (p=0.120). Examinees with higher ASDAS index have also significantly more expressed fatigue and back pain, but unlike BASDAI they have sedimentation (p=0.001). ASDAS is more recent clinical indicator of the AS activities which could be compared to BASDAI instrument. In this group of patients ASDAS seems to be more sensitive index because it discriminates more patients with the active disease. PMID:25508852

  18. Genética, HLA-B27 y espondilitis anquilosante: 40 años / Genetics of ankylosing spondylitis

    Scientific Electronic Library Online (English)

    Patricia, Castro-Santos; Miguel A, Gutiérrez; Roberto, Díaz-Peña.

    1165-11-01

    Full Text Available [...] Abstract in english Ankylosing spondylitis (AS) is a prototypical inflammatory disease of the locomotor system affecting axial skeleton. It is part of the general group of spondyloarthopathies (SpA). Its strong association with histocompatibility antigen HLA-B27 is known since 1973. However, HLA-B27 contribution to AS [...] genetic risk is approximately 16%. Therefore, other genes are necessarily involved in the pathogenesis of the disease. Genomic development and the possibility of making genome wide screening have contributed enormously to the study of the disease. In this paper, we describe the actual knowledge about AS genetic risk, which has contributed to understand the influence of HLA-B27 on the etiology and pathogenesis of the disease. We also intend to foresee how these findings will result in an improvement of patients’ quality of life.

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

    Directory of Open Access Journals (Sweden)

    M. de Almeida Santos Jr

    2011-06-01

    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...

  20. The natural history of ankylosing spondylitis in the 21st century

    Directory of Open Access Journals (Sweden)

    C. Campana

    2011-06-01

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory disease that affects the axial skeleton and evolves in stiffnes followed by ankylosis and disability. However, it may be difficult to exactly establish the natural history of the disease and the influence of risk factors of progression, since most patients are treated with various pharmacologic or non-pharmacologic agents, which may potentially influence the natural progression of the disease. In this context, we report here a very interesting case of a 40 year old man, presented to our outpatient clinic, 28 years after the onset of AS. Previously for personal reasons, did not choose not to undergo any treatment. This case allows us to evaluate the natural radiological progression of the disease and the influence of predictive risk factors.

  1. Circulating cytotoxic CD8(+) CD28(-) T cells in ankylosing spondylitis.

    Science.gov (United States)

    Schirmer, Michael; Goldberger, Christian; Würzner, Reinhard; Duftner, Christina; Pfeiffer, Karl-P; Clausen, Johannes; Neumayr, Günther; Falkenbach, Albrecht

    2002-01-01

    Circulating CD8(+) CD28(-) T cells were found to be expanded more in patients with ankylosing spondylitis than in an age-matched healthy population (41.2 +/- 17.7% versus 18.6 +/- 7.6%). The level of CD8(+)CD28(-) T cells was dependent on the disease status, but was independent of age. Most of the CD8(+) CD28(-) T cells produced perforin after stimulation in vitro, in contrast to their CD8(+)CD28(+) counterparts. From the clinical perspective, the percentage of the cytotoxic CD8(+) CD28(-) T cells reflected a more severe course of disease, as it correlated with distinct movement restrictions, as well as the metrology score summarizing cervical rotation (in sitting position), chin-to-jugulum distance, thoracic Schober, chest expansion, and fingers-to-floor distance (P = 0.032). PMID:11879540

  2. Circulating cytotoxic CD8+ CD28- T cells in ankylosing spondylitis

    Science.gov (United States)

    Schirmer, Michael; Goldberger, Christian; Würzner, Reinhard; Duftner, Christina; Pfeiffer, Karl-P; Clausen, Johannes; Neumayr, Günther; Falkenbach, Albrecht

    2002-01-01

    Circulating CD8+ CD28- T cells were found to be expanded more in patients with ankylosing spondylitis than in an age-matched healthy population (41.2 ± 17.7% versus 18.6 ± 7.6%). The level of CD8+CD28- T cells was dependent on the disease status, but was independent of age. Most of the CD8+ CD28- T cells produced perforin after stimulation in vitro, in contrast to their CD8+CD28+ counterparts. From the clinical perspective, the percentage of the cytotoxic CD8+ CD28- T cells reflected a more severe course of disease, as it correlated with distinct movement restrictions, as well as the metrology score summarizing cervical rotation (in sitting position), chin-to-jugulum distance, thoracic Schober, chest expansion, and fingers-to-floor distance (P = 0.032). PMID:11879540

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

    Directory of Open Access Journals (Sweden)

    Sook Hee Chung

    2013-01-01

    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.

  4. Iatrogenic Cervical Fracture in a Case with Ankylosing Spondylitis and Rehabilitation Practices

    Directory of Open Access Journals (Sweden)

    ?lknur Tu?cu

    2010-06-01

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory rheumatic disease that primarily affects the vertebral column and sacroiliac joints. The development of syndesmophytosis in AS leads up to a rigid and bamboo shape spine. Osteoporosis and a rigid spine may be potential risk factors for fractures due to minor traumas in this patient group. In this article, we present a case of iatrogenic C6-7 fracture and dislocation occurred while the patient was being positioned for magnetic resonance imaging study. Health care professionals should be aware of the increased risk of spine injury due to minor traumas in patients with AS. Turk J Phys Med Rehab 2010;56:88-90.

  5. Hyperplasia of the coronoid process in patients with ankylosing spondylitis (Bechterew disease).

    Science.gov (United States)

    Wenghoefer, Matthias; Martini, Markus; Allam, Jean-Piere; Novak, Natalja; Reich, Rudolf; Bergé, Stefaan J

    2008-07-01

    Although involvement of the temporomandibular joint in patients with ankylosing spondylitis (AS, Bechterew disease) has been described previously, hyperplasia of the mandibular coronoid process in those patients has not been reported yet. Case notes were studied, and records were made of age, sex, clinical symptoms, radiography, and treatment in all patients with a confirmed diagnosis of coronoid hyperplasia presenting at the Department of Oral and Maxillofacial Surgery, University of Bonn, between 1995 and 2007. Sixteen cases of coronoid hyperplasia were recruited, of which 12 were bilateral and 4 were unilateral. Four patients had AS, 3 of them were HLA-B27-positive. Temporomandibular joint symptoms are frequently seen in patients with AS. Nevertheless, it must be considered that a limitation of jaw mobility in those patients might also be caused by an elongation of the mandibular coronoid process. PMID:18650743

  6. Expression of uncarboxylated matrix Gla protein in ankylosing spondylitis and its significance

    Directory of Open Access Journals (Sweden)

    Han-qing HUANG

    2013-07-01

    Full Text Available Objective?To investigate the serum level of uncarboxylated matrix Gla protein (ucMGP in ankylosing spondylitis (AS patients, and to evaluate its diagnostic value and the relation of ucMGP to inflammation and ossification process in AS. Methods?Eight-two AS patients and 76 healthy controls were enrolled in this randomized controlled study. The clinical indices (age, gender, course of disease, disease activity, changes in radiographic studies, and indices of bone metabolism or inflammation, including erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, osteocalcin (OC, and bone-specific alkaline phosphatase (BALP were evaluated or measured. The disease activity was assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, and changes in radiographic pictures were evaluated according to the modified Stoke AS Spine Score (mSASSS, and serum level of ucMGP was measured by a competitive ELISA. The relationship between ucMGP and clinical indexes, radiographic scoring, indices in bone metabolism or inflammation was estimated by SPSS software, and the diagnostic value of ucMGP was analyzed by receiver operator characteristic (ROC curve. Results?The levels of ESR and CRP in AS patients were higher than those in healthy controls, but the serum ucMGP was lower (2958±654nmol/L compared with healthy controls (4551±1036nmol/L, P0, r=?0.715, P1, r=?0.741, P10, r=?0.776, P<0.01; mSASSS <10, r=?0.297, P=0.028. Conclusion?Serum ucMGP may serve as a diagnostic biomarker of AS and progression index of ossification, especially in late stage of AS.

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

    Directory of Open Access Journals (Sweden)

    Hasan Ulusoy

    2010-03-01

    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.

  8. The 1957 MRC report on leukaemia and aplastic anaemia in patients irradiated for ankylosing spondylitis

    International Nuclear Information System (INIS)

    The estimation of the carcinogenic effects of exposure to low doses of ionizing radiation has depended primarily on extrapolation from effects seen in two populations exposed to relatively high doses-the survivors of the atomic bomb explosions in Japan and patients treated in the UK with x-rays for the arthritic condition ankylosing spondylitis. The study of the leukaemia risk in over 14000 irradiated spondylitis patients was completed in an astonishingly short period of time in the mid-1950s. The full report of the original study has been difficult to access because it was not published in a journal but only as a Special Report of the UK Medical Research Council. To mark 50 years since this publication this full report is reproduced in this issue of the Journal. This accompanying review describes the background to the study, the principal findings and the further follow-up of the population that documented the risks of cancers in addition to leukaemia associated with the x-ray treatment. The architects of the study were a radiobiologist, Michael Court-Brown, and an epidemiologist, Richard Doll. Their very productive study of the leukaemia risk among spondylitics spawned a lifelong collaboration including further seminal studies of the carcinogenic effects of radiation exposure, which are also summarised in the review. (review)

  9. Prevalence, clinical relevance and characterization of circulating cytotoxic CD4+CD28- T cells in ankylosing spondylitis.

    Science.gov (United States)

    Duftner, Christina; Goldberger, Christian; Falkenbach, Albrecht; Würzner, Reinhard; Falkensammer, Barbara; Pfeiffer, Karl P; Maerker-Hermann, Elisabeth; Schirmer, Michael

    2003-01-01

    Circulating CD3+CD4+CD28- cells exhibit reduced apoptosis and were found to be more enriched in patients with ankylosing spondylitis than in age-matched healthy control individuals (7.40 +/- 6.6% versus 1.03 +/- 1.0%; P < 0.001). Levels of CD4+CD28- T cells correlate with disease status as measured using a modified metrology score, but they are independent of age and duration of ankylosing spondylitis. CD4+CD28- T cells produce IFN-gamma and perforin, and thus they must be considered proinflammatory and cytotoxic. These T cells share phenotypic and functional properties of natural killer cells, strongly expressing CD57 but lacking the lymphocyte marker CD7. MHC class I recognizing and activating natural killer cell receptors on the surface of CD4+CD28- T cells may be involved in a HLA-B27 mediated co-stimulation of these proinflammatory and cytotoxic cells. PMID:12932293

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

    OpenAIRE

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

    1985-01-01

    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...

  11. Anti TNF-a therapy might be responsible for an increased incidence of varicocele in patients with ankylosing spondylitis

    OpenAIRE

    Yilmaz, Ömer; UGAN, Yunus; YENER, Mahmut; UMUL, Mehmet; Kayan, Mustafa; Akta?, Aykut Recep; ÜNLÜ, Elif Nisa; KISACIK, Bünyamin; DE??RMENC?, Bumin; ÇET?N, Meltem

    2014-01-01

    To evaluate the effects of anti-tumor necrosis factor-alpha (TNF-a) therapy on the frequency of varicocele in patients with ankylosing spondylitis (AS) using color Doppler ultrasound. Materials and methods: The patients were divided into 2 groups: patients with AS who were on anti-TNF-a treatment and patients with AS who were not regularly taking any antiinflammatory drugs. Thirty-one healthy volunteers were included as controls. Results: Left-sided varicocele was determined in 14 patients ...

  12. Cost-Effectiveness Evaluation of Etoricoxib versus Celecoxib and Nonselective NSAIDs in the Treatment of Ankylosing Spondylitis in Norway

    OpenAIRE

    Jansen, Jeroen P.; Taylor, Stephanie D

    2011-01-01

    Objectives. To evaluate the cost-effectiveness of etoricoxib (90?mg) relative to celecoxib (200/400?mg), and the nonselective NSAIDs naproxen (1000?mg) and diclofenac (150?mg) in the initial treatment of ankylosing spondylitis in Norway. Methods. A previously developed Markov state-transition model was used to estimate costs and benefits associated with initiating treatment with the different competing NSAIDs. Efficacy, gastrointestinal and cardiovascular safety, and resource use data...

  13. Ankylosing Spondylitis

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

    International Nuclear Information System (INIS)

    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 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.)

  15. Optimisation of rheumatology assessments - the actual situation in axial spondyloarthritis including ankylosing spondylitis.

    Science.gov (United States)

    Braun, J; Kiltz, U; Baraliakos, X; van der Heijde, D

    2014-01-01

    The spondyloarthritides (SpA) are currently differentiated into axial and peripheral SpA. Patients with axial SpA (axSpA) may be further classified into the classical form ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA). The SpA are genetically linked, and the subtypes including psoriatic arthritis (PsA) share characteristic clinical symptoms such as inflammatory back pain (IBP) and enthesitis. IMP can be due to sacroiliitis and spondylitis, enthesitis may occur with or without arthritis, and anterior uveitis, as well as other extraarticular manifestations such as psoriasis and chronic inflammatory bowel disease (IBD). In addition to clinical findings, imaging, mainly conventional radiography and magnetic resonance imaging (MRI), and laboratory results such as HLA B27 and CRP are important tools for classification and diagnosis of SpA. The Assessment of SpondyloArthritis international Society (ASAS), an international group of experts in the field of SpA since 1995, has published on assessments and outcome parameters in SpA. The publication of classification criteria for axSpA has now largely replaced the 1984 criteria for AS. However, the established cut-off between AS and nr-axSpA, 'definite' structural changes in the sacroiliac joints, has been recently debated because of limited reliability. Since imaging plays an important role in all criteria sets, the ASAS group has recently published definitions for inflammatory changes in the SIJ and the spine. The most important domains in AS are disease activity, function, spinal mobility, structural damage, and quality of life, some of which are discussed in this manuscript. For axSpA there are two major tools to assess disease activity, the BASDAI and the ASDAS, one for function, the BASFI, and several mobility measures including the BASMI. The AS Health Index (AS-HI) is introduced elsewhere in this supplement. PMID:25365096

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

    International Nuclear Information System (INIS)

    Court Brown and Doll identified over 14,000 patients with ankylosing spondylitis who had been treated with one or more courses of x-irradiation from 1935 to 1954 at one of 87 radiotherapy centers in Great Britain and Northern Ireland. The first reports from this study analyzed mortality among these patients from leukemia and other causes, particularly cancer, but these analyses included many patients who had been treated with x-rays for their spondylitis more than once. This complicated the interpretation of the late effects of the treatment on mortality, as it was not clear to what extent the subsequent treatments contributed to the excess of deaths that persisted for many years after the first treatment. Smith and Doll (1982) avoided this difficulty by examining the death rate from leukemia and other radiation-induced cancers at different times after a single course of treatment. A comparison of the mortality of this group with the mortality of Japanese atomic bomb survivors revealed good agreement between the two studies, thus increasing confidence in the belief that both studies are giving sensible estimates of the risk of cancer from high doses of radiation. The follow-up of those spondylitic patients who received a single course of treatment only has recently been extended until the end of 1982, that is, for an additional 13 years. A further 1406 patients are now known to have died, including an additional 335 deaths for which the certified cause is cancer. Deta which the certified cause is cancer. Detailed results of this further follow-up will be presented

  17. Associations of the PTPN22 and CTLA-4 genetic polymorphisms with Taiwanese ankylosing spondylitis.

    Science.gov (United States)

    Huang, Chun-Huang; Wei, James Cheng-Chung; Chen, Chun-Chieh; Chuang, Chih-Shien; Chou, Chia-Hsuan; Lin, Yu-Jie; Wang, Ming-Fuu; Wong, Ruey-Hong

    2014-05-01

    Ankylosing spondylitis (AS) is an autoimmune disease, and the imbalance of peripheral tolerance is involved in its pathogenesis. Importantly, the negative signal of activated T cells plays a crucial role in the balance of peripheral tolerance. It has been postulated that human protein tyrosine phosphatase nonreceptor 22 (PTPN22) and cytotoxic T-lymphocyte antigen-4 (CTLA-4) genes encode proteins that are actively involved in regulating T-cell activation. Therefore, we evaluated the effects of PTPN22 and CTLA-4 genotypes on the occurrence of AS. Genetic polymorphisms of PTPN22 -1123G/C and CTLA-4 +49A/G were identified by polymerase chain reaction for 391 AS patients and 391 healthy controls. Subjects with PTPN22 CC and GC genotypes had a greater risk of AS occurrence than those with PTPN22 GG genotype [relative risk = 1.39, 95 % confidence interval (95 % CI) 1.03-1.88]. Further, subjects with PTPN22 CC/CTLA-4 AA or PTPN22 GC/CTLA-4 AA genotypes had 1.90-fold (95 % CI 1.02-3.49) greater risk of AS development than those with other combinations of PTPN22 and CTLA-4 genotypes. Our findings indicated that PTPN22 -1123G/C and CTLA-4 +49A/G genetic polymorphisms have a combined effect on the development of AS. PMID:24212676

  18. Association between Endoplasmic Reticulum Aminopeptidase-1 (ERAP-1 and Susceptibility to Ankylosing Spondylitis in Iran

    Directory of Open Access Journals (Sweden)

    Mona Oraei

    2012-12-01

    Full Text Available Ankylosing Spondylitis (AS is an inflammatory arthritis, which affects mainly spine and sacroiliac joints. According to recent studies, ERAP1 is the second most common candidategene for AS susceptibility after HLA-B27. The aim of this study was to determine the association of ERAP1 gene polymorphisms with AS in Iranian population.The study group comprised 387 Iranian AS patients and 316 healthy controls from Iran.Using Real Time PCR allelic discrimination method, we genotyped four SNPs (rs30187,rs469876, rs13167972 and rs27434 of ERAP1.We found that rs30187 and rs27434 were significantly associated with AS in Iranian population (P=6×10-5, P=7×10-3, respectively. The rs30187 T/T genotype was associated with AS compared with C/C genotype (P=1.5×10-5. The rs27434 G/G genotype was inversely associated with AS (P=5×10-3. Two specific haplotypes including: rs30187/ rs469876/ rs13167972/ rs27434 TAAA and CAGG were associated with increased and decreased risk of AS in Iranian population, respectively.These results indicated that ERAP1 SNPs and haplotypes were associated with AS in Iranian population.

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

    Science.gov (United States)

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

    2014-09-01

    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

  20. Allicin attenuates inflammation and suppresses HLA-B27 protein expression in ankylosing spondylitis mice.

    Science.gov (United States)

    Gu, Xin; Wu, Haishan; Fu, Peiliang

    2013-01-01

    Here we aimed to determine the therapeutic effect of allicin on ankylosing spondylitis (AS) and explore the mechanism(s) of action. AS mouse model was constructed by transferring the HLA-B2704 gene into Kunming mice and verified by RT-PCR and CT imaging. Verified AS mice were randomly divided into model group (n = 6) and allicin-treated groups (50, 100, and 200 mg/kg, resp., n = 6, p.o., for 2 months). Wild type mice were used as control (n = 6). The levels of AS-related inflammatory factors were measured by ELISA. mRNA and protein expressions of HLA-B27 were checked by RT-PCR and western blotting. As the results, the mouse model of AS was successfully established, and high-dose allicin could markedly alleviate spine inflammatory injury possibly via reducing the secretion of the inflammatory factors (IL-6, IL-8, and TNF- ? ) sharply in AS mice. Moreover, allicin significantly inhibited HLA-B27 protein translation but failed to suppress HLA-B27 gene transcription in AS mice, indicating a posttranscriptional mechanism of this modulation. In conclusion, allicin has potential to be used for AS treatment as an anti-inflammatory nutraceutical. PMID:24324956

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

    International Nuclear Information System (INIS)

    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)

  2. Reduced serum b7-h3 levels in patients with ankylosing spondylitis.

    Science.gov (United States)

    Yan, Ruhong; Hu, Yae; Yu, Peijuan; Wen, Huiyan; Feng, Ping; Yang, Shun

    2015-06-01

    This study aimed to investigate molecule B7-H3 expression profiles of patients with ankylosing spondylitis (AS) and the clinical significance of B7-H3 in the pathogenesis of AS. Serum B7-H3 levels were measured by ELISA in patients with AS and healthy controls. The expression of B7-H3 protein and mRNA on CD14+ monocytes of peripheral blood mononuclear cells (PBMCs) and serum levels of T cell-associated cytokines were also analyzed. The serum B7-H3 levels in AS patients were significantly lower than in healthy controls. The expression of B7-H3 protein and mRNA on CD14+ monocytes of PBMCs and serum levels of TNF-?, IL-6, and IL-17A in AS patients were significantly higher than in controls. The reduced serum B7-H3 level was highly negatively correlated with AS Disease Activity Score (ASDAS), TNF-?, and IL-17A. Upregulated B7-H3 protein may play a role in the pathogenesis of AS by binding its receptor on T cells. PMID:25567370

  3. Gender differences in ankylosing spondylitis-associated cumulative healthcare utilization: a population-based cohort study

    Scientific Electronic Library Online (English)

    Hsin-Hua, Chen; Tzeng-Ji, Chen; Yi-Ming, Chen; Chiu, Ying-Ming; Der-Yuan, Chen.

    Full Text Available BACKGROUND: Ankylosing spondylitis (AS) is one of the most common rheumatic diseases with gender differences in prevalence and clinical presentation. This study aimed to examine whether such gender differences are correlated with cumulative healthcare utilization in Taiwan. METHODS: The National Hea [...] lth Insurance Research Database supplied claim records of one million individuals from 1996 to 2007. Selected cases included patients aged >16 years. Certified rheumatologists diagnosed the patients in three or more visits and gave prescriptions for AS. Multivariate adjusted logistic regression analyses were used to calculate the influence of gender on cumulative healthcare utilization associated with AS. RESULTS: The study included 228 women and 636 men. After adjustment for potential confounding factors, men had more cumulative outpatient visits associated with AS (odds ratio, 1.59; 95% confidence interval, 1.13 -2.23; p = 0.008). Men also exhibited a trend for higher frequency of AS-related hospitalization (p = 0.054). CONCLUSION: Men are more likely to have high cumulative AS-associated healthcare utilization than women. Further investigation of the causal factors is warranted.

  4. Evaluation of Postural Stability and Fall Risk in Patients with Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Ahmet Inanir

    2013-02-01

    Full Text Available Purpose: The purpose of this study is to evaluate the influences of Ankylosing spondylitis on postural balance and the risk of falls. Methods: A total of 73 sobjects were recruited for the study, including 36 with AS (17 men, 19 women and 37 healthy controls (19 men, 18 women. Patients were evaluated in terms of balance and risk of falls. Balance and risk of falls was assessed with the Biodex Stability System. Results: The mean age, gender and body mass index of the participants did not differ significantly between (p=0.308, p=0.724, p=0.766, respectively. When groups were evaluated in terms of postural stability indexes Overall Stability Index (OSI, Antero-Posteior Stability Index (APSI and Medio-Lateral Stability Index (MLSI had no statistically significant difference (p=0.190, p=0.437 ve p=0.144, respectively. Fall Risk Index (FRI evaluations showed that as patients? test scores were higher than control group (p=0.001. (Table 1. Conclusions: In this study, we present numerical data that suggests that AS are associated with risk of falling. [Cukurova Med J 2013; 38(1.000: 86-91

  5. Superoxide dismutases in polymorphonuclear leukocytes from patients with ankylosing spondylitis or rheumatoid arthritis.

    Science.gov (United States)

    Pasquier, C; Laoussadi, S; Sarfati, G; Raichvarg, D; Amor, B

    1985-01-01

    The activity of cyanide-sensitive and cyanide-insensitive superoxide dismutase (CNs- and CNi-SOD) was measured in polymorphonuclear neutrophils isolated from the blood of patients with ankylosing spondylitis (A.S.) or adults with rheumatoid arthritis (R.A.). Our purpose was to detect alterations in the protecting activity of these enzymes that might cause rheumatic lesions secondary to superoxide anion generation in the inflammatory loci. There was no difference in total SOD activity (CNs + CNi) in either A.S. or R.A. when compared to the control group. In contrast, CNi-SOD activity decreased in R.A. and A.S. and CNs-SOD activity rose significantly in A.S. only. None of the changes observed in SOD activity correlated with patient's age, erythrocyte sedimentation rate, clinical evolution of the disease or the drug doses administered. It is concluded that the reduced activity of CNi-SOD might be partly responsible for the reduced protection of the joints against oxygen-free radicals in patients with A.S. or R.A. Other factors however appear to have greater effects on the clinical evolution of these diseases. PMID:4017308

  6. Interaction between ERAP1 and HLA-B27 in ankylosing spondylitis implicates peptide handling in the mechanism for HLA-B27 in disease susceptibility.

    OpenAIRE

    Evans, DM; Spencer, CCA; Pointon, JJ; Su, Z; Harvey, D.; Kochan, G; Opperman, U; Dilthey, A; Pirinen, M; Stone, MA; Appleton, L; Moutsianis, L; Leslie, S.; Wordsworth, T; Kenna, TJ

    2011-01-01

    Ankylosing spondylitis is a common form of inflammatory arthritis predominantly affecting the spine and pelvis that occurs in approximately 5 out of 1,000 adults of European descent. Here we report the identification of three variants in the RUNX3, LTBR-TNFRSF1A and IL12B regions convincingly associated with ankylosing spondylitis (P < 5 × 10(-8) in the combined discovery and replication datasets) and a further four loci at PTGER4, TBKBP1, ANTXR2 and CARD9 that show strong association across...

  7. Psychometric characteristics of the short form 36 health survey and functional assessment of chronic illness Therapy-Fatigue subscale for patients with ankylosing spondylitis

    OpenAIRE

    Luo Michelle P; Rentz Anne M; Revicki Dennis A; Wong Robert L

    2011-01-01

    Abstract Background We evaluated the psychometric characteristics of the Short Form 36 (SF-36) Health Survey and the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue subscale in patients with ankylosing spondylitis (AS). Methods We analyzed clinical and patient-reported outcome (PRO) data collected during 12-week, double-blind, placebo-controlled periods of two randomized controlled trials comparing adalimumab and placebo for the treatment of active AS. The Bath Ankylosing Spo...

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

    OpenAIRE

    Garci?a-medel, Noel; Sanz-bravo, Alejandro; Nguyen, Dung; Galocha, Begon?a; Go?mez-molina, Patricia; Marti?n-esteban, Adria?n; Alvarez-navarro, Carlos; Castro, Jose? A. Lo?pez

    2012-01-01

    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 in...

  9. Taylor?s approach in an ankylosing spondylitis patient posted for percutaneous nephrolithotomy: A challenge for anesthesiologists

    Directory of Open Access Journals (Sweden)

    Jindal Parul

    2009-01-01

    Full Text Available We describe a patient with long-standing ankylosing spondylitis who underwent percutaneous nephrolithotomy under spinal anesthesia. At preoperative assessment, it was considered that intubation of the trachea was likely to be difficult. Fiberoptic bronchoscopy was attempted, but without success. As the standard technique for spinal anesthesia failed, a variation of the paramedian approach in the lumbosacral approach, also known as Taylor?s approach was successfully attempted. This resulted in adequate sensory and motor blockade for the surgical procedure. The patient did not require airway interventions, but equipment and aids to secure airway were available.

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

    OpenAIRE

    Myeong Soo Lee; Won Tae Chung; Eun-Nam Lee; Young-Hee Kim

    2007-01-01

    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...

  11. Scoring inflammatory activity of the spine by magnetic resonance imaging in ankylosing spondylitis: a multireader experiment.

    DEFF Research Database (Denmark)

    Lukas, Cédric; Braun, Jürgen

    2007-01-01

    OBJECTIVE: Magnetic resonance imaging (MRI) of the spine is increasingly important in the assessment of inflammatory activity in clinical trials with patients with ankylosing spondylitis (AS). We investigated feasibility, inter-reader reliability, sensitivity to change, and discriminatory ability of 3 different scoring methods for MRI activity and change in activity of the spine in patients with AS. METHODS: Thirty sets of spinal MRI at baseline and after 24 weeks of followup, derived from a randomized clinical trial comparing a tumor necrosis factor (TNF)-blocking drug (n = 20) with placebo (n = 10) and selected to cover a wide range of activity at baseline and change in activity, were presented electronically in a partial latin-square design to 9 experienced readers from different countries (Europe, Canada). Readers scored each set of MRI 3 times, using 3 different methods including the Ankylosing Spondylitis spine Magnetic Resonance Imaging-activity [ASspiMRI-a, grading activity (0-6) per vertebral unit in23 units]; the Berlin modification of the ASspiMRI-a; and the Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system, which scores the 6 vertebral units considered by the reader as the most abnormal, with additional scores for "depth" and "intensity." Both the order of the methods used by each reader and the timepoints (before/after treatment) were randomized. Feasibility of each scoring system was evaluated by measuring the mean time needed to score each set of MRI, and inter-reader reliability was evaluated by smallest detectable change (SDC) and by intraclass correlation coefficients (ICC) for all readers together and for all possible reader pairs separately. Sensitivity to change was investigated by calculating Guyatt's effect size on change scores. Discriminatory ability was assessed using Z-scores (Mann-Whitney test) comparing change in score between patients treated with TNF-blocking drug and placebo. RESULTS: The mean time to score one set of MRI was shortest for the Berlin method. SDC was lowest for the Berlin method and highest for SPARCC. Overall inter-reader ICC per method were between 0.49 and 0.77 for scoring activity status, and between 0.46 and 0.72 for scoring activity change. ICC for all possible reader pairs showed much more fluctuation per method, with lowest observed values of about 0.05 (very low agreement) and highest observed values over 0.90 (excellent agreement). In general, ICC for SPARCC were consistently higher than for other systems. Sensitivity to change differed per reader, and was more consistent with SPARCC than with the other methods, but was in general excellent for all 3 methods. Discrimination between groups (TNF-blocker vs placebo) assessed by Z-scores was good and comparable among methods. CONCLUSION: This experiment demonstrates the feasibility of multiple-reader MRI scoring exercises for method comparison, provides evidence for the feasibility, reliability, sensitivity to change, and discriminatory capacity of all 3 tested scoring systems to be used in assessing spinal activity on MRI in patients with AS in clinical trials. On the basis of these results it is not possible to prioritize one of the 3 methods. Udgivelsesdato: 2007-Apr

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

    Directory of Open Access Journals (Sweden)

    Carlos Rogério Degrandi Oliveira

    2007-04-01

    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

  13. Spinal inflammation by magnetic resonance imaging in patients with ankylosing spondylitis: association with disease activity and outcome parameters.

    Science.gov (United States)

    Konca, Sefika; Keskin, Dilek; C?l?z, Deniz; Bodur, Hatice; Sakman, Bülent

    2012-12-01

    Magnetic resonance imaging (MRI) has major contribution in early diagnosis of ankylosing spondylitis (AS). As it is difficult to determine disease activity owing to the lack of close relation between laboratory tests, clinical findings and imaging, MRI has been used as an objective outcome measure. The aim of this study is to investigate the relation between spinal MRI findings with disease activity and other outcome measures. Fifty patients fulfilling modified New York criteria for AS were enrolled to the study. All the patients were evaluated with Bath AS Disease Activity Index (BASDAI), AS Disease Activity Score (ASDAS), Bath AS Functional Index (BASFI), Bath AS Metrology Index (BASMI), Bath AS Radiology Index (BASRI) and As Quality of Life. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured as laboratory parameters, and ASspiMR scores were determined by spinal MRI. The median total ASspiMR-a score was 5.2. Spinal inflammation was evaluated in spinal segments, and thoracic segments had the highest mean ASspiMR-a level (3.1 ± 5.94). Cervical and lumbar ASspiMR were correlated with only BASRI, and total ASspiMR score was correlated with BASRI, BASMI and CRP. Thoracic ASspiMR score was correlated with patient's and doctor's global assessments, BASFI, BASMI, BASRI, ASDAS A, ASDAS B, ASDAS C, ASDAS D, ESR and CRP (P < 0.05). According to our results, the thoracic spine was the most related region with disease activity parameters and clinical outcome measures, so we suggest thoracic spine MRI evaluation in order to determine the disease activity. PMID:22159818

  14. Reducing work disability in Ankylosing Spondylitis – development of a work instability scale for AS

    Directory of Open Access Journals (Sweden)

    Helliwell Philip

    2009-06-01

    Full Text Available Abstract Background The Work Instability Scale for Rheumatoid Arthritis (RA-WIS is established and is used by physicians to identify patients at risk of job loss for rapid intervention. The study objective was to explore the concept of Work Instability (a mismatch between an individual's abilities and job demands in Ankylosing Spondylitis (AS and develop a Work Instability Scale specific to this population. Methods New items generated from qualitative interviews were combined with items from the RA-WIS to form a draft AS-WIS. Rasch analysis was used to examine the scaling properties of the AS-WIS using data generated through a postal survey. The scale was validated against a gold standard of expert assessment, a test-retest survey examined reliability. Results Fifty-seven participants who were in work returned the postal survey. Of the original 55 items 38 were shown to fit the Rasch model (?2 37.5; df 38; p 0.494 and free of bias for gender and disease duration. Following analysis for discrimination against the gold standard assessments 20 items remained with good fit to the model (?2 24.8; df 20; p 0.21. Test-retest reliability was 0.94. Conclusion The AS-WIS is a self-administered scale which meets the stringent requirements of modern measurement. Used as a screening tool it can identify those experiencing a mismatch at work who are at risk of job retention problems and work disability. Work instability is emerging as an important indication for the use of biologics, thus the AS-WIS has the potential to become an important outcome measure.

  15. Choice of a nonsteroidal anti-inflammatory drug in ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Rimma Mikhailovna Balabanova

    2014-12-01

    Full Text Available Ankylosing spondylitis (AS is a chronic systemic disease with predominant axial skeleton injury, peripheral articular and entheseal involvements, and extra-skeletal manifestations. 8–10 years elapse since the first manifestations of AC to its diagnosis, leading to delays in adequate therapy, to the progression of structural and functional impairments in the axial skeleton and peripheral joints and to the development of complications. According to the international and Russia's Association of Rheumatologists guidelines, nonsteroidal anti-inflammatory drugs (NSAIDs are an important component of AS therapy. It is necessary to carefully choose the safest NSAID for these patients, by taking into consideration that AS therapy should be long-term and continuous.The trial previously performed by the authors evaluated comorbidity in 220 AS patients long receiving nimesulide. Its long-term administration was shown to cause no increase in the level of liver enzymes. Esophagogastroduodenoscopy revealed antral gastritis in 23.6% of the patients, gastric mucosal erosions in 13, and gastric ulcer disease without an exacerbation in 3.6%. It was noted that the physicians had not prescribed gastroprotectors to the patients. Nimesulide caused no blood pressure (BP elevation even in patients who had baseline hypertension. Elevated BP occurred in 2.5% of the patients. There was no clear association of higher BP with nimesulide intake since the patients had previously used other NSAIDs, mainly diclofenac, to treat severe pain syndrome. These findings suggest that in addition to its analgesic activity, nimesulide shows good tolerability in patients with AS, which permits its long-term use, but in this case the gastrointestinal tract and BD should be carefully monitored, which will be able to prevent the possible adverse events characteristic of the entire group of NSAIDs.

  16. Preferential type 1 chemokine receptors and cytokine production of CD28? T cells in ankylosing spondylitis

    Science.gov (United States)

    Duftner, C; Dejaco, C; Kullich, W; Klauser, A; Goldberger, C; Falkenbach, A; Schirmer, M

    2006-01-01

    Objective To examine serum levels of type 1 and type 2 chemokines and lymphocytic expression of chemokine receptors, and to compare the results with lymphocytic cytokine production in patients with ankylosing spondylitis (AS). Methods Twelve patients with AS (mean (SD) age 44.9 (14.7)?years) and 27 healthy controls (46.4 (12.8)?years) were enrolled into the study. The expression of chemokine receptors (CCR?5, CXCR?3, CCR?4) and cytokines (interferon ? (IFN?), interleukin (IL)2, IL4, IL10, tumour necrosis factor ? (TNF?)) on CD28+ and CD28? T cell subtypes was analysed by a three colour FACS technique of peripheral blood samples. Serum ELISAs were performed to detect the CCR?5 ligands CCL?5, CCL?3; the CXCR?3 ligands CXCL?10, CXCL?9; and the CCR?4 ligand, CCL?17 before and after administration of the TNF? blocking agent infliximab. Results CD4+CD28? T cells had higher ratios of CXCR?3 to CCR?4 than CD4+CD28+ T cells. Both, CD4+ and CD8+CD28? T cells of patients with AS produced more IFN?, TNF?, and IL10 than their CD28+ counterparts (p<0.05), and lacked the production of IL2 and IL4. Serum levels of CXCL?9 were increased in patients with AS to 59.2?pg/ml (34.1–730.5) compared with 32.5?pg/ml (20.0–79.5) in healthy controls (p?=?0.016). The levels of both type 1 (CCL?5, CXCL?9) and type 2 chemokines (CCL?17) decreased under blockade of TNF? (p<0.05). Conclusions The profile of chemokine receptor expression and cytokine production by CD28? T cells suggests a type 1 immune reaction in AS, although IL10 is frequently produced by CD28? T cells. Treatment with TNF? blocking antibodies decreased both types of chemokines in patients' sera. PMID:16219708

  17. Muscle activation patterns and gait biomechanics in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    A. Caliri

    2011-09-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Laura MUNTEAN

    2009-12-01

    Full Text Available 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 sacroiliac, anteroposterior and lateral dorso-lumbar spine radiographs in order to grade sacroiliitis and assess syndesmophytes. Disease activity was evaluated using C-reactive protein (CRP levels and erythrocyte sedimentation rate (ESR. Demographic data and BMD measurements were compared with those of 167 age- and sex-matched healthy controls. Results: Patients with AS had a significantly lower BMD at the spine, femoral neck, trochanter and total hip as compared to age-matched controls (all p<0.01. According to the WHO classification, osteoporosis was present in 20.6% of the AS patients at the lumbar spine and in 14.6% at the femoral neck. There were no significant differences in BMD when comparing men and women with AS, except for trochanter BMD that was lower in female patients. No correlations were found between disease activity markers (ESR, CRP and BMD. Femoral neck BMD was correlated with disease duration, Schober’s test and sacroiliitis grade. Conclusion: Patients with AS have a lower spine and hip BMD as compared to age- and sex-matched controls. Bone loss at the femoral neck is associated with disease duration and more severe AS.

  19. 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

    OpenAIRE

    Wong Robert L; Luo Michelle P; Rentz Anne M; Revicki Dennis A; Doward Lynda C; McKenna Stephen P

    2009-01-01

    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.

  20. Psychometric characteristics of the short form 36 health survey and functional assessment of chronic illness Therapy-Fatigue subscale for patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Luo Michelle P

    2011-05-01

    Full Text Available Abstract Background We evaluated the psychometric characteristics of the Short Form 36 (SF-36 Health Survey and the Functional Assessment of Chronic Illness Therapy (FACIT-Fatigue subscale in patients with ankylosing spondylitis (AS. Methods We analyzed clinical and patient-reported outcome (PRO data collected during 12-week, double-blind, placebo-controlled periods of two randomized controlled trials comparing adalimumab and placebo for the treatment of active AS. The Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, and other clinical measures were collected during the clinical trial. We evaluated internal consistency/reliability, construct validity, and responsiveness to change for the SF-36 and FACIT-Fatigue. Results The SF-36 (Cronbach alpha, 0.74-0.92 and FACIT-Fatigue (Cronbach alpha, 0.82-0.86 both had good internal consistency/reliability. At baseline, SF-36 and FACIT-Fatigue scores correlated significantly with Ankylosing Spondylitis Quality of Life scores (r = -0.36 to -0.66 and r = -0.70, respectively; all p Conclusions The SF-36 is a reliable, valid, and responsive measure of health-related quality of life and the FACIT-Fatigue is a brief and psychometrically sound measure of the effects of fatigue on patients with AS. These PROs may be useful in evaluating effectiveness of new treatments for AS. Trial Registration ClinicalTrials.gov: NCT00085644 and NCT00195819

  1. Interaction between ERAP1 and HLA-B27 in ankylosing spondylitis implicates peptide handling in the mechanism for HLA-B27 in disease susceptibility

    Science.gov (United States)

    Evans, David M; Spencer, Chris C A; Pointon, Jennifer J; Su, Zhan; Harvey, David; Kochan, Grazyna; Oppermann, Udo; Dilthey, Alexander; Pirinen, Matti; Stone, Millicent A; Appleton, Louise; Moutsianas, Loukas; Leslie, Stephen; Wordsworth, Tom; Kenna, Tony J; Karaderi, Tugce; Thomas, Gethin P; Ward, Michael M; Weisman, Michael H; Farrar, Claire; Bradbury, Linda A; Danoy, Patrick; Inman, Robert D; Maksymowych, Walter; Gladman, Dafna; Rahman, Proton; Morgan, Ann; Marzo-Ortega, Helena; Bowness, Paul; Gaffney, Karl; Gaston, J S Hill; Smith, Malcolm; Bruges-Armas, Jacome; Couto, Ana-Rita; Sorrentino, Rosa; Paladini, Fabiana; Ferreira, Manuel A; Xu, Huji; Liu, Yu; Jiang, Lei; Lopez-Larrea, Carlos; Díaz-Peña, Roberto; López-Vázquez, Antonio; Zayats, Tetyana; Band, Gavin; Bellenguez, Céline; Blackburn, Hannah; Blackwell, Jenefer M; Bramon, Elvira; Bumpstead, Suzannah J; Casas, Juan P; Corvin, Aiden; Craddock, Nicholas; Deloukas, Panos; Dronov, Serge; Duncanson, Audrey; Edkins, Sarah; Freeman, Colin; Gillman, Matthew; Gray, Emma; Gwilliam, Rhian; Hammond, Naomi; Hunt, Sarah E; Jankowski, Janusz; Jayakumar, Alagurevathi; Langford, Cordelia; Liddle, Jennifer; Markus, Hugh S; Mathew, Christopher G; McCann, Owen T; McCarthy, Mark I; Palmer, Colin N A; Peltonen, Leena; Plomin, Robert; Potter, Simon C; Rautanen, Anna; Ravindrarajah, Radhi; Ricketts, Michelle; Samani, Nilesh; Sawcer, Stephen J; Strange, Amy; Trembath, Richard C; Viswanathan, Ananth C; Waller, Matthew; Weston, Paul; Whittaker, Pamela; Widaa, Sara; Wood, Nicholas W; McVean, Gilean; Reveille, John D; Wordsworth, B Paul; Brown, Matthew A; Donnelly, Peter

    2013-01-01

    Ankylosing spondylitis is a common form of inflammatory arthritis predominantly affecting the spine and pelvis that occurs in approximately 5 out of 1,000 adults of European descent. Here we report the identification of three variants in the RUNX3, LTBRTNFRSF1A and IL12B regions convincingly associated with ankylosing spondylitis (P < 5 × 10?8 in the combined discovery and replication datasets) and a further four loci at PTGER4, TBKBP1, ANTXR2 and CARD9 that show strong association across all our datasets (P < 5 × 10?6 overall, with support in each of the three datasets studied). We also show that polymorphisms of ERAP1, which encodes an endoplasmic reticulum aminopeptidase involved in peptide trimming before HLA class I presentation, only affect ankylosing spondylitis risk in HLA-B27–positive individuals. These findings provide strong evidence that HLA-B27 operates in ankylosing spondylitis through a mechanism involving aberrant processing of antigenic peptides. PMID:21743469

  2. Interaction between ERAP1 and HLA-B27 in ankylosing spondylitis implicates peptide handling in the mechanism for HLA-B27 in disease susceptibility.

    Science.gov (United States)

    Evans, David M; Spencer, Chris C A; Pointon, Jennifer J; Su, Zhan; Harvey, David; Kochan, Grazyna; Oppermann, Udo; Opperman, Udo; Dilthey, Alexander; Pirinen, Matti; Stone, Millicent A; Appleton, Louise; Moutsianas, Loukas; Moutsianis, Loukas; Leslie, Stephen; Wordsworth, Tom; Kenna, Tony J; Karaderi, Tugce; Thomas, Gethin P; Ward, Michael M; Weisman, Michael H; Farrar, Claire; Bradbury, Linda A; Danoy, Patrick; Inman, Robert D; Maksymowych, Walter; Gladman, Dafna; Rahman, Proton; Morgan, Ann; Marzo-Ortega, Helena; Bowness, Paul; Gaffney, Karl; Gaston, J S Hill; Smith, Malcolm; Bruges-Armas, Jacome; Couto, Ana-Rita; Sorrentino, Rosa; Paladini, Fabiana; Ferreira, Manuel A; Xu, Huji; Liu, Yu; Jiang, Lei; Lopez-Larrea, Carlos; Díaz-Peña, Roberto; López-Vázquez, Antonio; Zayats, Tetyana; Band, Gavin; Bellenguez, Céline; Blackburn, Hannah; Blackwell, Jenefer M; Bramon, Elvira; Bumpstead, Suzannah J; Casas, Juan P; Corvin, Aiden; Craddock, Nicholas; Deloukas, Panos; Dronov, Serge; Duncanson, Audrey; Edkins, Sarah; Freeman, Colin; Gillman, Matthew; Gray, Emma; Gwilliam, Rhian; Hammond, Naomi; Hunt, Sarah E; Jankowski, Janusz; Jayakumar, Alagurevathi; Langford, Cordelia; Liddle, Jennifer; Markus, Hugh S; Mathew, Christopher G; McCann, Owen T; McCarthy, Mark I; Palmer, Colin N A; Peltonen, Leena; Plomin, Robert; Potter, Simon C; Rautanen, Anna; Ravindrarajah, Radhi; Ricketts, Michelle; Samani, Nilesh; Sawcer, Stephen J; Strange, Amy; Trembath, Richard C; Viswanathan, Ananth C; Waller, Matthew; Weston, Paul; Whittaker, Pamela; Widaa, Sara; Wood, Nicholas W; McVean, Gilean; Reveille, John D; Wordsworth, B Paul; Brown, Matthew A; Donnelly, Peter

    2011-08-01

    Ankylosing spondylitis is a common form of inflammatory arthritis predominantly affecting the spine and pelvis that occurs in approximately 5 out of 1,000 adults of European descent. Here we report the identification of three variants in the RUNX3, LTBR-TNFRSF1A and IL12B regions convincingly associated with ankylosing spondylitis (P < 5 × 10(-8) in the combined discovery and replication datasets) and a further four loci at PTGER4, TBKBP1, ANTXR2 and CARD9 that show strong association across all our datasets (P < 5 × 10(-6) overall, with support in each of the three datasets studied). We also show that polymorphisms of ERAP1, which encodes an endoplasmic reticulum aminopeptidase involved in peptide trimming before HLA class I presentation, only affect ankylosing spondylitis risk in HLA-B27-positive individuals. These findings provide strong evidence that HLA-B27 operates in ankylosing spondylitis through a mechanism involving aberrant processing of antigenic peptides. PMID:21743469

  3. Serum 25-hydroxyvitamin D and parathyroid hormone in patients with ankylosing spondylitis before and after a three-week rehabilitation treatment at high altitude during winter and spring.

    Science.gov (United States)

    Falkenbach, A; Tripathi, R; Sedlmeyer, A; Staudinger, M; Herold, M

    2001-04-30

    Does a sojourn at high altitude during the winter and spring improve vitamin D status (and possibly suppress parathyroid hormone [PTH]) in patients with ankylosing spondylitis (AS)? In 73 patients with AS, serum concentrations of 25-hydroxy-vitamin D [25(OH)D] and PTH were determined before and after a three-week rehabilitation treatment at Bad Gastein (1000 m above sea level). At the first examination, serum 25(OH)D was median (25th, 75th percentile) 15.5 ng mL-1 (10.0 ng mL-1, 20.6 ng mL-1). Thirteen patients (18%) had a 25(OH)D concentration below 8 ng mL-1. In 53 patients (73%) the level was below 20 ng mL-1. After the sojourn, 25(OH)D significantly (p = 0.02) increased to 19.7 (11.3, 24.6) ng mL-1. PTH did not change significantly, being 32 (22.4, 43.9) pg mL-1 before and 30.3 (24.1, 39.9) pg mL-1 after the sojourn. Analysing different periods of sojourn, a significant (p < 0.001) increase in 25(OH)D was found in April but not in the other months. Patients with ankylosing spondylitis may have extremely low levels of 25(OH)D. The results of the present study suggest that a sojourn at high altitude in early spring is liable to reduce vitamin D deficiency. PMID:11388078

  4. Elevated serum level of IL-27 and VEGF in patients with ankylosing spondylitis and associate with disease activity.

    Science.gov (United States)

    Lin, Tian-Tian; Lu, Jing; Qi, Chen-Yue; Yuan, Lin; Li, Xiao-Lin; Xia, Li-Ping; Shen, Hui

    2015-05-01

    Interleukin (IL)-27 is an IL-12 family cytokine and exerts a critical role in immune regulation in the context of infection, autoimmunity, and angiogenesis. In this study, we aimed to investigate the possible pathophysiological role of IL-27 and vascular endothelial growth factor (VEGF) in ankylosing spondylitis (AS). One hundred and forty AS patients and 90 healthy controls were included in the current study. The levels of IL-27 and VEGF in serum and synovial fluid (SF) samples were measured by enzyme-linked immunosorbent assay. Erythrocyte sedimentation rate, C-reactive protein, and human leukocyte antigen (HLA)-B27 were measured by standard laboratory techniques. Disease activity in AS was scored with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Hip involvement, peripheral arthritis, and eye involvement were also recorded. The serum levels of IL-27 were remarkably higher in AS patients than healthy groups and significantly correlated with serum levels of VEGF. Furthermore, the serum levels of IL-27 were correlated with BASDAI independent of other markers of inflammation. Elevated serum levels of IL-27 and VEGF were detected in AS patients with peripheral arthritis and HLA-B27 positive. The SF levels of IL-27 and VEGF were significantly higher than serum levels in AS patients with peripheral arthritis. By contrast, levels of IL-27 and VEGF were not increased in AS patients with hip involvement and eye involvement. IL-27 may regulate the immunological or inflammatory process of AS. PMID:24710630

  5. Cost-Effectiveness Evaluation of Etoricoxib versus Celecoxib and Nonselective NSAIDs in the Treatment of Ankylosing Spondylitis in Norway.

    Science.gov (United States)

    Jansen, Jeroen P; Taylor, Stephanie D

    2011-01-01

    Objectives. To evaluate the cost-effectiveness of etoricoxib (90?mg) relative to celecoxib (200/400?mg), and the nonselective NSAIDs naproxen (1000?mg) and diclofenac (150?mg) in the initial treatment of ankylosing spondylitis in Norway. Methods. A previously developed Markov state-transition model was used to estimate costs and benefits associated with initiating treatment with the different competing NSAIDs. Efficacy, gastrointestinal and cardiovascular safety, and resource use data were obtained from the literature. Data from different studies were synthesized and translated into direct costs and quality adjusted life years by means of a Bayesian comprehensive decision modeling approach. Results. Over a 30-year time horizon, etoricoxib is associated with about 0.4 more quality adjusted life years than the other interventions. At 1 year, naproxen is the most cost-saving strategy. However, etoricoxib is cost and quality adjusted life year saving relative to celecoxib, as well as diclofenac and naproxen after 5 years of follow-up. For a willingness-to-pay ceiling ratio of 200,000 Norwegian krones per quality adjusted life year, there is a >95% probability that etoricoxib is the most-cost-effective treatment when a time horizon of 5 or more years is considered. Conclusions. Etoricoxib is the most cost-effective NSAID for initiating treatment of ankylosing spondylitis in Norway. PMID:21772851

  6. The potential of selected South African plants with anti-Klebsiella activity for the treatment and prevention of ankylosing spondylitis.

    Science.gov (United States)

    Cock, I E; van Vuuren, S F

    2015-02-01

    A wide variety of herbal remedies are used in traditional African medicine to treat inflammatory disorders, including some autoimmune diseases. Thirty-four extracts from 13 South African plant species traditionally used for the treatment of inflammation were investigated for their ability to control a microbial trigger for ankylosing spondylitis (Klebsiella pneumoniae). Twenty-six of the extracts (76.5%) inhibited the growth of K. pneumoniae. Methanol and water extracts of Ballota africana, Carpobrotus edulis leaves, Kigellia africana, Lippia javanica, Pelargonium fasiculata, Syzygium cordatum (including bark), Terminalia pruinoides and Terminalia sericea were effective K. pneumoniae inhibitors, with MIC values UV-Vis spectroscopy for the presence of resveratrol. Methanolic extracts of B. africana, C. edulis leaves, L. javanica, T. pruinoides and T. sericea, as well as aqueous B. africana, T. pruinoides and T. sericea extracts, displayed peaks with retention times and UV-Vis spectra consistent with the presence of resveratrol. Resveratrol was generally a minor component, indicating that resveratrol was not solely responsible for the anti-Klebsiella growth inhibitory properties. Plant extracts with K. pneumoniae inhibitory activity were either non-toxic, or of low toxicity in the Artemia (brine shrimp) nauplii bioassay. Their low toxicity and antibiotic bioactivity against K. pneumoniae indicate their potential for both preventing the onset of ankylosing spondylitis and minimising its symptoms once the disease is established. PMID:25412961

  7. [German patient version of the ASAS/EULAR recommendations for the management of ankylosing spondylitis].

    Science.gov (United States)

    Kiltz, U; Feldtkeller, E; Braun, J

    2010-03-01

    The evidence-based recommendations on the management of ankylosing spondylitis (AS) have enjoyed a high level of acceptance and circulation in Germany, as well as in other European countries. To make patient participation in the decision-making process regarding their disease easier, as well as to strengthen the physician-patient relationship, the ASAS and EULAR have set up an initiative to formulate a patient-friendly version of the recommendations, initially in English. In order that this lay version can also be used in German-speaking countries, a group predominantly comprising patients was formed to ensure that the German translation of this version has the broadest possible basis. In cooperation with the German (DVMB), Austrian (OVMB) and Swiss Morbus Bechterew Associations (SVMB), as well as the German Rheumatology League, patients from Germany, Austria and Switzerland with appropriate English skills were invited to a meeting in 2008. The aim of the translation was to leave the content unchanged while finding a level of speech easily understandable to the lay person. The translated text was considered as accepted when a minimum of 12 patients (>80%) gave their approval on the wording of the translation of individual recommendations in an open vote. The rheumatologist given the function of moderator was not entitled to vote. The level of approval for each recommendation was determined (0: no approval to 10: full approval). The 14 patients were able to translate the English patient version into German. Choice of words and style of speech were discussed intensively. Acceptance of the translation of the 10 recommendations was generally high. The content was clearly accepted with an approval rate of 8.4+/-1.6. This was the first time that patients, in cooperation with rheumatologists, have translated an international patient version on AS management into German under controlled conditions. The translation text was approved by the majority in terms of both form and content. Acceptance and circulation of the German patient version should be evaluated in the near future. PMID:19214540

  8. Beneficial effects of tripterygium glycosides tablet on biomarkers in patients with ankylosing spondylitis.

    Science.gov (United States)

    Ji, Wei; Chen, Yajun; Zhao, Xia; Guo, Yunke; Zhong, Lingyu; Li, Honggang; Wang, Dan; Song, Yanna

    2015-07-01

    The aim of the current study was to explore the effects and possible mechanisms of tripterygium glycosides tablet (TGT) in the treatment of active ankylosing spondylitis (AS). Thirty?six patients with active AS were given a 20 mg TGT treatment three times per day for 12 weeks, and 21 unrelated healthy controls were recruited as the control group. Efficacy measures included the Bath AS disease activity index (BASDAI), erythrocyte sedimentation rate (ESR) and C?reactive protein (CRP) prior and subsequent to TGT treatment. Serum dickkopf homolog 1 (DKK1) and interleukin-17 (IL?17) levels before and after TGT treatment were assessed using reverse transcription?quantitative polymerase chain reaction (RT?qPCR) and ELISA assay. The levels of several serum biomarkers were determined by ELISA, including receptor activator of nuclear factor ??B ligand (RANKL), osteoprotegerin (OPG), bone alkaline phosphatase (BAP), bone morphogenetic protein?2 (BMP?2), matrix metalloproteinase?3 (MMP?3), cross?linked telopeptide of type II collagen (CTX?II), vascular endothelial growth factor (VEGF), and prostaglandin E2 (PGE2). After 12 weeks of TGT treatment, the BASDAI score of the patients was significantly reduced (P<0.05), their levels of ESR and CRP were significantly reduced to a normal level (P<0.05, P<0.05), RT?PCR and ELISA showed a significant increase in the level of DKK1 expression (P<0.05) and a significant decreased IL?17 expression (P<0.05), there was a significant increase in the expression of OPG, BAP and BMP?2 (P<0.01, P<0.01, P<0.01) and a significant reduction in the expression levels of RANKL, CTX?II. MMP?3, PGE2, and VEGF (P<0.01, P<0.01, P<0.01, P<0.05, P<0.01) compared with those of the controls. TGT is effective at improving the signs and symptoms of patients with AS through the regulation of serum biomarkers, and the mechanisms may be associated with the anti?inflammatory effect, inhibition of new bone formation and potential bone?protective effects. PMID:25760304

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

    Scientific Electronic Library Online (English)

    Elena, Kokuina; Araceli, Chico; Miguel, Estévez; Flora, Calzadilla; Ángela, Gutiérrez.

    2007-03-01

    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, eda [...] d 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. Abstract in english 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.

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

    Directory of Open Access Journals (Sweden)

    Elena Kokuina

    2007-03-01

    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.

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

    Science.gov (United States)

    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

    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

  12. [Patient evaluation of the German version of the ASAS/EULAR recommendations for the management of ankylosing spondylitis].

    Science.gov (United States)

    Kiltz, U; Feldtkeller, E; Braun, J

    2008-12-01

    On the initiative of the ASAS (Assessment of SpondyloArthritis International Society) and EULAR (European League against Rheumatism), evidence-based recommendations for the management of ankylosing spondylitis (AS) were drawn up, with healthcare professionals as the target group for these recommendations. To facilitate patient participation in the decision-making process with regard to their disease, and to further improve the doctor-patient relationship, the ASAS and EULAR are working on a patient-friendly version of the recommendations.In order to establish to what extent the ASAS/EULAR recommendations, as translated by German experts, can be understood by patients, the recommendations for health care professionals, together with an evaluation form, was distributed to 105 delegates of the German society for ankylosing spondylitis (Deutschen Vereinigung Morbus Bechterew, DVMB). Responders were questioned on text comprehension and their level of agreement (0: not agree at all to 10: fully agree). Space was also provided for additional comments.In total, 59 delegates filled out the questionnaire (rate of return: 56.2%). For recommendation Nos. 1, 2, 5, 6 and 7, text comprehension was moderate. On average, the recommendations were positively assessed with 8.38+/-1.9. Recommendation No. 4 (non-pharmacological therapy) was given the highest agreement (9.54+/-1.02), while recommendation No. 7 (corticosteroids, 6.54+/-2.55) received the lowest agreement. The acceptance of the recommendation was high with 87.9% questions answered.For the first time, the German expert translation of recommendations for the management of AS patients was evaluated by patients. The present translation met with broad approval. To minimize text comprehension problems, patients should be involved in compiling a future patient version. PMID:19011877

  13. Ankylosing spondylitis in women: A comparison of scintigraphic, clinical, and radiological findings

    International Nuclear Information System (INIS)

    Since ankylosing spondylits (S.a.) tends to be milder and less progressive in women than in men, there are great difficulties in diagnosing S.a. in fermale patients. The role of scintiscanning for investigation of S.a. in women is discussed by few examiners only especially there are no investigations of quantitative sacroiliac scintigraphy in large groups of female patients. Quantitative sacroiliac scintigraphy was performed in 19 female patients with S.a. and in 30 control subjects. The sacroiliac/sacrum ratio (Index ISG/sacrum) was calculated. Significantly increased uptakes were found in the patient group compared with the controls. Especially in the early periods of S.a. the activity index was highest. When history and physical examination lead to a suspicion of S.a. and there is not verification by roentgenographic studies, sacroiliac joint scintigraphy is indicated. If clinical and laboratory findings are respected in each patient, quantitative sacroiliac scintigraphy is useful for the early diagnosis of S.a. in female patients. (orig.)

  14. Endorsement of definitions of disease activity states and improvement scores for the Ankylosing Spondylitis Disease Activity Score: results from OMERACT 10.

    Science.gov (United States)

    Machado, Pedro M M C; Landewé, Robert B M; van der Heijde, Désirée M

    2011-07-01

    The Ankylosing Spondylitis Disease Activity Score (ASDAS) is a new composite index to assess disease activity in ankylosing spondylitis (AS). Criteria for disease activity states and improvement scores are important for use in clinical practice, observational studies, and clinical trials, and have been proposed by the Assessment of SpondyloArthritis international Society (ASAS). At OMERACT 10, our aim was to obtain endorsement from OMERACT for the ASDAS disease activity states and response criteria proposed by the ASAS membership. This article summarizes the associated discussions, the scientific basis of the validation process, and the results from the voting sessions, and identifies areas for research using the ASDAS. OMERACT participants agreed with the selection of cutoff values, which now have the combined endorsement of ASAS and OMERACT and are ready to be used in clinical practice and in research settings. PMID:21724723

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

    Scientific Electronic Library Online (English)

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

    2003-12-01

    Full Text Available 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.

  16. Risks of leukemia in Japanese atomic bomb survivors, in women treated for cervical cancer, and in patients treated for ankylosing spondylitis

    OpenAIRE

    Little, Mp; Weiss, Ha; Boice, Jd; Darby, Sc; Day, Ne; Muirhead, Cr

    1999-01-01

    The dose-response relationship for radiation-induced leukemia was examined in a pooled analysis of three exposed populations: Japanese atomic bomb survivors, women treated for cervical cancer, and patients irradiated for ankylosing spondylitis. A total of 383 leukemias were observed among 283,139 study subjects. Considering all leukemias apart from chronic lymphocytic leukemia, the optimal relative risk model had a dose response with a purely quadratic term representing induction and an expon...

  17. Ankylosing spondylitis or diffuse idiopathic skeletal hyperostosis in royal Egyptian mummies of 18th -20th Dynasties? CT and archaeology studies.

    Science.gov (United States)

    Saleem, Sahar N; Hawass, Zahi

    2014-12-01

    Objective. To study the computed tomography(CT) images of royal Ancient Egyptian mummies dated to the 18th to early 20th Dynasties for the claimed diagnoses of ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) and to correlate the findings with the archaeology literature.Methods. We studied the CT images of 13 royal Ancient Egyptian mummies (1492–1153 BC) for evidence of AS and DISH and correlated our findings with the archaeology literature.Results. The findings of the CT scans excluded the diagnosis of AS, based on the absence of sacroiliac joint erosions or fusion of the facet joints. Four mummies fulfilled the diagnostic criteria for DISH:Amenhotep III (18th Dynasty), Ramesses II, his son Merenptah, and Ramesses III (19th to early 20th Dynasties).The diagnosis of DISH, a commonly a symptomatic disease of old age, in the 4 pharaohs is in concordance with their longevity and active lifestyles.Conclusion. CT findings excluded the diagnosis of AS in the studied royal Ancient Egyptian mummies and brought into question the antiquity of the disease. The CT features of DISH during this ancient period were similar to those commonly seen in modern populations,and it is likely that they will also be similar in the future.The affection of Ramesses II and his son Merenptah supports familial clustering of DISH. The process of mummification may induce changes in the spine that should be considered during investigations of disease in ancient mummies. PMID:25329920

  18. Raised incidence of ankylosing spondylitis among Inuit populations could be due to high HLA-B27 association and starch consumption.

    Science.gov (United States)

    Rashid, Taha; Wilson, Clyde; Ebringer, Alan

    2015-06-01

    Ankylosing spondylitis (AS) is a chronic inflammatory arthritis mainly affecting the spinal joints. It would appear that the most likely causative agent in the development of AS is an environmental factor in the genetically susceptible, HLA-B27 positive, individuals. Extensive data from several countries support the notion that Klebsiella pneumonia bacteria are the most likely culprit in the causation of AS. These microbes possess antigens which resemble HLA-B27 and spinal collagens. Increased intake of high-starch diet is directly proportional to the gut-associated bacterial load, especially in the large intestine, and among these microbial agents, Klebsiella is considered as one of the main constituting components. Therefore, a low-starch diet intake alongside the currently used medical therapeutic modalities could be beneficial in the management of patients with early AS. It is suggested that a change in the dietary habits from high protein, low-starch marine components to the Westernized high-starch diet among the Inuit peoples of Alaska and Canada could be considered as one of the main contributing factors in the increased prevalence of AS during the last few decades within this genetically unmixed native population. PMID:25385438

  19. Bone turnover and predictors of response in ankylosing spondylitis : results from the GLAS study

    OpenAIRE

    Arends, Suzanne

    2012-01-01

    Ankyloserende spondylitis (AS), ofwel de ziekte van Bechterew, is een chronische reumatische aandoening, waarbij vooral de wervelkolom en de heiligbeengewrichten zijn aangedaan. De ziekte wordt gekenmerkt door ontsteking in combinatie met overmatige botvorming (met als gevolg verstijving van de wervelkolom) en botverlies (met als gevolg wervelinzakkingen). Dit proefschrift is gebaseerd op gegevens van de Groningen Leeuwarden AS (GLAS) studie, een prospectief observationeel cohort onderzoek...

  20. Celecoxib: a review of its use for symptomatic relief in the treatment of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis.

    Science.gov (United States)

    McCormack, Paul L

    2011-12-24

    Celecoxib (Celebrex®) was the first cyclo-oxygenase (COX)-2 selective inhibitor (coxib) to be introduced into clinical practice. Coxibs were developed to provide anti-inflammatory/analgesic activity similar to that of nonselective NSAIDs, but without their upper gastrointestinal (GI) toxicity, which is thought to result largely from COX-1 inhibition. Celecoxib is indicated in the EU for the symptomatic treatment of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis in adults. This article reviews the clinical efficacy and tolerability of celecoxib in these EU-approved indications, as well as overviewing its pharmacological properties. In randomized controlled trials, celecoxib, at the recommended dosages of 200 or 400?mg/day, was significantly more effective than placebo, at least as effective as or more effective than paracetamol (acetaminophen) and as effective as nonselective NSAIDs and the coxibs etoricoxib and lumiracoxib for the symptomatic treatment of patients with active osteoarthritis, rheumatoid arthritis or ankylosing spondylitis. Celecoxib was generally well tolerated, with mild to moderate upper GI complaints being the most common body system adverse events. In meta-analyses and large safety studies, the incidence of upper GI ulcer complications with recommended dosages of celecoxib was significantly lower than that with nonselective NSAIDs and similar to that with paracetamol and other coxibs. However, concomitant administration of celecoxib with low-dose cardioprotective aspirin often appeared to negate the GI-sparing advantages of celecoxib over NSAIDs. Although one polyp prevention trial noted a dose-related increase in cardiovascular risk with celecoxib 400 and 800?mg/day, other trials have not found any significant difference in cardiovascular risk between celecoxib and placebo or nonselective NSAIDs. Meta-analyses and database-derived analyses are inconsistent regarding cardiovascular risk. At recommended dosages, the risks of increased thrombotic cardiovascular events, or renovascular, hepatic or hypersensitivity reactions with celecoxib would appear to be small and similar to those with NSAIDs. Celecoxib would appear to be a useful option for therapy in patients at high risk for NSAID-induced GI toxicity, or in those responding suboptimally to or intolerant of NSAIDs. To minimize any risk, particularly the cardiovascular risk, celecoxib, like all coxibs and NSAIDs, should be used at the lowest effective dosage for the shortest possible duration after a careful evaluation of the GI, cardiovascular and renal risks of the individual patient. PMID:22141388

  1. Clinical, para-clinical and subjective quality of life modifications after[224Ra] radium-chloride-therapy (224 SpondylAT) in ankylosing spondylitis (Bechterew's disease)

    International Nuclear Information System (INIS)

    Aim: The ankylosing spondylitis is a painful, chronically inflammatory illness which mainly manifests itself at the spine, and in addition at the peripheral joints with a pronounced inclination to reinforcement. Over the last years we again have been having the possibility to help the patients with a [224Ra]radium treatment to reduce the pain and probably stop the progress of the disease. The purpose was to examine the analgetic effect in connection with the para-clinical inflammation parameters and subjective modifications of the quality of life. Material and Methods: In our clinic, 5 patients (1 woman, 4 men) (age median 43,4 years) were treated over a period of 10 weeks with one weekly injection of 1 MBq [224Ra]radium chloride (224 SpondylAT). Before the therapy, at the last day of treatment, and 3 and 6 month after the therapy we documented the pain score (scale 1 to 10) of patients and the laboratory-chemical data (hemoglobin, leukocytes, neutrophile leukocytes, thrombocytes, CRP, blood sedimentation). Physical operability, psychological fortunes and the social role behavior was measured with the clinical test profile of quality of life chronically patients. The patients were asked retrospectively (approx. 5 to 15 months) to estimate their pre- and post-therapeutic situation. Results: Before the therapy, the inflammation parameters CRP (average 24.5) and BSR (average 47) of all patients were clearly increased47) of all patients were clearly increased. After 3 months, the CRP value showed a descending tendency, after 6 months however the starting value was almost reached again. The blood sedimentation rate was lowest 3 months after therapy; at a check after 6 months it was somewhat more higher, however still under the outgoing value. After 3 months, the pain score indicated by the patients was reduced from the first value of 7 significantly to 5,3, and after 6 months to 3,7. A significant modification of the blood cell parameters did not occur during the investigation period. 4 of 5 patients showed an altogether significant improvement of the quality of life, particularly on the scales of performance fortune and affiliation feeling. Conclusion: In the investigation period, a significant lowering of the pain score and a clear improvement within almost all areas of the subjective quality of life could be determined on all patients. This good analgetic and psychological effect was not connected with a significant decrease of the para-clinical inflammation parameters

  2. Interleukin-6 serum concentration in ankylosing spondylitis: a reliable predictor of disease progression in the subsequent year?

    Science.gov (United States)

    Falkenbach, A; Herold, M; Wigand, R

    2000-01-01

    The aim of the present study was to evaluate whether in ankylosing spondylitis (AS), interleukin-6 (IL-6) is a reliable predictor of changes in mobility in the subsequent year. Of 261 AS patients who had been enrolled in a previous study, 128 returned for treatment at our health centre after 1 year (+/-3 months). The variables for mobility after 1 year (II) were compared with the findings of the previous year (I). Differences in parameters for mobility were related to the serum concentration of IL-6 in the previous year. Relation between serum concentration of IL-6 and difference (II-I) in occiput-to-wall distance (Spearman's rank correlation coefficient r(s), P value) was 0.02, 0.82; chin-chest distance -0.09, 0.31; cervical rotation -0.08, 0.39; chest expansion 0.05, 0.54; finger-floor distance -0.02, 0.84; Ott sign (flexibility of the thoracic spine) -0.11, 0.22; Schober sign 0.01, 0.94. After 1 year there was a significant improvement in cervical rotation in patients with low IL-6 serum concentration (lower quartile), but not in those with high levels of IL-6 (upper quartile). No further difference was seen between patients with high or low levels of IL-6. The present data suggest that the serum concentration of IL-6 does not allow a prediction of disease progression in the subsequent year. PMID:10836525

  3. Long-term investigation of the risk of malignant diseases following intravenous radium-224 treatment for ankylosing spondylitis

    International Nuclear Information System (INIS)

    Background and purpose: in German-speaking countries, the intravenous treatment of ankylosing spondylitis (AS) with radium-224 (224Ra) was common between the late 1940s and 2005. In this long-term investigation, the risk of malignant diseases following intravenous 224Ra treatment for AS was assessed. Patients and methods: in a prospective long-term study, 1,471 patients with AS who were treated with 224Ra between 1948 and 1975 have been followed together with a control group of 1,324 AS patients treated neither with radioactive drugs nor with X-rays. Standardized questionnaires to evaluate the patients' health status were used. Observed numbers of malignant diseases were compared with those of the control group as well as with expected numbers for a normal population. Results: After 26 years of follow-up, causes of death have been certified for 1,006 patients of the exposure group (control group: 1,072 patients). Significantly increased rates of myeloid leukemia (12 cases observed vs. 2.9 expected; p 224Ra led to increased incidences of myeloid leukemia and malignancies of kidneys, thyroid and female genital organs. Although this kind of therapy is now abandoned, there is a need for close follow-up of patients who received it. (orig.)

  4. A Rare Co-Segregation-Mutation in the Insulin Receptor Substrate 1 Gene in One Chinese Family with Ankylosing Spondylitis

    Science.gov (United States)

    Zhang, Pingping; Wu, Xinyu; Huang, Jinxian; Li, Chao; Liao, Zetao; Xie, Yingying; Lv, Qing; Wei, Qiujing; Li, Tianwang; Huang, Jianlin; Cao, Shuangyan; Shen, Yan; Gu, Jieruo

    2015-01-01

    Ankylosing spondylitis (AS; MIM 106300) is a common rheumatic disease with strong genetic components affecting approximately 0.3% of the population. The exact genetic mechanism of AS remains elusive. Our previous study showed that AS could be transmitted in an autosomal dominant inheritance mode and a 6-cM candidate region located on the chromosome 2q36.1-36.3 was mapped in a Chinese family. Mutation screening was conducted within the candidate region in the family and other AS by sequencing, and the novel mutation will be further validated in other AS families, sporadic cases and healthy controls by mass spectrometry. We identified a rare non-synonymous mutation (Arg580Gly) in insulin receptor substrate 1 (IRS1) co-segregated with disease phenotype in patients of the family, which was not found in other AS families, sporadic patients and healthy controls. In the study, we found a rare non-synonymous mutation in IRS1 co-segregation in one Chinese family with AS, which indicated a new candidate disease causative gene for AS. PMID:25978640

  5. Effect of infliximab on quality of life in patients with ankylosing spondylitis according to sf-36 questionnaire data

    Directory of Open Access Journals (Sweden)

    Tatyana Alekseevna Raskina

    2013-10-01

    Full Text Available Objective: to evaluate the effect of infliximab (INF on quality of life (QL in patients with ankylosing spondylitis (AS, by analyzing the results of a SF-36 questionnaire survey. Subjects and methods. Sixty-six male patients, diagnosed with AS (according to the 1984 modified New-York criteria in its extensive or end stage with a high activity (BASDAI ?4.0, were followed up. All the patients were divided into 2 groups according to the option of disease-modifying antirheumatic drug therapy: 1 16 patients who received combination therapy with INF given as a standard regimen at 0, 2, and 6 weeks followed by a regimen of 5 mg/kg body weight and nonsteroidal anti-inflammatory drugs (NSAIDs in standard doses every 8 weeks; 2 50 patients who had monotherapy with NSAIDs in the same doses. QL was assessed using the Short-Form 36 (SF-36 questionnaire in patients with AS. Results. The scales evaluating physical health showed the greatest group differences in pain intensity (38.42%; p<0.0001 and the least in the general health status (24.48%; p<0.001. Those assessing mental health displayed statistically significant group differences in vital activity (24.78%; p<0.01.Conclusion. The patients receiving monotherapy with NSAIDs were found to have lower scores in all SF-36 scales than those on combination therapy with INF and NSAIDs.

  6. Ankylosing Spondylitis Patients Commencing Biologic Therapy Have High Baseline Levels of Comorbidity: A Report from the Australian Rheumatology Association Database

    Directory of Open Access Journals (Sweden)

    John Oldroyd

    2009-01-01

    Full Text Available Aims. To compare the baseline characteristics of a population-based cohort of patients with ankylosing spondylitis (AS commencing biological therapy to the reported characteristics of bDMARD randomised controlled trials (RCTs participants. Methods. Descriptive analysis of AS participants in the Australian Rheumatology Association Database (ARAD who were commencing bDMARD therapy. Results. Up to December 2008, 389 patients with AS were enrolled in ARAD. 354 (91.0% had taken bDMARDs at some time, and 198 (55.9% completed their entry questionnaire prior to or within 6 months of commencing bDMARDs. 131 (66.1% had at least one comorbid condition, and 24 (6.8% had a previous malignancy (15 nonmelanoma skin, 4 melanoma, 2 prostate, 1 breast, cervix, and bowel. Compared with RCT participants, ARAD participants were older, had longer disease duration and higher baseline disease activity. Conclusions. AS patients commencing bDMARDs in routine care are significantly different to RCT participants and have significant baseline comorbidities.

  7. Psychometric evaluation of the Arabic version of the multidimensional assessment of fatigue scale (MAF) for use in patients with ankylosing spondylitis.

    Science.gov (United States)

    Bahouq, Hanane; Rostom, Samira; Bahiri, Rachid; Hakkou, Jinane; Aissaoui, Nawal; Hajjaj-Hassouni, Najia

    2012-12-01

    Fatigue is a frequent symptom during ankylosing spondylitis (AS) often under estimated which needs to be measured properly with respect to its intensity by appropriate measures, such as the multidimensional assessment of fatigue (MAF). The aims of this study were to translate into the classic Arabic version of the MAF questionnaire and to validate its use for assessing fatigue in Moroccan patients with AS. The MAF contains 16 items with a global fatigue index (IGF). The MAF was translated and back-translated to arabic, pretested and reviewed by a committee following the Guillemin criteria (J Clin Epidemiol 46:1417-1432, 1993). It was then validate on 110 Moroccan patients with AS. Reliability for the 3-day test-retest was assessed using internal consistency by Cronbach's alpha coefficient and the intra-class correlation coefficient (ICC). External construct validity was assessed by correlation with pain, activity of disease and other keys variable. The reproducibility of the 15 items was satisfactory with a kappa statistics of agreement superior to 0.6. The ICC for IGF score reproducibility was good and reached 0.98 (IC 95%, 0.96-0.99). The internal consistency was at 0.991 with Cronbach's alpha coefficient. The construct validity showed a positive correlation between MAF and the axial (r = 0.34) and peripheral (r = 0.32) visual analogical scale, the Bath ankylosing spondylitis disease activity index (BASDAI) (r = 0.77), the first item of BASDAI (r = 0.85), the functional disability by the Bath ankylosing spondylitis functional index (r = 0.64), the erythrocyte sedimentation rate (r = 0.43) and the C reactive protein (r = 0.30) (for all P Arabic version of the MAF has good comprehensibility, internal consistency, reliability and validity for the evaluation of Arabic speaking patients with AS. PMID:22205382

  8. Posterior Fixation of a Cervical Fracture Using the RRS Loop Spine System and Polyethylene Tape in an Elderly Ankylosing Spondylitis Patient: A Case Report.

    Science.gov (United States)

    Koizumi, Munehisa; Iida, Jin; Shigematsu, Hideki; Satoh, Nobuhisa; Tanaka, Masato; Kura, Tomohiko; Tsukamoto, Shinji; Kato, Yoshinobu; Tanaka, Yasuhito

    2012-03-01

    An 80-year-old woman presented with neck pain and paraparesis of Frankel C in her upper and lower extremities after falling. Imaging revealed an ankylosing cervical spine and a fracture line running obliquely from the anterior C3-4 to the posterior C4-5 level. Posterior fixation from the occi pit to T3 was performed using the RRS Loop Spine System and concomitant polyethylene tape fixation. This system is characterized by the uniqueness of how it screws to the occi pit and its use of a fixation rod with a larger diameter than in other instrumentation devices for use in the cervical region. Sublaminar banding using polyethylene tape was used to secure fixation. Her postoperative course was unremarkable, and her neck pain was relieved, although neurological improvement was minor. To our knowledge, this is the first report of an application of the RRS Loop Spine System to an ankylosing spondylitis patient with a cervical fracture. PMID:22439090

  9. Inflammatory pseudotumor around metal-on-polyethylene total hip arthroplasty in patients with ankylosing spondylitis: description of two cases and review of literature.

    Science.gov (United States)

    Fu, Dong; Sun, Wei; Shen, Jiakang; Ma, Xiaojun; Cai, Zhengdong; Hua, Yingqi

    2015-01-01

    Inflammatory pseudotumor has been commonly reported in patients undertaking total hip replacement (THR) for different reasons. The precise etiology of this biological reaction and whether the primary disease has an influence on pseudotumor formation remain unclear. There seems to be a consensus that metal ions and debris do play an important role during this process. Recently, however, compared to metal particles along, immune response induced by metal particles attracts more attention. We present two cases of pseudotumor who have accepted THR for ankylosing spondylitis (AS) and later required revision surgery and hindquarter amputation, respectively. By thorough literature review, we tried to investigate the association between inflammatory pseudotumors and immunology. PMID:25889422

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

    Directory of Open Access Journals (Sweden)

    Krsti? Nikola

    2010-01-01

    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.

  11. 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)

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

    2013-06-01

    Full Text Available 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.

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

    DEFF Research Database (Denmark)

    Pedersen, O B; Svendsen, Anders JØrgen

    2008-01-01

    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.

  13. Ankylosing spondylitis and central core disease: case report Espondilite anquilosante e doença do core central: relato de caso

    Directory of Open Access Journals (Sweden)

    Rosana Herminia Scola

    2003-09-01

    Full Text Available Ankylosing spondylitis (AS is an inflammatory disorder of unknown cause that primarily affects the axial skeleton. Neurological manifestations of AS are usually related to spinal deformities. Previous studies of the paraspinal muscles of AS patients showed muscle fiber atrophy, and core fibers. On the other hand, central core disease (CCD is a genetic condition that primarily involves the skeletal muscles, but can present articular deformities secondary to muscular weakness. We report the case of a 45-year-old man with clinical and radiological diagnosis of AS and proximal muscular weakness in the lower limbs. Needle electromyography showed myopathic features and nerve conduction study was normal. Muscle biopsy disclosed almost complete predominance of type-1 fibers, and fibers with central cores. This is the first report of AS and CCD. Whether central core myopathy is coincidental or a new association with AS is discussed.A espondilite anquilosante (EA é desordem inflamatória de causa desconhecida que afeta primariamente o esqueleto axial. Estudos prévios dos músculos para-espinhais em pacientes acometidos de EA demonstraram atrofia de fibras musculares e fibras com core central. Por outro lado, a doença do core central (DCC é condição genética que envolve primariamente a musculatura esquelética, podendo acarretar deformidades articulares devido a fraqueza muscular. Relatamos o caso de um paciente de 45 anos com diagnóstico clínico e radiológico de espondilite anquilosante e fraqueza muscular proximal nos membros inferiores. A eletromiografia de agulha mostrou padrão miopático e a biópsia muscular evidenciou predominância quase total de fibras tipo 1 e fibras com cores, compatível com DCC. Este é o primeiro relato de EA e DCC. Discutimos se a EA é apenas coincidência ou uma nova associação com a DCC.

  14. Ankylosing spondylitis and central core disease: case report / Espondilite anquilosante e doença do core central: relato de caso

    Scientific Electronic Library Online (English)

    Rosana Herminia, Scola; Kátia, Lin; Fábio Massaiti, Iwamoto; Walter Oleschko, Arruda; Lineu Cesar, Werneck.

    2003-09-01

    Full Text Available A espondilite anquilosante (EA) é desordem inflamatória de causa desconhecida que afeta primariamente o esqueleto axial. Estudos prévios dos músculos para-espinhais em pacientes acometidos de EA demonstraram atrofia de fibras musculares e fibras com core central. Por outro lado, a doença do core cen [...] tral (DCC) é condição genética que envolve primariamente a musculatura esquelética, podendo acarretar deformidades articulares devido a fraqueza muscular. Relatamos o caso de um paciente de 45 anos com diagnóstico clínico e radiológico de espondilite anquilosante e fraqueza muscular proximal nos membros inferiores. A eletromiografia de agulha mostrou padrão miopático e a biópsia muscular evidenciou predominância quase total de fibras tipo 1 e fibras com cores, compatível com DCC. Este é o primeiro relato de EA e DCC. Discutimos se a EA é apenas coincidência ou uma nova associação com a DCC. Abstract in english Ankylosing spondylitis (AS) is an inflammatory disorder of unknown cause that primarily affects the axial skeleton. Neurological manifestations of AS are usually related to spinal deformities. Previous studies of the paraspinal muscles of AS patients showed muscle fiber atrophy, and core fibers. On [...] the other hand, central core disease (CCD) is a genetic condition that primarily involves the skeletal muscles, but can present articular deformities secondary to muscular weakness. We report the case of a 45-year-old man with clinical and radiological diagnosis of AS and proximal muscular weakness in the lower limbs. Needle electromyography showed myopathic features and nerve conduction study was normal. Muscle biopsy disclosed almost complete predominance of type-1 fibers, and fibers with central cores. This is the first report of AS and CCD. Whether central core myopathy is coincidental or a new association with AS is discussed.

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

    Scientific Electronic Library Online (English)

    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

    Full Text Available 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.

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

    International Nuclear Information System (INIS)

    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 estimates indicate comparable doses in the two studies, and similar levels of cancer risk were observed. For these sites, when information from the studies was combined, there were statistically significant excesses for cancers of the esophagus, stomach, lung, and ovaries, multiple myeloma, other lymphomas, and tumors of the spinal cord and nerves. Very high relative risks (RR's) for tumors of the spinal cord and nerves were observed in both studies. For sites that were lightly irradiated in the spondylitics, in addition to previously documented sites, there was a statistically significant excess of cancers of the liver and gallbladder among atomic bomb survivors. A previous subdivision of cancer sites into radiosensitive and other tissues was not supported by the atomic bomb survivor data. Changes in the rates of radiation-induced cancers with age at exposure and time since exposure were studied and compared with the use of generalized linear modeling of the RR's and also by examiear 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

  17. Is the work ability index useful to evaluate absence days in ankylosing spondylitis patients? A cross-sectional study

    Science.gov (United States)

    Meyer, Katharina; Niedermann, Karin; Tschopp, Alois; Klipstein, Andreas

    2013-01-01

    Background The work incapacity of ankylosing spondylitis (AS) ranges between 3% and 50% in Europe. In many countries, work incapacity is difficult to quantify. The work ability index (WAI) is applied to measure the work ability in workers, but it is not well investigated in patients. Aims To investigate the work incapacity in terms of absence days in patients with AS and to evaluate whether the WAI reflects the absence from work. Hypothesis Absence days can be estimated based on the WAI and other variables. Design Cross-sectional design. Setting In a secondary care centre in Switzerland, the WAI and a questionnaire about work absence were administered in AS patients prior to cardiovascular training. The number of absence days was collected retrospectively. The absence days were estimated using a two-part regression model. Participants 92 AS patients (58 men (63%)). Inclusion criteria: AS diagnosis, ability to cycle, age between 18 and 65?years. Exclusion criteria: severe heart disease. Primary and secondary outcome measures Absence days. Results Of the 92 patients, 14 received a disability pension and 78 were in the working process. The median absence days per year of the 78 patients due to AS alone and including other reasons was 0 days (IQR 0–12.3) and 2.5?days (IQR 0–19), respectively. The WAI score (regression coefficient=?4.66 (p<0.001, CI ?6.1 to ?3.2), ‘getting a disability pension’ (regression coefficient=?106.8 (p<0.001, 95% CI ?141.6 to ?72.0) and other not significant variables explained 70% of the variance in absence days (p<0.001), and therefore may estimate the number of absence days. Conclusions Absences in our sample of AS patients were equal to pan-European countries. In groups of AS patients, the WAI and other variables are valid to estimate absence days with the help of a two-part regression model. PMID:23524041

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

    DEFF Research Database (Denmark)

    Muñoz-Ortego, Juan; Vestergaard, Peter

    2014-01-01

    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?

  19. Fat metaplasia and backfill are key intermediaries in the development of sacroiliac joint ankylosis in patients with ankylosing spondylitis

    DEFF Research Database (Denmark)

    Maksymowych, Walter P; Wichuk, Stephanie

    2014-01-01

    OBJECTIVE: Fat metaplasia in bone marrow on T1-weighted magnetic resonance imaging (MRI) scans may develop after resolution of inflammation in patients with ankylosing spondylitis (AS) and may predict new bone formation in the spine. Similar tissue, termed backfill, may also fill areas of excavated bone in the sacroiliac (SI) joints and may reflect resolution of inflammation and tissue repair at sites of erosions. The purpose of this study was to test our hypothesis that SI joint ankylosis develops following repair of erosions and that tissue characterized by fat metaplasia is a key intermediary step in this pathway. METHODS: We used the Spondyloarthritis Research Consortium of Canada (SPARCC) SI structural lesion score (SSS) method to assess fat metaplasia, erosions, backfill, and ankylosis on MRIs of the SI joints in 147 patients with AS monitored for 2 years. Univariate and multivariate regression analyses focused first on identifying significant MRI predictors of new backfill and fat metaplasia. We then assessed the role of backfill and fat metaplasia in the development of new ankylosis. All analyses were adjusted for demographic features, treatment, and baseline and 2-year change in SSS values for parameters of inflammation and MRI structural lesions. RESULTS: Resolution of inflammation and reduction of erosions were each independently associated with the development of new backfill and fat metaplasia at 2 years on multivariate analyses. Multivariate regression analysis that included demographic features, baseline and 2-year change in parameters of inflammation and MRI structural lesion showed that reduction in erosions (P = 0.0005) and increase in fat metaplasia (P = 0.002) at 2 years was each independently associated with the development of new ankylosis. CONCLUSION: Our data support a disease model whereby ankylosis develops following repair of erosions, and fat metaplasia and backfill are key intermediary steps in this pathway.

  20. Predictors of treatment response and drug continuation in 842 patients with ankylosing spondylitis treated with anti-tumour necrosis factor: results from 8 years' surveillance in the Danish nationwide DANBIO registry

    DEFF Research Database (Denmark)

    Glintborg, Bente; Østergaard, Mikkel

    2010-01-01

    To use prospectively registered data from the Danish nationwide rheumatological database (DANBIO) to describe disease activity, clinical response, treatment duration and predictors of drug survival (ie, number of days individual patients maintained treatment) and clinical response among patients with ankylosing spondylitis (AS) receiving their first treatment series with a tumour necrosis factor a (TNFa) inhibitor.

  1. Risk of leukaemia following intravenous treatment with 224Ra - results of a long term follow-up study of ankylosing spondylitis patients

    International Nuclear Information System (INIS)

    In an epidemiological study of the somatic late effects risk following incorporation of a short lived ?-emitter, 1473 ankylosing spondylitis patients treated with repeated intravenous injections of 224Ra in the years 1948 - 75, have been observed in the GSF. The usual therapeutic plan consisted of a total of 10 - 12 injections of 1.036 MBq (28 ?Ci) of 224Ra each, given at weekly intervals; this would result in an cumulative ?-dose of 0.56 - 0.67 Gy to the marrow-free skeleton of a 70-kg-man (standard man). These patients have been followed together with a control group of ankylosing spondylitis patients not treated with radioactive drugs and/or X-rays. Until May 1993 (mean follow-up time 19.9 yr), 595 patients of the exposure group and 722 patients of the control group have died, causes of death have been ascertained for 578, resp. 668 patients. Among others we observed in the exposure group 10 cases of leukaemia (vs. 2.7 - 2.8 cases expected, p 239Pu, an ?-emitter which like 224Ra deposits preferentially on the bone surface. (orig.)

  2. Combined Effects of Ankylosing Spondylitis-associated ERAP1 Polymorphisms Outside the Catalytic and Peptide-binding Sites on the Processing of Natural HLA-B27 Ligands*

    Science.gov (United States)

    Martín-Esteban, Adrian; Gómez-Molina, Patricia; Sanz-Bravo, Alejandro; López de Castro, José A.

    2014-01-01

    ERAP1 polymorphism involving residues 528 and 575/725 is associated with ankylosing spondylitis among HLA-B27-positive individuals. We used four recombinant variants to address the combined effects of the K528R and D575N polymorphism on the processing of HLA-B27 ligands. The hydrolysis of a fluorogenic substrate, Arg-528/Asp-575 peptide-dependent. Sometimes the epitope yields were variant-specific at all times. For other peptides, concomitant generation and destruction led to similar epitope amounts with all the variants at long, but not at short, digestion times. The generation/destruction balance of two related HLA-B27 ligands was analyzed in vitro and in live cells. Their relative yields at long digestion times were comparable with those from HLA-B27-positive cells, suggesting that ERAP1 was a major determinant of the abundance of these peptides in vivo. The hydrolysis of fluorogenic and peptide substrates by an HLA-B27 ligand or a shorter peptide, respectively, was increasingly inhibited as a function of ERAP1 activity, indicating that residues 528 and 575 affect substrate inhibition of ERAP1 trimming. The significant and complex effects of co-occurring ERAP1 polymorphisms on multiple HLA-B27 ligands, and their potential to alter the immunological and pathogenetic features of HLA-B27 as a function of the ERAP1 context, explain the epistatic association of both molecules in ankylosing spondylitis. PMID:24352655

  3. 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)

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

    2014-03-01

    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

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

    Scientific Electronic Library Online (English)

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

    2012-09-01

    Full Text Available 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.

  5. Spinal Radiographic Progression in Patients with Ankylosing Spondylitis Treated with TNF-? Blocking Therapy: A Prospective Longitudinal Observational Cohort Study

    Science.gov (United States)

    Maas, Fiona; Spoorenberg, Anneke; Brouwer, Elisabeth; Bos, Reinhard; Efde, Monique; Chaudhry, Rizwana N.; Veeger, Nic J. G. M.; van Ooijen, Peter M. A.; Wolf, Rinze; Bootsma, Hendrika; van der Veer, Eveline; Arends, Suzanne

    2015-01-01

    Objectives To evaluate spinal radiographic damage over time and to explore the associations of radiographic progression with patient characteristics and clinical assessments including disease activity in ankylosing spondylitis (AS) patients treated with tumor necrosis factor-alpha (TNF-?) blocking therapy in daily clinical practice. Methods Consecutive outpatients from the Groningen Leeuwarden AS (GLAS) cohort were included based on the availability of cervical and lumbar radiographs before start of TNF-? blocking therapy and after 2, 4, and/or 6 years of follow-up. Clinical data were assessed at the same time points. Radiographs were scored by two independent readers using the modified Stoke AS Spine Score (mSASSS). Spinal radiographic progression in relation to clinical assessments was analyzed using generalized estimating equations. Results 176 AS patients were included, 58% had syndesmophytes at baseline. Median mSASSS increased significantly from 10.7 (IQR: 4.6–24.0) at baseline to 14.8 (IQR: 7.9–32.8) at 6 years. At the group level, spinal radiographic progression was linear with a mean progression rate of 1.3 mSASSS units per 2 years. Both spinal radiographic damage at baseline and radiographic progression were highly variable between AS patients. Male gender, older age, longer disease duration, higher BMI, longer smoking duration, high CRP, and high ASDAS were significantly associated with syndesmophytes at baseline. Significantly more radiographic progression was seen in patients with versus without syndesmophytes (2.0 vs. 0.5 mSASSS units per 2 years) and in patients >40 versus ?40 years of age (1.8 vs. 0.7 mSASSS units per 2 years). No longitudinal associations between radiographic progression and clinical assessments were found. Conclusions This prospective longitudinal observational cohort study in daily clinical practice shows overall slow and linear spinal radiographic progression in AS patients treated with TNF-? blocking therapy. At the individual level, progression was highly variable. Patients with syndesmophytes at baseline showed a 4-fold higher radiographic progression rate than patients without syndesmophytes. PMID:25879956

  6. 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)

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

    2014-07-01

    Full Text Available 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

  7. 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)

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

    2012-06-01

    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. 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.

  8. 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)

    José Eduardo Pompeu

    2012-06-01

    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.

  9. Effects and safety of allogenic mesenchymal stem cell intravenous infusion in active ankylosing spondylitis patients who failed NSAIDs: a 20-week clinical trial.

    Science.gov (United States)

    Wang, Peng; Li, Yuxi; Huang, Lin; Yang, Jiewen; Yang, Rui; Deng, Wen; Liang, Biling; Dai, Lie; Meng, Qingqi; Gao, Liangbin; Chen, Xiaodong; Shen, Jun; Tang, Yong; Zhang, Xin; Hou, Jingyi; Ye, Jichao; Chen, Keng; Cai, Zhaopeng; Wu, Yanfeng; Shen, Huiyong

    2014-01-01

    Our objective was to evaluate the feasibility, safety, and efficacy of intravenous (IV) infusion of allogenic mesenchymal stem cells (MSCs) in ankylosing spondylitis (AS) patients who are refractory to or cannot tolerate the side effects of nonsteroidal anti-inflammatory drugs (NSAIDs). AS patients enrolled in this study received four IV infusions of MSCs on days 0, 7, 14, and 21. The percentage of ASAS20 responders (the primary endpoint) at the fourth week and the mean ASAS20 response duration (the secondary endpoint) were used to assess treatment response to MSC infusion and duration of the therapeutic effects. Ankylosing Spondylitis Disease Activity Score Containing C-reactive Protein (ASDAS-CRP) and other preestablished evaluation indices were also adopted to evaluate the clinical effects. Magnetic resonance imaging (MRI) was performed to detect changes of bone marrow edema in the spine. The safety of this treatment was also evaluated. Thirty-one patients were included, and the percentage of ASAS20 responders reached 77.4% at the fourth week, and the mean ASAS20 response duration was 7.1 weeks. The mean ASDAS-CRP score decreased from 3.6 ± 0.6 to 2.4 ± 0.5 at the fourth week and then increased to 3.2 ± 0.8 at the 20th week. The average total inflammation extent (TIE) detected by MRI decreased from 533,482.5 at baseline to 480,692.3 at the fourth week (p > 0.05) and 400,547.2 at the 20th week (p < 0.05). No adverse effects were noted. IV infusion of MSCs is a feasible, safe, and promising treatment for patients with AS. PMID:23711393

  10. Golimumab therapy-induced indicators of X-ray inflammation progression and magnitude according to magnetic resonance imaging evidence in patients with rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    Aleksandr Viktorovich Smirnov

    2013-06-01

    Full Text Available The paper gives data on the progression of X-ray and magnetic resonance imaging changes in the hand and foot joints of patients with rheumatoid arthritis and psoriatic arthropathy and in the axial skeleton of those with ankylosing spondylitis when golimumab is used. Golimumab therapy is shown to retard the progression of structural changes in the peripheral joints and vertebral column. There is a significant correlation between magnetic resonance imaging evidence and blood C-reactive protein concentrations.

  11. Surface electromyography assessment of muscle activation patterns while sitting down in young healthy women and patients with ankylosing spondylitis [Povrchové elektromyografické hodnocení svalové aktivity ve zkoušce posazení u zdravých mladých žen a u pacient? s ankylozující spondylitidou

    OpenAIRE

    Petr Uhlí?; Jaroslav Opavský; Amr Mohamed Zaki Zaatar

    2011-01-01

    BACKGROUND: Muscle activation patterns depend on many factors. Surface electromyography (SEMG) can reveal these patterns in subjects of different ages and health states. We studied patterns of muscle activation in two groups of subjects - healthy young women (as a control group) and patients with ankylosing spondylitis. OBJECTIVE: The aim of this study was to register and compare muscle activation patterns while sitting down in these two groups in four situations with different positions of t...

  12. Reproducibility of the Bath Ankylosing Spondylitis Indices of disease activity (BASDAI), functional status (BASFI) and overall well-being (BAS-G) in anti-tumour necrosis factor-treated spondyloarthropathy patients

    DEFF Research Database (Denmark)

    Madsen, Ole R; Rytter, Anne

    2010-01-01

    The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Function Index (BASFI) and the Bath Ankylosing Spondylitis Global Score (BAS-G) (ranges 0-10) have gained widespread in use as self-reported measures of disease activity, functional impairment and overall well-being in patients with ankylosing spondylitis and other spondyloarthropathies (SpA). In Denmark, BASDAI, BASFI and BAS-G are systematically used to monitor treatment response in patients treated with tumour necrosis factor (TNF) inhibitors. The purpose of the present study was to examine the reproducibility of the indices in anti-TNF-treated SpA patients already familiar with the use of the indices. Testing was performed twice on two different days (median interval 7 days, range 4-10 days) under standardised conditions in 26 out-clinic patients (median age 39 years, range 22-56 years). Limits of agreement were calculated as the 95% likely range for the difference between paired scores. Test-retest results were significantly intercorrelated with r (s) = 0.90 for BASDAI, 0.92 for BASFI and 0.74 for BAS-G. Limits of agreement for BASDAI, BASFI and BAS-G were +/-1.8, +/-1.4 and +/-3.2, respectively. Reproducibility as expressed as the mean of individual standard deviations was significantly poorer for BAS-G than for BASDAI and BASFI (p <0.01). Internal consistency reliability and construct validity of BASDAI and BASFI were acceptable. In conclusion, in a sample of anti-TNF-treated patients experienced with the use of BASDAI, BASFI and BAS-G, random measurement errors of the scores were not negligible. The finding should be considered when monitoring anti-TNF treatment in daily clinical practice.

  13. Symptoms of Ankylosing Spondylitis

    Science.gov (United States)

    ... in a peripheral joint such as the hip, ankle, elbow, knee, heel or shoulder. This pain is commonly caused by enthesitis, which is the inflammation of the site where a ligament or tendon attaches to bone. Inflammation and pain ...

  14. Association between IL-1RN gene polymorphisms and susceptibility to ankylosing spondylitis: a large Human Genome Epidemiology review and meta-analysis.

    Science.gov (United States)

    Jin, G X; Duan, J Z; Guo, W L; Li, L; Cui, S Q; Wang, H

    2013-01-01

    We made a Human Genome Epidemiology review and meta-analysis to examine a possible association between interleukin-1 receptor antagonist (IL-1RN) polymorphisms and susceptibility to ankylosing spondylitis (AS). Studies of IL-1RN polymorphisms and susceptibility to AS were found by searching the Pubmed, Cochrane library, Embase, Web of Science, Springerlink, CNKI, and CBM databases. Data were extracted by 2 independent reviewers. The meta-analysis was performed with the Review Manager Version 5.1.6 and STATA Version 12.0 software. The odds ratio (OR) and 95% confidence intervals (95%CI) were calculated based on the extracted data. Thirteen studies with 5391 AS cases and 5239 healthy controls were retrieved. Seven IL-1RN polymorphisms were addressed, including rs30735, rs31017, rs419598, rs315951, rs315952, rs27810, and VNTR. Meta-analysis showed that the rs30735*C allele/carrier, the rs31017*G carrier and the rs315952*T carrier were positively and significantly associated with susceptibility to AS (OR = 1.45, 95%CI = 1.19-1.76; OR = 1.73, 95%CI = 1.34-2.24; OR = 1.30, 95%CI = 1.01-1.69; OR = 1.54, 95%CI = 1.16-2.04). A subgroup analysis based on ethnicity revealed significant positive associations between the rs30735*C allele/carrier and the rs31017*G allele and susceptibility to AS in both Caucasian and Asian populations, while the positive association between the rs315952*T carrier and AS susceptibility was significant only in Asian populations (OR = 1.54, 95%CI = 1.16-2.04). This meta-analysis suggests that IL-1RN polymorphisms are involved in the pathogenesis of AS. The rs30735*C allele/carrier, and the rs31017*G allele may be risk factors for ankylosing spondylitis in Caucasians and Asians, while the rs315952*T carrier is associated with susceptibility to this disease only in Asians. PMID:23765978

  15. In ankylosing spondylitis serum interleukin-6 correlates with the degree of mobility restriction, but not with short-term changes in the variables for mobility.

    Science.gov (United States)

    Falkenbach, A; Herold, M

    1998-01-01

    The aim of this study was to evaluate whether the serum concentration of interleukin-6 (IL-6) reflects disease activity in ankylosing spondylitis (AS). A group of 271 AS patients were enrolled in the study, 261 of whom completed the entire protocol (201 males, 60 females, median age of 53 years). Serum IL-6 was measured three times (I, baseline; II, after 10-12 days; III, after 17-24 days) during a 3- or 4-week treatment at the health resort. At the same times, the variables for mobility were measured, and the patients were asked to assess their complaints (score) in a self-styled questionnaire. The serum concentration of IL-6 correlated with the measurements of occiput-to-wall distance, cervical rotation, finger-floor distance and Schober sign, and with morning pain at all three evaluations. Comparisons between changes in IL-6 and changes in the variables (measures of mobility, scores of the questionnaires) did not reveal significant correlations. Present data would suggest that in AS the serum concentration of IL-6 indicates the degree of mobility restriction resulting from previous disease progression, but is not a reliable marker of current disease activity. PMID:9833250

  16. Clinical response, drug survival and predictors thereof in 432 ankylosing spondylitis patients after switching tumour necrosis factor ? inhibitor therapy : Results from the Danish nationwide DANBIO registry

    DEFF Research Database (Denmark)

    Glintborg, Bente; Ostergaard, Mikkel

    2013-01-01

    OBJECTIVE: To investigate frequencies and reasons for switching, treatment responses and drug survival in patients with ankylosing spondylitis (AS) switching tumour-necrosis-factor-? inhibitor (TNFi) treatment in routine clinical care. METHODS: AS patients were identified in the Danish nationwide DANBIO registry. Disease activity, treatment responses (50% or 20 mm reduction in Bath AS Disease Activity Index (BASDAI)), duration and rates of drug survival and predictors thereof were studied in patients receiving ?2 different biological drugs. RESULTS: Of 1436 AS patients starting TNFi treatment, 432 patients (30%) switched to a second and 137 (10%) to a third biological drug. Compared with non-switchers, switchers were more frequently women (33%/22%), had shorter disease duration (3 years/5 years) and higher BASDAI (62(52-76) mm/56(43-69) mm (median(interquartile-range))), Bath AS Functional Index (BASFI) (54(39-71) mm/47(31-65) mm) and visual-analogue-scale (VAS) global, pain and fatigue scores when they started the first TNFi (all p

  17. Clinical response, drug survival and predictors thereof in 432 ankylosing spondylitis patients after switching tumour necrosis factor ? inhibitor therapy : results from the Danish nationwide DANBIO registry

    DEFF Research Database (Denmark)

    Glintborg, Bente; Østergaard, Mikkel

    2013-01-01

    OBJECTIVE: To investigate frequencies and reasons for switching, treatment responses and drug survival in patients with ankylosing spondylitis (AS) switching tumour-necrosis-factor-? inhibitor (TNFi) treatment in routine clinical care. METHODS: AS patients were identified in the Danish nationwide DANBIO registry. Disease activity, treatment responses (50% or 20 mm reduction in Bath AS Disease Activity Index (BASDAI)), duration and rates of drug survival and predictors thereof were studied in patients receiving ?2 different biological drugs. RESULTS: Of 1436 AS patients starting TNFi treatment, 432 patients (30%) switched to a second and 137 (10%) to a third biological drug. Compared with non-switchers, switchers were more frequently women (33%/22%), had shorter disease duration (3 years/5 years) and higher BASDAI (62(52-76) mm/56(43-69) mm (median(interquartile-range))), Bath AS Functional Index (BASFI) (54(39-71) mm/47(31-65) mm) and visual-analogue-scale (VAS) global, pain and fatigue scores when they started the first TNFi (all p

  18. Association between mean platelet volume and bone mineral density in patients with ankylosing spondylitis and diagnostic value of diffusion-weighted magnetic resonance imaging

    Science.gov (United States)

    Resorlu, Hatice; Resorlu, Mustafa; Gokmen, Ferhat; Akbal, Ayla; Adam, Gurhan; Komurcu, Erkam; Goksel, Ferdi; Guven, Mustafa; Aras, Adem Bozkurt; Sariyildirim, Abdullah; Cevizci, Sibel

    2015-01-01

    [Purpose] The aim this study was to assess the relation between bone mineral density (BMD) and mean platelet volume (MPV) in ankylosing spondylitis (AS) patients, and evaluate the diagnostic role of the diffusion-weighted magnetic resonance imaging (MRI). [Subjects and Methods] Fifty patients diagnosed with AS were divided into two groups on the basis of BMD, a normal group (n=30) and an osteopenic (n=20) group. [Results] Duration of disease in the group with a normal BMD was 10.3±7.0?years, while it was 16.7±12.2?years in the osteopenia group. MPV was high in the osteopenia group, while no significant differences were observed between the groups in terms of apparent diffusion coefficient (ADC) and platelet distribution width (PDW). There was a positive correlation between MPV and duration of disease. Correlations between ADC value and the lumbar T score, femoral neck T score, and duration of disease were insignificant. A negative correlation was observed between BMD and disease duration. [Conclusion] Diffusion-weighted imaging provides valuable results in osteoporosis but is not a suitable technique for evaluating BMD in patients with AS because of the local and systemic inflammatory effects in the musculoskeletal system. The common pathophysiology of atherosclerosis and osteoporosis plays an important role in the negative correlation observed between MPV and BMD in patients with AS. PMID:25995574

  19. Follow-up testing of interferon-gamma release assays are useful in ankylosing spondylitis patients receiving anti-tumor necrosis factor alpha for latent tuberculosis infection.

    Science.gov (United States)

    Son, Chang-Nam; Jun, Jae-Bum; Kim, Jong-Heon; Sung, Il-Hoon; Yoo, Dae-Hyun; Kim, Tae-Hwan

    2014-08-01

    We evaluated the utility of follow-up interferon-gamma release assays (IGRAs) for the diagnosis of reactivation of latent tuberculosis infection (LTBI) or new tuberculosis in ankylosing spondylitis (AS) patients receiving anti-tumor necrosis factor alpha (anti-TNF?). The study participants (n=127) had a negative IGRA screening before receiving anti-TNF? and were evaluated by follow-up IGRA. We retrospectively examined data of the subjects according to age, gender, tuberculosis prophylaxis, concomitant medications, IGRA conversion and anti-TNF?, including type and treatment duration. The median duration of anti-TNF? was 21.5 months, and the median age was 35.3 yr. Of the 127 patients, IGRA conversion was found in 10 patients (7.9%). There was no significant variation between IGRA conversion rate and any risk factors except for age. IGRA conversion rate was not significantly different between AS and rheumatoid arthritis (P=0.12). IGRA conversion was observed in AS patients receiving anti-TNF? in Korea. A follow-up IGRA test can be helpful for identifying LTBI or new tuberculosis in AS patients receiving anti-TNF?. PMID:25120318

  20. IL-8 but not other biomarkers of endothelial damage is associated with disease activity in patients with ankylosing spondylitis without treatment with anti-TNF agents.

    Science.gov (United States)

    Azevedo, Valderilio Feijó; Faria-Neto, J R; Stinghen, Andrea; Lorencetti, Pedro G; Miller, Wagner P; Gonçalves, Beatriz P; Szyhta, Carla C; Pecoits-Filho, Roberto

    2013-07-01

    The objective of the study was to investigate the association between IL-8 and other biomarkers of endothelial dysfunction (MCP-1, V-CAM, I-CAM) and the disease activity scores in a sample of 54 patients with ankylosing spondylitis (AS) without use of biological agents. Fifty-four AS patients without treatment with anti-TNFs agents between 18 and 80 years old, who met modified New York criteria and at the same time the axial ASAS criteria, were evaluated using an epidemiological questionnaire that included among others clinical data, BASDAI, BASFI, ASQoL, ASDAS and plasma levels of CRP, ESR, MCP-1, IL-8, ICAM-1 and VCAM-1. IL-8 varied in proportion to disease activity rates (BASDAI and ASDAS) p < 0.05, being strongly correlated with the disease activity. The levels of adhesion molecules I-CAM and VCAM, as described in other studies, were positively correlated with predisposing factors for cardiovascular disease. IL-8 has shown to be strongly correlated with clinical markers of disease activity and inflammatory activity and may be an additional variable to the overall assessment of the activity of the AS. PMID:23297014

  1. Influence of Anti-TNF and Disease Modifying Antirheumatic Drugs Therapy on Pulmonary Forced Vital Capacity Associated to Ankylosing Spondylitis: A 2-Year Follow-Up Observational Study

    Science.gov (United States)

    Rocha-Muñoz, Alberto Daniel; Brambila-Tapia, Aniel Jessica Leticia; Zavala-Cerna, María Guadalupe; Vásquez-Jiménez, José Clemente; De la Cerda-Trujillo, Liliana Faviola; Vázquez-Del Mercado, Mónica; Rodriguez-Jimenez, Norma Alejandra; Díaz-Rizo, Valeria; Díaz-González, Viviana; Cardona-Muñoz, Ernesto German; Dávalos-Rodríguez, Ingrid Patricia; Salazar-Paramo, Mario; Gamez-Nava, Jorge Ivan; Nava-Zavala, Arnulfo Hernan; Gonzalez-Lopez, Laura

    2015-01-01

    Objective. To evaluate the effect of anti-TNF agents plus synthetic disease modifying antirheumatic drugs (DMARDs) versus DMARDs alone for ankylosing spondylitis (AS) with reduced pulmonary function vital capacity (FVC%). Methods. In an observational study, we included AS who had FVC% <80% at baseline. Twenty patients were taking DMARDs and 16 received anti-TNF + DMARDs. Outcome measures: changes in FVC%, BASDAI, BASFI, 6-minute walk test (6MWT), Borg scale after 6MWT, and St. George's Respiratory Questionnaire at 24 months. Results. Both DMARDs and anti-TNF + DMARDs groups had similar baseline values in FVC%. Significant improvement was achieved with anti-TNF + DMARDs in FVC%, at 24 months, when compared to DMARDs alone (P = 0.04). Similarly, patients in anti-TNF + DMARDs group had greater improvement in BASDAI, BASFI, Borg scale, and 6MWT when compared to DMARDs alone. After 2 years of follow-up, 14/16 (87.5%) in the anti-TNF + DMARDs group achieved the primary outcome: FVC% ?80%, compared with 11/20 (55%) in the DMARDs group (P = 0.04). Conclusions. Patients with anti-TNF + DMARDs had a greater improvement in FVC% and cardiopulmonary scales at 24 months compared with DMARDs. This preliminary study supports the fact that anti-TNF agents may offer additional benefits compared to DMARDs in patients with AS who have reduced FVC%. PMID:26078986

  2. Inflammatory lesions of the spine on magnetic resonance imaging predict the development of new syndesmophytes in ankylosing spondylitis: Evidence of a relationship between inflammation and new bone formation

    DEFF Research Database (Denmark)

    Maksymowych, Walter P; Chiowchanwisawakit, Praveena

    2008-01-01

    OBJECTIVE: To determine whether a vertebral corner that demonstrates an active corner inflammatory lesion (CIL) on magnetic resonance imaging (MRI) in patients with ankylosing spondylitis (AS) is more likely to evolve into a de novo syndesmophyte visible on plain radiography than is a vertebral corner that demonstrates no active inflammation on MRI. METHODS: MRI scans and plain radiographs were obtained for 29 patients recruited into randomized placebo-controlled trials of anti-tumor necrosis factor alpha (anti-TNFalpha) therapy. MRI was conducted at baseline, 12 or 24 weeks (n = 29), and 2 years (n = 22), while radiography was conducted at baseline and 2 years. A persistent CIL was defined as a CIL that was found on all available scans. A resolved CIL was defined as having completely disappeared on either the second or third scan. A validation cohort consisted of 41 AS patients followed up prospectively. Anonymized MRIs were assessed independently by 3 readers who were blinded with regard to radiographic findings. RESULTS: New syndesmophytes developed significantly more frequently in vertebral corners with inflammation (20%) than in those without inflammation (5.1%) seen on baseline MRI (P

  3. Ectopic Germinal Centers and IgG4-Producing Plasmacytes Observed in Synovia of HLA-B27+ Ankylosing Spondylitis Patients with Advanced Hip Involvement

    Science.gov (United States)

    Feng, Xiugao; Xu, Xiangjin; Wang, Yue; Zheng, Zhiyong; Lin, Guiying

    2015-01-01

    Introduction. Ectopic lymphoid neogenesis and the presence of IgG4-positive plasmacytes have been confirmed in chronic inflammatory sclerosing diseases. This study aims to investigate hip synovial tissues of ankylosing spondylitis (AS) patients for IgG4-positive plasma cells and ectopic lymphoid tissues with germinal centers (GCs). Methods. Synovial samples were collected from 7 AS patients who received total hip replacement and were evaluated using immunohistochemistry for the presence of CD20+ B-cells, CD3+ T-cells, CD21+ follicular dendritic cells (FDC), and CD38+ plasma cells. Furthermore, immunoglobulin G (IgG and IgG4), IgA, IgM, and complement components C3d and C4d in synovia were evaluated. Both synovial CD21+ FDCs and IgG4-producing plasmacytes were analyzed. Results. All seven patients had severe fibrosis. Massive infiltrations of lymphocytes were found in 5 out of 7 patients' synovia. Ectopic lymphoid tissues with CD21+ FDC networks and IgG4-positive plasma cells were observed coincidentally in two patients' synovia. Conclusion. The pathophysiological mechanism of AS patients' hip damage might be related to the coincidental presence of ectopic lymphoid tissue with FDCs network and IgG4-positive plasma cells identified here for the first time in AS patients' inflamed synovial tissue. PMID:25954311

  4. The effect of three years of TNF alpha blocking therapy on markers of bone turnover and their predictive value for treatment discontinuation in patients with ankylosing spondylitis: a prospective longitudinal observational cohort study

    Science.gov (United States)

    2012-01-01

    Introduction The aim of this study was to investigate the effect of three years of tumor necrosis factor-alpha (TNF-?) blocking therapy on bone turnover as well as to analyze the predictive value of early changes in bone turnover markers (BTM) for treatment discontinuation in patients with ankylosing spondylitis (AS). Methods This is a prospective cohort study of 111 consecutive AS outpatients who started TNF-? blocking therapy. Clinical assessments and BTM were assessed at baseline, three and six months, as well as at one, two, and three years. Z-scores of BTM were calculated to correct for age and gender. Bone mineral density (BMD) was assessed yearly. Results After three years, 72 patients (65%) were still using their first TNF-? blocking agent. In these patients, TNF-? blocking therapy resulted in significantly increased bone-specific alkaline phosphatase, a marker of bone formation; decreased serum collagen-telopeptide (sCTX), a marker of bone resorption; and increased lumbar spine and hip BMD compared to baseline. Baseline to three months decrease in sCTX Z-score (HR: 0.394, 95% CI: 0.263 to 0.591), AS disease activity score (ASDAS; HR: 0.488, 95% CI: 0.317 to 0.752), and physician's global disease activity (HR: 0.739, 95% CI: 0.600 to 0.909) were independent inversely related predictors of time to treatment discontinuation because of inefficacy or intolerance. Early decrease in sCTX Z-score correlated significantly with good long-term response regarding disease activity, physical function and quality of life. Conclusions Three years of TNF-? blocking therapy results in a bone turnover balance that favors bone formation, especially mineralization, in combination with continuous improvement of lumbar spine BMD. Early change in sCTX can serve as an objective measure in the evaluation of TNF-? blocking therapy in AS, in addition to the currently used more subjective measures. PMID:22546520

  5. 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)

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

    2014-12-01

    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

  6. Agreement of Turkish Physiatrists with the Assessment in Spondyloarthritis International Society and the European League Against Rheumatism Recommendations for the Management of Ankylosing Spondylitis and Rheumatoid Arthritis

    Science.gov (United States)

    Ozgocmen, Salih; Akgul, Ozgur; Ak?nc?, Aysen; Ataman, Sebnem; Birtane, Murat; Bodur, Hatice; Günayd?n, Rezan; Kuru, Ömer; Rezvani, Aylin; ?endur, Omer Faruk; ?enel, Kaz?m; Tuncer, Tiraje

    2012-01-01

    Background: New developments in the field of targeted therapies or biologic agents led more effective management of ankylosing spondylitis (AS) and rheumatoid arthritis (RA). Recommendations for the management of rheumatic diseases propose to reduce inappropriate use of medications, minimize variations among countries, and enable cost-effective use of health care resources. Objective: The aim this study was to evaluate conceptual agreement of ASsessment in SpondyloArthritis International Society (ASAS) and the EUropean League Against Rheumatism (EULAR) recommendations for the management of AS and EULAR recommendations for RA and to assess the rate of application among Turkish physiatrists in daily clinical practice. Methods: An online survey link has been sent to 1756 Turkish physiatrists with e-mails asking to rate agreement on 11-item ASAS/EULAR AS recommendations and 15-item EULAR RA recommendations with synthetic and biological disease-modifying anti-rheumatic drugs. Also barriers and difficulties for using biologic agents were assessed. Results: Three hundred nine physiatrists (17.5%) completed the survey. The conceptual agreement with both recommendations was very high (Level of agreement; mean 8.35±0.82 and 8.90± 0.67 for RA and AS recommendations, respectively), and the self-declared application of overall recommendations in the clinical practice was also high for both RA and AS (72.42% and 75.71%, respectively). Conclusion: Turkish physiatrists are in good conceptual agreement with the evidence-based recommendations for the management of AS and RA. These efforts may serve to disseminate the knowledge and increase the current awareness among physicians who serve to these patients and also implementation of these recommendations is expected to increase as well. PMID:22481985

  7. 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)

    Mauricio Restrepo Escobar

    2012-01-01

    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.

  8. Adalimumab and infliximab of use inflammatory markers, cytokines and matrix metalloproteinase-3 levels effect in patient with rheumatoid arthritis and ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Sibel Serin

    2015-01-01

    Full Text Available Objective: We aimed to assess adalimumab(ADA and infliximab(IFX efficacy on the patients of rheumatoid arthritis (RA and ankylosing spondylitis (AS by using erithrocyte sedimentation rate (ESR, C-reactive protein (CRP, interferon gamma (IF-?, interleukin-1 beta (IL-1ß, interleukin 6 (IL- 6, matrix metalloproteinase 3 (MMP-3. Material and Method: Sixteen RA, 15 AS patients were enrolled to this study. ADA was used on the half of RA patients , IFX was used on the other half randomly. ADA was used on 7 AS patients and IFX was used on 8 AS patients randomly too. Blood samples were taken at the weeks of 0, 1, 4 and 12. ESR and CRP were calculated at the same time with controls. Blood samples were hidden at the -20°C to evaluate after. Results: There wasn't any significant difference between the groups of RA and AS patients in terms of ESH and CRP levels (p>0.05. IF-? was found lower on both patient groups and IL-6 and IL-1ß were not included statistical analysis due to the wide range of values. MMP-3 levels was found correlated with ESR and CRP levels in both treatment and patient groups. MMP -3 was more supressed at ADA treated group on AS patients according to the IFX group on AS patients significantly (p0.05. Conclusion: MMP-3 was significantly more depressed on ADA treated group of the AS patients according to IFX treated group. We think many similar studies that include more patients needs to be done to say ADA's better efficacy than in AS patients. It can be said that MMP-3 is a stable marker to determine the activity of chronic inflammatory diseases and monitoring response to therapy according to the cytokines.

  9. A cautionary note on the impact of protocol changes for genome-wide association SNP × SNP interaction studies: an example on ankylosing spondylitis.

    Science.gov (United States)

    Bessonov, Kyrylo; Gusareva, Elena S; Van Steen, Kristel

    2015-07-01

    Genome-wide association interaction (GWAI) studies have increased in popularity. Yet to date, no standard protocol exists. In practice, any GWAI workflow involves making choices about quality control strategy, SNP filtering, linkage disequilibrium (LD) pruning, analytic tool to model or to test for genetic interactions. Each of these can have an impact on the final epistasis findings and may affect their reproducibility in follow-up analyses. Choosing an analytic tool is not straightforward, as different tools exist and current understanding about their performance is based on often very particular simulation settings. In the present study, we wish to create awareness for the impact of (minor) changes in a GWAI analysis protocol can have on final epistasis findings. In particular, we investigate the influence of marker selection and marker prioritization strategies, LD pruning and the choice of epistasis detection analytics on study results, giving rise to 8 GWAI protocols. Discussions are made in the context of the ankylosing spondylitis (AS) data obtained via the Wellcome Trust Case Control Consortium (WTCCC2). As expected, the largest impact on AS epistasis findings is caused by the choice of marker selection criterion, followed by marker coding and LD pruning. In MB-MDR, co-dominant coding of main effects is more robust to the effects of LD pruning than additive coding. We were able to reproduce previously reported epistasis involvement of HLA-B and ERAP1 in AS pathology. In addition, our results suggest involvement of MAGI3 and PARK2, responsible for cell adhesion and cellular trafficking. Gene ontology biological function enrichment analysis across the 8 considered GWAI protocols also suggested that AS could be associated to the central nervous system malfunctions, specifically, in nerve impulse propagation and in neurotransmitters metabolic processes. PMID:25939665

  10. Increased Risk of Ischemic Heart Disease in Young Patients with Newly Diagnosed Ankylosing Spondylitis – A Population-Based Longitudinal Follow-Up Study

    Science.gov (United States)

    Huang, Ya-Ping; Wang, Yen-Ho; Pan, Shin-Liang

    2013-01-01

    Background Prospective data is sparse on the association between ischemic heart disease (IHD) and ankylosing spondylitis (AS) in the young. The purpose of this population-based, age- and sex- matched follow-up study was to investigate the risk of IHD in young patients with newly diagnosed AS. Methods A total of 4794 persons aged 18 to 45 years with at least two ambulatory visits in 2001 with the principal diagnosis of AS were enrolled in the AS group. The non-AS group consisted of 23970 age- and sex-matched, randomly sampled subjects without AS. The three-year IHD-free survival rate and cumulative incidence of IHD were calculated using the Kaplan-Meier method. The Cox proportional hazards regression model was used to estimate the hazard ratio of IHD after controlling for demographic and cardiovascular co-morbidities. Results During follow-up, 70 patients in the AS group and 253 subjects in the non-AS group developed IHD. The cumulative incidence rate of IHD over time was higher in the AS group than the non-AS group. The crude hazard ratio of IHD for the AS group was 1.47 (95% CI, 1.13 to 1.92; p?=?0.0043) and the adjusted hazard ratio after controlling for demographic characteristics and comorbid medical disorders was 1.47 (95% CI, 1.13 to 1.92; p?=?0.0045). Conclusions This study showed an increased risk of developing IHD in young patients with newly diagnosed AS. PMID:23691161

  11. A meta-analysis of tumor necrosis factor inhibitors and glucocorticoids on bone density in rheumatoid arthritis and ankylosing spondylitis trials.

    Science.gov (United States)

    Siu, Stephanie; Haraoui, Boulos; Bissonnette, Robert; Bessette, Louis; Roubille, Camille; Richer, Vincent; Starnino, Tara; McCourt, Collette; McFarlane, Alexandra; Fleming, Patrick; Kraft, John; Lynde, Charles; Gulliver, Wayne; Keeling, Stephanie; Dutz, Jan; Pope, Janet E

    2014-11-21

    Objective: This systematic review examined the impact of anti-rheumatic drugs on bone mineral density (BMD) in rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis, and psoriasis. Methods: Electronic databases were systematically searched for randomized controlled trials. Studies were grouped based on disease, treatment, and site of BMD measurement. Change in BMD (?BMD) from baseline to end-of-study was recorded. Standardized mean difference (SMD) of ?BMD between treatment and controls was standardized for meta-analyses and 95% confidence interval (CI) calculated. Results: Treatment effects on BMD were not the primary outcomes of the trials. Thirteen studies were eligible (11 RA, 2 AS, 0 psoriatic arthritis, 0 psoriasis). For RA, significantly less hand bone loss was seen with TNF inhibitors (TNFi) (SMD ?BMD=0.33, CI 0.13-0.53, p=0.001, I(2) =0%) and glucocorticoids (SMD ?BMD=0.51, CI 0.20-0.81, p=0.001, I(2) =0%). TNFi had no significant effect on lumbar spine (LS) and hip BMD. Glucocorticoids were associated with a negative effect on LS (SMD ?BMD=-0.30, CI -0.55to-0.04, p=0.02, I(2) =52%) but not hip BMD. For AS, a significant increase in BMD was seen with TNFi at LS (SMD ?BMD=0.96, CI 0.64-1.27, p<0.001, I(2) =16%) and hip (SMD ?BMD=0.38, 95% CI 0.13-0.62, p=0.003, I(2) =0%). Data were insufficient to perform meta-analyses in psoriatic arthritis and psoriasis or for other anti-rheumatic drugs. Conclusion: In RA, TNFi and glucocorticoids appeared to attenuate hand bone loss. TNFi did not impact LS and hip BMD and glucocorticoids had negative effects on LS and no effect on hip BMD. In AS, TNFi was associated with improved LS and hip BMD. This article is protected by copyright. All rights reserved. PMID:25418272

  12. Survival of disease-modifying antirheumatic drugs used as the first antirheumatic medication in the treatment of ankylosing spondylitis in Finland. A nationwide population-based register study.

    Science.gov (United States)

    Relas, Heikki; Kautiainen, Hannu; Puolakka, Kari; Virta, Lauri J; Leirisalo-Repo, Marjatta

    2014-08-01

    The tight national drug reimbursement regulations in the treatment of ankylosing spondylitis (AS) in Finland lead to the practice that at least one traditional disease-modifying antirheumatic drug (DMARD), if not contraindicated, has been tried and has failed before a patient can be eligible for reimbursement of anti-tumour necrosis factor (TNF) treatment. The aim of the present study is to evaluate drug survival of the firstly prescribed DMARDs in patients with AS. All AS patients from January 1, 2000 to December 31, 2007 were collected from the nationwide drug reimbursement registry maintained by the Social Insurance Institution (SII). Data on antirheumatic medication came from the prescription registry of SII. A total of 2,890 AS patients (60 % males) were identified. Sulfasalazine (SSA) monotherapy was the most common first antirheumatic treatment (2,319 patients, 87 %), followed by methotrexate (MTX) monotherapy (230 patients, 9 %) and by hydroxychloroquine monotherapy (77 patients, 3 %). A combination of two or more DMARDs was used by 44 patients (2 %). Only seven patients (0.3 %) had biological (etanercept or adalimumab) started as the first antirheumatic drug. Median survival time of SSA monotherapy was 4.5 years (95 % CI 4.2 to 4.8) and that of MTX was 1.9 years (95 % CI 1.5 to 2.1). SSA is almost the standard as the first antirheumatic treatment of AS in Finland. Although the clinical efficiency of SSA was not evaluable in the present study, these data suggest that the use of SSA can at least postpone the need and start of TNF inhibitors with marked economic consequences. PMID:24907035

  13. 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)

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

    2012-01-01

    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. 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.

  14. 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)

    Valderilio Feijó Azevedo

    2013-02-01

    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.

  15. Longitudinal Numbers-Needed-To-Treat (NNT for Achieving Various Levels of Analgesic Response and Improvement with Etoricoxib, Naproxen, and Placebo in Ankylosing Spondylitis

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    Wang Hongwei

    2011-07-01

    Full Text Available Abstract Background Clinical analgesic trials typically report response as group mean results. However, research has shown that few patients are average and most have responses at the extremes. Moreover, group mean results do not convey response levels and thus have limited value in representing the benefit-risk at an individual level. Responder analyses and numbers-needed-to-treat (NNT are considered more relevant for evaluating treatment response. We evaluated levels of analgesic response and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI score improvement and the associated NNTs. Methods This was a post-hoc analysis of a 6-week, randomized, double-blind study (N = 387 comparing etoricoxib 90 mg, etoricoxib 120 mg, naproxen 1000 mg, and placebo in AS. Spine pain and BASDAI were measured on a 100-mm visual analog scale. The number and percentage of patients achieving ?30% and ?50% improvement in both BASDAI and spine pain were calculated and used to determine the corresponding NNTs. Patients who discontinued from the study for any reason were assigned zero improvement beyond 7 days of the time of discontinuation. Results For etoricoxib 90 mg, etoricoxib 120 mg and naproxen 1000 mg, the NNTs at 6 weeks compared with placebo were 2.0, 2.0, and 2.7 respectively for BASDAI ?30% improvement, and 3.2, 2.8, and 4.1 for ?50% improvement. For spine pain, the NNTs were 1.9, 2.0, and 3.2, respectively, for ?30% improvement, and 2.7, 2.5, and 3.7 for ?50% improvement. The differences between etoricoxib and naproxen exceeded the limit of ±0.5 units described as a clinically meaningful difference for pain. Response rates and NNTs were generally similar and stable over 2, 4, and 6 weeks. Conclusions For every 2 patients treated with etoricoxib, 1 achieved a clinically meaningful (?30% improvement in spine pain and BASDAI beyond that expected from placebo, whereas the corresponding values were approximately 1 in every 3 patients treated with naproxen. Use of NNTs and responder analyses provide additional, complementary information beyond population mean responses when assessing efficacy compared to placebo and amongst active therapies.

  16. 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)

    Valderilio Feijó, Azevedo; Pedro Grachinski, Buiar.

    2013-02-01

    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 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.

  17. 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)

    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

    Full Text Available 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.

  18. Avaliação do desempenho do BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) numa coorte brasileira de 1.492 pacientes com espondiloartrites: dados do Registro Brasileiro de Espondiloartrites (RBE) / Evaluation of performance of BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) in a Brazilian cohort of 1492 patients with spondyloarthritis: data from the Brazilian Registry of Spondyloarthritides (RBE)

    Scientific Electronic Library Online (English)

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

    2015-02-01

    Full Text Available Objetivo Avaliar os resultados da aplicação do Índice de Atividade de Doença da Espondilite Anquilosante de Bath (BASDAI) numa série de pacientes brasileiros com EpA e estabelecer suas correlações com as variáveis específicas do grupo. Métodos Um protocolo comum de investigação foi prospectivamente [...] aplicado em 1.492 pacientes brasileiros classificados como EpA pelos critérios do Grupo Europeu de Estudo das Espondiloartropatias (ESSG), acompanhados em 29 centros de referência em reumatologia no Brasil. Variáveis clínicas, demográficas e índices de doença foram colhidos. Os valores totais do BASDAI foram comparados com a presença das diferentes variáveis. Resultados O valor médio do BASDAI foi de 4,20 ± 2,38. Os escores médios do BASDAI foram mais elevados nos pacientes com forma clínica combinada, comparado às formas axiais e periféricas isoladas, nos pacientes do sexo feminino e nos sedentários. Com relação ao componente axial, valores mais altos do BASDAI estiveram significativamente associados à lombalgia inflamatória, à dor alternante em nádegas, à dor cervical e ao acometimento de coxofemorais. Houve associação estatística entre os valores do BASDAI e o comprometimento periférico, relacionado ao número de articulações inflamadas, tanto dos membros inferiores quanto dos membros superiores, e às entesites. A positividade do HLA-B27 e a presença de manifestações extra-articulares não estiveram correlacionadas com os valores médios do BASDAI. Valores mais baixos do BASDAI estiveram associados ao uso de agentes biológicos (p Abstract in english Objective To analyze the results of the application of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in a large series of Brazilian patients with the diagnosis of SpA and establish its correlations with specific variables into the group. Methods A common protocol of investigation [...] was prospectively applied to 1492 Brazilian patients classified as SpA according to the European Spondyoarthropathies Study Group (ESSG), attended at 29 referral centers of Rheumatology in Brazil. Clinical and demographic variables, and disease indices (BASDAI, Basfi, Basri, Mases, ASQol) were applied. The total values of BASDAI were compared to the presence of the different variables. Results The mean score of BASDAI was 4.20 ± 2.38. The mean scores of BASDAI were higher in patients with the combined (axial + peripheral + entheseal) (4.54 ± 2.38) clinical presentation, compared to the pure axial (3.78 ± 2.27) or pure peripheral (4.00 ± 2.38) clinical presentations (P

  19. The clinical usefulness of ESR, CRP, and disease duration in ankylosing spondylitis: the product of these acute-phase reactants and disease duration is associated with patient's poor physical mobility.

    Science.gov (United States)

    Chen, Chun-Hsiung; Chen, Hung-An; Liao, Hsien-Tzung; Liu, Chin-Hsiu; Tsai, Chang-Youh; Chou, Chung-Tei

    2015-07-01

    We evaluated the clinical usefulness of ESR, CRP, and disease duration in ankylosing spondylitis (AS) disease severity. There were 156 Chinese AS patients included in Taiwan. Patients completed the questionnaires, containing demographic data, disease activity (BASDAI), functional status (BASFI), and patient's global assessment (BASG). Meanwhile, patient's physical mobility (BASMI) and acute-phase reactants, including ESR and CRP levels were measured. Receiver operating characteristic (ROC) plot analysis was used to evaluate the performance of ESR, CRP, and disease duration in the AS patients. ESR mildly correlated with BASFI (r = 0.176, p = 0.028) and disease duration (r = 0.214, p = 0.008), and moderately correlated with BASMI (r = 0.427, p mobility (BASMI ? 3.6, the Median) (AUC = 0.748, 0.751 and 0.738, respectively, all p mobility. For detecting poor physical mobility (BASMI ? 3.6) in the AS patients: ESR × disease duration (?60.0 mm/h × year): sensitivity = 72.7 % and specificity = 72.8 %; CRP × disease duration (?8.3 mg/dl × year): sensitivity = 72.7 % and specificity = 74.6 %. ESR, CRP, and disease duration are particularly related to AS patient's poor physical mobility. Combining the usefulness of acute-phase reactants and disease duration, the values of ESR × disease duration and CRP × disease duration demonstrate better association with poor physical mobility in AS patients. PMID:25708781

  20. 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

  1. Posterior Fixation of a Cervical Fracture Using the RRS Loop Spine System and Polyethylene Tape in an Elderly Ankylosing Spondylitis Patient: A Case Report

    OpenAIRE

    Koizumi, Munehisa; Iida, Jin; Shigematsu, Hideki; Satoh, Nobuhisa; Tanaka, Masato; Kura, Tomohiko; Tsukamoto, Shinji; Kato, Yoshinobu; Tanaka, Yasuhito

    2012-01-01

    An 80-year-old woman presented with neck pain and paraparesis of Frankel C in her upper and lower extremities after falling. Imaging revealed an ankylosing cervical spine and a fracture line running obliquely from the anterior C3-4 to the posterior C4-5 level. Posterior fixation from the occi pit to T3 was performed using the RRS Loop Spine System and concomitant polyethylene tape fixation. This system is characterized by the uniqueness of how it screws to the occi pit and its use of a fixati...

  2. Espondilite Anquilosante: o exercício físico como reabilitação e promotor da qualidade de vida / Ankylosing spondylitis: The physical exercise as a form of rehabilitation and promoter of quality of life

    Scientific Electronic Library Online (English)

    Rosa Maria Dantas, Costa; Maria Dolores Gonzalez, Monteagudo.

    2008-06-01

    Full Text Available Introdução: o objectivo principal do estudo foi verificar a relação entre a prática de exercício físico e a qualidade de vida em doentes com Espondilite Anquilosante. Material e métodos: procedeu-se a um estudo quantitativo, com abordagem descritiva correlacional. Como instrumento de colheita de dad [...] os utilizou-se um questionário, com duas partes, a primeira recolheu informações sócio-demográficas, realização ou não de reabilitação e prática de exercício físico e a segunda, pelo questionário de estado de saúde, SF36. Para o tratamento de dados recorreu-se ao programa estatístico SPSS (Statistical Package for Social Sciences), versão 12.0. Em termos de técnicas estatísticas, foram utilizadas a estatística descritiva e a inferencial. Resultados: participaram no estudo 19 pacientes com Espondilite Anquilosante, 10 do género feminino e 9 do género masculino, com média de idades de 46,58 anos. Os primeiros sintomas apareceram em média aos 27,53 anos; o tempo decorrido até ser estabelecido o diagnóstico foi de 6,88 anos e apresentavam, em média, 10,83 anos de evolução da doença. Relativamente à prática de exercício físico, comprovou-se que 10 indivíduos praticavam regularmente e os restantes 9 não efectuavam qualquer tipo de exercício físico. Conclusões: observou-se que a idade, idade do diagnóstico e o tempo de estabelecimento do diagnóstico influenciam positiva e negativamente na qualidade de vida e que subsistem diferenças na percepção do estado de saúde em relação à prática de exercício físico. Abstract in english Introduction: the main goal of this study was to verify if the practice of physical exercise is related to the quality of life in patients with Ankylosing Spondylitis. Material and methods: it was made a quantitative study, following a correlative and descriptive approach. As a means of data collect [...] ion it was used a questionnaire that it was organized in two parts, the first one to get information about the social- demographic level, whether if it makes or not rehabilitation and about the practise of exercise and the second one related to the quality of life questionnaire, SF36. For the data treatment, it was used the statistical program SPSS (Statistical Package for Social Sciences), version 12.0. The statistical techniques used were the descriptive and deductive ones. Results: it involved 19 patients with Ankylosing Spondylitis, 10 females and 9 males, whose average age was 46,58 years old. The first symptoms occurred, in average, at the age of 27,53 ; the lapse of time between the disease appearance and the diagnosis was of 6,88 years and the patients presented, in average, 10,83 years of evolution of disease. Concerning physical exercise, the study proved that 10 patients practised it regularly, while the other 9 didn’t practise any type of physical exercise. Conclusions: It was possible to conclude that the age, age of diagnosis and the lapse of time between the disease appearance and the diagnosis influence positive and negative in quality of life and that there are different perceptions regarding the relation between health and physical exercise.

  3. The effect of comedication with conventional synthetic disease modifying antirheumatic drugs on TNF inhibitor drug survival in patients with ankylosing spondylitis and undifferentiated spondyloarthritis : results from a nationwide prospective study

    DEFF Research Database (Denmark)

    Lie, Elisabeth; Kristensen, Lars Erik

    2015-01-01

    OBJECTIVE: To assess the effect of comedication with conventional synthetic disease modifying antirheumatic drugs (csDMARDs) on retention to tumour necrosis factor inhibitor (TNFi) therapy in patients with ankylosing spondylitis (AS) and undifferentiated spondyloarthritis (uSpA). METHODS: Data on patients with a clinical diagnosis of AS or uSpA starting treatment with adalimumab, etanercept or infliximab as their first TNFi during 2003-2010 were retrieved from the Swedish national biologics register and linked to national population based registers. Five-year drug survival was analysed by Cox regression with age, sex, baseline csDMARD comedication, TNFi type, prescription year and covariates representing frailty and socioeconomic status. AS and uSpA were analysed separately. Sensitivity analyses included models with csDMARD as a time-dependent covariate and adjustments for additional potential confounders. RESULTS: 1365 patients with AS and 1155 patients with uSpA were included, of whom 40.8% versus 50.3% used csDMARD comedication at baseline. In the unadjusted analyses superior drug survival was observed for patients using versus not using csDMARD comedication among patients with AS (p<0.001) but not among patients with uSpA (p=0.175). In the multivariable Cox regression analyses comedication with csDMARD was associated with better retention to TNFi therapy both in AS (HR 0.71, p<0.001) and uSpA (HR 0.82, p=0.020). The results were similar with csDMARD comedication as a time-dependent covariate, and the associations were retained when adjusting for erythrocyte sedimentation rate, C-reactive protein, patient global, swollen joints, uveitis, psoriasis and inflammatory bowel disease. CONCLUSIONS: In this large register study of patients with AS and uSpA, use of csDMARD comedication was associated with better 5-year retention to the first TNFi.

  4. Polymorphisms of HLA-A, -B, -Cw and DRB1 antigens in Moroccan patients with ankylosing spondylitis and a comparison of clinical features with frequencies of HLA-B*27.

    Science.gov (United States)

    El Mouraghi, I; Ouarour, A; Ghozlani, I; Collantes, E; Solana, R; El Maghraoui, A

    2015-02-01

    Ankylosing spondylitis (AS) is very often associated with human leukocyte antigen (HLA), particularly HLA-B*27. However, the strength of this association and clinical features may vary in different ethnic groups. Our study aims to assess the distribution of HLA-A, -B, -Cw and DRB1 alleles in Moroccan patients with AS and to compare the clinical features of AS and the frequencies of HLA-B27 in patients from Morocco with other series. Seventy-five patients diagnosed with AS and assessed for clinical manifestations were selected and compared to 100 healthy controls. HLA class I and II antigens were typed by polymerase chain reaction sequence-specific oligonucleotide. HLA-B27 subtypes were studied by polymerase chain reaction amplification with sequence-specific primers. HLA-B27 was found in 64% of patients. It was positively associated with younger age at disease onset, family history, and uveitis while it had a negative association with late onset. Six B*27 subtypes were identified in the AS group. HLA-B*2705 and B*2702 were the most common observed subtypes. Among other HLA genes, a significant increase in the prevalence of HLA-Cw*02 and HLA-DRB*15 was found in AS patients. HLA-B27 is involved in the predisposition of AS in the Moroccan population. HLA-B*2705 and B*2702 were the predominant subtypes supporting previous reports in Caucasian spondyloarthropathies. Other HLA genes, HLA-Cw*02 and HLA-DRB1*15, seem to confer predisposing effect to the disease. However, the lower frequency of HLA-B27 compared to the literature in our study suggests the existence of different genetic and/or environmental factors in Morocco. PMID:25626601

  5. 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)

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

    2011-12-01

    Full Text Available 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.

  6. Responsiveness of the Ankylosing Spondylitis Disease Activity Score (ASDAS), and clinical and magnetic resonance imaging measures of disease activity in a 1 year follow-up study of patients with axial spondyloarthritis treated with TNF-{alpha} inhibitors

    DEFF Research Database (Denmark)

    Pedersen, Susanne J; SØrensen, Inge J

    2010-01-01

    OBJECTIVES: To investigate construct validity and responsiveness of the novel ankylosing spondylitis disease activity score (ASDAS) in patients with spondyloarthritis (SpA). METHODS: In a 46 weeks prospective, longitudinal multi-center study of 60 SpA patients (80% men, median age 40 years (range 21-62)) treated with tumor-necrosis-factor-alpha (TNF-alpha) inhibitors (infliximab (n=41), etanercept (n=13), adalimumab (n=6)) responsiveness of ASDAS, conventional clinical measures of disease activity and treatment response, and the Berlin magnetic resonance imaging (MRI) sacroiliac joint (SIJ) and lumbar spine inflammation scores were compared. RESULTS: After 22 weeks, 58.3% of the patients were clinical responders (50% or 20mm reduction in BASDAI). At baseline, clinical responders had significantly higher ASDAS (median 4.15 (range 1.98-6.04), p=0.008) compared with non-responders (2.99, 2.05-6.19). Changes in ASDAS correlated with changes in clinical measures of disease activity (incl. BASDAI (rho=0.76) and CRP(0.79)), MRI SIJ inflammation (0.46) and MRI total inflammation scores (0.34). Patients with higher BASDAI or ASAS responses obtained more profound reductions in ASDAS. ASDAS demonstrated the highest responsiveness with an effect size of 2.04 and a standardized response mean of 1.45, whereas BASDAI (1.86; 1.36) and CRP (0.63; 0.70) were less responsive. Linear regression demonstrated that a change in BASDAI of 20mm or 50% corresponded to change in ASDAS of 1.38 and 1.95, respectively. CONCLUSION: ASDAS demonstrated construct validity and high responsiveness during treatment with TNF-alpha inhibitors in SpA patients. The proposed thresholds for disease activity and treatment response need further validation.

  7. Atividade física regular preserva a função pulmonar em pacientes com espondilite anquilosante sem doença pulmonar prévia Regular physical activity preserves the lung function in patients with ankylosing spondylitis without previous lung alterations

    Directory of Open Access Journals (Sweden)

    Karin M. Goya

    2009-04-01

    Full Text Available A espondilite anquilosante é uma doença inflamatória que influencia de maneira restritiva a mecânica respiratória por meio do acometimento das articulações da coluna, bem como das alterações posturais decorrentes desse processo como o aumento da cifose torácica. OBJETIVO: O objetivo deste estudo foi avaliar a alteração pulmonar dos pacientes portadores de espondilite anquilosante e relacioná-la à atividade física, verificando a influência na capacidade respiratória. MÉTODOS:Foram recrutados para este estudo 104 pacientes. Apenas 15 preenchiam os critérios de inclusão e exclusão, sendo divididos em dois grupos: grupo I, composto por indivíduos sedentários, e o grupo II, composto por pacientes que praticam uma atividade física regular moderada. RESULTADOS:Os dois grupos não diferiram em relação à média da idade (49,6 ± 11,6 versus 43,3 ± 13,2 anos, p = 0,19, peso (70,9 ± 9,7 versus 74,1 ± 12,1 kg, p = 0,30 e a altura (164,6 ± 3,5 versus 167,6 ± 6,9 cm, p = 0,16. Entretanto, o tempo médio de doença foi significantemente maior no grupo I comparado ao grupo de ativos (20,1 ± 6,9 vs. 9,6 ± 3,4, p = 0,004. Como tema de interesse, observou-se que o volume minuto foi significativamente maior no grupo ativo que no inativo (4,83 ± 1,07 versus 6,1 ± 1,25, p = 0,035. Por outro lado, isso não foi demonstrado em relação à frequência respiratória (14,57 ± 1,76 versus 16,25 ± 3,53 ipm, p = 0,15, ao volume corrente (0,402 ± 0,07 versus 0,342 ± 0,10 L, p = 0,13, bem como às medidas de pressão PI máx (84,29 ± 24,99 versus 93,13 ± 16,76 cmH2O, p = 0,24 e PE máx (102,2 ± 29,26 versus 105 ± 17,32 cmH2O, p = 0,42. CONCLUSÃO:Este estudo pareceu demonstrar que os volumes pulmonares são mantidos em pacientes com espondilite anquilosante que realizam atividade física regular.Ankylosing spondylitis is an inflammatory condition which causes restriction in the lung function due to column joint alterations leading to postural dysfunction and thoracic ciphosis. OBJECTIVE: The objective of this study was to evaluate the lung function in patients with ankylosing spondylitis and to associate this parameter with physical activity. METHODS:104 patients were selected and only 15 fulfilled inclusion and exclusion criteria. They were divided in two groups: group I composed by sedentary patients, and group II with patients that has a regular physical activity. Demographic features, parameters of cervical, dorsal and lumbar column mobility were collected. Measurements of minute volume, respiratory rate, maximum inspiratory and expiratory pressures and quality of life (HAQ-S were also evaluated. RESULTS: Both groups were similar regarding mean age (49.6 ± 1.6 vs. 43.3 ± 13.2 years, p = 0.19, weight (70.9 ± 9.7 vs. 74.1 ± 12.1 kg, p = 0.30 and height (164.6 ± 3.5 vs. 167.6 ± 6.9 cm, p = 0.16. However, the mean disease duration was significantly higher in the group I compared to the active group (20.1 ± 6.9 vs. 9.6 ± 3.4 years, p = 0.004. Interestingly, a significantly higher minute volume was observed in the active group than inactive one (4.83 ± 1.07 vs. 6.1 ± 1.25 L/min, p = 0.035. On the other hand, no differences were found regarding respiratory rate (14.57 ± 1.76 vs. 16.25 ± 3.53 ipm, p = 0.15, tidal volume (0.402 ± 0.07 vs. 0.342 ± 0.10 L, p = 0.13, as well as maximum inspiratory pressure (84.29 ± 24.99 vs. 93.13 ± 16.76 cmH2O, p = 0.24 and maximum expiratory pressure (102.2 ± 29.26 vs. 105 ± 17.32 cmH2O, p = 0.42. , CONCLUSION: This study seems to show that respiratory volumes are maintained stable in patients with ankylosing spondylitis that are under regular physical activity.

  8. Atividade física regular preserva a função pulmonar em pacientes com espondilite anquilosante sem doença pulmonar prévia / Regular physical activity preserves the lung function in patients with ankylosing spondylitis without previous lung alterations

    Scientific Electronic Library Online (English)

    Karin M., Goya; Luciana T., Siqueira; Renata Alqualo, Costa; Andréa Lopes, Gallinaro; Celio Roberto, Gonçalves; Jozélio Freire de, Carvalho.

    2009-04-01

    Full Text Available A espondilite anquilosante é uma doença inflamatória que influencia de maneira restritiva a mecânica respiratória por meio do acometimento das articulações da coluna, bem como das alterações posturais decorrentes desse processo como o aumento da cifose torácica. OBJETIVO: O objetivo deste estudo foi [...] avaliar a alteração pulmonar dos pacientes portadores de espondilite anquilosante e relacioná-la à atividade física, verificando a influência na capacidade respiratória. MÉTODOS:Foram recrutados para este estudo 104 pacientes. Apenas 15 preenchiam os critérios de inclusão e exclusão, sendo divididos em dois grupos: grupo I, composto por indivíduos sedentários, e o grupo II, composto por pacientes que praticam uma atividade física regular moderada. RESULTADOS:Os dois grupos não diferiram em relação à média da idade (49,6 ± 11,6 versus 43,3 ± 13,2 anos, p = 0,19), peso (70,9 ± 9,7 versus 74,1 ± 12,1 kg, p = 0,30) e a altura (164,6 ± 3,5 versus 167,6 ± 6,9 cm, p = 0,16). Entretanto, o tempo médio de doença foi significantemente maior no grupo I comparado ao grupo de ativos (20,1 ± 6,9 vs. 9,6 ± 3,4, p = 0,004). Como tema de interesse, observou-se que o volume minuto foi significativamente maior no grupo ativo que no inativo (4,83 ± 1,07 versus 6,1 ± 1,25, p = 0,035). Por outro lado, isso não foi demonstrado em relação à frequência respiratória (14,57 ± 1,76 versus 16,25 ± 3,53 ipm, p = 0,15), ao volume corrente (0,402 ± 0,07 versus 0,342 ± 0,10 L, p = 0,13), bem como às medidas de pressão PI máx (84,29 ± 24,99 versus 93,13 ± 16,76 cmH2O), p = 0,24) e PE máx (102,2 ± 29,26 versus 105 ± 17,32 cmH2O, p = 0,42). CONCLUSÃO:Este estudo pareceu demonstrar que os volumes pulmonares são mantidos em pacientes com espondilite anquilosante que realizam atividade física regular. Abstract in english Ankylosing spondylitis is an inflammatory condition which causes restriction in the lung function due to column joint alterations leading to postural dysfunction and thoracic ciphosis. OBJECTIVE: The objective of this study was to evaluate the lung function in patients with ankylosing spondylitis an [...] d to associate this parameter with physical activity. METHODS:104 patients were selected and only 15 fulfilled inclusion and exclusion criteria. They were divided in two groups: group I composed by sedentary patients, and group II with patients that has a regular physical activity. Demographic features, parameters of cervical, dorsal and lumbar column mobility were collected. Measurements of minute volume, respiratory rate, maximum inspiratory and expiratory pressures and quality of life (HAQ-S) were also evaluated. RESULTS: Both groups were similar regarding mean age (49.6 ± 1.6 vs. 43.3 ± 13.2 years, p = 0.19), weight (70.9 ± 9.7 vs. 74.1 ± 12.1 kg, p = 0.30) and height (164.6 ± 3.5 vs. 167.6 ± 6.9 cm, p = 0.16). However, the mean disease duration was significantly higher in the group I compared to the active group (20.1 ± 6.9 vs. 9.6 ± 3.4 years, p = 0.004). Interestingly, a significantly higher minute volume was observed in the active group than inactive one (4.83 ± 1.07 vs. 6.1 ± 1.25 L/min, p = 0.035). On the other hand, no differences were found regarding respiratory rate (14.57 ± 1.76 vs. 16.25 ± 3.53 ipm, p = 0.15), tidal volume (0.402 ± 0.07 vs. 0.342 ± 0.10 L, p = 0.13), as well as maximum inspiratory pressure (84.29 ± 24.99 vs. 93.13 ± 16.76 cmH2O), p = 0.24) and maximum expiratory pressure (102.2 ± 29.26 vs. 105 ± 17.32 cmH2O, p = 0.42). ), CONCLUSION: This study seems to show that respiratory volumes are maintained stable in patients with ankylosing spondylitis that are under regular physical activity.

  9. Effects of natural factors of Niška Banja spa on indexes of mobility of vertebral column in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Nedovi? Jovan

    2009-01-01

    Full Text Available Introduction. Ankylosing spondilitis (AS is a disease from a group of seronegative spondyloarthropathies with the prevalence of 0.1% affecting mainly young males, which also gives sociomedical significance to the disease. Among all inflammatory arthropathies, AS is the most suitable for balneotherapy. Thermomineral water of the Niška Banja spa is homeothermic, oligomineral, alkaline, low radioactive radon water and also, in conjunction with mineral peloid, is considered to be optimal for this indication. Objective. Our aim was to investigate the effects of natural factors of the Niška Banja spa as a part of complex treatment on the indexes of mobility of the vertebral column in the patients with AS. Methods. The study enrolled 40 patients with the average age of 48.0±14.82 years and the average duration of disease of 16.9±6.42 years. Patients were treated with hydro- and peloid- otherapy during the average of 17.23±2.71 days. At the beginning and at the end of treatment, a number of indexes of spinal mobility were measured. The statistical significance of differences was calculated using the Student's t-test. Results. All of the measured indexes were better after balneotherapy reaching statistically significant differences in regard to the wall-to-occiput distance (p<0.05, the index of sagittal mobility of the cervical (p<0.05 and lumbar (p<0.005 spine. Conclusion. The application of natural factors of the Niška Banja spa during complex treatment of the patients with AS is accompanied with the objective increase of the spine mobility.

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

    DEFF Research Database (Denmark)

    Madsen, Ole Rintek; Egsmose, Charlotte

    2009-01-01

    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

  11. A functional variant of pre-miRNA-196a2 confers risk for Behcet's disease but not for Vogt-Koyanagi-Harada syndrome or AAU in ankylosing spondylitis.

    Science.gov (United States)

    Qi, Jian; Hou, Shengping; Zhang, Qi; Liao, Dan; Wei, Lin; Fang, Jing; Zhou, Yan; Kijlstra, Aize; Yang, Peizeng

    2013-12-01

    This study aimed to investigate the predisposition of common pre-miRNA SNPs with Behcet's disease (BD), Vogt-Koyanagi-Harada (VKH) syndrome and acute anterior uveitis (AAU) associated with ankylosing spondylitis (AS). A two-stage association study was carried out in 859 BD, 400 VKH syndrome, 209 AAU(+)AS(+) patients and 1,685 controls all belonging to a Chinese Han population. Genotyping, the expression of miR-196a and Bach1 (the target gene of miR-196a), cell proliferation, cytokine production were examined by PCR-RFLP, real-time PCR, CCK8 and ELISA. In the first stage study, the results showed significantly increased frequencies of the miR-196a2/rs11614913 TT genotype and T allele in BD patients (adjusted P(c) = 0.024, OR = 1.63; adjusted P(c) = 5.4 × 10(-3), OR = 1.45, respectively). However, no significant association of the tested SNPs with VKH and AAU(+)AS(+) patients was observed. The second stage and combined studies confirmed the association of rs11614913 with BD (TT genotype: adjusted P(c) = 6×10(-5), OR = 1.53; T allele: adjusted P(c) = 8×10(-6), OR = 1.35; CC genotype: adjusted P(c) = 0.024, OR = 0.68). A stratified analysis showed an association of the rs11614913 TT genotype and T allele with the arthritis subgroup of BD (P(c) = 5.3 × 10(-3), OR = 1.89; P(c) = 0.015, OR = 1.56, respectively). Functional experiments showed a decreased miR-196a expression, an increased Bach1 expression and an increased production of IL-1? and MCP-1 in TT cases compared to CC cases (P = 0.023, P = 0.0073, P = 0.012, P = 0.002, respectively). This study shows that a functional variant of miR-196a2 confers risk for BD but not for VKH syndrome or AAU(+)AS(+) by modulating the miR-196a gene expression and by regulating pro-inflammatory IL-1? and MCP-1 production. PMID:23928854

  12. Expression of PADI4 in patients with ankylosing spondylitis and its role in mediating the effects of TNF-? on the proliferation and osteogenic differentiation of human mesenchymal stem cells.

    Science.gov (United States)

    Yang, Yong; Dai, Min

    2015-08-01

    Peptidyl arginine deiminase, type IV (PADI4) plays an important role in inflammation and in the immune response, and it has been shown to be associated with rheumatoid arthritis, osteoarthritis and ankylosing spondylitis (AS). However, little is known about the precise role of PADI4 in the pathogenic process in vitro. In this study, we aimed to investigate the expression of PADI4 in the synovial tissue of patients with AS and to determine the potential effects of PADI4 on human mesenchymal stem cell (hMSC) proliferation and osteogenic differentiation under normal and pathological conditions. Synovial tissues were collected from 18 patients with AS and 11 control subjects. The results of reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blot analysis revealed that the expression of PADI4 was upregulated in the patients with AS. In the hMSCs, the protein expression of PADI4 was increased following treatment with tumor necrosis factor-? (TNF-?) in a dose- and time-dependent manner. MTT assay revealed that TNF-? promoted hMSC proliferation. In addition, we found that TNF-? promoted the osteogenic differentiation of hMSCs, as demonstrated by an increase in alkaline phosphatase (ALP) activity, as well as an increase in the expression of bone morphogenetic protein 2 (BMP-2), runt-related transcription factor 2 (Runx2) and Osterix. The hMSCs were transfected with PADI4 siRNA to silence PADI4 expression. We found that, under normal conditions, the silencing of PADI4 did not have any effect on hMSC proliferation or osteogenic differentiation. However, in the presence of TNF-?, hMSC proliferation and osteogenic differentiation were induced. These effects were attenuated by the silencing of PADI4. In conclusion, the findings of this study demonstrate that the expression of PADI4 differs between patients with AS and normal subjects. In addition, our data suggest that PADI4 plays a role in hMSC proliferation and differentiation, which are induced by TNF-?. PMID:26082376

  13. Infecção fúngica pulmonar por hialo-hifomicose associada a zigomicose e Actinomyces spp. em paciente com espondilite anquilosante / Pulmonary fungal infection with hyalohyphomycosis associated with zygomycosis and Actinomyces spp. in a patient with ankylosing spondylitis

    Scientific Electronic Library Online (English)

    Valderílio Feijó, Azevedo; Lúcio Ricardo Hiurko, Felippe; Larissa Luvison Gomes da, Silva; Carlos Frederico Rodrigues, Parchen; Flávio Queiros, Telles.

    2009-10-01

    Full Text Available A espondilite anquilosante (EA) pode cursar com manifestações extra-articulares e, dentre elas, as pulmonares. A fibrose nos ápices pulmonares ocorre em até 30% dos casos e as formações císticas são menos frequentes e observadas em casos avançados. A colonização dessas cavidades é uma complicação ra [...] ra. Um paciente com diagnóstico de EA desde 1998, com comprometimento axial, histórico de tuberculose pulmonar tratada em 2002 e 2007, evoluiu com um quadro de aspergilose bilateral em ápices pulmonares associada à zigomicose e Actinomyces spp. Havia sido internado para investigar queixa de emagrecimento, sudorese noturna, tosse produtiva e lesão nos ápices pulmonares. Foi submetido a tratamento cirúrgico de lobectomia de lobo pulmonar superior direito, após identificação de bola fúngica nos ápices pulmonares nas radiografias e tomografias, comprovados por exames de fibrobroncoscopia e biópsia com exame anatomopatológico. Evoluiu sem expansão pulmonar direita, foi submetido à nova fibrobroncoscopia que sugeriu oclusão do brônquio lobar médio. Uma nova toracotomia não confirmou o achado da fibrobroncoscopia. Permaneceu sem expansão pulmonar direita, evoluiu com choque séptico refratário ao tratamento e ao óbito. Abstract in english Ankylosing spondylitis (AS) can be associated with extra-articular manifestations, among which we find pulmonary disorders. Fibrosis of the pulmonary apices is seen in up to 30% of the cases, and cyst formation is less common, being seen in advanced cases. Colonization of those cavities is a rare co [...] mplication. A patient with a diagnosis of AS since 1998 with axial involvement and history of pulmonary tuberculosis treated in 2002 and 2007, developed bilateral aspergillosis of the pulmonary apices associated with zygomycosis and Actinomyces spp. The patient had been hospitalized to investigate complaints of weight loss, nocturnal diaphoresis, productive cough, and lesion in both lung apices. He was submitted to right upper pulmonary lobectomy after identification of a fungus ball on chest X-ray and CT scan, which was confirmed by a fibrobronchoscopy and biopsy for anatomopathological exam. The patient evolved without expansion of the right lung and underwent another fibrobronchoscopy that suggested occlusion of the middle lobar bronchus. Repeat thoracotomy did not confirm the findings of the last fibrobronchoscopy, but the right lung failed to expand. The patient developed septic shock refractory to treatment and died.

  14. Infecção fúngica pulmonar por hialo-hifomicose associada a zigomicose e Actinomyces spp. em paciente com espondilite anquilosante Pulmonary fungal infection with hyalohyphomycosis associated with zygomycosis and Actinomyces spp. in a patient with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Valderílio Feijó Azevedo

    2009-10-01

    Full Text Available A espondilite anquilosante (EA pode cursar com manifestações extra-articulares e, dentre elas, as pulmonares. A fibrose nos ápices pulmonares ocorre em até 30% dos casos e as formações císticas são menos frequentes e observadas em casos avançados. A colonização dessas cavidades é uma complicação rara. Um paciente com diagnóstico de EA desde 1998, com comprometimento axial, histórico de tuberculose pulmonar tratada em 2002 e 2007, evoluiu com um quadro de aspergilose bilateral em ápices pulmonares associada à zigomicose e Actinomyces spp. Havia sido internado para investigar queixa de emagrecimento, sudorese noturna, tosse produtiva e lesão nos ápices pulmonares. Foi submetido a tratamento cirúrgico de lobectomia de lobo pulmonar superior direito, após identificação de bola fúngica nos ápices pulmonares nas radiografias e tomografias, comprovados por exames de fibrobroncoscopia e biópsia com exame anatomopatológico. Evoluiu sem expansão pulmonar direita, foi submetido à nova fibrobroncoscopia que sugeriu oclusão do brônquio lobar médio. Uma nova toracotomia não confirmou o achado da fibrobroncoscopia. Permaneceu sem expansão pulmonar direita, evoluiu com choque séptico refratário ao tratamento e ao óbito.Ankylosing spondylitis (AS can be associated with extra-articular manifestations, among which we find pulmonary disorders. Fibrosis of the pulmonary apices is seen in up to 30% of the cases, and cyst formation is less common, being seen in advanced cases. Colonization of those cavities is a rare complication. A patient with a diagnosis of AS since 1998 with axial involvement and history of pulmonary tuberculosis treated in 2002 and 2007, developed bilateral aspergillosis of the pulmonary apices associated with zygomycosis and Actinomyces spp. The patient had been hospitalized to investigate complaints of weight loss, nocturnal diaphoresis, productive cough, and lesion in both lung apices. He was submitted to right upper pulmonary lobectomy after identification of a fungus ball on chest X-ray and CT scan, which was confirmed by a fibrobronchoscopy and biopsy for anatomopathological exam. The patient evolved without expansion of the right lung and underwent another fibrobronchoscopy that suggested occlusion of the middle lobar bronchus. Repeat thoracotomy did not confirm the findings of the last fibrobronchoscopy, but the right lung failed to expand. The patient developed septic shock refractory to treatment and died.

  15. Long-term investigation of the risk of malignant diseases following intravenous radium-224 treatment for ankylosing spondylitis; Langzeituntersuchung zum Risiko maligner Erkrankungen nach intravenoeser Behandlung des Morbus Bechterew mit Radium-224

    Energy Technology Data Exchange (ETDEWEB)

    Schulte, Tobias L. [Klinik und Poliklinik fuer Allgemeine Orthopaedie und Tumororthopaedie, Universitaetsklinikum Muenster (Germany); Nekolla, Elke A. [Bundesamt fuer Strahlenschutz (BfS), Neuherberg (Germany); Wick, Roland R. [Inst. fuer Strahlenbiologie, Helmholtz-Zentrum Muenchen, Deutsches Forschungszentrum fuer Gesundheit und Umwelt, Neuherberg (Germany)

    2009-09-15

    Background and purpose: in German-speaking countries, the intravenous treatment of ankylosing spondylitis (AS) with radium-224 ({sup 224}Ra) was common between the late 1940s and 2005. In this long-term investigation, the risk of malignant diseases following intravenous {sup 224}Ra treatment for AS was assessed. Patients and methods: in a prospective long-term study, 1,471 patients with AS who were treated with {sup 224}Ra between 1948 and 1975 have been followed together with a control group of 1,324 AS patients treated neither with radioactive drugs nor with X-rays. Standardized questionnaires to evaluate the patients' health status were used. Observed numbers of malignant diseases were compared with those of the control group as well as with expected numbers for a normal population. Results: After 26 years of follow-up, causes of death have been certified for 1,006 patients of the exposure group (control group: 1,072 patients). Significantly increased rates of myeloid leukemia (12 cases observed vs. 2.9 expected; p < 0.001), kidney cancer (18 vs. 9.1; p < 0.01), thyroid cancer (4 vs. 1.2; p = 0.03) and borderline significantly increased rates of cancer of female genital organs (10 vs. 5.6; p = 0.06) were found in the exposure group in contrast to no significant increases of these diseases in the control group. Rates of pulmonary and gastrointestinal malignancies were not increased. Lymphatic leukemia (exposure group: 8 vs. 2.7; p < 0.01; control group: 7 vs. 3; p = 0.03) was significantly elevated due to a high rate of chronic lymphatic leukemia in both, the exposure as well as the control group. Conclusion: treatment of AS with {sup 224}Ra led to increased incidences of myeloid leukemia and malignancies of kidneys, thyroid and female genital organs. Although this kind of therapy is now abandoned, there is a need for close follow-up of patients who received it. (orig.)

  16. Brucellar Spondylitis

    OpenAIRE

    Lee, Hong Jae; Hur, Jin Woo; Lee, Jong Won; Lee, Sang Rok

    2008-01-01

    The incidence of Brucellosis is increasing in Korea. Spondylitis is the most frequent complication, but it is difficult to diagnose because its clinical symptoms are non-specific. It should therefore be included in the differential diagnosis of back pain. We report three rare cases of brucellar spondylitis successfully treated by medical and surgical therapy.

  17. Surface electromyography assessment of muscle activation patterns while sitting down in young healthy women and patients with ankylosing spondylitis [Povrchové elektromyografické hodnocení svalové aktivity ve zkoušce posazení u zdravých mladých žen a u pacient? s ankylozující spondylitidou

    Directory of Open Access Journals (Sweden)

    Petr Uhlí?

    2011-03-01

    Full Text Available BACKGROUND: Muscle activation patterns depend on many factors. Surface electromyography (SEMG can reveal these patterns in subjects of different ages and health states. We studied patterns of muscle activation in two groups of subjects - healthy young women (as a control group and patients with ankylosing spondylitis. OBJECTIVE: The aim of this study was to register and compare muscle activation patterns while sitting down in these two groups in four situations with different positions of the lower and upper limbs. METHODS: Muscle activity was registered with the use of 8 channel surface polyelectromyography (Noraxon-Myosystem 1400A. We tested the following muscles bilaterally while the subjects were sitting down (tibialis anterior muscle, medial head of the gastrocnemius muscle, gluteus maximus muscle, erectores spinae muscles. The onset of each individual muscle's activity was determined by calculating the sum of the mean value of the SEMG baseline plus 10% of the maximum value of amplitude (peak. RESULTS: It was registered that the medial head of the gastrocnemius muscle and/or erectores spinae muscles were activated as the first ones in both groups of the subjects under study in most of the studied postural situations. We registered differences in timing (sequence of muscle activation among various studied body and limb positions (P–, P+, PD–, and PN–. A great degree of variability in the sequence of muscle activation was revealed, depending on the positions of the upper and lower limbs. CONCLUSIONS: We did not find any unique patterns of muscle activation in either of the two groups under study.[VÝCHODISKA: ?asové zapojování (aktivace sval? je závislé na mnoha faktorech. Povrchová polyelektromyografie zachycuje vzorce zapojování sval? u proband? rozdílného v?ku a zdravotního stavu v r?zných podmínkách. CÍLE: Cílem studie byla registrace a hodnocení po?adí zapojování sval? v pr?b?hu sedání u t?chto dvou skupin žen ve ?ty?ech situacích s rozdílnými pozicemi horních i dolních kon?etin. METODIKA: Studovali jsme po?adí zapojování sval? u dvou skupin žen – zdravých mladých žen (jako kontrolní skupiny a pacient? s ankylozující spondylitidou. Aktivace vybraných sval? byla hodnocena povrchovou polyelektromyografií (Noraxon-MyoSystem 1400A. Elektrody byly umíst?ny nad ?ty?i vybrané svaly bilateráln? (m. tibialis anterior, mediální hlava m. gastrocnemii, m. gluteus maximus a mm. erectores spinae. Pro zjišt?ní okamžiku nástupu zapojení sval? (timing jsme používali klidovou hodnotu amplitudy EMG signálu plus 10 % maximální hodnoty amplitudy (peak. VÝSLEDKY: V naší studii jsme zjistili, že ve v?tšin? sledovaných situací prvním aktivovaným svalem byla mediální hlava m. gastrocnemii nebo mm. erectores spinae. Dále byla zjišt?na velká variabilita v po?adí zapojování sval?, která byla závislá na pozici horních a dolních kon?etin. ZÁV?RY: V této studii nebyly prokázány jednotné vzorce pro po?adí zapojování sval? v pr?b?hu sedání u obou skupin proband?.

  18. Intestinal bacteria as triggering agents in murine ankylosing enthesopathy.

    Czech Academy of Sciences Publication Activity Database

    ?eháková, Z.; ?apková, Jana; Šinkora, J.; Osterreicher, J.; Ivanyi, P.

    2004-01-01

    Ro?. 3, Suppl. 2 (2004), s. 108. ISSN 1568-9972. [International Congress of Autoimmunity /4./. Budapeš?, 03.11.2004-07.11.2004] R&D Projects: GA ?R GA305/03/0287 Keywords : ankylosing spondylitis * ANKENT * HLA-B27 Subject RIV: EC - Immunology

  19. 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 considerinproblems will only be solved by considering y synopsis of all findings. (orig.)

  20. Cyphotic deformity associated with ankylosing spondylitis

    International Nuclear Information System (INIS)

    This book describes a newly developed surgical method, including the modifications made to improve it further, which permitted to largely overcome the former drawbacks of those interventions. As the number of patients operated for cyphotic changes associated with Bechterew's disease was larger than any such cohorts so far dealt with in the literature, it appeared worthwhile not only to describe the surgical technique and available medium-term and long-term results but also to give a global survey of the clinical procedures followed in cyphotic deformity and to correlate these data with each other. Routine procedures include radiological examinations, which are used to diagnose the disease and to confirm the success of surgical intervention. Mention is also made of radiotherapy, as this offers an alternative to drug treatment and surgery. It is, however, pointed out that the analgesic effect achieved by irradiation is not of a lasting nature. As repeat radiotherapy is precluded by a number of reasons, this method can, irrespective of certain advantages, not be regarded as a real substitute for other forms of treatment. (orig./MG) With 60 figs., 43 tabs

  1. Microbes, the gut and ankylosing spondylitis

    OpenAIRE

    Costello, Mary-Ellen; Elewaut, Dirk; Kenna, Tony J; Brown, Matthew A

    2013-01-01

    It is increasingly clear that the interaction between host and microbiome profoundly affects health. There are 10 times more bacteria in and on our bodies than the total of our own cells, and the human intestine contains approximately 100 trillion bacteria. Interrogation of microbial communities by using classic microbiology techniques offers a very restricted view of these communities, allowing us to see only what we can grow in isolation. However, recent advances in sequencing technologies ...

  2. MRI Findings of Brucellar Spondylitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  3. Sexual dimorphism, but not testosterone itself, is responsible for ankylosing enthesitis of the ankle in B10.BR(H-2k) male mice.

    Czech Academy of Sciences Publication Activity Database

    ?apková, Jana; Ivanyi, P.; ?eháková, Z.

    2006-01-01

    Ro?. 65, ?. 1 (2006), s. 130-132. ISSN 0003-4967 R&D Projects: GA ?R(CZ) GA305/03/0287 Institutional research plan: CEZ:AV0Z50520514 Keywords : ankylosing enthesopathy * ankylosing spondylitis * testosterone Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 5.767, year: 2006

  4. Infectious spondylitis and its differential diagnosis; Spondylitis und ihre Differenzialdiagnosen

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-06-15

    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.)

  5. MRI characteristics of tuberculous spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  6. Ankyloserende spondylitis er associeret med øget kardiovaskulær morbiditet og mortalitet

    DEFF Research Database (Denmark)

    Madsen, Ole Rintek; Lindhardsen, Jesper

    2011-01-01

    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.

  7. CD4 and CD8 T cell response to the rHSP60 from Klebsiella pneumoniae in peripheral blood mononuclear cells from patients with ankylosing spondylitis / Respuesta de linfocitos T CD4 y CD8 contra la rHSP60 de Klebsiella pneumoniae en células mononucleares de sangre periférica de pacientes con espondilitis anquilosa

    Scientific Electronic Library Online (English)

    Francisco, Zambrano-Zaragoza; Ethel, García-Latorre; María Lilia, Domínguez-López; Mario Eugenio, Cancino-Díaz; Rubén, Burgos-Vargas; Luis, Jiménez-Zamudio.

    2005-08-01

    Full Text Available Objetivo.Determinar las vías utilizadas por las células mononucleares de sangre periférica (CMSP) de pacientes con espondilitis anquilosante para procesar a la rHSPGO de Klebsiella pneumoniae (rHSPGOKp) y las subpoblaciones de linfocitos T involucrados en la activación. Métodos. Se determinó la resp [...] uesta linfoproliferativa, por incorporación de ³H-TdR en CMSP, en presencia de la rHSPGOKp, en 14 pacientes con EA HLA-B27+y en 15 sujetos sanos HLA-B27-. La ruta de procesamiento y presentación de la rHSPGOKp se determinó por incorporación de ³H-TdR en las CMSP de los pacientes utilizando como células presentadoras a las CMSP homologas, preíncubadas con el antígeno y los inhibidores específicos: cloroquína, brefeldína A y N-acetil-L-leucil-L-leucil-L-nor-leucinal (LLnL), y fijadas con p-formaldehído. Se evaluaron las subpoblaciones de linfocitos T CD4+ y CD8+ que expresaron CD69, frente al antígeno, por citometría de flujo. Resultados. Ocho de los 14 pacientes y ninguno de los sujetos sanos, tuvo respuesta linfoproliferativa positiva (IE > 3.0) contra la rHSPGOKp (p Abstract in english Objective. To determine the processing pathways used by peripheral blood mononuclear cells (PBMC) and present the rHSP60Kp, and the T cell subpopulations involved in the response, in patients with ankylosing spondylitis (AS) Methods. The lymphoproliferative response to the rHSP60Kp in PBMC from 14 H [...] LA-B27 + AS patients and 15 B27 healthy controls was assessed by ³H-TdR incorporation. The processing pathways for the rHSP60Kp were analyzed by ³H-TdR incorporation in fresh PBMC from patients using homologous PBMC preincubated with the antigen and specific inhibitors: chloroquine, N-acetyl-L-leucil-L-leucil-L-nor-leucinal (LLnL) or brefeldin A (BFA), fixed with p-formaldehyde (fixed APC). The CD4+/CD8+ T cell subpopulation activated with the antigen was determined by three colours flow cytometry in PBMC from patients. Results. Eight out of fourteen patients showed positive lymphoproliferative responses to the rHSP60Kp while none of the healthy controls responded (p

  8. Differential diagnosis between tuberculous and pyogenic spondylitis using MRI

    International Nuclear Information System (INIS)

    To evaluate the MRI findings and usefulness of MRI for the differential diagnosis of tuberculous and pyogenic spondylitis. MRI was performed in a total of 38 patients in whom tuberculous spondylitis (n=27) and pyogenic spondylitis (n=11) had been pathologically confirmed. Using T1WI, T2*WI and gadolinium-DTPA T1WI, MRI findings of vertebral collapse, involvement of paraspinal soft tissue and marginal configuration, subligamentous extension and enhancement pattern were retrospectively investigated. Infected lesions were identified by observing signal change on T1WI and T2*WI. In tuberculous spondylitis, vertebral collapse(seen in 85.2% of cases), subligamentous extension(92.5%) and rim enhancement(92.6%) were more common than in pyogenic spondylitis;a diffuse enhancement pattern was more commonly observed in pyogenic (100%) than in tuberculous spondylitis(7.4%), however. The involvement of paraspinal soft tissue was more extensive, smooth and well marginated in tuberculous than in pyogenic spondylitis, though involvement of the vertebral cortex and disc was more prevalent in pyogenic than in tuberculous spondylitis. MRI is one of the better modalities for differential diagnosis of tuberculous and pyogenic spondylitis and for early and accurate treatment of either disease

  9. 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)

    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

    Full Text Available 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.

  10. 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)

    Sidiropoulos, P.I.; Hatemi, G.

    2008-01-01

    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 Udgivelsesdato: 2008/3

  11. Recommendations for starting anti TNF-? in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    L. Punzi

    2011-09-01

    Full Text Available La spondilite anchilosante è la malattia più rappresentativa del gruppo delle spondiloartriti. Di esso fanno parte anche l’artrite reattiva, l’artrite psoriasica, l’artrite associata alla colite ulcerosa ed alla malattia di Crohn e forme che non rientrando in nessuna della categorie precedenti sono dette indifferenziate (1. Si tratta di malattie molto frequenti che complessivamente colpiscono l-2% della popolazione (2. La spondilite anchilosante inizia di solito nella seconda e terza decade di vita ed è più frequente nel sesso maschile. In molti casi la malattia è progressiva ed è causa di un grado di disabilità non inferiore a quello provocato dall’artrite reumatoide (3. Gli scopi della terapia della spondilite anchilosante sono: ridurre l’intensità del dolore e della rigidità, migliorare la funzione, contrastare la progressione del danno radiologico e prevenire la disabilità. Sino a poco tempo fa la terapia della spondilite anchilosante consisteva nella somministrazione di farmaci antinfiammatori non-steroidei (FANS e nel programma di riabilitazione. I FANS sono efficaci nel controllo del dolore e della rigidità e consentono anche di ottenere un miglioramento della funzione.

  12. Recurrent disc herniation in a man with ankylosing spondylitis.

    Science.gov (United States)

    Stenback, B A; Reigo, T

    1994-01-01

    Disc herniation in patients with Bechterew disease is rare; even rarer are recurrent disc herniations, a condition which we have not found described before. The patient was operated on with an excellent result. PMID:7866832

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  14. Attempt to modify klebsiella carriage in ankylosing spondylitic patients by diet: correlation of klebsiella carriage with disease activity.

    OpenAIRE

    Shinebaum, R.; Neumann, V.; Hopkins, R.; Cooke, E. M.; Wright, V.

    1984-01-01

    Patients with ankylosing spondylitis were asked to follow a 'klebsiella exclusion diet' for 5 months of a 10-month study. The same percentage of faecal samples were positive for klebsiella whether the patients were on or off the experimental diet. The diet also failed to influence variability of klebsiella serotypes. We found no correlation between acquisition of klebsiella and deterioration of disease symptoms, as recorded by the patients. Furthermore, carriage of klebsiella did not correlat...

  15. 18F-FDG PET/CT imaging of pyogenic and tuberculous spondylitis: correlation with MRI

    International Nuclear Information System (INIS)

    To evaluate the usefulness of PET/CT and compare it with the diagnostic performance of MRI for differentiating tuberculous and pyogenic spondylitis. This study was approved by the institutional review board of our institution, and informed consent was obtained. Twenty-two consecutive patients who were confirmed with tuberculous or pyogenic spondylitis, were included. They had undergone both MRI and dual-time PET /CT examinations. The PET/CT data of the early and delayed scans was analyzed using the standardized uptake value (SUV). Radiologists scored the MRI findings and differentiated between tuberculous and pyogenic spondylitis. The MRI results were compared with the SUVs of PET/CT. We also compared each maximum and mean SUV and each difference in maximum and mean values between the early and delayed phases in tuberculous and pyogenic spondylitis. The reviewers identified tuberculous spondylitis (n = 11) with sensitivity, specificity, and positive predictive values of 83%, 90%, and 91%, respectively, on MRI. For pyogenic spondylitis (n = 11), the corresponding values were 90%, 83%, and 82%. The differences in the maximum SUVs of the early phase in tuberculous and pyogenic spondylitis, were statistically significant (p=0.028), however, other comparisons were insignificant (p>0.05). In addition, MRI was superior to PET/CT for differentiating tuberculous and pyogenic spondylitis (p=0.043). The maximum SUVs of early-phase PET/CT were helpful for differentiating pyogenic were helpful for differentiating pyogenic and tuberculous spondylitis. Therefore, PET/CT may be a helpful and complementary method to MRI for differentiating pyogenic and tuberculous spondylitis

  16. MR evaluation of tuberculous spondylitis

    International Nuclear Information System (INIS)

    A total of 29 proven tuberculous spondylitis patients underwent MR studies. Gd-DTPA enhancement was performed in 10 patients. Contiguous 2 vertebral involvement, subligamental spread of paraspinal abscesses and cord indentation were observed in 93% of the cases. Destruction of the vertebral body occurred in 76%. Intermediate or low T1 signal intensity and high T2 signal intensity were observed by MR. A combination of these characteristic findings strongly suggests the diagnosis of tuberculous spondylitis. Gd-DTPA administration did not facilitate diagnosis. MR examination should be considered as the main imaging modality for patients with suspected tuberculous spondylitis. (orig.)

  17. 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? ...

  18. Role of whole-body magnetic resonance imaging in diagnosing early spondyloarthritis

    International Nuclear Information System (INIS)

    Ankylosing spondylitis is the prototypical spondyloarthritis. Early diagnosis has gained clinical importance with the advent of new therapeutic options such as TNF-? inhibitors, which can dramatically improve clinical outcome when initiated early. Whole-body MRI can contribute important diagnostic information for detecting early forms of spondyloarthritis because it enables evaluation of all important joints that may be involved in the disease process as a one-stop shop modality. MRI allows much more accurate diagnostic evaluation of the thoracic spine, which is affected in the majority of patients. This article provides an overview of the use of whole-body magnetic resonance imaging (MRI) in the spondyloarthritides. The recommendations given reflect the most recent scientific data and expert opinions. The focus of this review is on MRI findings at both the axial and the appendicular skeleton and the technical feasibility of whole-body MRI in the clinical setting.

  19. Ankylosed spines are prone to fracture.

    OpenAIRE

    Hunter, T.; Forster, B.; Dvorak, M.

    1995-01-01

    Fracture of an ankylosed spine is often overlooked. Because the force that damages an ankylosed spine is frequently slight, patients do not realize they are injured. Doctors can miss the fracture for the same reason and because patients already have a history of back pain. Plain radiographs sometimes fail to demonstrate the fracture site.

  20. Scintigraphic evaluation of the sacroiliac joints in anklylosing spondylitis

    International Nuclear Information System (INIS)

    The sedimentation of sup(99m)Tc-phosphate complexes into the sacroiliac joints was investigated in 94 patients with loin pains and suspected of ankylosing spondylitis (SpA) and a control group of 96 healthy patients. The investigation yields the following results: 1. the visual evaluation of the scintigrams does not allow a reliable diagnosis and should be replaced by a semi-quantitative technique, 2. the index ISC/sacrum does remarkably depend on age, 3rd even in young patients the scintigraphic examination appears to be useful to alidate the clinical suspicion of sacroilictis which is in contradiction to literature, 4th with increasing SpA the scintigraphic detectability of changes in the ISG decreases. 5th the floriditily of the ISG process determines the scintigraphic detectability of the process of the disease, 6th the scintigraphic finding is unspecific. Inflammatory states of the disease of different genesis and degenerative processes in the ISG equally yield pathological index values. (orig./MG)

  1. Spondylitis of thoracic spine: Case report

    Directory of Open Access Journals (Sweden)

    Timotijevi? Sla?an

    2008-01-01

    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. .

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

    OpenAIRE

    Chung, Sook Hee; Park, Soo Jung; Hong, Sung Pil; Cheon, Jae Hee; Kim, Tae Il; Kim, Won Ho

    2013-01-01

    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....

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

    OpenAIRE

    Sook Hee Chung; Soo Jung Park; Sung Pil Hong; Jae Hee Cheon; Tae Il Kim; Won Ho Kim

    2013-01-01

    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 refrac...

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

    OpenAIRE

    Carlos Rogério Degrandi Oliveira

    2007-01-01

    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 mu...

  5. [Special considerations in therapy of injuries of the cervical spine in ankylosing spondylitis (Bechterew disease)].

    Science.gov (United States)

    Einsiedel, T; Kleimann, M; Nothofer, W; Neugebauer, R

    2001-12-01

    Cervical spine changed by Bechterew's disease is severely endangered with any increased load. Even decent trauma is enough to produce a fracture with affection of spinal cord. Because of little knowledge in these special items, late diagnosis of overlooked injury is not rare, especially in two-level injuries. Neurolesions following secondary fracture dislocations may occur ("fatal pause"). From january 1990 to february 2000 12 patients underwent surgery (dorsoventral stabilisation, ventral stabilisation, laminectomy). Diagnostic procedures, levels of injury, pre- and postoperative neurostatus (following Frankel's score), operative technique, typical complications and follow-up (Ø 17.8 months) were analyzed and compared with the literature. 11 patients showed preoperative neurodeficits. They were better in five cases and disappeared at all in another five cases after surgery (83% positive neurological outcome). There was no increase of neurology failure. Two patients died (ARDS and cerebral ischemia with destruction of vertebral arteries). One patient had to be reoperated because of implant dislocation. MRI is obvious in diagnostic for these lesions. There is also an absolute need for total (both clinical and radiological) examination of the whole spinal column, because there is often injury of more than one level (three times in our study). Therapy should be operative (dorsoventral stabilisation, in certain cases only anterior procedure or laminectomy). Late diagnosis and therapy with secondary worsening after fracture dislocation is not rare because of "overlooked injury". There were four patients, that would not have suffered cervical spine fracture (minimal injury force) without Bechterew's changes. There is often pulmonary failure through limitation of thoracic movement and cerebral ischemia following rupture of vertebral arteries as typical complications. Mortality (2 cases; 16%) in our collective is less than literature's medium rates (35-57%). PMID:11803718

  6. Indication for the Ra-224 therapy in ankylosing spondylitis (Morbus Struempell-Bechterew-Marie)

    International Nuclear Information System (INIS)

    For a better understanding of the effects of corpuscular ?- and ?-rays of 224Ra on growing and matured bone tissue the results of animal experiments are briefly introduced and compared with clinical observations made in humans. The therapeutic effect of 224Ra-injection on Bechterew's disease is proved, but indication and eventual contra-indications should be observed with attention. (MG)

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

    International Nuclear Information System (INIS)

    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)

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

    Science.gov (United States)

    ... 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 ...

  9. Avaliação colonoscópica em pacientes com espondilite anquilosante / Colonoscopic evaluation in patients with ankylosing spondylitis

    Scientific Electronic Library Online (English)

    Haim Cesar, Maleh; Blanca Elena Rios Gomes, Bica; José Ângelo de Souza, Papi; Mário Newton Leitão de, Azevedo; Antônio José de Vasconcellos, Carneiro.

    2014-10-01

    Full Text Available Introdução: Pacientes com espondilite anquilosante podem apresentar-se com lesões inflamatórias intestinais, e, por isso, deve ser definido o uso da colonoscopia para tais pacientes. Objetivos: Avaliar as alterações colonoscópicas intestinais macroscópicas e achados histopatológicos microscópicos [...] de pacientes com espondilite anquilosante; correlacionar os achados colonoscópicos e histopatológicos; e estudar a relação dos achados histopatológicos com as manifestações extra-articulares da doença, HLA-B27, BASFI and BASDAI. Métodos: Este é um estudo transversal de 22 pacientes com espondilite anquilosante. Os pacientes passaram por uma avaliação clínica, BASDAI e BASFI, coleta de sangue para determinação de HLA-B27, e colonoscopia com biópsia de quarto segmentos intestinais (íleo terminal, cólon direito, cólon sigmoide e reto). Resultados: Resultados colonoscópicos anormais foram obtidos em 13 (59,1%) pacientes, e a principal anormalidade foi a presença de pólipos intestinais. Os grupos de resultados colonoscópicos normais e anormais (n = 9 e n = 13, respectivamente) foram homogêneos no que diz respeito à idade, BASFI, BASDAI, e variáveis categóricas, e o valor P não revelou diferença significativa entre grupos. Dos resultados histopatológicos, 81% tiveram uma biópsia anormal do íleo terminal, 90.9% tiveram uma biópsia anormal do cólon sigmoide, e a biópsia retal estava anormal em 86.4%. Os achados histopatológicos revelaram biópsias anormais em 81%, 90.9%, 90.9% e 86.4% para o íleo terminal, cólon direito, cólon sigmoide e reto, respectivamente. Os resultados histopatológicos não revelaram associação estatisticamente significativa com as manifestações extra-articulares, BASFI, BASDAI e positividade para HLA B27. Conclusões: A análise histological dos quatro segmentos intestinais evidenciou lesões inflamatórias em pacientes com resultados colonoscópicos normais e anormais, independentemente da sintomatologia intestinal e do tratamento usado para a doença basal.

  10. Comparison of two ELISA versions for infliximab serum levels in patients diagnosed with ankylosing spondylitis.

    Science.gov (United States)

    Hernández-Flórez, Diana; Valor, Lara; de la Torre, Inmaculada; Nieto, Juan Carlos; Martínez-Estupiñán, Lina; González, Carlos; López-Longo, Francisco Javier; Monteagudo, Indalecio; Garrido, Jesús; Naredo, Esperanza; Carreño, Luis

    2015-06-01

    There are various immunosorbent assays which can be used to determine infliximab (IFX) levels. Results vary between assays complicating reliability in everyday clinical practice. The aim of this study was to determine whether quantitative or qualitative assay data prove more accurate in the assessment of infliximab levels in AS patients. We analyzed 40 serum samples, taken prior to infusion, from AS patients who had been undergoing IFX therapy as a first-line of biological treatment for more than a year. IFX levels and IFX-anti-drug antibodies (ADA) were measured using two different ELISA assays [Promonitor(®) IFX R1 and R2 (version 1), Promonitor(®) IFX and anti-IFX (version 2) (Progenika Biopharma, Spain)] strictly following the manufacturer's guidelines. Cohen's unweighted kappa and the intraclass correlation coefficient determined qualitative and quantitative agreement for serum levels in version 1 and version 2. Bland-Altman plots were drawn to compare both assays. The comparison of data measuring IFX levels for version 1 and version 2 resulted in questionable quantitative agreement (ICC 0.659; 95 % CI 0.317-0.830) and moderate qualitative agreement (? 0.607; 95 % CI 0.387-0.879) owing to systematically higher values in version 2 than version 1. Version 2 consistently detected higher levels of infliximab, particularly when analyzed in a quantitative context. Further research is needed to synchronize cutoff levels between essays and diseases so therapeutic drug ranges can be established. PMID:25410014

  11. Ankylosing spondylitis: genomic and functional characterization of candidate genes and their repercussion in clinical practice

    OpenAIRE

    Santos, Fernando Manuel Pimentel Dos 

    2012-01-01

    RESUMO: Introdução: A espondilite anquilosante (EA) é uma doença inflamatória crónica caracterizada pela inflamação das articulações sacroilíacas e da coluna. A anquilose progressiva motiva uma deterioração gradual da função física e da qualidade de vida. O diagnóstico e o tratamento precoces podem contribuir para um melhor prognóstico. Neste contexto, a identificação de biomarcadores, assume-se como sendo muito útil para a prática clínica e representa hoje um grande de...

  12. Radiology changes in brucella spondylitis, experience with 26 cases

    International Nuclear Information System (INIS)

    Background/objective: brucellosis is an endemic zoonosis in the Middle East and despite all public health efforts it has not yet been eradicated in Iran. We aimed to highlight and categorize the imaging features of Brucella spondylitis. Material and method: twenty six cases of Brucella spondylitis were treated by the authors from 1982 up to 2003. The available imaging studies of all the cases are reviewed and include X-ray films, conventional myelography, computerized tomographic (CT Scan) and magnetic resonance imaging. Results: there were 21 male and 5 female patients with an age range of 5 to 62 years and the majority (60 %) in the 4 Th and 5 Th decades of life. Wright hemagglutination tests were positive in all cases. Plain x-ray films typically showed lysis of the end plates with osteophyte formation involving affected vertebrae, followed by narrowing of the inter spaces and destruction or collapse of the vertebral bodies in 7 cases. Myelography demonstrated various types of epidural filling defects and obstruction to the flow of contrast material in 10 cases. CT scan, available in 3 cases, showed erosion and cauliflower-like proliferation at the bony edges of the vertebral bodies and end plates. MRI findings varied depending upon the acute or chronic stages of the illness with hypo- or hyper-intense changes on T1 sequences, and primarily hyper-intense changes of T2 sequences in 8 cases. Conclusion: The findings in this series of patients suggest that imaging fineries of patients suggest that imaging findings of Brucella spondylitis are scarcely specific. However when considering the medical history, place of origin of the patients, clinical presentation and laboratory findings, the early diagnosis of the illness may be possible before proceeding to surgical intervention

  13. Computed tomographic appearance of tuberculous spondylitis

    International Nuclear Information System (INIS)

    The computed tomographic (CT) appearance of six cases of comfirmed tuberculosis spondylitis are analyzed. By comparison with plain and conventional tomography CT is useful for evaluation of bone destruction, the evidence and extent of the para-vertebral soft tissue mass, the detection of the bone fragment and calcified structure and soft tissue mass in the spinal canal. But differential diagnosis with other infectious spondylitis or metastatic tumor are often very difficult. So it is recomended to perform biopsy for diagnosis. Also CT provides approach map not only for biopsy, but for surgery. (author)

  14. HLA-B27 Test

    Science.gov (United States)

    ... confirm a suspected diagnosis of ankylosing spondylitis (AS) , reactive arthritis , juvenile rheumatoid arthritis (JRA) , or sometimes anterior uveitis . ... certain autoimmune disorders , such as ankylosing spondylitis and reactive arthritis. Ankylosing spondylitis and reactive arthritis are both chronic , ...

  15. Vasoactive Intestinal Peptide in Early Spondyloarthritis: Low Serum Levels as a Potential Biomarker for Disease Severity.

    Science.gov (United States)

    Seoane, Iria V; Tomero, Eva; Martínez, Carmen; Garcia-Vicuña, Rosario; Juarranz, Yasmina; Lamana, Amalia; Ocón, Elena; Ortiz, Ana M; Gómez-León, Nieves; González-Álvaro, Isidoro; Gomariz, Rosa P

    2015-07-01

    Spondyloarthritis (SpA) is a family of inflammatory diseases sharing clinical, genetic, and radiological features. While crucial for tailoring early interventions, validated prognostic biomarkers are scarce in SpA. We analyze the correlation between serum levels of vasoactive intestinal peptide (VIP) and disease activity/severity in patients with early chronic inflammatory back pain. The study population comprised 54 patients enrolled in our early chronic inflammatory back pain register. We collected demographic information, clinical data, laboratory data, and imaging findings. VIP levels were measured by enzyme immunoassay in serum samples from 162 visits. The association between independent variables and VIP levels was analyzed using longitudinal multivariate analysis nested by patient and visit. No significant differences were observed in VIP levels between these two groups. Lower levels of VIP were significantly associated with a higher Bath Ankylosing Spondylitis Disease Activity Index (BASFI) score, presence of bone edema in magnetic resonance imaging (MRI) scan, and lower hemoglobin levels. Coexistence of cutaneous psoriasis was independently associated with lower VIP levels, and similar trend was observed for enthesitis. We conclude that SpA patients with low serum VIP levels had worse 2-year disease outcome, suggesting that serum VIP levels could be a valid prognostic biomarker. PMID:25711477

  16. Cauda equina syndrome associated with dural ectasia in chronic anlylosing spondylitis.

    Science.gov (United States)

    Ha, Sang-Woo; Son, Byung-Chul

    2014-12-01

    Cauda equina syndrome (CES) associated with dural ectasia is a rare neurologic complication in patients with longstanding ankylosing spondylitis (AS). We report a 68-year-old male with a 30-year history of AS who presented a typical symptom and signs of progressive CES, urinary incontinence and neuropathic pain of the lumbosacral radiculopathy. Computed tomography (CT) and magnetic resonance imaging (MRI) findings showed the unique appearances of dural ectasia, multiple dural diverticula, erosion of posterior element of the lumbar spine, tethering of the conus medullaris and adhesion of the lumbosacral nerve roots to the posterior aspect of the dural ectasia. Considering the progressive worsening of the clinical signs, detethering of the conus medullaris through resection of the filum terminale was performed through a limited laminectomy. However, the urinary incontinence did not improve and there was a partial relief of the neuropathic leg pain only. The possible pathogenetic mechanism of CES-AS and the dural ectasia in this patient with longstanding AS are discussed with a literature review. PMID:25628815

  17. Association of biomarkers of inflammation, cartilage and bone turnover with gender, disease activity, radiological damage and sacroiliitis by magnetic resonance imaging in patients with early spondyloarthritis.

    Science.gov (United States)

    Almodóvar, Raquel; Ríos, Valeria; Ocaña, Sara; Gobbo, Milena; Casas, María-Luisa; Zarco-Montejo, Pedro; Juanola, Xavier

    2014-02-01

    To assess the association between biomarkers of inflammation, cartilage and bone turnover with gender, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Spondylitis Disease Activity Score (ASDAS) and bone marrow oedema in resonance magnetic imaging (MRI) of sacroiliac joints (SIJs) and radiological damage in early spondyloarthritis (SpA). Cross-sectional study of 60 patients (56.7 % females; mean age, 32.4 years) with early SpA. Sociodemographic data, clinical features, serum matrix metalloproteinase 3 (MMP-3), high sensitivity C-reactive protein (hsCRP), C-terminal cross-linking telopeptides of type I collagen (CTX-I) and urinary deoxypyridinoline, ASDAS, BASDAI, BASFI, BASRI and MRI of the SIJs were collected. The mean (SD) disease duration was 12.4 (6.8 months). Twenty-two (68.7 %) of the 32 patients had active sacroiliitis by MRI. MMP-3 and CTX I correlated with swollen joint (r?=?0.515, r?=?0.386, p?=?0.01). hsCRP correlated with ESR (r?=?0.303, p?=?0.05), with CRP (r?=?0.455, p?=?0.01) and with total BASRI (r?=?0.95, p?=?0.05). Biomarkers were unrelated with the rest of variables. Levels of MMP-3 (44.3?±?52.4 vs 24.7?±?33.4, p?early SpA. Male gender had higher levels of CTX-I and MMP-3, which may indicate higher disease activity. Higher hsCRP levels trended towards correlation with more baseline radiographic damage. Therefore, these biomarkers may help identify a subgroup of patients who will need closer monitoring and more intensive treatment. PMID:23917391

  18. Pharmacologic treatment of psoriatic arthritis and axial spondyloarthritis with traditional biologic and non-biologic DMARDs.

    Science.gov (United States)

    Soriano, Enrique Roberto; Acosta-Felquer, Maria Laura; Luong, Phat; Caplan, Liron

    2014-10-01

    This manuscript focuses on the pharmacologic treatment of psoriatic arthritis and axial spondyloarthritis - including ankylosing spondylitis - using traditional biologic and non-biologic disease-modifying antirheumatic drugs. Early treatment of psoriatic arthritis and axial spondyloarthritis/ankylosing spondylitis as well as the treat-to-target concept receive particular attention. This review also surveys recent national and international guidelines for the treatment of both psoriatic arthritis and couches practice recommendations for axial spondyloarthritis/ankylosing spondylitis within the context of various international guidelines. PMID:25488785

  19. Tuberculous Spondylitis after Percutaneous Vertebroplasty: Misdiagnosis or Complication?

    OpenAIRE

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

    2013-01-01

    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 com...

  20. Case report 469: Spondylitis (lumbar spine) due to Brucella abortus

    Energy Technology Data Exchange (ETDEWEB)

    Manaster, B.J.

    1988-03-01

    The current case is interesting in that, although the plain radiographs were diagnostic of infection and the patient's work history suggested brucellosis, both the negative serum antibody titers to brucella and the CT appearance of large calcified psoas abscesses made the diagnosis of tuberculous spondylitis most probable. Open biopsy with tissue culture proved brucella. From this experience it appears that the presence of large calcified psoas abscesses should not eliminate the diagnosis of brucella spondylitis in the proper clinical setting.

  1. Usefulness of the WuScope to Facilitate Double-lumen Endotracheal Tube Placement in A Patient with Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Han-Dung Yu

    2011-04-01

    Full Text Available Functional separation of the lungs may be accomplished by several methods. Patientswith a stiff neck and limited mouth opening restrict options to a one-lung ventilation. Wereport the use of the WuScope video system, a new tool for facilitating double-lumen endotrachealtube placement for one-lung ventilation, in a patient who suffered from ankylosingspondylitis with a stiff, flexed neck and limited mouth opening for his recurrent spontaneouspneumothorax.

  2. Performance of response scales of activity and functional measures of ankylosing spondylitis: numerical rating scale versus visual analog scale.

    Science.gov (United States)

    Akad, Kivanc; Solmaz, Dilek; Sari, Ismail; Onen, Fatos; Akkoc, Nurullah; Akar, Servet

    2013-10-01

    The aim of this study was to compare the performance characteristics of two answer modalities for BASDAI and BASFI in patients with AS and to show validity and reliability of NRS in Turkish version. BASDAI and BASFI were simultaneously employed with a 10-cm VAS and an 11-point NRS. Internal consistency was assessed by using Cronbach's alpha coefficients. Testing was performed on baseline and next day under standardized conditions. Construct validity was determined by association of these measures with ASDAS, DFI, global disease activity, pain scores, ASQOL, HAQ, and SF-36. We also tested the ability of NRS version of BASDAI and BASFI to detect changes. A total 114 patients with AS according to the modified New York criteria were included. There was a good agreement between the total scores of each instrument on day 0 (ICC values were 0.894-0.934). Scores of the both answering modality of each instrument were correlated with ASDAS-CRP, and the scores of DFI, patient global assessment of disease activity and patient-reported pain, ASQOL, HAQ. Response time for BASDAI and BASFI was significantly shorter in NRS answer modality (P < 0.001). Our patients found NRS modality more comprehensible and easier to understand (P < 0.001). Our results showed the validity of NRS version of BASDAI and BASFI and provided an evidence for using these questionnaires in 11-point NRS answer modality in Turkish AS patients. PMID:23736275

  3. Peptides from HLA-B27 molecules of patients with ankylosing spondylitis reveal increased glutamic acid/glutamine ratio.

    Czech Academy of Sciences Publication Activity Database

    Stod?lková, Eva; Ivašková, E.; Sedlá?ková, M.; Pohl, J.; Votruba, Jaroslav; Man, Petr; ?apková, Jana; Ivanyi, J.; Flieger, Miroslav

    Oslo : Verlag, 2006, s. 12-12. [European Immunogenetics and Histocompatibility conference /20./. Oslo (NO), 08.06.2006-11.06.2006] R&D Projects: GA MZd 1A8631 Institutional research plan: CEZ:AV0Z50200510; CEZ:AV0Z50520514 Keywords : sped * peptide Subject RIV: EE - Microbiology, Virology

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

    OpenAIRE

    Shinohara, Akira; Ueno, Yutaka; Marumo, Keishi

    2014-01-01

    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 in...

  5. Osteoporose bei Spondylitis ankylosans - Einfluß von Lebensgewohnheiten

    Directory of Open Access Journals (Sweden)

    Aglas F

    2004-01-01

    Full Text Available Krankheitsbedingte Artefakte können bei der SpA (Spondylitis ankylosans; Mb. Bechterew die Sensitivität einer Knochendichtemessung im Lumbalbereich beeinträchtigen. Das bei dieser rheumatischen Erkrankung bekannte Osteoporoserisiko ist neben genetischen Faktoren und Entzündungsmechanismen auch von verschiedenen exogenen Einflüssen abhängig. An 47 SpA-Patienten wurde mittels DEXA eine vergleichende Knochendichtemessung (BMD an der Hüfte (Schenkelhals und Ward'sches Dreieck sowie im Bereich der Wirbelsäule (L1-L4 vorgenommen. Zusätzlich erfolgte eine Erhebung der Lebens-Ernährungsgewohnheiten der SpA-Patienten in bezug auf die BMD, um exogene Einflüsse erfassen zu können. Die Knochendichtemessungen ergaben an der LWS wesentlich häufiger eine BMD im Normbereich als am proximalen Femur. Besonders deutliche Unterschiede traten im höheren Lebensalter auf, bei dem aufgrund von Kalzifizierungsvorgängen und Syndesmophyten an der LWS fälschlicherweise eine Dichtezunahme vorgetäuscht wird. Es kann daher bei SpA empfohlen werden, die wesentlich sensitivere Dichtemessung am Schenkelhals durchzuführen. Die über einen Zeitraum von 3 Jahren beobachteten, signifikant erhöhten, medianen CRP-Spiegel zeigen, daß eine permanente Aktivierung von Entzündungsprozessen bei SpA auch einen negativen Faktor betreffend des Knochenmasseverlustes darstellt. Die Analyse der Lebensgewohnheiten ergab, daß SpA-Patienten mit normaler BMD ausnahmslos regelmäßig kalziumreiche Nahrungsmittel zu sich nehmen; bei verminderter BMD wurde in der Mehrheit ein fehlender Konsum an Milchprodukten beobachtet. Leider war auch mit abnehmender BMD eine Verminderung der bei SpA empfohlenen Bewegungsübungen festzustellen. Aufgrund der Resultate ergibt sich eine generelle Empfehlung zu regelmäßigen Bewegungsübungen plus Osteoporosediät bei allen Bechterew-Patienten.

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

    Directory of Open Access Journals (Sweden)

    Dragojlovi?-Ruži?i? Radica

    2013-01-01

    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.

  7. Spondylitis Following Kyphoplasty: A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Ömer AKAR

    2012-06-01

    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.

  8. Cervical spondylitis and spinal abscess due to Actinomyces meyeri

    Scientific Electronic Library Online (English)

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

    2014-01-01

    Full Text Available 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.

  9. A case of retropharyngeal abscess with spondylitis causing tetraplegia

    Directory of Open Access Journals (Sweden)

    Noritsugu Ono

    2012-03-01

    Full Text Available We report a case of retropharyngeal abscess with spondylitis causing tetraplegia. At a previous hospital, administration of antibiotics improved the inflammation findings. However, magnetic resonace imaging showed a remaining retropharyngeal abscess. This patient showed a disturbance of consciousness under this therapy. Therefore, he was admitted to our hospital and underwent a drainage operation. At 1 day after this operation, he recovered from the disturbance of consciousness.

  10. Seronegative spondarthritis associated with Takayasu's arteritis.

    OpenAIRE

    Magaro, M.; Altomonte, L.; Mirone, L.; Zoli, A.; Corvino, G.

    1988-01-01

    A young woman presented with an aortic arch syndrome a few years after the onset of ankylosing spondylitis. Tissue typing showed HLA-B27. The possibility of an association between ankylosing spondylitis and Takayasu's arteritis is suggested.

  11. Possible radiotherapy of Morbus Bechterew

    International Nuclear Information System (INIS)

    Early diagnosis is most important for an effective therapy of ankylosing spondylitis (Morbus Bechterew). Especially the radiologic findings improve the diagnosis in the early stage of the disease. Concerning the treatment modalities, which are reviewed in detail, the radiation therapy is of special interest. There is no risk for the patient treating with low dose radiation. In the last years the therapy with 224Ra (Thorium X) has become important enough to be included in the treatment planing of the ankylosing spondylitis. Indications, contraindications, risks as well as results of different therapeutic modalities are discussed. (orig.)

  12. The diagnostic use of MRT in cases of suspected spondylitis; MRT-Differentialdiagnose bei Verdacht auf Spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Lehner, K. [Inst. fuer Roentgendiagnostik, Klinikum rechts der Isar der Technischen Univ. Muenchen (Germany)

    1994-11-01

    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.) [Deutsch] Wenn bei einer Spondylitis ein dafuer beweisender Abszess oder eine typische Destruktion des Wirbelkoerpers nicht vorliegt, ist auch nach Durchfuehrung einer MRT oft eine differentialdiagnostische Abgrenzung gegenueber anderen Ursachen erforderlich. Ferner stehende Differentialdiagnosen wie Insuffizienzfraktur, rheumatische Erkrankungen und eine Neoplasie koennen mit den Moeglichkeiten des konventionellen Roentgenbildes meist ausgeschlossen werden. An die konventionelle- und Computertomographie sollte - auch nach Durchfuehrung der MRT - noch in unklaren Einzelfaellen von aktivierter Arthrose oder Postdisketomie-Syndrom gedacht werden. Eine gute differentialdiagnostische Moeglichkeit zur Unterscheidung zwischen einem Infekt und einem nicht infektioesen/reaktivem Geschehen ist die Wiederholungs-MRT mit KM-Applikation nach durchgefuehrter antibiotischer Behandlung. (orig.)

  13. 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?

    DEFF Research Database (Denmark)

    Carlsen, Thomas Gelsing; Kjærsgaard, Pernille

    2014-01-01

    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.

  14. Magnetic resonance imaging of pyogenic spondylitis complicating neurological symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Aoyama, Tomoki; Takahashi, Shinobu; Ishibe, Tatsuya; Kotoura, Yoshihiko; Suzuki, Kiichi; Akiyama, Yasutaka [Nagahama City Hospital, Shiga (Japan)

    2001-11-01

    The cause of paralysis in and surgery application on pyogenic spondylitis were examined on MRI findings of the disease after conservative therapy. Subjects were 2 male and 6 female patients (mean 68.2 years old) who had complicated paralysis of spinal cord or cauda equina and gave MRI findings in the therapeutic period of mean 2 years + 2 months. Paralysis was assessed by Frankel's method and other clinical evaluations and treatments were also conducted during the period. T1 and T2 weighted MRI with Gd was done at hospitalization, at 1, 3 and 6 months after the therapy and evaluated by Demaerel's method. Scout roentgenograms were assessed by Miyakoshi's method. Case by case presentation and finding summary of patients indicated that those MRI findings revealed pathological and healing processes and thus were useful to consider the treatment. (K.H.)

  15. Tuberculosis of the sternum in patients with infective spondylitis

    Scientific Electronic Library Online (English)

    W, Haynes; S, Govender.

    Full Text Available OBJECTIVE: Tuberculous osteomyelitis of the sternum is rare. With the increased incidence of HIV seropositivity, atypical musculoskeletal manifestations of tuberculosis (TB) are becoming more common. The aim of this study was to review the clinical presentation, diagnosis, treatment and outcome of p [...] atients presenting with tuberculous involvement of the sternum. METHODS: A retrospective chart review was performed on all patients with tuberculous involvement of the sternum, with specific reference to: age, gender, clinical presentation, HIV status, CD4 count, antiretroviral treatment, co-morbidities, diagnosis, management and outcomes. RESULTS: Fourteen patients with sternal TB were reviewed at King George V Hospital from May 2006 to June 2008. The average age was 17.5 years. All 14 cases had infective spondylitis with associated sternal involvement. There were no cases of primary sternal TB. There were three cases of delayed diagnosis that presented with severe spinal and anterior chest wall deformities. The diagnosis was suspected clinically in seven patients and an incidental finding in the remaining seven. Sternal lesions on lateral radiographs were only picked up in two patients. MRI was diagnostic in all 14 patients. The disease was multifocal in all cases. Seven patients had multiple level, non-contiguous infective spondylitis. It was noted that all patients had a lesion in the dorsal spine. Six patients were HIV-positive, with average CD4 counts of 277 (110-696). None of the patients were on antiretroviral therapy prior to the diagnosis of sternal TB. The sternal component of the disease was managed non-operatively with antituberculous chemotherapy. Average follow-up was 14 months (3-22). All patients responded well to therapy. CONCLUSION: Atypical manifestations of TB are becoming increasingly prevalent. Due to increased awareness among clinicians and improved imaging techniques, the diagnosis of sternal TB is easier to make and treatment with antituberculous chemotherapy appears to be an effective management strategy.

  16. Estimates of radiation doses in tissue and organs and risk of excess cancer in the single-course radiotherapy patients treated for ankylosing spondylitis in England and Wales

    International Nuclear Information System (INIS)

    The estimates of absorbed doses of x rays and excess risk of cancer in bone marrow and heavily irradiated sites are extremely crude and are based on very limited data and on a number of assumptions. Some of these assumptions may later prove to be incorrect, but it is probable that they are correct to within a factor of 2. The excess cancer risk estimates calculated compare well with the most reliable epidemiological surveys thus far studied. This is particularly important for cancers of heavily irradiated sites with long latent periods. The mean followup period for the patients was 16.2 y, and an increase in cancers of heavily irradiated sites may appear in these patients in the 1970s in tissues and organs with long latent periods for the induction of cancer. The accuracy of these estimates is severely limited by the inadequacy of information on doses absorbed by the tissues at risk in the irradiated patients. The information on absorbed dose is essential for an accurate assessment of dose-cancer incidence analysis. Furthermore, in this valuable series of irradiated patients, the information on radiation dosimetry on the radiotherapy charts is central to any reliable determination of somatic risks of radiation with regard to carcinogenesis in man. The work necessary to obtain these data is under way; only when they are available can more precise estimates of risk of cancer induction by radiation in man be obtained

  17. Longitudinal Numbers-Needed-To-Treat (NNT) for Achieving Various Levels of Analgesic Response and Improvement with Etoricoxib, Naproxen, and Placebo in Ankylosing Spondylitis

    OpenAIRE

    Wang Hongwei; Smugar Steven S; Gammaitoni Arnold; Peloso Paul M; Moore Andrew R

    2011-01-01

    Abstract Background Clinical analgesic trials typically report response as group mean results. However, research has shown that few patients are average and most have responses at the extremes. Moreover, group mean results do not convey response levels and thus have limited value in representing the benefit-risk at an individual level. Responder analyses and numbers-needed-to-treat (NNT) are considered more relevant for evaluating treatment response. We evaluated levels of analgesic response ...

  18. The results of simultaneous posterior–anterior–posterior surgery in multilevel tuberculosis spondylitis associated with severe kyphosis

    OpenAIRE

    Erturer, Erden; Tezer, Mehmet; Aydogan, Mehmet; Mirzanl?, Cunety; Ozturk, I?rfan

    2010-01-01

    We retrospectively studied the cases with tuberculous spondylitis of thoracolumbar region with two or more levels of involvement that underwent posterior instrumentation and fusion and anterior fusion with titanium mesh following anterior decompression using simultaneous successive posterior–anterior–posterior surgery. Among all patients with tuberculous spondylitis accompanied by medium or severe kyphosis, 20 patients who underwent simultaneous successive decompression, fusion and instru...

  19. 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.)

  20. Multifocal tuberculous spondylitis with rib involvement: a case report and review of the literature

    Scientific Electronic Library Online (English)

    JWM, Kigera; N, Orwotho.

    Full Text Available Tuberculosis is a common diagnosis in the developing world. Its incidence is increasing in the developed world due to immigrants from endemic regions, increased cases of immune-compromised patients, multi-drug resistance and low socio-economic status. Tuberculous spondylitis is the commonest extra-p [...] ulmonary manifestation of tuberculosis. The rib is only very rarely involved. We present a case of multifocal tuberculous spondylitis in the T6-9 and L3 regions with involvement of the ninth rib.

  1. Rheumatological presentation of developmental bone diseases

    International Nuclear Information System (INIS)

    Developmental bone disease may be present, with rheumatological disorders as the major symptoms, even in children. The major lesions encountered are early osteo arthritis, osteo chondromatosis and vertebral involvement with two leading types, pseudo Scheuermann's disease or pseudo ankylosing spondylitis. This paper presents the different features and lists the rheumatological problems in bone dysplasia

  2. Early failure of the Durom prosthesis in metal-on-metal hip resurfacing in Chinese patients.

    Science.gov (United States)

    Li, Jia; He, Chongru; Li, Dahe; Zheng, Wei; Liu, Denghui; Xu, Weidong

    2013-12-01

    Hip resurfacing (HR) is being used increasingly as an alterative to total hip arthroplasty in osteonecrosis (ON) and ankylosing spondylitis (AS) of the hip. We performed 141 consecutive HR arthroplasties in 111 patients comprising 3 etiology groups: ON, AS, and osteoarthritis (OA). After retrospective study of retrieved components, we hypothesized that the main reason for revision was femoral loosening in the ON group (4 of 46 hips; 8.7%) and femoral-neck fracture in the AS group (3 of 58 hips; 5.2%). Necrotic areas were seen on femoral heads retrieved from patients with femoral loosening, whereas femoral heads were fixed tightly to components in patients with femoral-neck fractures. Etiology may be an important risk factor for postoperative complications. PMID:23831082

  3. Espondilo artritis anquilosante: presentación de un caso atípico Ankylosing spondyloarthritis: an atypical case report

    Directory of Open Access Journals (Sweden)

    Bárbara del Rosario Hernández Bravo

    2009-12-01

    Full Text Available La espondiloartritis anquilosante es una enfermedad que tiene muy baja prevalencia en Cuba, y es muy rara en Pinar del Río, y más en la juventud. Se presenta un caso de un joven adolescente de 16 años, estudiante, blanco, que debuta con dolor plantar y espolones calcáneos. Es ingresado y estudiado y se le diagnóstica espondiloartritis anquilosante. Se expone el cuadro clínico, los complementarios y la terapéutica utilizada. Se revisa la literatura al respecto.Ankylosing spondyloarthritis (AS is an uncommon disease in Cuba, and very rare in Pinar del Río Province, and much more uncommon in teenagers. A white 16- year-old adolescent student begins with plantar pain and calcaneous spikes. He is admitted to be studied and Ankylosing Spondyloarthritis is diagnosed. Clinical chart, complementary exams and the therapeutics to be used are discussed. Medical Literature is reviewed.

  4. Espondilo artritis anquilosante: presentación de un caso atípico / Ankylosing spondyloarthritis: an atypical case report

    Scientific Electronic Library Online (English)

    Bárbara del Rosario, Hernández Bravo; Ramón, Suárez Junco; José G, Sanabria Negrín.

    2009-12-01

    Full Text Available La espondiloartritis anquilosante es una enfermedad que tiene muy baja prevalencia en Cuba, y es muy rara en Pinar del Río, y más en la juventud. Se presenta un caso de un joven adolescente de 16 años, estudiante, blanco, que debuta con dolor plantar y espolones calcáneos. Es ingresado y estudiado y [...] se le diagnóstica espondiloartritis anquilosante. Se expone el cuadro clínico, los complementarios y la terapéutica utilizada. Se revisa la literatura al respecto. Abstract in english Ankylosing spondyloarthritis (AS) is an uncommon disease in Cuba, and very rare in Pinar del Río Province, and much more uncommon in teenagers. A white 16- year-old adolescent student begins with plantar pain and calcaneous spikes. He is admitted to be studied and Ankylosing Spondyloarthritis is dia [...] gnosed. Clinical chart, complementary exams and the therapeutics to be used are discussed. Medical Literature is reviewed.

  5. Total Knee Arthroplasty in a Patient with an Ankylosing Knee after Previous Patellectomy

    OpenAIRE

    Suh, Jeung Tak; Rhee, Seung Joon; Park, Shi Hwan; Hong, Sung Min

    2014-01-01

    Patellectomized patients may have less satisfactory clinical outcomes following total knee arthroplasty (TKA) due to a decreased extensor mechanism efficiency and potential instability. Furthermore, the existing literature does not provide concrete guidance on the expected results of TKA or the type of implant that should be used in patellectomized patients. We present a case of a patient with an ankylosing knee who had undergone patellectomy due to gunshot injury 45 years ago and was treated...

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.)

  7. Radiological aspects of psoriatic osteoarthropathia

    International Nuclear Information System (INIS)

    Psoriatic osteoarthropathia is a disease of the joints, spine, and bones. It belongs to the category of ''seronegative spondarthritis'', the prototype of which is ankylosing spondylitis. Contrary to earlier assumptions, morphological changes in the X-ray picture are frequent if the joints (psoriatic arthritis) or axial skeleton (psoriatic spondylitis) are affected. Radiographic signs are listed and scintigraphic findings discussed. The morphological changes in the X-ray picture are characteristic, even without psoriatic lesions of the skin. Sacro-iliac changes in the axial skeleton are frequent. In other parts of the skeleton, typical parasyndesmophytes are slightly less frequent, and changes as in ankylosing spondylitis may occur. The diagnosis is easier with whole-body scintiscanning as this technique is able to detect early changes which are not noticeable clinically or radiologically. (orig.)

  8. Percutaneous Discectomy—Continuous Irrigation and Drainage for Tuberculous Lumbar Spondylitis: A Report of Two Cases

    OpenAIRE

    Shibuya, Sei; Komatsubara, Satoshi; Yamamoto, Tetsuji; Arima, Nobuo; Kanda, Yoshiaki; Oka, Shiro

    2009-01-01

    Percutaneous curettage and continuous irrigation were performed for definitive diagnosis and treatment of tuberculous (TB) lumbar spondylitis. Under local anaesthesia, affected lumbar discs were curetted using a procedure of percutaneous nucleotomy, and in-tube and the out-tube were placed for continuous irrigation. The period of continuous irrigation was 12–16 days. Mycobacterium tuberculosis was demonstrated in case 1 by culture and PCR, whereas histology showed tuber...

  9. On the differential diagnosis of inflammatory ankyloses and congenital synostoses in the carpal region

    International Nuclear Information System (INIS)

    It will be reported on the problems involved in the differential diagnosis of congenital synostoses and acquired ankyloses in the carpal region. As a guideline it can be assumed that the fusion of two carpal bones which are arranged parallely in one carpal line most probably is a congenital defect, whereas the fusion of two or more bone elements in a longitudinal axis, e.g. between forearm and carpus or carpus and metacarpal bone most likely is acquired and thus can be characterized as ankylosis. (orig.)

  10. Commensal intestinal bacterial strains trigger ankylosing enthesopathy of the ankle in inbred B10.BR (H-2k) male mice.

    Czech Academy of Sciences Publication Activity Database

    Šinkorová, Z.; ?apková, Jana; Niederlová, J.; Št?pánková, Renata; Šinkora, Ji?í

    2008-01-01

    Ro?. 69, ?. 12 (2008), s. 845-850. ISSN 0198-8859 R&D Projects: GA ?R GA305/03/0287 Institutional research plan: CEZ:AV0Z50520701; CEZ:AV0Z5020903 Keywords : Spondyloarthropathies * Ankylosing enthesopathy * Intestinal microflora Subject RIV: EC - Immunology Impact factor: 3.061, year: 2008

  11. Induction of Regulatory t Cells by Low Dose il2 in Autoimmune and Inflammatory Diseases

    Science.gov (United States)

    2015-04-20

    Rheumatoid Arthritis; Ankylosing Spondylitis; Systemic Lupus Erythematosus; Psoriasis; Behcet's Disease; Wegener's Granulomatosis; Takayasu's Disease; Crohn's Disease; Ulcerative Colitis; Autoimmune Hepatitis; Sclerosing Cholangitis

  12. Contrast enhancement and morphological findings of hematopoietic regions of bone marrow on MR imaging. Comparative study with spondylitis and vertebral tumors

    Energy Technology Data Exchange (ETDEWEB)

    Amano, Yasuo; Hayashi, Hiromitsu; Matsuura, Maki; Watari, Jun; Kumazaki, Tatsuo [Nippon Medical School, Tokyo (Japan)

    1995-06-01

    The enhanced MR findings of hematopoietic regions in aplastic anemia were compared with those of spondylitis, metastatic vertebral tumors and hematologic neoplasms. The enhanced MR images showed hematopoietic regions to homogeneously enhance and occupy the margin of vertebral bodies, while spondylitis and metastatic tumors appeared as round, inhomogeneously enhancing lesions. MR images of leukemia and myelodysplastic syndrome showed homogeneous enhancement at the margins of vertebrae that was difficult to differentiate from hematopoietic regions. Enhanced MR images were useful in detecting the hematopoietic areas in marrow and differentiating them from spondylitis and metastatic tumors, although further experience is needed to distinguish between tumorous hyperplastic regions and benign hematopoietic regions in marrow. (author).

  13. Contrast enhancement and morphological findings of hematopoietic regions of bone marrow on MR imaging. Comparative study with spondylitis and vertebral tumors

    International Nuclear Information System (INIS)

    The enhanced MR findings of hematopoietic regions in aplastic anemia were compared with those of spondylitis, metastatic vertebral tumors and hematologic neoplasms. The enhanced MR images showed hematopoietic regions to homogeneously enhance and occupy the margin of vertebral bodies, while spondylitis and metastatic tumors appeared as round, inhomogeneously enhancing lesions. MR images of leukemia and myelodysplastic syndrome showed homogeneous enhancement at the margins of vertebrae that was difficult to differentiate from hematopoietic regions. Enhanced MR images were useful in detecting the hematopoietic areas in marrow and differentiating them from spondylitis and metastatic tumors, although further experience is needed to distinguish between tumorous hyperplastic regions and benign hematopoietic regions in marrow. (author)

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

    Directory of Open Access Journals (Sweden)

    Chiba Kazuhiro

    2011-04-01

    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.

  15. [Risks and recommendations in Bechterew disease. Paraparesis after epidural anesthesia].

    Science.gov (United States)

    Allen, D; Dahlgren, N; Nellgård, B

    1997-12-10

    We describe a case of paraparesis caused by an epidural haematoma in a 74-year-old man with advanced ankylosing spondylitis who received combined epidural and general anaesthesia for graft repair of an aneurysm of the abdominal aorta. Before the induction of general anaesthesia, an epidural catheter was inserted at the level of thoracic vertebrae 10-11 without difficulty or signs of bleeding. Total analgesia and paralysis of the legs in the early postoperative period raised suspicions of the presence of an epidural haematoma, which was confirmed by magnetic resonance tomography. Aspiration of the epidural catheter yielded 13 ml of blood. Despite early surgical decompression after transfer to a regional hospital, the patient remains paraparetic. We wish to highlight the risks of epidural anaesthesia in cases of ankylosing spondylitis, and to stress the need of routine control of motor function after epidural anaesthesia. PMID:9445957

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

    Czech Academy of Sciences Publication Activity Database

    ?apková, Jana; Hrn?í?, Tomáš; Kubátová, Alena; Tlaskalová-Hogenová, Helena

    2012-01-01

    Ro?. 13, ?. 6 (2012). ISSN 1471-2474 R&D Projects: GA ?R(CZ) GAP304/11/1252; GA ?R GP310/09/P182; GA MŠk(CZ) 7E09091 Institutional research plan: CEZ:AV0Z50520701 Institutional support: RVO:61388971 Keywords : Ankylosing enthesopathy * Interleukin-10 * Lipopolysacharid * Cytokines Subject RIV: EC - Immunology Impact factor: 1.875, year: 2012

  17. Potential of 18F-FDG-PET as a valuable adjunct to clinical and response assessment in rheumatoid arthritis and seronegative spondyloarthropathies

    OpenAIRE

    Sandip Basu; Lata Bichile; Vishu Vijayant; Manjit Sarma; Hrushikesh Aurangabadkar

    2012-01-01

    AIM: To evaluate the role of fluorine-18-labeled fluorodeoxyglucose positron emission tomography (18F-FDG PET) in various rheumatic diseases and its potential in the early assessment of treatment response in a limited number of patients. METHODS: This study involved 28 newly diagnosed patients, of these 17 had rheumatoid arthritis (RA) and 11 had seronegative spondyloarthropathy (SSA). In the SSA group, 7 patients had ankylosing spondylitis, 3 had psoriatic arthritis, and one had non-specific...

  18. Spontaneous Symptomatic Pseudoarthrosis at the L2-L3 Intervertebral Space with Diffuse Idiopathic Skeletal Hyperostosis: A Case Report

    OpenAIRE

    Akihito Wada; Shintaro Tsuge; Masayuki Sekiguchi; Wataru Shishikura; Daisuke Suzuki; Kazumasa Nakamura; Ryo Takamatsu; Katsunori Fukutake; Yuichirou Yokoyama; Hiroshi Takahashi; Yasuaki Iida; Keiji Hasegawa

    2013-01-01

    Pseudoarthrosis at the intervertebral space in patients with ankylosing spondylitis has occasionally been reported, but symptomatic pseudoarthrosis at the intervertebral disc level is rare in patients with diffuse idiopathic skeletal hyperostosis (DISH). Here, we report a case of symptomatic pseudoarthrosis at the L2-L3 intervertebral space that was diagnosed based on clinical history. We first performed L1–L5 fixation, but back-out of the pedicle screw occurred in the early postoperative p...

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

    OpenAIRE

    Padula, A.; Nigro, A.; Leccese, P.; Angelo, Salvatore D.; Palazzi, C.; Olivieri, I.

    2013-01-01

    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) crit...

  20. Rheumatic disease and the Australian Aborigine

    OpenAIRE

    Roberts-thomson, R.; Roberts-thomson, P.

    1999-01-01

    OBJECTIVE—To document the frequency and disease phenotype of various rheumatic diseases in the Australian Aborigine.?METHODS—A comprehensive review was performed of the archaeological, ethnohistorical, and contemporary literature relating to rheumatic diseases in these indigenous people.?RESULTS—No evidence was found to suggest that rheumatoid arthritis (RA), ankylosing spondylitis (AS), or gout occurred in Aborigines before or during the early stages of white settlement of Australi...

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

    Directory of Open Access Journals (Sweden)

    A. Padula

    2013-03-01

    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...

  2. 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)

    Antonio Iglesias-Gamarra

    2006-03-01

    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.

  3. 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)

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

    2006-03-01

    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. [...] 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. [...

  4. Clinical utility of the new ASAS criteria for spondyloarthritis and the disease activity score.

    Science.gov (United States)

    Castillo-Gallego, Concepción; Aydin, Sibel Z; Marzo-Ortega, Helena

    2011-10-01

    The advent of new therapeutic agents that are efficacious in the treatment of ankylosing spondylitis and related spondyloarthropathies has highlighted important unmet needs in our understanding of these conditions. Chief among these is the possibility of making a diagnosis at the early, nonradiographic phase, when the burden of disease is substantial and comparable to that of more advanced stages. The new Assessments in Spondyloarthritis International Society (ASAS) classification criteria provide a unique tool to allow research standardization in this area and may also be of clinical utility. The development of the disease activity index ASDAS (Ankylosing Spondylitis Disease Activity Score) aims to provide a composite measure that can discriminate and show sensitivity to change while incorporating measurable biomarkers. Both instruments represent a major step forward in the research field of spondyloarthritis, although further validation is now required. PMID:21748416

  5. Long-term results of ventro-dorsal versus ventral instrumentation fusion in the treatment of spondylitis

    OpenAIRE

    Linhardt, O.; Matussek, J.; Refior, H. J.; Kro?del, A.

    2006-01-01

    This study examines prospectively the randomised, long-term, clinical and radiological results of the treatment of spondylitis patients by ventro-dorsal or ventral spine fusion. Group 1 consisted of 12 patients who (after ventral removal of the focus of infection and autologous bone grafting) were treated by dorsal instrumentation. Group 2 consisted of ten patients who, after similar ventral removal and bone interposition, were stabilised by ventral instrumentation. The patients prospective...

  6. 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.)

  7. [Bilateral ankylosing paraarticular ossifications of the hip joint with involvement of the sciatic nerve].

    Science.gov (United States)

    St?drý, V; Zv?rina, E; Chomiak, J

    2004-01-01

    In December 1997 a 48 year-old man was treated by resection of the bilateral paraarticular ankylosing ossifications that developed after 6 weeks of unconsciousness after necrotic pancreatitis. The ossifications on the posterior part of the hip joint involved a highly separated sciatic nerve. There was a bilateral osseous ankylosis of the hip joint and total denervation of sciatic nerve. In April 1999 the ossifications on the right side were removed. The splitted sciatic nerve was in two osseous channels. The head of the femur was vital and immediately following the operation, flexion of the hip joint was possible to 90 degrees. The same procedure was performed on the left hip joint in October 1999. In April 2000, a re-occurance of the paraarticular ossification on the ventral part of the right hip joint was removed from an ilioinquinal approach. In June 2002 the patient was able to stand and walk without crutches. ROM of the knee joints improved bilaterally to 120 degrees of flexion. The flexion of the right hip joint is 70 degrees and in the left hip is 80 degrees. 3 years after decompression of both sciatic nerves involved in heterotopic bone established significant reinervation. The motor function of the proximal femoral muscles and the function of the tibial nerve was renewed. Complete motor denervation syndrom persists in common peroneal nerve. Sensitive inervation was renewed as in n. tibialis as in common peroneal nerve except acral parts of the foot a toes. Concerning function of the sciatic nerves, the overall results can be assessed as partially succesfull because of partial denervation syndrome of sciatic nerves. In definite clinical improvement the recovery of the neurologic status is very important besides the mechanical improvement of range of motion of the hip joint. PMID:15600127

  8. Brucellar spondylitis: evaluation by NMR imaging, CT and biomedical radiography - a case report; Espondilite por brucelose - relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Campos, Juliana C. de; Marins, Jose Luiz C.; Pereira, Rubens Marcondes [Centro Radiologico, Campinas, SP (Brazil)

    1999-03-01

    A 50-year-old white woman presented with a 4-month history of low pain with lower extremity irradiation. Image studies showed inflammatory changes of the vertebral bodies and invertebral disk at L3-L4 level. Considering she had no previous spinal surgery, negative tests for tuberculosis and a positive history of exposure to brucellosis, further studies were done, and the serologic tests were positive for brucellar antibodies. Follow-up studies within the first two months demonstrated the progressive spinal changes in brucellar spondylitis. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.)

  10. Interleukin-17 is a critical target for the treatment of ankylosing enthesitis and psoriasis-like dermatitis in mice.

    Science.gov (United States)

    Ebihara, Shin; Date, Fumiko; Dong, Yupeng; Ono, Masao

    2015-06-01

    Ankylosis is a major pathological manifestation of spondyloarthropathy. The aim of this study was to evaluate the effects of anti-IL-17 therapy on spontaneous ankylosing enthesitis in mice. In this study, we used male DBA/1 mice as a spontaneous ankylosis model. Serum IL-17 concentrations were determined using enzyme-linked immunosorbent assay. Male DBA/1 mice from different litters were mixed and caged together preceding the treatment at 10 weeks (wk) of age (prophylaxis) or 21?wk of age (intervention). Treatment with anti-IL-17 antibodies or saline was initiated after caging in groups of mice and administered weekly. The onset of tarsal ankylosis was assessed by ankle swelling and histopathological examination. Pathological changes and mRNA expression levels were assessed in joints and ears obtained at the experimental end-point. We found that circulating IL-17 increased with the onset of ankylosis in male DBA/1 mice, coinciding with the onset of dermatitis. The symptoms of dermatitis corresponded to the pathological characteristics of psoriasis: acanthosis with mild hyperkeratosis, scaling, epidermal microabscess formation and augmented expression of K16, S100A8 and S100A9. Prophylactic administration of anti-IL-17 antibodies significantly prevented the development of both ankylosis and dermatitis in male DBA/1 mice caged together. On the other hand, administration of anti-IL-17 antibodies after disease onset had a lesser but significant effect on ankylosis progression but did not affect dermatitis progression. In conclusion, IL-17 is a key mediator in the pathogenic process of tarsal ankylosis and psoriasis-like dermatitis in male DBA/1 mice caged together. Thus, IL-17 is a potential therapeutic target in ankylosing enthesitis and psoriasis in humans. PMID:25352178

  11. Patterns of disease on MRI in 53 children with tuberculous spondylitis and the role of gadolinium

    International Nuclear Information System (INIS)

    Tuberculosis (TB) of the spine is the most common site of osseous involvement and has a higher prevalence in developing nations with an increasing incidence in developed nations. There are few paediatric reports of TB spondylitis (TBS) that include MRI findings.Objective. To determine the MRI characteristics of TBS in children with special reference to gadolinium enhancement and findings on follow-up MRI.Materials and methods. A retrospective review of patient records and MRI scans by three readers using a consensus method of 53 patients below 13 years of age.Results. Seventy-nine percent presented with kyphosis. MRI showed thoracic involvement in 83%. Eighty-five percent showed contiguous involvement of two or more vertebral bodies. An intraspinal or paraspinal soft-tissue mass or abscess was present in 98%. Subligamentous extension was noted in 64% of patients. Gadolinium was administered in 26 patients. Ring enhancement of the soft-tissue mass was shown in 65% of these. Subligamentous enhancement was shown in 35% and bone enhancement was shown in 100% of patients. Follow-up MRI performed in 16 patients showed progressive bone destruction in 10 patients, progressive kyphosis in 2 patients and progression of soft-tissue disease in 4 patients.Conclusions. We have demonstrated an advanced pattern of TBS in this childhood population, which supports other reports that describe a more aggressive process in children. Kyphosis and cord compressions were the most common compord compressions were the most common complications. The use of gadolinium is promising in detecting disease earlier, as it invariably results in bone enhancement and may assist in making the diagnosis when the rim-enhancing pattern of the soft-tissue mass is demonstrated. Follow-up imaging with MRI is a suitable way of assessing resolution of cord compression and decrease in size of the soft-tissue mass. Therefore, considering the pattern of involvement in children with TBS demonstrated by this study, MRI is considered an ideal modality for making the diagnosis, demonstrating the extent of disease, identifying complications and assessing response to treatment. (orig.)

  12. Pneumorraquis, espondilitis y meningitis secundarios a cistitis enfisematosa: Report of one case / Pneumorrhachis, spondylitis and meningitis secondary to emphysematous cystitis

    Scientific Electronic Library Online (English)

    Susana, Michalland; Daniel, Erlij; Oscar, Neira.

    1061-10-01

    Full Text Available [...] Abstract in english We report a 57-year-old woman who presented with low back pain, fever and impairment of consciousness. The patient was admitted to the intensive care unit in Glasgow 8, with neck stiffness, peritoneal irritation, leukocytosis, hyperglycemia requiring insulin and a urine test suspecting an infection. [...] Brain CT was unremarkable, while CT of the abdomen and pelvis evidenced emphysematous cystitis, retropneumoperitoneum and pneumorrhachis. Blood, urine and cerebrospinal fluid cultures were positive to Escherichia coli. She was treated with ceftriaxone, ciprofloxacin and amikacin during one month followed by ciprofloxacin until completing 100 days. The air in the spinal canal and bladder decreased. However she suffered several infectious complications such as multiple paravertebral, epidural and psoas abscesses, L5-S1 spondylitis and a L3 fracture. As an inflammatory complication she developed a bulbar infarction and tetraparesis. She had a good clinical response with medical treatment, partial improvement of the paresis and reduction of epidural abscesses.

  13. 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 signifie 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)

  14. The CARRA Registry

    Science.gov (United States)

    2015-04-22

    Juvenile Idiopathic Arthritis; Systemic Lupus Erythematosus; Mixed Connective Tissue Disease; Juvenile Ankylosing Spondylitis; Juvenile Dermatomyositis; Localized Scleroderma; Systemic Sclerosis; Vasculitis; Sarcoid; Fibromyalgia, Primary; Auto-inflammatory Disease; Idiopathic Uveitis Idiopathic

  15. Induction of human leukemia by ionizing radiation

    International Nuclear Information System (INIS)

    Leukemia was recognized early to be a major health consequence of ionizing radiation. In both of the major sources of human evidence concerning ionizing radiation and malignant disease, the data from Hiroshima and Nagasaki and the Ankylosing spondylitis series, leukemia was the malignancy which became apparent earliest. For the quantitative analysis of leukemia, only the Hiroshima-Nagasaki data is utilized. In the analyses, it is assumed that 10% of the leukemia deaths will occur after the twenty-ninth year post-irradiation, which is the latest follow-up year for the survivors for which data are available

  16. A Case of Tumor Necrosis Factor-? Inhibitors-induced Pustular Psoriasis

    OpenAIRE

    Park, Jae-jeong; Lee, Seung-chul

    2010-01-01

    Anti-tumor necrosis factor (TNF)-? agents promise better disease control for the treatment of ankylosing spondylitis resistant to classical disease-modifying treatments. Etanercept, a recombinant human TNF receptor fusion protein, is used to treat a variety of TNF-?-mediated diseases by inhibiting the biological activity of TNF-?. We experienced a case of pustular psoriasis in a 32-year-old man during anti-TNF-? therapy with etanercept. He had a history of ankylosing spondylitis for 2 yea...

  17. [Swiss Bechterew's Disease Association: a patient self-help organization].

    Science.gov (United States)

    Baumberger, H

    1991-06-01

    Ankylosing spondylitis (AS) is the third most common form of rheumatism and as such of considerable economic and social significance due to its early outbreak, its course of flare-ups and its remissions, chronic persistence and risk of early invalidity. As there is no basic therapy, the main emphasis of modern treatment lies on the practice of regular and intensive AS-specific physical exercise, complemented by suitable sports. In these circumstances, the active cooperation of the patients themselves is of utmost importance; therefore, it was obvious that the information of AS patients on their disease and their interest to improve their physical and psychological situation would be further encouraged by the foundation of a self-assistance organization for AS patients, thereby lightening the blow fate had dealt them. The Swiss Ankylosing Spondylitis Association (Schweizerische Vereinigung Morbus Bechterew, SVMB, Société de la spondylarthrite ankylosante, SSSA, Società svizzera morbo di Bechterew, SSMB), founded in 1978, has its headquarters in Zurich (Röntgenstrasse 22, CH-8005 Zurich, Tel. 01 272 78 66) and strives for the following: --the organization of local and regional therapy groups for AS gymnastics and sports --information for patients and their families on all aspects concerning AS --preparation of 'contact' meetings between AS patients to exchange experiences and thoughts --information for doctors on the latest developments in the field of AS and about the activities of the AS Society --promotion of research in the field of AS and its related diseases --information to the general population about the physical aspects of AS and the problems confronting AS patients --cooperation with other AS societies within the framework of the Ankylosing Spondylitis International Federation, ASIF. PMID:2063048

  18. [Rathbun syndrome (hypophosphatasia). Clinical aspects: dwarfism and Bechterew symptoms].

    Science.gov (United States)

    Krohn-Grimberghe, B; Ludwig, B; Furkert, D

    1991-01-01

    We report on a 43-year-old patient with short stature (hyposomia), allegedly the result of vitamin-D-resistant rickets, previously treated for ankylosing spondylitis. In addition, a uricostatic drug therapy was also necessary because of hyperuricemia with gout attacks. Further examinations revealed the accurate diagnosis: Rathbun's disease. Hypophosphatasia is a hereditary disorder characterized by a deficiency of liver/bone/kidney alkaline phosphatase activity in serum and tissues with defective bone mineralization, bone deformities, short stature, early loss of teeth, and craniosynostosis. In our patient radiographic features were spinal hyperostosis, but with syndesmophytes, chondrocalcinosis of peripheral joints and intervertebral discs, calcific periarthritis and premature closure of skull sutures. Curved ribs and short stature were suggestive of rickets. The aim of this case report is to demonstrate the close relations between hypophosphatasia and spondylitis ankylosans in respect to radiology and clinical symptoms. PMID:1796658

  19. 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)

  20. Spondylitis: Frequently Asked Questions

    Science.gov (United States)

    ... with psoriasis, it is called psoriatic arthritis (PsA). Reactive Arthritis (ReA) - Reactive Arthritis (also known as Reiter's Syndrome) is a form ... the bladder, the genitals and the mucus membranes. Reactive arthritis is thought to occur as a "reaction" to ...

  1. Spondylitis Medical Glossary

    Science.gov (United States)

    ... i.e. X-ray absorption at two different quantum energies or wavelengths. Disorder: A synonym for disease. ... that stimulate or inhibit nerve impulses in the brain that relay information about external stimuli and sensations, ...

  2. [Effect of a positive family history on the prognosis in patient with Bechterew disease].

    Science.gov (United States)

    Falkenbach, A; Griessmayer, H; Tripathi, R

    1998-01-16

    The objective of the present study was to evaluate whether the patients with a family history of ankylosing spondylitis might have a milder course of the disease than patients with a negative family history. We investigated a group of 197 patients with ankylosing spondylitis who had been suffering from symptoms of the disease for > or = 20 years. After exclusion of the patients with a history, or current evidence of colitis or urethritis, the remaining 148 patients with ankylosing spondylitis (none with psoriasis) were divided into 2 groups on the basis of a positive (25 patients) or a negative (123 patients) family history of ankylosing spondylitis. The variables of mobility were compared. Furthermore, the present height was compared with the former (maximum) height. All variables measured in the present study showed slightly better results in the patients with a positive family history, but the differences were not significant. The decrease of height was slightly larger in patients with a positive family history. Evidently, a positive family history does not appear to give a reliable prediction of the long-term prognosis in Austrian and German patients with ankylosing spondylitis. PMID:9499474

  3. Orthodontic treatment of severe anterior open bite and alveolar bone defect complicated by an ankylosed maxillary central incisor: a case report.

    Science.gov (United States)

    Lin, Feiou; Sun, Hao; Yao, Linjie; Chen, Qiushuo; Ni, Zhenyu

    2014-01-01

    Incisor trauma is common in children, and can cause severe complications during adolescent growth and development. This report describes the treatment of a 16-year-old patient with severe anterior open bite due to ankylosis of the maxillary left incisor after dental trauma as an 8-year-old. No examination or active treatment was undertaken until he was 16 years old. Clinical examination revealed that the maxillary left incisor was severely intruded accompanied by a vertical alveolar bone defect. Orthodontic treatment combined with surgical luxation took 3 years and 7 months. During treatment, the intruded incisor was moved to the occlusal level and the alveolar bone defect was restored, achieving normal occlusion. After two years of retention, the maxillary left incisor was retained in a stable normal position with a slightly reduced overbite. This case demonstrates that surgical luxation with orthodontic traction can be an effective approach, especially when the ankylosed tooth has a single root. Long-term monitoring of orthodontic stability and the maintenance of periodontal health are crucial in the post-treatment period. PMID:25414141

  4. [Pathogenesis of Bechterew disease].

    Science.gov (United States)

    Gran, J T

    1998-11-30

    The etiopathogenesis of ankylosing spondylitis is still incompletely understood. HLA-B27 is important as more than 90% of the patients possess the antigen, but how this genetic marker confers disease susceptibility is yet to be understood. Recent studies of families and twins affected by ankylosing spondylitis have shown that additional non-HLA-B27 genes are necessary for disease development. The exogenous agent initiating chronic inflammation is yet to be identified, but Klebsiella pneumoniae remains a candidate. The microorganism may act through the intestinal canal as more than 60% of the patients exhibit inflammatory changes in the bowel. PMID:9889641

  5. [Possible diagnostic error of "Bechterew disease"].

    Science.gov (United States)

    Uitz, E; Aglas, F; Hermann, J; Rainer, F; Kleinert, R; Krejs, G J

    1996-01-01

    A 41-year old caucasian male presented with limited range of motion of the entire spine and myogenous intermittent claudication. He was referred with the diagnosis "ankylosing spondylitis". The clinical picture mimicked ankylosing spondylitis, but there were no corresponding radiological abnormalities despite a 13-year history of his disease. Laboratory values showed markedly elevated levels of muscle enzymes. The diagnosis of rigid spine syndrome, a subtype of muscular dystrophy, was made from the clinical picture a normal EMG and degenerative changes on a biopsy from the muscle trapezius. We would like to draw attention to this rare cause of back pain. PMID:9045530

  6. [C6 fatal trans-vertebral dislocation fracture with tracheal lesion in Bechterew disease. A case presentation].

    Science.gov (United States)

    Kessler, T; Quintel, M; Winkler, H; Wentzensen, A

    1996-07-01

    A fracture of the cervical spine is a dangerous and life-threatening injury in patients suffering from ankylosing spondylitis. A 71-year-old motorist with a long history of ankylosing spondylitis was injured during a car accident. A rare transverse fracture through the body of C6 occurred and in addition a lesion of the trachea was found. This combination of injuries is described for the first time. Special problems relating to the initial rescue, diagnosis and treatment are discussed according to the literature. The necessity of handling the cervical spine with extreme caution during all medical procedures, taking into account the kyphotic deformity is stressed. PMID:8928023

  7. ASDAS, BASDAI and different treatment responses and their relation to biomarkers of inflammation, cartilage and bone turnover in patients with axial spondyloarthritis treated with TNF? inhibitors

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; SØrensen, Inge Juul

    2011-01-01

    To investigate the relation between ankylosing spondylitis disease activity score (ASDAS), Bath ankylosing spondylitis disease activity index (BASDAI) and treatment response and biomarkers of inflammation (C-reactive protein (CRP), interleukin-6 (IL-6), YKL-40), angiogenesis (vascular endothelial growth factor (VEGF)), cartilage (C-terminal crosslinking telopeptide of type II collagen (CTX-II), matrix metalloproteinase-3 (MMP-3), total aggrecan, cartilage oligomeric matrix protein) and bone (C-terminal crosslinking telopeptide of type I collagen, osteocalcin) turnover in 60 patients with axial spondyloarthritis initiating tumour necrosis factor alpha (TNF?) inhibitor therapy.

  8. ASDAS, BASDAI and different treatment responses and their relation to biomarkers of inflammation, cartilage and bone turnover in patients with axial spondyloarthritis treated with TNF{alpha} inhibitors

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; SØrensen, Inge Juul

    2011-01-01

    To investigate the relation between ankylosing spondylitis disease activity score (ASDAS), Bath ankylosing spondylitis disease activity index (BASDAI) and treatment response and biomarkers of inflammation (C-reactive protein (CRP), interleukin-6 (IL-6), YKL-40), angiogenesis (vascular endothelial growth factor (VEGF)), cartilage (C-terminal crosslinking telopeptide of type II collagen (CTX-II), matrix metalloproteinase-3 (MMP-3), total aggrecan, cartilage oligomeric matrix protein) and bone (C-terminal crosslinking telopeptide of type I collagen, osteocalcin) turnover in 60 patients with axial spondyloarthritis initiating tumour necrosis factor alpha (TNF?) inhibitor therapy.

  9. Classification criteria for spondyloarthropathies

    Directory of Open Access Journals (Sweden)

    Ozgur Akgul

    2011-01-01

    Full Text Available Spondyloarthropathies (SpA are a group of inflammatory arthritis which consist of ankylosing spondylitis (AS, reactive arthritis, arthritis/spondylitis associated with psoriasis (PsA, and arthritis/spondylitis associated with inflammatory bowel diseases. It is now more important than ever to diagnose and treat SpA early. New therapeutic agents including blockers of tumor necrosis factor have yielded tremendous responses not only in advanced disease but also in the early stages of the disease. Sacroiliitis on conventional radiography is the result of structural changes which may appear late in the disease process. However, magnetic resonance imaging (MRI can visualize active inflammation at sacroiliac joints and spine in recent onset disease. The modified New York criteria, the European Spondyloarthropathy Study Group criteria and the Amor criteria do not include advanced imaging techniques like MRI which is very sensitive to the early Inflammatory changes. Assessment of SpondyloArthritis international Society has defined MRI methods for the assessment of sacroiliac joints and spine, criteria for inflammatory back pain and developed new criteria for classification of axial and peripheral spondyloarthritis. These new criteria are intended to be used for patients with SpA at the very early stage of their disease. Also, classification of psoriatic arthritis study group developed criteria for the classification of PsA. The widespread use of these criteria in clinical trials will provide evidence for a better definition of early disease and recognize many patients who may further develop classical AS or PsA. These efforts will guide therapeutic trials of potent drugs like biological agents in the early stage of these diseases.

  10. Determination of oxygen radical production in spondyloarthropathies by whole blood chemiluminescence.

    OpenAIRE

    M Ristola; LEIRISALO-REPO, M.; Repo, H

    1991-01-01

    Oxygen derived free radicals are considered to play an important part in the development of inflammation. A whole blood chemiluminescence assay was used to study N-formyl-methionyl-leucyl-phenylalanine induced oxygen radical production in subjects with ankylosing spondylitis or previous yersinia arthritis. In luminol enhanced chemiluminescence, the subjects with previous yersinia arthritis showed significantly increased initial activation (at one minute), whereas the subjects with ankylosing ...

  11. IMAGING OF PSORIATIC ARTHRITIS

    Directory of Open Access Journals (Sweden)

    S. D'Angelo

    2011-09-01

    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

  12. 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

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

    Directory of Open Access Journals (Sweden)

    M.A. Cimmino

    2011-09-01

    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.

  14. Spontaneous Symptomatic Pseudoarthrosis at the L2-L3 Intervertebral Space with Diffuse Idiopathic Skeletal Hyperostosis: A Case Report

    Science.gov (United States)

    Hasegawa, Keiji; Takahashi, Hiroshi; Iida, Yasuaki; Yokoyama, Yuichirou; Fukutake, Katsunori; Takamatsu, Ryo; Nakamura, Kazumasa; Suzuki, Daisuke; Shishikura, Wataru; Tsuge, Shintaro; Sekiguchi, Masayuki; Wada, Akihito

    2013-01-01

    Pseudoarthrosis at the intervertebral space in patients with ankylosing spondylitis has occasionally been reported, but symptomatic pseudoarthrosis at the intervertebral disc level is rare in patients with diffuse idiopathic skeletal hyperostosis (DISH). Here, we report a case of symptomatic pseudoarthrosis at the L2-L3 intervertebral space that was diagnosed based on clinical history. We first performed L1–L5 fixation, but back-out of the pedicle screw occurred in the early postoperative phase and may have been caused by a short fixation range and concomitant Parkinson's disease. However, the prognosis of the case was favorable after a second surgery. This case indicates that a fixation range of at least 3 above and 3 below is necessary for bone fracture of a thoracolumbar vertebra and pseudoarthrosis in patients with DISH. PMID:24294532

  15. Value of contrast-enhanced ultrasound in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

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

    Directory of Open Access Journals (Sweden)

    Bernard Combe

    2008-06-01

    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

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

    LENUS (Irish Health Repository)

    Harty, Leonard

    2012-02-01

    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%.

  18. Back Pain

    Science.gov (United States)

    ... lifestyle, can lead to obesity, which can put stress on the back. Heredity: Some causes of back pain, such as ankylosing spondylitis, a form of arthritis that affects the spine, have a genetic component. Race: Race can be a factor in back problems. ...

  19. Osteoporosis and rheumatic diseases

    OpenAIRE

    Maruotti, N.; A. Corrado; Cantatore, F.P.

    2014-01-01

    Numerous rheumatic diseases, including rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, systemic lupus erythematosus, systemic sclerosis, dermatomyositis/polymyositis and vasculitis are characterized by osteoporosis and fragility fractures. Inflammatory cytokines, glucocorticoid treatment, immobilization and reduced physical activity due to painful joints and muscle weakness are considered the main risk factors that cause low body mass density ...

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

    OpenAIRE

    Oliver, Jacqueline E; Silman, Alan J.

    2009-01-01

    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...

  1. Artropathies that produce osseous bridges

    International Nuclear Information System (INIS)

    In this paper, it is reviewed the most common artropathies that are presented with osseous bridging, with emphasis in the radiological finding of the spine. Also, it's showed other different radiological finding that can help in the differential diagnosis of this disease, such us the sacroilitis in the ankylosing spondylitis or the osteolysis in the psoriatic arthritis

  2. Pseudoarthrosis and ankylosis of the vertebral spine without sacroiliitis associated with Takayasu's arteritis: review of the association

    Energy Technology Data Exchange (ETDEWEB)

    Schuetz, C.T.; Anderson, S.E. [Department of Diagnostic Radiology, University Hospital of Berne, Inselspital, 3010 Berne (Switzerland); Aeberli, D.; Oertle, S. [Department of Rheumatology, University Hospital of Berne, Inselspital, 3010 Berne (Switzerland)

    2002-09-01

    Pseudoarthrosis and ankylosis of the vertebral spine associated with Takayasu's arteritis is extremely rare. We present a patient with the entity who was HLA-B27 negative and had normal sacroiliac joints. The association between Takayasu's arteritis and ankylosing spondylitis appears real but seemingly rare. (orig.)

  3. [Bechterew disease and top level sport: an attainable combination?].

    Science.gov (United States)

    Kleinjan, Marjolein; van Rijthoven, André W A M; Backx, Frank J G

    2009-01-01

    One 23-year-old and two 24- year-old athletes were diagnosed with ankylosing spondylitis. Because of their wish to compete in sport at the highest level, we considered the feasible extent and intensity of physical sports-load regarding the short-, middle- and long-term effects in this particular subgroup of ankylosing spondylitis patients. We could not find any published articles regarding the physical capacities of highly motivated athletes with ankylosing spondylitis. To give 'tailor made' advice to each athlete, we analysed these patients by using a standardized questionnaire, followed by analysis of the case history and a thorough physical examination. As a result we obtained an idea of the maximum individual feasible sports-load in relation to individual capacity for each athlete. Individual and disease characteristics, as well as the sport-specific physical load, can influence the physical capacity of the athlete. To register the effects of maximum sports-load in the middle and long term, and to work towards offering the best possible advice to athletes with ankylosing spondylitis, follow-up research in these 3 patients is advisable. PMID:19785895

  4. Diffuse idiopathic skeletal hyperostosis causing dysphagia

    International Nuclear Information System (INIS)

    Radiographic, clinical and pathologic abnormalities of diffuse idiopathic skeletal hyperostosis (DISH) are presented. Definite criteria must be fulfilled to differentiate DISH from other diseases of the spine, especially intervertebral osteochondrosis and ankylosing spondylitis. A case of massive DISH in the cervical spine causing dysphagia is described. (orig.)

  5. Diagnostic imaging of sacroiliac joints and the spine in the course of spondyloarthropathies

    OpenAIRE

    Sudo?-Szopinska, Iwona; Urbanik, Andrzej

    2013-01-01

    Spondyloarthropathies belong to a group of rheumatic diseases, in which inflammatory changes affect mainly the sacroiliac joints, spine, peripheral joints, tendon, ligaments and capsule attachments (entheses). This group includes 6 entities: ankylosing spondylitis, arthritis associated with inflammatory bowel disease, reactive arthritis, undifferentiated spondyloarthropathy, psoriatic arthritis and juvenile spondyloarthropathy.

  6. Presentation of Ewing’s sarcoma as unilateral sacroiliitis

    Directory of Open Access Journals (Sweden)

    Balebail Gopalakrishna Dharmanand

    2013-05-01

    Full Text Available Presence of sacroiliitis (SI is one of the hallmarks for diagnosing seronegative spondyloarthropathy, especially ankylosing spondylitis. In certain cases, the occurrence of erosions around sacroiliac joint due to other causes can mislead the diagnosis. We are discussing here a rare case of Ewing’s sarcoma, which clinically presented as SI.

  7. Drug: D10161 [KEGG MEDICUS

    Lifescience Database Archive (English)

    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 ...

  8. Drug: D00970 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D00970 Drug Naproxen sodium (USP); Anaprox (TN) C14H13O3. Na 252.0762 252.241 D00970.gif Anti-in ... e: G02CC02 M01AE02 M02AA12 Indications: Rheumatoid arthritis , Osteoarthritis , Ankylosing spondylitis, Juvenile ...

  9. 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.)

  10. Etoricoxib for arthritis and pain management

    OpenAIRE

    Brooks, Peter; Kubler, Paul

    2006-01-01

    Nonsteroidal antiinflammatory drugs (NSAIDs), including selective cyclooxygenase (COX)-2 inhibitors, have come to play an important role in the pharmacologic management of arthritis and pain. Clinical trials have established the efficacy of etoricoxib in osteoarthritis, rheumatoid arthritis, acute gouty arthritis, ankylosing spondylitis, low back pain, acute postoperative pain, and primary dysmenorrhea. Comparative studies indicate at least similar efficacy with etoricoxib versus traditional ...

  11. Pseudoarthrosis and ankylosis of the vertebral spine without sacroiliitis associated with Takayasu's arteritis: review of the association

    International Nuclear Information System (INIS)

    Pseudoarthrosis and ankylosis of the vertebral spine associated with Takayasu's arteritis is extremely rare. We present a patient with the entity who was HLA-B27 negative and had normal sacroiliac joints. The association between Takayasu's arteritis and ankylosing spondylitis appears real but seemingly rare. (orig.)

  12. Vertebral hyperostosis, ankylosed vertebral fracture and atlantoaxial rotatory subluxation in an elderly patient with a history of infantile idiopathic scoliosis; a case report

    Directory of Open Access Journals (Sweden)

    Al Kaissi Ali

    2007-06-01

    Full Text Available Abstract This is a case report of a 48-year-old-woman with scoliosis since early childhood. Recent radiographic spinal assessment revealed the presence of distinctive spinal abnormalities. To the best of our knowledge this is the first clinical report describing a constellation of unusual changes in an elderly woman with a history of infantile idiopathic scoliosis.

  13. Early-Onset Alzheimer's

    Science.gov (United States)

    MENU Return to Web version Early-Onset Alzheimer’s What is early-onset Alzheimer’s disease? Early-onset Alzheimer’s disease is when Alzheimer’s affects a person younger than 65 years of age. People ...

  14. Early treatment in early undifferentiated arthritis.

    Science.gov (United States)

    Olivieri, Ignazio; Sarzi-Puttini, Piercarlo; Bugatti, Serena; Atzeni, Fabiola; d'Angelo, Salvatore; Caporali, Roberto

    2012-06-01

    The early diagnosis of new-onset rheumatoid arthritis (RA) has become a major objective for rheumatologists in order to identify a management strategy able to change the natural history of the disease and to prevent joint damage and functional impairment. Emergent evidence emphasizes the benefits of early aggressive therapy of RA. By the nineties, early arthritis cohorts have been collected throughout the world with the aim to increase the early referral of patients with early onset disease by the general practitioners and to collect data on the development of full-blown RA. The frequency of undifferentiated arthritis (UA) ranged from 23% to 81% in these early cohorts with most of them reporting a rate of 30%. The transition rate from UA to RA was between 13% and 54%. A percentage of 20-60% of patients with UA had a self-limiting disease. Our article deals with the controversy existing in the management of UA. Should every patient with UA be treated? Could patients with a favorable disease course be exposed to unnecessary risk with initiation of aggressive therapy with synthetic disease-modifying anti-rheumatic drugs (DMARDs) or biologic agents? The pros and cons of treating patients with UA are examined. PMID:22037115

  15. 75 FR 20830 - Early Learning

    Science.gov (United States)

    2010-04-21

    ...DEPARTMENT OF EDUCATION Early Learning AGENCY: Office of the Secretary, Department...State agencies responsible for early learning and development, families (including...assistance providers, researchers of early learning, stakeholders who work with early...

  16. 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)

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

    2011-06-01

    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 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.

  17. 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)

    Manuel Castillo-Angeles

    2011-06-01

    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.

  18. Prostate cancer early detection

    OpenAIRE

    Kawachi, Mh; Bahnson, Rr; Barry, M.; Carroll, Pr; Carter, Hb; Catalona, Wj; Epstein, Ji; Etzioni, Rb; Hemstreet Iii, Gp; Howe, Rj; Kopin, Jd; Lange, Ph; Lilja, H.; Mohler, J.; Moul, J.

    2007-01-01

    Since the early 1990s when the ACS developed guidelines for the early detection of prostate cancer, many variants of the tPSA assay have been introduced to increase the sensitivity of screening programs (cancer detection) while maintaining specificity (elimination of unnecessary biopsies). Again, the NCCN guidelines recommend how individuals and their physicians can use these new methods rationally for the early detection of prostate cancer. These guidelines are not designed to provide an arg...

  19. Early bioenergetic evolution

    OpenAIRE

    Sousa, Filipa L.; Thorsten Thiergart; Giddy Landan; Shijulal Nelson-Sathi; Pereira, In Xeas A. C.; Allen, John F.; Nick Lane; Martin, William F.

    2013-01-01

    Life is the harnessing of chemical energy in such a way that the energy-harnessing device makes a copy of itself. This paper outlines an energetically feasible path from a particular inorganic setting for the origin of life to the first free-living cells. The sources of energy available to early organic synthesis, early evolving systems and early cells stand in the foreground, as do the possible mechanisms of their conversion into harnessable chemical energy for synthetic reactions. With rega...

  20. Early Intervention in Vietnam

    Science.gov (United States)

    Hodes, Marja

    2007-01-01

    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…

  1. Early College High Schools

    Science.gov (United States)

    Dessoff, Alan

    2011-01-01

    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…

  2. Earthquake early warning videos

    Science.gov (United States)

    Matthew d'Alessio

    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.

  3. Magnetic resonance imaging in psoriatic arthritis: a review of the literature.

    DEFF Research Database (Denmark)

    McQueen, F.M.; Lassere, M.

    2006-01-01

    Psoriatic arthritis is a diverse condition that may be characterized by peripheral inflammatory arthritis, axial involvement, dactylitis and enthesitis. Magnetic resonance imaging (MRI) allows visualization of soft tissue, articular and entheseal lesions, and provides a unique picture of the disease process that cannot be gained using other imaging modalities. This review focuses on the literature on MRI in psoriatic arthritis published from 1996 to July 2005. The MRI features discussed include synovitis, tendonitis, dactylitis, bone oedema, bone erosions, soft tissue oedema, spondylitis/sacroiliitis and subclinical arthropathy. Comparisons have been drawn with the more extensive literature describing the MRI features of rheumatoid arthritis and ankylosing spondylitis.

  4. 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 ...

  5. Obtaining Early Mammalian Embryos

    Science.gov (United States)

    Frank J. Dye (Western Connecticut State University; )

    1993-01-01

    The methods presented in this chapter provide the wherewithal to study the early development of living mouse embryos. Depending on individual circumstances, these methods will allow for simple observation of these embryos or for their culture and manipulation.

  6. Early Head Start Evaluation

    U.S. Department of Health & Human Services — Longitudinal information from an evaluation where children were randomly assigned to Early Head Start or community services as usual;direct assessments and...

  7. Breast Cancer: Early Detection

    Science.gov (United States)

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

  8. Diversification of early ferns

    OpenAIRE

    GALTIER, JEAN; Scott, Andrew C

    1985-01-01

    A review of current knowledge of early fern evolution is presented including new data on age, morphology and anatomy with two diagrams summarising the early diversification of cauline and foliar anatomy and of the reproductive structures. The relationships and even the attribution of some Devonian taxa to the ferns is questioned whilst most of the Carboniferous coenopterids are considered indisputable ferns, some of them being related to modern filicaleans. The discovery, in the Lower Carboni...

  9. Doug Clements: Early Mathematics

    Science.gov (United States)

    2012-09-14

    This collection of 5 video "snap shots" features Dr. Doug Clements speaking on mathematics in early childhood. Topics include Learning Trajectories, Intentional Play-Based Learning, Intentional Instruction, Integrated Concrete Concepts, and Early Math Learning. He addresses content knowledge necessary for teaching and the development of children's mathematical understanding. Each video is between 2 and 9 minutes long and may be viewed online or downloaded.

  10. Early Prediction of Preeclampsia

    OpenAIRE

    Poon, Leona C.; Nicolaides, Kypros H.

    2014-01-01

    Effective screening for the development of early onset preeclampsia (PE) can be provided in the first-trimester of pregnancy. Screening by a combination of maternal risk factors, uterine artery Doppler, mean arterial pressure, maternal serum pregnancy-associated plasma protein-A, and placental growth factor can identify about 95% of cases of early onset PE for a false-positive rate of 10%.

  11. GISEA: an Italian biological agents registry in rheumatology

    Directory of Open Access Journals (Sweden)

    F. Trotta

    2011-11-01

    Full Text Available The GISEA registry is an independent database that was established by the Italian Group for the Study of Early Arthritis (GISEA in 2008, funded by the Italian Association of Rheumatic Patients (ANMAR - ONLUS. In line with the network’s epidemiological strategy, the initial protocol was designed to collect long-term follow-up data concerning patients with rheumatic diseases treated with biological agents in order to investigate the realworld characteristics in terms of disease activity, comorbidities and survival on treatment. We here describe the design and methodology used to collect patient data. Information concerning demographics, disease activity, treatment changes (including the reasons for changing and the duration of each therapy, concomitant therapies and adverse events is available to all the members of the study groups by means of a web-based interface that allows queries and the presentation of numerical data, as well as graphics to illustrate trends. Fourteen Italian rheumatology centres have contributed patients to the database which, at the time writing, includes 5145 patients (72% women with a mean age of 53 years (range 16-88. The initial diagnoses were rheumatoid arthritis (3494 patients, 67.9%, psoriatic arthritis (833, 16.2%, ankylosing spondylitis (493, 9.6%, undifferentiated spondylo-arthritides (307, 5.9%, enteropathic arthritis (14, 0.3% and spondylitis following reactive arthritis (4, 0.1%. These patients have been followed for up to 10 years, and 1927 (35.8% have been treated for at least three years. The biological treatments received include etanercept, infliximab, anakinra, adalimumab, abatacept, rituximab and tocilizumab. A total of 2926 adverse events have been observed, with 1171 patients (22% reporting at least one. Analysis of the accumulated data will provide insights into the critical early phase of the studied arthritides, and enable us to identify the clinical and laboratory profiles that may predict responsiveness to a specific therapy.

  12. How early is early dark energy?

    CERN Document Server

    Pettorino, Valeria; Wetterich, Christof

    2013-01-01

    We investigate constraints on early dark energy (EDE) from the Cosmic Microwave Background (CMB) anisotropy, taking into account data from WMAP9 combined with latest small scale measurements from the South Pole Telescope (SPT). For a constant EDE fraction we propose a new parametrization with one less parameter but still enough to provide similar results to the ones previously studied in literature. The main emphasis of our analysis, however, compares a new set of different EDE parametrizations that reveal how CMB constraints depend on the redshift epoch at which Dark Energy was non negligible. We find that bounds on EDE get substantially weaker if dark energy starts to be non-negligible later, with early dark energy fraction Omega_e free to go up to about 5% at 2 sigma if the onset of EDE happens at z < 100. Tight bounds around 1-2% are obtained whenever dark energy is present at last scattering, even if its effects switch off afterwards. We show that the CMB mainly constrains the presence of Dark Energy ...

  13. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.)

  15. 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.)

  16. [10-year epidemiological study on rheumatic diseases in Shantou area].

    Science.gov (United States)

    Zeng, Q; Huang, S; Chen, R

    1997-03-01

    22,049 adults were surveyed in a ten-year epidemiological study. The frequency of common rheumatic symptoms in Shantou population was much lower than that in northern China. The prevalence of ankylosing spondylitis, rheumatoid arthritis, osteoarthritis, osteoporosis and gout was 0.20%-0.32%, 0.20%-0.26%, 8.3%-10.8%, 12.4% and 0.15%-0.17% respectively. The frequency of HLA-B27 was 4.1% among general population and 90.6% in ankylosing spondylitis. The most commonly involved sites of osteoarthritis were lumbar spine, neck, and knee; but hands and hip were rarely involved. 85% subjects under investigation were found to be short of calcium intake. The differences between the north and the south of China in the prevalence of rheumatic symptoms may be related to the diversities in consciousness of seeking medical advice, reduction of bone content, climate and ergonomics. PMID:10374316

  17. The skin tissue is adversely affected by TNF-alpha blockers in patients with chronic inflammatory arthritis: a 5-year prospective analysis

    Scientific Electronic Library Online (English)

    Natalia P., Machado; Edgard Torres dos, Reis Neto; Maria Roberta M.P., Soares; Daniele S., Freitas; Adriana, Porro; Rozana M., Ciconelli; Marcelo M., Pinheiro.

    1189-11-01

    Full Text Available OBJECTIVE: We evaluated the incidence of and the main risk factors associated with cutaneous adverse events in patients with chronic inflammatory arthritis following anti-TNF-? therapy. METHODS: A total of 257 patients with active arthritis who were taking TNF-? blockers, including 158 patients w [...] ith rheumatoid arthritis, 87 with ankylosing spondylitis and 12 with psoriatic arthritis, were enrolled in a 5-year prospective analysis. Patients with overlapping or other rheumatic diseases were excluded. Anthropometric, socioeconomic, demographic and clinical data were evaluated, including the Disease Activity Score-28, Bath Ankylosing Spondylitis Disease Activity Index and Psoriasis Area Severity Index. Skin conditions were evaluated by two dermatology experts, and in doubtful cases, skin lesion biopsies were performed. Associations between adverse cutaneous events and clinical, demographic and epidemiological variables were determined using the chi-square test, and logistic regression analyses were performed to identify risk factors. The significance level was set at p

  18. Clinical and radiological evaluation of hybrid hip replacement in various disorders of hip

    Directory of Open Access Journals (Sweden)

    Dhaon B

    2005-01-01

    Full Text Available Background: High rates of loosening of cemented implants led to change in technique of fixation of the implant. Methods: Fifty-nine hips were operated in 42 patients with non-cemented acetabular and cemented femoral components between January 1999 and July 2003. The average age of the patient was 45.2 years in our study. Preoperative diagnosis was avascular necrosis (28, ankylosing spondylitis (18, fracture neck femur (9, rheumatoid arthritis (2 and osteoarthritis (2. Results: At an average follow up of 3.6 years (range 1.2-5.8 years excellent to good results were obtained 92% according to Harris hip criteria. No radiological loosening was noted in any femoral or acetabular component on follow up. One poor result was seen in a case of bilateral ankylosing spondylitis operated on one side. Conclusion: Hybrid THA provides a viable and highly acceptable method of treatment of diseases of hip in young patients.

  19. Illinois Early Learning Project

    Science.gov (United States)

    The importance of early childhood education cannot be underestimated, and there are numerous educational policy initiatives that demonstrate a nuanced understanding of this situation. The state of Illinois has recently developed this website to provide "a source of evidence-based, reliable information on early care and education for parents, caregivers, and teachers of young children". While intended primarily for residents of Illinois, much of the material can be used by people from around the country. The site itself is funded by the Illinois Board of Education, and works closely with the Clearinghouse on Early Education and Parenting (CEEP) at the University of Illinois. One of the first stops for new visitors should be the tip sheet section, as it offers a number of nice tip sheets on various topics. Some of the topics covered include social and emotional development, parenting and family life, social science, and fine arts. Additionally, many of the tip sheets are also available in Spanish and Polish.

  20. Earthquake Early Warning Systems

    Directory of Open Access Journals (Sweden)

    Pei-Yang Lin

    2011-12-01

    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.

  1. Early College Entrance in Australia

    Science.gov (United States)

    Jung, Jae Yup; Young, Marie; Gross, Miraca U. M.

    2015-01-01

    Early college entry is an educational intervention that is being increasingly used in Australia. Following a review of the current Australian literature on early college entry, an overview is provided of the characteristics of, and the procedures associated with, one formal Australian early college entry program (the Early Admission for…

  2. Baseline characteristics and patient reported outcome data of patients prescribed etanercept: web-based and telephone evaluation

    OpenAIRE

    Koscielny Volker; Pumford Neil; Crawford Gordon M; Wade Alan G; Maycock Susan; McConnachie Alex

    2011-01-01

    Abstract Background The anti-TNF inhibitor, etanercept is administered as a once or twice weekly subcutaneous injection for the treatment of rheumatoid arthritis, psoriasis, ankylosing spondylitis, psoriatic arthritis and juvenile idiopathic arthritis (JIA). Limited data from the patients' perspective are available on the use of biologics in the treatment of these chronic conditions and this evaluation was designed to collect data from patients who had been prescribed etanercept for the first...

  3. A common assessment tool in inflammatory rheumatisms

    OpenAIRE

    Dan Neme?; Mihai Dr?goi; Poenaru, Dan V; R?zvan Dr?goi; Elena Amaric?i; Daniel Popa; Oana Suciu; Diana Andrei; Octavian Cre?u; Crina Gruin

    2010-01-01

    Aims: Once the biologic therapies have been used, the present-day medicine trend is to homogenize the treatment of the inflammatory autoimmune rheumatic diseases, meaning rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA) and systemic lupus erythematosus (SLE). But, there is still the need to find out a common assessment instrument for this pathology.Methods:The study included 120 patients (40 patients with RA, 40 patients with AS, 20 patients with PsA and 20 pa...

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

    OpenAIRE

    Datto C; Hellmund R; Mk, Siddiqui

    2013-01-01

    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...

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

    OpenAIRE

    Charalampos Papagoras; Paraskevi V Voulgari; Drosos, Alexandros A

    2009-01-01

    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...

  6. The Emerging Role of Biotechnological Drugs in the Treatment of Gout

    OpenAIRE

    Cavagna, L.; Taylor, W. J.

    2014-01-01

    One of the most important therapeutic advances obtained in the field of rheumatology is the availability of the so-called bio(techno)logical drugs, which have deeply changed treatment perspectives in diseases such as rheumatoid arthritis and ankylosing spondylitis. According to the steadily increasing attention on gout, due to well-established prognostic and epidemiology implications, in the last 5 years, the same change of perspective has been observed also for this disease. In fact, several...

  7. The nonspecific inhibitory effect of synovial tissue extracts on leucocyte migration in vitro.

    OpenAIRE

    Morgan, J. E.; Hall, N D; Collins, A J; Bacon, P A

    1980-01-01

    The leucocyte migration inhibition test (LMT) has been used to search for specific antigens in rheumatoid synovial tissue. Synovial samples were collected from 20 patients with rheumatoid arthritis, from 1 patient with ankylosing spondylitis, and from 1 patient with pigmented villonodular synovitis. Inhibitory material was obtained from all 21 synovia with inflammatory disease but not from the noninflammatory synovium. The tissue extracts generally caused nonspecific migration inhibition when...

  8. Angioedema associated with Crohn's disease: Response to biologics

    OpenAIRE

    Flavio Habal; Vivian Huang

    2012-01-01

    A 46-year-old female patient with terminal ileum Crohn’s disease and ankylosing spondylitis presented with recurrent angioedema and urticaria. Investigations ruled out hereditary angioedema, and environmental or food allergen triggers. She was diagnosed with chronic idiopathic urticaria with angioedema, and was treated with a trial of intravenous immunoglobulin immunotherapy, danazol, prednisone and hydroxyzine. Due to ongoing bowel and arthritic complaints, she was started on inflixim...

  9. Juvenile spondyloarthropathies: clinical manifestations and medical imaging

    International Nuclear Information System (INIS)

    The spondyloarthropathies comprise four distinct entities - ankylosing spondylitis, psoriatic arthritis, the arthritis associated with inflammatory bowel disease, and Reiter's syndrome and other related forms of reactive arthritis. Although these are distinct diseases, they have a number of clinical, radiologic, and genetic characteristics in common which permit them to be classified under the unifying term ''spondyloarthropathy''. The plain radiograph is the primary and most important imaging modality for the assessment of these diseases. However, an expanding role of magnetic resonance imaging is evident. (orig.)

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

    OpenAIRE

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

    2011-01-01

    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...

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

    OpenAIRE

    Gupta G; Gaud R

    2006-01-01

    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...

  12. Uveitis, vitreous humor, and klebsiella. I. Binding studies with rabbit antisera.

    OpenAIRE

    Avakian, H.; Abuknesha, R.; Welsh, J.; Ebringer, A.

    1981-01-01

    Uveitis occur in a proportion of patients with ankylosing spondylitis, and an increased faecal isolation of the Gram-negative micro-organism Klebsiella pneumoniae has been reported from such patients. Immunological cross-reactivity between K. pneumoniae and bovine vitreous humour has been studied by 2 different antibody binding techniques: I125-labelled antigen binding assay with and without carrier, and beta-galactosidase enzyme-immunoassay. Sera from rabbits immunised with whole klebsiella ...

  13. Klebsiella and acute anterior uveitis.

    OpenAIRE

    Beckingsale, A. B.; Williams, D; Gibson, J. M.; Rosenthal, A. R.

    1984-01-01

    Samples of the faeces of 153 consecutive patients presenting with acute anterior uveitis (AAU), and of 47 controls were examined for the presence of Klebsiella pneumoniae. No increase in the carriage rate of klebsiella was found in the AAU patients as compared with the controls. Furthermore no increase was found in any group of patients whether subdivided by HLA-B27 status, sex, or presence of ankylosing spondylitis (AS). No difference was found between patients having their first attack of A...

  14. Intestinal microsporidiosis: a hidden risk in rheumatic disease patients undergoing anti-tumor necrosis factor therapy combined with disease-modifying anti-rheumatic drugs?

    OpenAIRE

    Nadia Emi Aikawa; Aline de Oliveira Twardowsky; Jozélio Freire de Carvalho; Silva, Clovis A; Silva, Ivan Leonardo Avelino França e; Ana Cristina de Medeiros Ribeiro; Carla Goncalves Schain Saad; Julio César Bertacini Moraes; Roberto Acayaba Toledo; Eloísa Bonfá

    2011-01-01

    OBJECTIVE: Immunosuppressed patients are at risk of microsporidiosis, and this parasitosis has an increased rate of dissemination in this population. Our objective was to evaluate the presence of microsporidiosis and other intestinal parasites in rheumatic disease patients undergoing anti-tumor necrosis factor/disease-modifying anti-rheumatic drug treatment. METHODS: Ninety-eight patients (47 with rheumatoid arthritis, 31 with ankylosing spondylitis and 11 with psoriatic arthritis) and 92 hea...

  15. Enhancement of Dissolution of Aceclofenac Film Coated Tablet by Micronisation Technique

    OpenAIRE

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

    2013-01-01

    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...

  16. The semeiology of arthritis: discriminating between patients on the basis of their symptoms.

    OpenAIRE

    Helliwell, P. S.

    1995-01-01

    OBJECTIVES--To examine the intended meaning of words used by patients to describe arthritic symptoms, and to distinguish between different patient groups on the basis of these words. METHODS--A Joint Symptom Questionnaire, developed to resemble the McGill Pain Questionnaire, was given to health professionals (n = 50) and patients with rheumatoid arthritis (RA) (n = 100), fibromyalgia (FM) (n = 50), ankylosing spondylitis (AS) (n = 50), and osteoarthritis (OA) (n = 50). Respondents were invite...

  17. Acceleration of coxarthrosis by an exostosis causing femoroacetabular impingement

    Directory of Open Access Journals (Sweden)

    Murat Arikan

    2010-04-01

    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.

  18. Acceleration of coxarthrosis by an exostosis causing femoroacetabular impingement

    OpenAIRE

    Murat Arikan; Burcu Yanik; Mahmut Nedim Aytekin; Hakan Atalar

    2010-01-01

    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.

  19. The sex ratios of probands and of secondary cases in conditions of multifactorial inheritance where liability varies with sex.

    OpenAIRE

    James, W H

    1991-01-01

    Some pathological conditions affect one sex more often than the other. A curious feature of some of these conditions (dyslexia, congenital dislocation of the hip, pyloric stenosis, otosclerosis, lupus erythematosus, ankylosing spondylitis) is that the sex ratio (proportion of males) of randomly ascertained probands is more extreme than that of their affected relatives. In all these conditions, multifactorial inheritance has been suspected. A simple model is offered here of multifactorial inhe...

  20. Fatigue in patients with spondyloarthritis associates with disease activity, quality of life and inflammatory bowel symptoms.

    Science.gov (United States)

    Stebbings, Simon M; Treharne, Gareth J; Jenks, Katey; Highton, John

    2014-10-01

    The study aimed to assess the severity of fatigue in patients with axial spondyloarthritis (AxSpA), to assess the performance of two different fatigue measures in AxSpA, and to examine disease variables which may influence the severity of fatigue. Fatigue was examined among 67 patients with AxSpA using two measures: the fatigue Visual Analogue Scale (VAS) from the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Multidimensional Assessment of Fatigue (MAF) score. These measures were tested for convergent validity using linear regression analysis. Correlations between fatigue measured using both questionnaires, and key disease variables was examined using the following assessments: BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, spondyloarthritis modification of the Dudley Inflammatory Bowel Symptom Questionnaire (DISQ) and pain VAS. Human leucocyte antigen (HLA) B27 and CRP were performed and followed by physical examination, Bath AS Metrology Index (BASMI) and Ankylosing Spondylitis Disease Activity Score (ASDAS). Correlations were assessed using multivariate regression analysis. Mean (±SD) fatigue measured by MAF (range 0-50) was 24.7 (±11.5) and 5.14 (±2.47) on the BASDAI VAS fatigue item (range 0-10). The MAF scores and BASDAI VAS fatigue were strongly correlated (r?=?0.71, P?ASDAS disease activity and HLA-B27 status that were apparent in multivariate models. Patients with AxSpA experience substantial fatigue, which is associated with poorer quality of life. Fatigue VAS and MAF scores were strongly correlated. Factors most strongly associated with fatigue were disease activity and inflammatory bowel symptoms. PMID:24322832

  1. Comparison of ASDAS and BASDAI as a measure of disease activity in axial psoriatic arthritis.

    Science.gov (United States)

    K?l?ç, Gamze; K?l?ç, Erkan; Nas, Kemal; Karkucak, Murat; Çapk?n, Erhan; Da?l?, Abdullah Zübeyir; Çevik, Remzi; Özgöçmen, Salih

    2015-03-01

    The aim of this study was to compare the discriminative ability of Ankylosing Spondylitis Disease Activity Score (ASDAS) with Bath Ankylosing Spondylitis Activity Disease Activity Index (BASDAI) and other clinical disease activity parameters in patients with axial psoriatic arthritis (axPsA). Patients with axPsA were recruited from Erciyes Spondyloarthritis Cohort (ESPAC) and Anatolian Group for the Assessment in Rheumatic Disease (ANGARD) cohort and were assessed for BASDAI, ASDAS, BASFI (Bath Ankylosing Spondylitis Functional Index), Ankylosing Spondylitis Quality of Life (ASQoL), and visual analog scale (VAS) pain. The discriminant ability of ASDAS-C-reactive protein (-CRP) and ASDAS-erythrocyte sedimentation rate (-ESR) was assessed using standardized mean differences between patients with high and low disease activity. Fifty-four patients with axPsA were included in the study. Both ASDAS scores showed good discriminative ability between high and low disease activity states. Both ASDAS versions and BASDAI had relatively high area under the curve (AUC) according to ASAS partial remission, patient and physician global assessments in receiver operating characteristic (ROC) curve analysis. There was no significant difference between AUC scores for the models that compared ASDAS-CRP and ASDAS-ESR with BASDAI for each individual definition of disease activity states. ASDAS versions and BASDAI showed good similar discriminative ability between high and low disease activity as reflected by the AUC analysis in axPsA. The cutoff values for inactive disease and high disease activity were relatively similar to predefined cutoff values for AS. Further, prospective validation is now required to identify the appropriate assessment tools and cutoff values in axPsA. PMID:24985042

  2. Lymphocytes bearing Fc gamma receptors in rheumatoid arthritis. I. An increased subpopulation of cells in rheumatoid arthritis detected with Facb rosettes.

    OpenAIRE

    Hall, N. D.; Winrow, V. R.; Bacon, P. A.

    1980-01-01

    The chronic production of IgM and IgG antiglobulins is a major feature of rheumatoid arthritis. This implies an abnormal interaction between rheumatoid leucocytes and IgG. A novel rosette assay employing rabbit Facb-coated calf red blood cells has been developed to study receptors for IgG on peripheral blood lymphocytes. Cells were obtained from groups of patients with rheumatoid arthritis (RA), osteoarthritis (OA), ankylosing spondylitis (AS), and healthy control subjects. Receptors for Facb...

  3. [Extra-articular manifestations of seronegative spondyloarthritides].

    Science.gov (United States)

    Morovi?-Vergles, Jadranka; Culo, Melanie-Ivana

    2011-01-01

    The term seronegative spondyloarthritides (SpA) is used to refer to a family of inflammatory rheumatic diseases characterised by inflammation of axial joints, asymmetric oligoarthritis and enthesitis, sometimes involving nonarticular structures, such as skin, heart, aortic valve, eye and kidney. The SpA consist of the following entities: ankylosing spondylitis, reactive arthritis, psoriatic arthritis, spondyloarthritis associated with IBD and undifferentiated spondyloarthritis. The prevalence of SpA in the population is 0,5-2%. PMID:22232949

  4. Physical activity and health perception in inflammatory joint disease : A physiotherapy perspective

    OpenAIRE

    Brodin, Nina

    2008-01-01

    Ankylosing spondylitis (AS) and rheumatoid arthritis (RA) are inflammatory joint diseases, both leading to disability and reduced health. Physical activity is a powerful health measure and physiotherapists have an important role in its initiation and implementation among patients with inflammatory joint disease. However, more knowledge is needed of the characteristics of those patients in most need of support and the efficiency of physical activity interventions. The aims...

  5. [Hydroxyapatite microcrystals in synovial mitochondria in human and experimental rheumatism].

    Science.gov (United States)

    Delbarre, F; Laoussadi, S; Amor, B; Kahan, A

    1981-11-16

    This paper deals with mitochondria microcrystal deposition in some human inflammatory rheumatism and in experimental arthritis. Hydroxyapatite microcrystals were observed in Ankylosing Spondylitis (AS) and Reiter Syndrome (RS) but never in rheumatoid synovitis nor in chondrocalcinosis synovitis. In Rat and Rabbit experimental arthritis, they were always seen in mitochondria as in AS and RS and never in lysosomes. This fact suggests mitochondrial abnormalities in calcium metabolism, which may be a consequence of synovial inflammation in a susceptible host. PMID:6800572

  6. 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

  7. Including known covariates can reduce power to detect genetic effects in case-control studies.

    OpenAIRE

    Pirinen, M; Donnelly, P; Spencer, CC

    2012-01-01

    Genome-wide association studies (GWAS) search for associations between genetic variants and disease status, typically via logistic regression. Often there are covariates, such as sex or well-established major genetic factors, that are known to affect disease susceptibility and are independent of tested genotypes at the population level. We show theoretically and with data from recent GWAS on multiple sclerosis, psoriasis and ankylosing spondylitis that inclusion of known covariates can substa...

  8. Early rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    P. Sarzi-Puttini

    2011-09-01

    Full Text Available Rheumatoid arthritis (RA is a systemic disease characterized by chronic inflammation of the synovial joints damage and loss of the function. The ultimate goal in managing RA is to prevent joint damage and to maintain functional ability. Consequently, early diagnosis and treatment is important, but predictive markers for RA are still confined to auto- antibodies and also magnetic resonance imaging (MRI and sonography do not appear to sufficiently distinguish between early RA and non RA. Evidence shows that substantial and irreversible joint damage already occurs within the first 2 years after disease onset. This “window of opportunity” hypothesis for therapeutic intervention in RA is based on the existence of a time frame within which there is a potential for a greater response to therapy, resulting in sustained benefits or, perhaps most important, a chance of cure. There is increasing evidence for beneficial effects of early DMARDs (disease-modifying anti-rheumatic drugs therapy over delayed treatment in patients who present with arthritis of recent onset. However, no universal consensus exists concerning the choice of initial drug or whether single drug or combination should be given as initial treatments. Most studies demonstrated superiority of aggressive over conventional approaches. Because the tumor necrosis factor (TNF-? inhibitors have proved to stop joint damage progression in severe progressive RA, the achievement of these agents in early RA are currently of great interest.

  9. EARLY ERA ISLAMIC EDUCATION

    Directory of Open Access Journals (Sweden)

    Mahmut DÜNDAR

    2014-06-01

    Full Text Available The early Islamic education period, which consists of The Blesssed Era and Four Caliphs is religion-oriented. Education of this period reached to further levels with new initiatives during Four Caliphs. Training and education places of Blessed Era such as mosque, küttabs and education purposed-houses became more organized in this period. In addition, new units were founded under the roof of mosque depending on their functions like küttabs for children’s religious and cultural education. Thus, religion training shaped by the rules of early Islamic education developed to further points in the later periods with activities and institutions according to the possibilities and conditions. Hence education foundations of early period left their place to the madrasahs, schools and modern schools in the years ahead. While the methods like repetition, memorization and education circuits were used in the early period, modern techniques and strategies were used in the later periods. Also, in this era, the aim of training and education, including reading and writing, was teaching and learning Qur'an and Sunnah and practicing these in daily life for the Allah’s sake (cc. Accordingly, what was intended by education was to raise both perfect human being and good citizens.

  10. Early Pregnancy Loss

    Science.gov (United States)

    ... feelings as me? • How soon can I become pregnant after having a miscarriage? • Glossary Early Pregnancy Loss FREQUENTLY ASKED QUESTIONS FAQ090 ... show their grief. How soon can I become pregnant after having a miscarriage? You can ovulate and become pregnant as soon ...

  11. Early practice: neurotology.

    Science.gov (United States)

    Breen, Joseph T; Vrabec, Jeffrey T

    2015-04-01

    Besides technical and surgical proficiency, some of the most important skills for a young Neurotologist to refine include communication and critical thinking abilities. This Early Practice article provides perspectives on common challenges and career development from a current Neurotology fellow and his mentor. PMID:25650228

  12. 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.

  13. Clinical and Radiological Characteristics of Spondyloarthropathy

    Directory of Open Access Journals (Sweden)

    Lale Cerrahoglu

    2008-06-01

    Full Text Available Objective: The objective of this study is to determine the clinical characteristics of patients with spondyloarthropaties (SpA.Patients and Methods: One hundred -twenty patients that match European Spondyloarthropaties Study Group (ESSG diagnostic criteria, were included in this study. There were 48 ankylosing spondylitis (AS, 42 reactive arthritis (ReA, 9 psoriatic arthritis (PsA, 3 enteropathic arthritis (EA and 18 undifferentiated SpA (uSpA patients. Demographic data, clinical parameters and grade of sacroiliitis were assessed. Enthesitis were evaluated by the Mander Enthesis Index (MEI. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI and Bath Ankylosing Spondylitis Functional Index (BASFI evaluated disease activity and functional status in AS patients, respectively. Results: The most frequently seen symptom was night pain (55.1% and the most frequently seen radiographic involvement was right sacroiliitis ( 95.8%. Epin calcanei was most frequently observed in PsA (55.5% and EA (33.3% patients. The incidence of enthesitis in patients with SpA was 86.7%. Uveitis and heel pain were most commonly found respectively in AS (16.7%, and ReA (47.6% patients.Conclusion: Whereas patients with SpA had similar clinical symptoms, their most common complaint was night pain. We think that it should be keep in mind while medical treatment is put in order.

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

    Scientific Electronic Library Online (English)

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

    1179-11-01

    Full Text Available [...] 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.

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

    Directory of Open Access Journals (Sweden)

    CONSUELO ROMERO-SÁNCHEZ

    2010-09-01

    Full Text Available 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 intervention. 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.

  16. [Biomarkers for spondyloarthropathies. State of the art].

    Science.gov (United States)

    Romero-Sánchez, Consuelo; Londoño, John; DE Avila, Juliette; Valle-Oñate, Rafael

    2010-09-01

    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 intervention. 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. PMID:21249289

  17. TNF-alpha inhibitors: Current indications

    Directory of Open Access Journals (Sweden)

    Sharma Rashmi

    2007-01-01

    Full Text Available Advances in the DNA hybrid technology led to the development of various biologicals that specifically target TNF-?. There are currently three anti- TNF- ? drugs available- etanercept, infliximab and adalimumab. Etanercept is approved by FDA for rheumatoid arthritis (RA in 2000 followed by its approval for ankylosing spondylitis, psoriasis and psoriatic arthritis. Infliximab and adalimumab are approved by FDA in 2002 for RA. Infliximab is also approved for ankylosing spondylitis, psoriasis, psoriatic arthritis, crohn?s disease and ulcerative colitis and adalimumab for psoriatic arthritis and ankylosing spondylitis. Other conditions like bronchial asthma, diabetes mellitus, malignancies, septic shock, behcet?s disease, bullous dermatitis, neutrophilic dermatitis, toxic epidermal necrolysis, systemic vasculitis, pyoderma gangrenosum, pustular dermatitis, alcoholic hepatitis, cerebral malaria, hemolytic uremic syndrome, pre-eclampsia, allograft rejection, uveitis, otitis media, snakebite, erythema nodosum, myelodysplastic syndromes, graft versus host disease, dermatomyositis and polymyositis are the potential targets for anti-TNF- ? therapy. There are resent reports of serious infections like tuberculosis with the use of anti-TNF therapy. In developing country like India these agents should be used with strict pharmaco-vigilance and chemo-prophylaxis for tuberculosis.

  18. Expression of PADI4 during rheumatoid arthritis development

    Directory of Open Access Journals (Sweden)

    Yunzhong Zhang

    2009-06-01

    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.

  19. Classification and clinical assessment

    Directory of Open Access Journals (Sweden)

    F. Cantini

    2012-06-01

    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.

  20. Early anaerobic metabolisms

    OpenAIRE

    Canfield, Don E.; Rosing, Minik T.; Bjerrum, Christian

    2006-01-01

    Before the advent of oxygenic photosynthesis, the biosphere was driven by anaerobic metabolisms. We catalogue and quantify the source strengths of the most probable electron donors and electron acceptors that would have been available to fuel early-Earth ecosystems. The most active ecosystems were probably driven by the cycling of H2 and Fe2+ through primary production conducted by anoxygenic phototrophs. Interesting and dynamic ecosystems would have also been driven by the microbial cycling ...

  1. Early times in tunneling

    OpenAIRE

    Garcia-Calderon, Gaston; Villavicencio, Jorge

    2000-01-01

    Exact analytical solutions of the time-dependent Schr\\"odinger equation with the initial condition of an incident cutoff wave are used to investigate the traversal time for tunneling. The probability density starts from a vanishing value along the tunneling and transmitted regions of the potential. At the barrier width it exhibits, at early times, a distribution of traversal times that typically has a peak $\\tau_p$ and a width $\\Delta \\tau$. Numerical results for other tunne...

  2. Infusing Early Childhood Mental Health into Early Intervention Services

    Science.gov (United States)

    Grabert, John C.

    2009-01-01

    This article describes the process of enhancing early childhood mental health awareness and skills in non-mental health staff. The author describes a pilot training model, conducted the U.S. Army's Early Intervention Services, that involved: (a) increasing early childhood mental health knowledge through reflective readings, (b) enhancing…

  3. Early prevention of obesity

    Directory of Open Access Journals (Sweden)

    Claudio Maffeis

    2014-06-01

    Full Text Available Childhood obesity is the metabolic disorder with the highest prevalence in both children and adults. Urgency to treat and prevent childhood obesity is based on the clear evidence that obesity tends to track from childhood to adulthood, is associated to morbidity also in childhood and to long-term mortality. Early life, i.e., intrauterine life and the first two years, is a sensitive window for prevention. Anatomical and functional maturation of the hypothalamic structures devoted to regulating energy intake and expenditure and body size mainly occurs in the first 1,000 days of life. Therefore, factors affecting the foetal exposition to maternal metabolic environment and early postnatal nutrition are crucial in modulating the definition of the metabolic programming processes in the brain. Maternal diseases, mainly malnutrition for defect or excess, obesity and diabetes, placental disorders and dysfunctions, maternal use of alcohol and drugs, smoking, affect long term metabolic programming of the foetus with lifelong consequences. Similarly, early nutrition contributes to complete the long-term metabolic regulating framework initiated in the uterus. Breastfeeding, adequate weaning, attention to portion size and diet composition are potential tools for reducing the obesity risk later in childhood. Longitudinal randomized controlled studies are needed for exploring the efficacy of obesity prevention strategies initiated after conception.Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

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

    Directory of Open Access Journals (Sweden)

    M. Zanon

    2011-06-01

    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.

  5. Anterior chest wall inflammation by whole body MRI in patients with spondyloarthritis : lack of association between clinical and imaging findings in a cross-sectional study

    DEFF Research Database (Denmark)

    Weber, Ulrich; Lambert, Robert Gw

    2012-01-01

    ABSTRACT: INTRODUCTION: Inflammatory involvement of the anterior chest wall (ACW) impacts the quality of life in patients with spondyloarthritis (SpA) although involvement of the ACW is often neglected on clinical and imaging evaluation. Whole body (WB) MRI is an imaging method to assess the ACW in addition to the sacroiliac joints and spine without additional inconvenience for patients. The goals of this study were to describe the distribution of ACW inflammation by WB MRI in both early and established SpA and associations between clinical and imaging findings indicative of inflammation. METHODS: The ACW of 122 consecutive SpA patients (95 with ankylosing spondylitis (AS) and 27 with non-radiographic SpA (nrSpA)) and 75 healthy controls was scanned by sagittal and coronal WB MRI. The MR images were scored independently in random order by 7 readers blinded to patient identifiers. Active and structural inflammatory lesions of the ACW were recorded on a web-based data entry form. ACW pain by patient self-report, ACW tenderness on physical examination according to the Maastricht ankylosing spondylitis enthesitis score (MASES) and MRI lesions were analyzed descriptively. Kappa statistics served to assess the agreement between clinical and imaging findings. RESULTS: ACW pain or tenderness was present in 26% with little difference between AS and nrSpA patients. Bone marrow edema (BME), erosion and fat infiltration were recorded in 44.3%, 34.4% and 27.0% of SpA patients and in 9.3%, 12.0% and 5.3% of controls. MRI lesions occurred more frequently in AS patients (BME, erosion and fat infiltration in 49.5%, 36.8%, and 33.7%, respectively) compared with nrSpA patients (25.9%, 25.9%, and 3.7%, respectively). The most frequently affected joint by MRI lesions was the manubriosternal joint. The kappa values between clinical assessments and MRI inflammation ranged from -0.10 to only 0.33 for both AS and nrSpA patients. CONCLUSIONS: 26% of SpA patients showed clinical involvement of the ACW. WB MRI signs of ACW inflammation occurred in a substantial proportion of patients with AS (49.5%) and nrSpA (25.9%). There was no association between clinical assessments of ACW, including the MASES, and MRI features.

  6. Modeling Early Mars Climate

    Science.gov (United States)

    Ozak, Nataly; Halevy, Itay; Aharonson, Oded

    2013-04-01

    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.

  7. Early Physics and Astronomy

    Science.gov (United States)

    Pedersen, Olaf

    1993-03-01

    Preface; 1. Science before the Greeks; 2. The new concept of nature; 3. Plato and Greek mathematics; 4. Aristotle and the knowledge of Nature; 5. Practical astronomy; 6. Early Greek cosmology; 7. Mathematical astronomy; 8. The foundation of statics; 9. Dynamics in antiquity; 10. The conception of light and sound; 11. The structure of material substances; 12. Properties of matter and chemical change; 13. The transmission of Greek science; 14. Experimental physics in the Middle Ages; 15. The development of statics; 16. The establishment of kinematics; 17. Force and motion in the Middle Ages; 18. Mediaeval astronomy; 19. The change called Renaissance; 20. The reform of astronomy; Bibliography; Index.

  8. Artritis Temprana Early Arthritis

    Directory of Open Access Journals (Sweden)

    2011-02-01

    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.

  9. 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.)

  10. Early solar physics

    CERN Document Server

    Meadows, A J

    1970-01-01

    Early Solar Physics reviews developments in solar physics, particularly the advent of solar spectroscopy and the discovery of relationships between the various layers of the solar atmosphere and between the different forms of solar activity. Topics covered include solar observations during 1843; chemical analysis of the solar atmosphere; the spectrum of a solar prominence; and the solar eclipse of December 12, 1871. Spectroscopic observations of the sun are also presented. This book is comprised of 30 chapters and begins with an overview of ideas about the sun in the mid-nineteenth century, fo

  11. Relationship between psychiatric status, self-reported outcome measures, and clinical parameters in axial spondyloarthritis.

    Science.gov (United States)

    Kilic, Gamze; Kilic, Erkan; Ozgocmen, Salih

    2014-12-01

    This article aims to compare the risks of depression and anxiety in patients with ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (nr-axSpA) and investigate the relationship among self-reported outcome measures, clinical parameters, and physical variables of patients with axSpA. Patients with axSpA were recruited from Erciyes Spondyloarthritis Cohort. The patients met Assessment of Spondyloarthritis International Society classification criteria for axial SpA and were assessed in a cross-sectional study design for visual analog scale (VAS) pain, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Quality of Life questionnaire (ASQoL), and Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP). Psychological status was evaluated using the hospital anxiety and depression scale (HADS). Multivariate logistic regression analysis was applied to determine the associations between psychological variables and clinical parameters after adjusting for confounding variables. Of the 316 patients (142 nr-axSpA, 174 AS), 139 (44%) had high risk for depression (HADS-D score ? 7) and 71 (22.5%) for anxiety (HADS-A score ? 10). HADS-D and HADS-A scores were similar between patients with AS and nr-axSpA. Patients with high risk for depression and anxiety had higher scores in BASDAI, BASFI, and ASDAS-CRP, and also poorer scores in VAS pain and ASQoL. Multivariate logistic regression analysis showed that the ASDAS-CRP, ASQoL, BASDAI, as well as educational level were factors associated with the risk of depression whereas the ASQoL and educational level were factors associated with the risk of anxiety. Patients with nr-axSpA and AS have similar burden of psychological distress. The quality of life (ASQoL) and educational level were factors associated with the risk of both depression and anxiety whereas disease activity (BASDAI and ASDAS-CRP) was the independent risk factor associated with depression but not anxiety in axSpA. These findings suggest that psychological status should be examined while assessing patients with axSpA including AS and nr-axSpA. PMID:25546683

  12. Radiation early warning system

    International Nuclear Information System (INIS)

    A prototype station for a Radiation Early Warning Network has been designed and set up at the Austrian Research Centre Seibersdorf. This unit was developed to measure all relevant parameters necessary to detect and track radioactive contamination at an early stage. The station consists of the following components: (1) Radiation measuring channel for ambient gamma doserate; (2) meteorological measurement channels for air temperature and humidity, wind direction and wind speed, and precipitation; (3) data processing and storage unit. The system is capable of unattended operation and data acquisition even under adverse environmental conditions. Connection to a central processing platform may be achieved via leased line, dial up over public switched telephone network (PSTN), or radio-frequency transmission. The remote station will continue acquiring and storing data for at least a month, even if the communications link is broken. Multiple stations can be combined to form a network, providing detailed information about radiological and meteorological data at each site. Thus increased ambient radiation levels may be discovered, tracked, and forecasted based on calculations using current and local weather data. Highly sophisticated software for the central processing platform, employing 3-dimensional disperion calculations, yields time projected scenarios of probable dose distributions. This may be used as valuable tool in decision finding based on actual datainding based on actual data

  13. Radiation early warning system

    International Nuclear Information System (INIS)

    A prototype station for a Radiation Early Warning Network has been designed and set up at the Austrian Research Centre Seibersdorf. This unit was developed to measure all relevant parameters necessary to detect and track radioactive contamination at an early stage. The station consists of the following components: Radiation measuring channel for ambient gamma dose rate. Meteorological measurement channels for air temperature and humidity, wind direction and wind speed, and precipitation. Data processing and storage unit. The system is capable of unattended operation and data acquisition even under adverse environmental conditions. Connection to a central processing platform may be achieved via leased line, dial up over public switched telephone network (PSTN), or radio-frequency transmission. The remote station will continue acquiring and storing data for at least a month, even if the communications link is broken. Multiple stations can be combined to form a network, providing detailed information about radiological and meteorological data at each site. Thus increased ambient radiation levels may be discovered, tracked, and forecasted based on calculations using current and local weather data

  14. Nucleosynthesis in Early Stars

    CERN Document Server

    Campbell, S W

    2003-01-01

    We present preliminary results of stellar structure and nucleosynthesis calculations for some early stars. The study (still in progress) seeks to explore the expected chemical signatures of second generation low- and intermediate-mass stars that may have formed out of a combination of Big Bang and Pop III (Z=0) supernovae material. Although the study is incomplete at this stage, we find some important features in our models. The initial chemical composition of these early stars is found to be significantly different to that given by just scaling the solar composition. The most notable difference is the lack of nitrogen. This should not affect the structural evolution significantly as nitrogen will be quickly produced through the CNO cycle due to the presence of carbon (and oxygen). It should however effect the nucleosynthetic yields. We also find that our very low metallicity five solar-mass model, with [Fe/H]=-4.01, does not reach the RGB - it goes directly to the helium burning phase. It does not experience...

  15. Early times in tunneling

    CERN Document Server

    García-Calderón, G; Garcia-Calderon, Gaston; Villavicencio, Jorge

    2000-01-01

    Exact analytical solutions of the time-dependent Schr\\"odinger equation with the initial condition of an incident cutoff wave are used to investigate the traversal time for tunneling. The probability density starts from a vanishing value along the tunneling and transmitted regions of the potential. At the barrier width it exhibits, at early times, a distribution of traversal times that typically has a peak $\\tau_p$ and a width $\\Delta \\tau$. Numerical results for other tunneling times, as the phase-delay time, fall within $\\Delta \\tau$. The B\\"uttiker traversal time is the closest to $\\tau_p$. Our results resemble calculations based on Feynman paths if its noisy behaviour is ignored.

  16. Earth's early atmosphere.

    Science.gov (United States)

    Kasting, J F

    1993-02-12

    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

  17. 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

  18. The tumor necrosis factor-? inhibitor golimumab in the treatment of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Natalia Vladimirovna Chichasova

    2014-12-01

    Full Text Available The tumor necrosis factor-? (TNF-? golimumab (GLM, that is a fully human monoclonal anti-body, was registered in Russia in 2012 to treat rheumatic diseases, such as rheumatoid arthritis (RA, ankylosing spondylitis, and psoriatic arthritis. Its distinguishing characteristics are a high affinity for TNF-? and easiness-to-use: the drug as a 0.5-ml solution is injected subcutaneously once monthly. The registration of the medication was followed by the implementation of a massive program of clinical trials. The randomized placebo-controlled GO-FORWARD, GO-BEFORE, and GO-AFTER studies have indicated that GLM is effective in patients with RA from different subgroups and has a favorable safety profile as compared to that of the entire class of biological agents. According to the data of these studies, GLM had a positive effect on the functional status and quality of life in patients with RA: there was a significantly greater decrease in HAQ scores in both the early and long open treatment phases (to 5 years and in fatigability than in the control group (p=0.032, physical and mental health improvements, as shown by the SF-36 questionnaire, and a significant reduction in disability.

  19. Spondyloarthropathy presenting at a young age: case report and review

    International Nuclear Information System (INIS)

    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.)

  20. Spondyloarthropathy presenting at a young age: case report and review

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.)