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Sample records for early ankylosing spondylitis

  1. MRI appearances of inflammatory vertebral osteitis in early ankylosing spondylitis

    International Nuclear Information System (INIS)

    Background: Undiagnosed and early ankylosing spondylitis (AS), especially in adolescent patients suffering from back pain, may present with the finding of vertebral osteitis on MRI. Aims: To identify the early MRI changes of vertebral osteitis in AS. Patients and methods: Five patients (three boys, two girls) aged 11-20 years (mean 15.4 years) suffering from back pain underwent MRI of the thoracolumbar spine. There was no initial diagnosis of AS. After clinical and radiological suspicion of AS, MRI of the sacroiliac (SI) joints was performed. Results: During the course of AS, destructive and reactive changes affect the discovertebral junctions that are initially seen in the thoracolumbar area. At this stage plain radiography of the spinal column may be normal. On MR images, inflammatory osteitis of the vertebrae is seen as hypointense areas on T1-weighted images and hyperintense areas on T2-W images. The lesions enhance homogenously with contrast material. Conclusions: Awareness of the MRI appearances of vertebral osteitis is helpful in suspecting AS. Radiological examination of the SI facilitates the diagnosis and unnecessary further imaging can be avoided. (orig.)

  2. MRI appearances of inflammatory vertebral osteitis in early ankylosing spondylitis

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    Kurugoglu, Sebuh; Kanberoglu, Kaya; Mihmanli, Ismail; Cokyuksel, Oktay [Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University (Turkey); Kanberoglu, Ayfer [Department of Physical Medicine, SSK Istanbul Hospital, Istanbul (Turkey)

    2002-03-01

    Background: Undiagnosed and early ankylosing spondylitis (AS), especially in adolescent patients suffering from back pain, may present with the finding of vertebral osteitis on MRI. Aims: To identify the early MRI changes of vertebral osteitis in AS. Patients and methods: Five patients (three boys, two girls) aged 11-20 years (mean 15.4 years) suffering from back pain underwent MRI of the thoracolumbar spine. There was no initial diagnosis of AS. After clinical and radiological suspicion of AS, MRI of the sacroiliac (SI) joints was performed. Results: During the course of AS, destructive and reactive changes affect the discovertebral junctions that are initially seen in the thoracolumbar area. At this stage plain radiography of the spinal column may be normal. On MR images, inflammatory osteitis of the vertebrae is seen as hypointense areas on T1-weighted images and hyperintense areas on T2-W images. The lesions enhance homogenously with contrast material. Conclusions: Awareness of the MRI appearances of vertebral osteitis is helpful in suspecting AS. Radiological examination of the SI facilitates the diagnosis and unnecessary further imaging can be avoided. (orig.)

  3. Ankylosing Spondylitis: a Reflection and a Question

    Directory of Open Access Journals (Sweden)

    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.

  4. Alternative Treatments for Ankylosing Spondylitis

    Science.gov (United States)

    ... stands for "transcutaneous electrical nerve stimulation". The American Physical Therapy Association defines TENS as application of electrical current ... long-term treatment of ankylosing spondylitis with integrated traditional Chinese and western medicine. Zhongguo Zhong XiYi Jie ...

  5. Ankylosing spondylitis associated with Trichomonas vaginalis infection.

    OpenAIRE

    Kuberski, T. T.

    1981-01-01

    A patient is described who developed signs and symptoms of ankylosing spondylitis after prostatitis due to Trichomonas vaginalis. Chronic prostatitis of unknown cause had previously been reported as being common in patients with ankylosing spondylitis. The observations in this case raise the possibility that T. vaginalis might play a role in the prostatitis and pathogenesis of ankylosing spondylitis in some patients.

  6. Symptoms of Ankylosing Spondylitis

    Science.gov (United States)

    ... Women often present in a little more atypical fashion so it's even harder to make the diagnoses ... AS symptoms and why spondylitis hurts? Then our book, Straight Talk On Spondylitis is a perfect resource. ...

  7. Juvenile onset ankylosing spondylitis with ankylosing tarsitis: a rare combination.

    Science.gov (United States)

    Siddiq, A B; Hasan, S A; Abdullah, A M; Azad, S A; Khan, E H; Khasru, M R

    2012-01-01

    Ankylosing spondylitis is the most common whereas ankylosing tarsitis is the least common subgroup of juvenile onset spondyloarthritides. In our recent study a male presented with ankle joint pain and swelling with limited movements and characteristic radiological changes including; periarticular swelling, thickened heel pad, hyperostosis and reduced ankle, calcaneo-cuboid and talo-navicular joint space for ankylosing tarsitis. He also had persistent inflammatory low back pain with radiological sacroilitis satisfying the clinical features for ankylosing spondylitis. The patient was treated with different anti-inflammatory agents including intra-articular methyl-prednisolone with short-term relief. Associated back pain was improved with spine mobilizing exercise. PMID:22314479

  8. Scintigraphic findings in ankylosing spondylitis

    International Nuclear Information System (INIS)

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

  9. Scintigraphic findings in ankylosing spondylitis.

    Science.gov (United States)

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

    1977-06-01

    A prospective study of bone scintigraphic findings has been carried out in 63 patients, firmly diagnosed as having ankylosing spondylitis. In addition to abnormal uptake of the radiotracer at the sacroiliac joints, a peripheral arthropathy has been a common finding, particularly in the proximal joints, occurring in up to 50% of patients. Increased uptake of radiotracer in the spine has also been found both diffusely and focally. Focal increases have been noted at the apophyseal joints in 40% of patients and in three patients with a sterile intervertebral diskitis, an unusual complication of this disease only diagnosed in two patients after bone scintigraphy. PMID:859035

  10. Spinal instability in ankylosing spondylitis

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    Badve Siddharth

    2010-01-01

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

  11. Treat Ankylosing Spondylitis with Methazolamide

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    Xiaotian Chang, Xinfeng Yan, Yunzhong Zhang

    2011-01-01

    Full Text Available Background: Increased bone resorption and new bone information are two characteristics of ankylosing spondylitis (AS. Much evidence has shown that carbonic anhydrase inhibitors can restrain bone resorption. We had detected increased expression of carbonic anhydrase I (CA1 in synovium of patients with AS. This study aimed to evaluate the effectiveness and safety of methazolamide, an anti-carbonic anhydrase drug, for treating patients with AS.Methods: Two patients, called as S and L, were diagnosed with active AS based on BASDAI and BASFI assessments, radiographic data and other clinical indices. They took methazolamide tablets at a dose of 25 mg twice every day.Results: Patient S's BASDAI score fell from 5.4 to 4.4, while patient L's BASDAI fell from 2.4 to 2. Patient S's BASFI score change from 2.7 to 2.9, while patient L's BASFI score fell from 1.2 to 0.2. The ESR values of patient S were considerably reduced, while the ESR value of patient L remained unchanged and in the normal range. The calcium concentration of patient S decreased from 3.05 mmol/L to 2.39 mmol/L. The CT evidence indicates that the articular surfaces of the erosive sacroiliac joints became clearer and the area of the calcium deposits began decreased. No significant systemic side effects were observed in either patient.Conclusions: The above results indicate that methazolamide was effective for active AS. Methazolamide may improve AS symptoms by inhibiting carbonic anhydrase activity during the processes of bone reporption and new bone formation.

  12. Urolithiasis in ankylosing spondylitis: Correlation with Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI) and Bath ankylosing spondylitis metrology index (BASMI)

    Science.gov (United States)

    Fallahi, Sasan; Jamshidi, Ahmad Reza; Gharibdoost, Farhad; Mahmoud, Mahdi i; Paragomi, Pedram; Nicknam, Mohammad Hossein; Farhadi, Elham; Qorbani, Mostafa

    2012-01-01

    Background: Increased incidence of renal stone has been reported in ankylosing spondylitis (AS), but unlike some well-known renal involvements, they have not been fully studied. The aim of this study was to investigate the association of AS with urolithiasis and also the relation between urinary stone and severity markers. Methods: One hundred-sixty three AS patients were included in a cross-sectional study from Iranian AS association, Iran Rheumatology Center and Rheumatology Clinic of Shariati Hospital in Tehran. Prevalence of urolithiasis in AS patients was compared with results of a nationwide survey in Iran. Bath ankylosing spondylitis disease activity index (BASDAI), bath ankylosing spondylitis functional index (BASFI) and bath ankylosing spondylitis metrology index (BASMI) were determined for assessment of disease severity. Results: Urolithiasis was observed in 11.7% of AS patients versus 5.7% of normal population (p=0.001). After the elimination of corticosteroid effect, the prevalence of urolithiasis was still higher in AS patients than normal population but without maintaining significant difference. Significant higher values of BASFI, BASMI, BASDAI scores were observed in AS with urolithiasis than AS without urolithiasis. Conclusion: The results confirmed the association of AS with urolithiasis. However, this may be partly due to the effect of other factors such as corticosteroid. Moreover, urolithiais is accompanied with more severe diseases. PMID:24009925

  13. Increasing age at presentation for patients with ankylosing spondylitis.

    OpenAIRE

    Will, R.; Calin, A.; Kirwan, J.

    1992-01-01

    An analysis of the age at first presentation was undertaken in patients with ankylosing spondylitis and mechanical back pain seen at the London Hospital department of rheumatology between 1952 and 1983. There was a significant positive correlation with the calendar year of presentation in the patients with ankylosing spondylitis but a negative correlation in those with mechanical back pain. An increasing age at presentation in ankylosing spondylitis is likely to be due to an increasing age at...

  14. Confusion of roentgenographic differential diagnosis between ankylosing hyperostosis (Forestier's disease) and ankylosing spondylitis.

    Science.gov (United States)

    Yagan, R; Khan, M A

    1983-09-01

    A patient with ankylosing hyperostosis (Forestier's disease) initially diagnosed elsewhere as a case of ankylosing spondylitis with bamboo spine, is presented. The characteristic roentgenographic findings of Forestier's disease in the axial skeleton of this patient are described, including computerized tomography of the lower lumbar spine and sacroiliac joints. Major clinical and radiological distinguishing features of Forestier's disease and ankylosing spondylitis are discussed. PMID:6678701

  15. Cutaneous vasculitis and IgA glomerulonephritis in ankylosing spondylitis.

    OpenAIRE

    Beauvais, C.; Kaplan, G.; Mougenot, B.; Michel, C.; 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.

  16. Ankylosing Spondylitis and Postural Balance

    OpenAIRE

    Mahmut Nafiz Akman; Selda Bagis; Alper Nabi Erkan; Berrin Leblebici; Mehmet Adam

    2008-01-01

    Objective: In this study, we aimed to investigate that, due to postural changes, the patients with ankylosing spondyilitis (AS) have poorer postural balance than healthy subjects.Materials and Methods: Thirty patients with AS (19 female, 11 male) and 20 healthy subjects (13 female, 7 male) were tested by using the Tetrax Interactive Balance System. The general stability, Fourier analysis showing patterns of sway intensity within eight frequency bands between 0.1 and 3 Hz, and weight distribut...

  17. Management of ankylosing spondylitis with infliximab

    Directory of Open Access Journals (Sweden)

    Éric Toussirot

    2009-06-01

    Full Text Available Éric Toussirot1,2,3, Ewa Bertolini1, Daniel Wendling1,21Rheumatology, University Hospital Jean Minjoz, Besançon, France; 2Equipe d’Accueil 3186 “Agents pathogènes et Inflammation” University of Franche-Comté, Besançon, France; 3CiC – Biotherapy, St-Jacques Hospital, Besançon, FranceAbstract: Ankylosing spondylitis (AS is a systemic inflammatory rheumatic disease responsible for back pain, stiffness and progressive loss of  functional capacity with limited therapeutic options. Regular physical exercises together with the use of nonsteroidal antiinflammatory drugs are the two recognized treatment options in AS. Infliximab is a chimeric anti-tumor necrosis factor-? monoclonal antibody that has been demonstrated to be highly effective in the treatment of AS, providing clinical amelioration at both axial and peripheral skeleton. Infliximab also improves quality of life, function, biological parameters (acute phase reactants and inflammatory lesions of the spine as detected by magnetic resonance imaging. It is given at a 5 mg/kg dosage, as an infusion at weeks 0, 2, 6, and every 6 to 8 weeks after. Open-label and placebo-controlled trials have well demonstrated its high level of efficacy, with an improvement of the disease activity of at least 50% in 60%–80% of patients. In a large placebo-controlled trial, Assessment in Ankylosing Spondylitis Response Criteria (ASAS20 responders were observed in 61.2% of patients receiving infliximab compared to 19.2% of patients under placebo. Long-term efficacy is maintained when infliximab is administered every 6–8 weeks. Consensus international guidelines for the initiation and the use of this expensive treatment are available. Some questions remain, including the long-term safety, in particular the risk of lymphoma, and the potential influence of infliximab on radiological progression which is not currently demonstrated. Despite these concerns, infliximab has revolutionized the management of AS and represents a considerable therapeutic advancement in this disabling disease.Keywords: anti-TNF?, infliximab, ankylosing spondylitis

  18. Ankylosing spondylitis in nonhuman primates: the drill and the siamang.

    Science.gov (United States)

    Swezey, R L; Cox, C; Gonzales, B

    1991-12-01

    Nonhuman primates are known to be susceptible to many of the arthritides that afflict humans. Psoriatic like spondyloarthropathies have been reported in gorillas and skeletal hyperostosis in gibbons, rhesus monkeys, and gorillas, and additional cases of both of these conditions occurring in drills (baboons) are noted in this report. One western lowland gorilla and two rhesus monkeys with clinical features consistent with ankylosing spondylitis have been documented previously. Two additional nonhuman primate species with radiographic evidence of ankylosing spondylitis are described. A siamang (gibbon) and two drills (baboons) with the classic radiographic features of ankylosing spondylitis, namely a bamboo spine and sacroiliac joint fusion, are reported. PMID:1788553

  19. Axial skeletal changes in paralysed patients may mimic ankylosing spondylitis.

    Science.gov (United States)

    Fiske, D N; Bush, C H; Edwards, N L

    1995-02-01

    Patients with paralysis may develop radiographic changes in the axial skeleton and sacroiliac joints that resemble those seen in ankylosing spondylitis. These similarities can result in confusion when evaluating paralysed patients with back pain. We report on a patient with paralysis secondary to amyotrophic lateral sclerosis who developed back pain, apparent sacroiliac joint fusion, and a 'bamboo spine', leading to the misdiagnosis of ankylosing spondylitis. Serial radiographs of the bony changes in our patient are presented, along with a brief review of the literature on axial skeletal abnormalities in paralysis and a discussion of the subtle changes that distinguish immobilization spondyloarthropathy from ankylosing spondylitis. PMID:7704467

  20. Ankylosing Spondylitis and Postural Balance

    Directory of Open Access Journals (Sweden)

    Mahmut Nafiz Akman

    2008-09-01

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

  1. Outcomes in ankylosing spondylitis: what makes the assessment of treatment effects in ankylosing spondylitis different?

    OpenAIRE

    Ward, M. M.

    2006-01-01

    There are four major challenges in the assessment of outcomes in patients with ankylosing spondylitis (AS) that are particularly relevant to the evaluation of new therapies. Firstly, measures of symptoms and impairment in AS are not specific for inflammatory processes, they also capture mechanical symptoms and fixed limitations. The non?specific nature of these measures may cause them to be less responsive and therefore less useful in determining treatment efficacy. Secondly, acute phase re...

  2. Relation Between Clinical Parameters and Pulmonary Function in Ankylosing Spondylitis

    OpenAIRE

    Dilek Durmu?; F?rat Altay; O?uz Uzun; Ferhan Cantürk

    2009-01-01

    Objective: The aim of this study was to determine pulmonary function in ankylosing spondylitis (AS) patients and to assess the relationship with clinical parameters.Material and Methods: A total of 30 patients with definite AS (Group 1) and 20 age-matched healthy controls (Group 2) were recruited for the study. Patients and healthy controls were assessed according to visual analog scale (VAS) pain, 6 minute walk test (6MWT), chest expansion, the Bath Ankylosing Spondylitis Disease Activity In...

  3. Normative values for the bath ankylosing spondylitis functional index in the general population compared with ankylosing spondylitis patients in Morocco

    OpenAIRE

    Wariaghli Ghizlane; Allali Fadoua; Berrada Kenza; Idrissi Zineb; Hmamouchi Ihsane; Abouqal Redouane; Hajjaj-Hassouni Najia

    2012-01-01

    Abstract Background The Bath Ankylosing Spondylitis Functional Index (BASFI) has been commonly used in rheumatology to quantify functional disability in patients with Ankylosing Spondylitis (AS). Our aim was to evaluate the discriminating power of BASFI and determine the best cutoff score of this index in the general population compared with AS patients. Methods A cross-sectional study that included 200 patients suffering from AS and 223 subjects from the general population matched for age an...

  4. Experimental spondyloarthropathies: animal models of ankylosing spondylitis.

    Science.gov (United States)

    Adarichev, Vyacheslav A; Glant, Tibor T

    2006-08-01

    Spondyloarthropathies (SpAs), including ankylosing spondylitis, are chronic inflammatory diseases of the axial skeleton. Genomic scans of SpA families revealed the overwhelming complexity of the disease, which appears to be under the control of over 20 chromosome loci, including the major SpA gene HLA-B27 within class I of the major histocompatibility complex (MHC). Animal models confirmed the primary role of MHC in SpA susceptibility and supported the hypothesis that certain enterobacterial infections can trigger SpA. Immunization of mice with proteoglycan aggrecan also can provoke SpA, thus providing the opportunity to study genetic and clinical details of the disease initiation. PMID:16839505

  5. Juvenile ankylosing spondylitis in Turner syndrome.

    Science.gov (United States)

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

    2013-01-01

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

  6. Evaluation of serum paraoxonase and arylesterase activities in ankylosing spondylitis patients

    Scientific Electronic Library Online (English)

    Fazile Hatipoglu, Erdem; Saliha, Karatay; Kadir, Yildirim; Ahmet, Kiziltunc.

    Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVES: The aim of this study was to investigate the activities of serum paraoxonase and arylesterase in patients with ankylosing spondylitis with respect to those of healthy controls, to assess whether these enzyme levels are related to disease activity and functional capacity. METHODS: The stu [...] dy included 32 patients with ankylosing spondylitis whose diagnoses were made according to the modified New York criteria as well as 25 healthy controls matched for age and sex. The Bath Ankylosing Spondylitis Disease Activity Index and the Bath Ankylosing Spondylitis Functional Index were applied to the ankylosing spondylitis patients. As laboratory parameters, the erythrocyte sedimentation rate and serum C-reactive protein level were measured in patients and control subjects. Paraoxonase and arylesterase enzyme activities were measured using appropriate methods. RESULTS: No statistically significant differences (p>0.05) were found between the ankylosing spondylitis patients and controls in terms of serum paraoxonase or arylesterase levels. Furthermore, there was no correlation between clinical and laboratory parameters in patients with ankylosing spondylitis. CONCLUSION: Serum paraoxonase and arylesterase levels in ankylosing spondylitis patients may not differ from those of healthy controls, and there is no significant correlation between antioxidant parameters and the Bath Ankylosing Spondylitis Disease Activity Index or Bath Ankylosing Spondylitis Functional Index scores in ankylosing spondylitis patients. Further research is needed to provide deeper understanding of this disease.

  7. Ankylosing Spondylitis Associated With Bilateral TMJ Ankylosis

    International Nuclear Information System (INIS)

    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. Ankylosing Spondylitis: From Cells to Genes

    Science.gov (United States)

    Zambrano-Zaragoza, José Francisco; Agraz-Cibrian, Juan Manuel; González-Reyes, Christian; Durán-Avelar, Ma. de Jesús; Vibanco-Pérez, Norberto

    2013-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown etiology, though it is considered an autoimmune disease. HLA-B27 is the risk factor most often associated with AS, and although the mechanism of involvement is unclear, the subtypes and other features of the relationship between HLA-B27 and AS have been studied for years. Additionally, the key role of IL-17 and Th17 cells in autoimmunity and inflammation suggests that the latter and the cytokines involved in their generation could play a role in the pathogenesis of this disease. Recent studies have described the sources of IL-17 and IL-23, as well as the characterization of Th17 cells in autoimmune diseases. Other cells, such as NK and regulatory T cells, have been implicated in autoimmunity and have been evaluated to ascertain their possible role in AS. Moreover, several polymorphisms, mutations and deletions in the regulatory proteins, protein-coding regions, and promoter regions of different genes involved in immune responses have been discovered and evaluated for possible genetic linkages to AS. In this review, we analyze the features of HLA-B27 and the suggested mechanisms of its involvement in AS while also focusing on the characterization of the immune response and the identification of genes associated with AS. PMID:23970995

  9. 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.

  10. Osteoporosis in rheumatoid arthritis and ankylosing spondylitis.

    Science.gov (United States)

    Vosse, D; de Vlam, K

    2009-01-01

    Bone is a target in many inflammatory rheumatic diseases, such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The generalized effect of inflammation on bone may result in a decreased quality of bone and is associated with an increased risk of fractures and deformities, both in RA and AS. RA is characterized by periarticular osteopenia, systemic osteoporosis and bone erosions. Periarticular osteopenia and bone erosions are mainly correlated with disease activity. Unlike postmenopausal osteoporosis, osteoporosis in RA is more characterised by marked loss of bone in the hip and the radius, while the axial bone is relatively preserved. In general, several cross-sectional studies documented a lower bone mineral density in patients with RA, with a two-fold increase in osteoporosis compared to age- and sex-matched controls and relates to an increased fracture risk. Several factors contribute to the increased risk: older age, little exercise, long-term use of corticosteroids, and high disability index. AS is characterized by an increase in bone fragility due to reduced bone mineral density. The reported prevalence of osteoporosis in AS patients varies largely. The large variation reflects the difficulties in assessing BMD in AS due to new bone formation. Bone fragility is also due to changes in structural properties resulting from inflammation-induced bone failure in the spine in combination with reduced capacity of shock absorption leading to vertebral fractures. Different types of spinal fractures in patients with AS are described, including wedging. Wedging vertebral fractures contribute to hyperkyphosis and impaired physical function. In contrast to RA , bone loss in AS is accompanied by new bone formation. The pathophysiology of osteoporosis in RA and AS probably is fundamentally similar, but with different clinical phenotypes. The implications for therapeutically intervening in its occurrence and progression might be fundamentally different. PMID:19822048

  11. 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

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

    OpenAIRE

    Katsinelos P.; Christodoulou K.; . Pilpilidis I.; Papagiannis A.; Kalomenopoulou M.; Katsiba D.; Tarpagos A.; Katsos I.; Evgenidis N.

    2007-01-01

    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...

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

    International Nuclear Information System (INIS)

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

  14. Cervical osteotomy in ankylosing spondylitis: evaluation of new developments

    OpenAIRE

    Langeloo, Danielle D.; Journee, Henricus L.; Pavlov, Paul W.; Kleuver, Marinus

    2005-01-01

    Objectives: Cervical osteotomy can be performed on patients with cervical kyphosis due to ankylosing spondylitis. This study reviews the role of two new developments in cervical osteotomy surgery: internal fixation and transcranial electrical stimulated motor evoked potential monitoring (TES-MEP). Methods: From 1999 to 2004, 16 patients underwent a C7-osteotomy with internal fixation. In 11 patients, cervical osteotomy was performed in a sitting position with halo-cast immobilization (group S...

  15. 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)

  16. Polyarthritis flare in patient with ankylosing spondylitis treated with infliximab

    Directory of Open Access Journals (Sweden)

    E. Filippucci

    2011-06-01

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

  17. ASKyphoplan: a program for deformity planning in ankylosing spondylitis

    OpenAIRE

    Royen, Barend J.; Scheerder, Famke J.; Jansen, Eric; Smit, Theo H.

    2007-01-01

    A closing wedge osteotomy of the lumbar spine may be considered to correct posture and spinal balance in progressive thoracolumbar kyphotic deformity caused by ankylosing spondylitis (AS). Adequate deformity planning is essential for reliable prediction of the effect of surgical correction of the spine on the sagittal balance and horizontal gaze of the patient. The effect of a spinal osteotomy on the horizontal gaze is equal to the osteotomy angle. However, the effect of a spinal osteotomy on...

  18. Fracture of the odontoid peg in ankylosing spondylitis: case report.

    Science.gov (United States)

    Peh, W C; Ho, E K

    1995-03-01

    Fractures in patients with ankylosing spondylitis tend to affect the lower cervical spine. We describe a 50-year-old man who sustained fractures of the odontoid peg and body of the second cervical vertebra after a hyperextension injury. In absence of atlanto-occipital fusion, deformity from previous lower cervical spine injury may have contributed to susceptibility for this very rare combination of fractures. The patient was treated surgically with a good result. PMID:7897715

  19. Relation Between Clinical Parameters and Pulmonary Function in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Dilek Durmu?

    2009-12-01

    Full Text Available Objective: The aim of this study was to determine pulmonary function in ankylosing spondylitis (AS patients and to assess the relationship with clinical parameters.Material and Methods: A total of 30 patients with definite AS (Group 1 and 20 age-matched healthy controls (Group 2 were recruited for the study. Patients and healthy controls were assessed according to visual analog scale (VAS pain, 6 minute walk test (6MWT, chest expansion, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, and the Bath Ankylosing Spondylitis Functional Index (BASFI. Pulmonary function was assessed by forced vital capacity (FVC, forced expiratory volume in 1 second (FEV1, and vital capacity (VC.Results: There was no statistically significant difference in age or body mass index between groups (p>0.05. There were significant differences in VAS pain, chest expansion, BASDAI and BASFI scores and pulmonary function parameters FVC, FEV1, VC and 6MWT between groups (p<0.05. There were significant correlations between all pulmonary function parameters and clinical and functional measures.Conclusion: Based on these results, we conclude that there is a correlation among functional performance, pulmonary capacities and clinical parameters in AS patients.

  20. 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

  1. Clinical feature and imaging findings of juvenile ankylosing spondylitis

    International Nuclear Information System (INIS)

    Objective: To analyze the clinical features and imaging findings of juvenile ankylosing spondylitis (JAS) in order to improve the diagnosis and the prognosis of JAS. Methods: Twelve cases were analyzed retrospectively and 14 cases, who were followed-up averagely for 2.3 years, were analyzed prospectively. Initially 10 were diagnosed as Still's disease and four were diagnosed as rheumatoid arthritis. Photography was performed in all cases, CT scan was done in 18 cases, and MRI in 8 cases. Lower extremity big joint disorders were observed in all cases and the small joints were reserved. The abnormalities of the sacroiliac joint were revealed in the early stage in 12 cases. The results were analyzed statistically. Results: The age of preliminary diagnosis was 9.3 years in average. There were statistical correlation between the age of the first episode and severity of the disease. And there were statistical correlation between the course of the illness and severity of the disease. The large joints of the lower extremities were most commonly involved. Conclusion: There were characteristic clinical features and imaging findings in the JAS. Early diagnosis and treatment improve the prognosis

  2. Taylor Approach of Spinal Anaesthesia in a case of Ankylosing Spondylitis for Hip Fracture Surgery

    Directory of Open Access Journals (Sweden)

    Urmila Palaria

    2011-11-01

    Full Text Available Ankylosing Spondylitis (AS is a chronic inflammatory rheumatic disease primarily affecting the axial joints manifesting as stiffnesss of the spine. Patient with ankylosing spondylitis is a challenge to anaesthesiologists in terms of airway management and neuraxial blocks. Modified paramedian approach (Taylor approach of spinal anaesthesia can be used as an alternative to technically difficult cases in patients undergoing lower limb surgeries.

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

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

    OpenAIRE

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

    2011-01-01

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

  5. Comparative evaluation of the quantitative bone scintigraphy and the radiography in patients with ankylosing spondylitis

    International Nuclear Information System (INIS)

    In 620 patients quantitative bone scintigraphy with 99mTc pyrophosphate of the sacroiliac joints and of the spine was performed: 365 patients with confirmed ankylosing spondylitis, 125 patients with clinical radiological suspicion for ankylosing spondylitis (probable Bechterev) and control group of 130 healthy individuals. By comparison of the activity in zones of interest of the sacroiliac joints, the spine and sacrum, the following indices were determined: sacroiliac (separately for the left and right sacroiliac joints), index D10/sacrum, index L4/sacrum and index C7/sacrum. The scintigraphic finding was compared to the X-ray one and to the radiological stage of the disease. A long-term follow-up of the patients was carried out during 1-6 years with scintigraphic, X-ray and clinical investigations. Emphasis was laid upon the posibilities for quantitative scintigraphy for early diagnostics of ankylosing spondylitis. The combination of scintigraphic with X-ray investigation improved the posibilities for establishment of a more precise diagnosis of the disease and check up of its evolution

  6. 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...

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

  8. Gender differences in Iranian patients with ankylosing spondylitis.

    Science.gov (United States)

    Shahlaee, Abtin; Mahmoudi, Mahdi; Nicknam, Mohammad Hossein; Farhadi, Elham; Fallahi, Sasan; Jamshidi, Ahmad Reza

    2015-02-01

    Inequalities in features and severity of ankylosing spondylitis (AS) have been noticed between men and women, suggesting a possible influence of gender on disease phenotypes. Comparing disease features and characterization of gender differences in clinical features and medications could help elucidate the potential influence of gender on the severity of AS in patients. This study aims to assess the influence of gender on disease patterns in Iranian patients with AS. Three hundred and twenty patients diagnosed with primary AS were assessed for demographic variables, clinical manifestations, HLA status, disease severity, functional capacities, quality of life, and treatment status. Sixty-seven women and 253 men were included corresponding to a male to female ratio of 3.78:1. Both groups were similar regarding ethnicity, positive family history, and juvenile onset AS. HLA-B27 was more frequent among males (78.3 vs. 55.2%; p?Early detection and specialized care would be of great practical importance. PMID:24288047

  9. Ankylosing spondylitis: recent breakthroughs in diagnosis and treatment.

    Science.gov (United States)

    Shaikh, Saeed A

    2007-12-01

    Ankylosing spondylitis (AS) is generally easy to diagnose when the characteristic findings of the "bamboo" spine and fused sacroiliac joints are present on radiographs. Unfortunately, these changes are usually seen late in the disease after tremendous suffering has been incurred by the patient. Diagnostic delay averages seven to ten years. Historically, once the diagnosis was made, the treatment options were often inadequate or poorly tolerated in many individuals. This condition most often starts in early adulthood when people are typically in the earlier stages of their careers, resulting in diminished workforce participation and decreased quality of life. If an individual has a family physician, this might be the first encounter with a healthcare provider. Quite often, the initial practitioner is sought at a public walk-in clinic or chiropractic office. In recent years, there have been two major developments in the management of AS that make earlier diagnosis possible and offer the hope of alleviating pain and preventing structural changes that result in loss of function. These developments include the use of magnetic resonance imaging (MRI) to visualize the inflammatory changes in the sacroiliac joint and the axial spine, and the demonstration that tumor necrosis factor (TNF) blocking agents are highly efficacious in reducing spinal inflammation and possibly in slowing radiographic progression. This review outlines diagnostic strategies that can help identify AS in its earlier stages. Special attention is focused on treatment advances, including the use of anti-TNF agents, and how these medications have been incorporated into clinical recommendations for daily use. PMID:18060011

  10. Surgical Treatment of Spinal Pseudoarthrosis in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Lih-Huei Chen

    2005-09-01

    Full Text Available Background: In ankylosing spondylitis (AS, the spine with osteoporotic changes is fragileand vulnerable to trauma. Patients may develop spinal pseudoarthrosis (SP,whose clinical features are usually misdiagnosed as a tuberculous infection.This study reports our experience with surgical treatment for SP in AS.Methods: Eight patients with AS and SP at the thoracolumbar area were treated surgicallyand followed-up for at least 3 years. All had persistent back pain andprogressive kyphosis. One patient had neurologic deficits preoperatively.Anterior debridement and interbody fusion followed by posterior stabilizationwere performed in all patients. A posterior corrective osteotomy wasadditionally done in 3 patients whose kyphotic angle exceeded 45°.Results: All patients with persistent back pain obtained significant pain relief postoperatively.On a visual analogue scale, there was an average improvement of43 points on the clinical scores. The patient with neurologic deficits showedimprovement after the operation. Solid bony fusion was achieved in an averageof 7.5 months, and correction of the kyphotic angle averaged 18.6°.Conclusions: Spinal pseudoarthrosis should be considered in patients with AS, and mustbe differentiated from tuberculous and other infections. The results of thisstudy show that pain relief and correction of the kyphotic deformity can beachieved by surgical treatment for ankylosing spondylitis complicated withpseudoarthrosis.

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

    OpenAIRE

    Sigl, T.; Cieza, A.; 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.

  12. Normative values for the bath ankylosing spondylitis functional index in the general population compared with ankylosing spondylitis patients in Morocco

    Directory of Open Access Journals (Sweden)

    Wariaghli Ghizlane

    2012-03-01

    Full Text Available Abstract Background The Bath Ankylosing Spondylitis Functional Index (BASFI has been commonly used in rheumatology to quantify functional disability in patients with Ankylosing Spondylitis (AS. Our aim was to evaluate the discriminating power of BASFI and determine the best cutoff score of this index in the general population compared with AS patients. Methods A cross-sectional study that included 200 patients suffering from AS and 223 subjects from the general population matched for age and sex was carried-out. The discriminating power of the BASFI by strata of age was evaluated by the area under the Receiver Operating Characteristic curve and the best cutoff was determined by the Youden index. Results The mean age of the general population was 39 ± 12 years. 76.7% of them were male. The median BASFI of the healthy subjects and patients was 0.2 and 4.5 (P Conclusions This study suggests that the discriminating power of BASFI is considered good at any age. The best cutoff of this index increased as age increases as functional disability is associated in part with lifestyle choices and increases with age. The cutoff values of the BASFI that we have presented could be used as a reference benchmark for both clinical practice and research.

  13. MRI of cauda equina syndrome in ankylosing spondylitis: a case report

    International Nuclear Information System (INIS)

    Cauda equina syndrome is a rare neurologic complication in patient with long-standing ankylosing spondylitis. Authors report a case of cauda equina syndrome in ankylosing spondylitis. On plain radiographs, typical 'bamboo spine' and fusion of sacroiliac joints were noted. MRI of the lumbar spine revealed arachnoid diverticulae which were isointense to cerebrospinal fluid on all spin echo sequences, and showed bony erosion and scalloping of posterior arches

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

    OpenAIRE

    Cortes, A.; Hadler, J.; Pointon, Jp; Robinson, Pc; Karaderi, T.; Leo, P.; Cremin, K.; Pryce, K.; Harris, J.; Lee, S.; Joo, Kb; Shim, Sc; Weisman, M.; Ward, M.; Zhou, X.

    2013-01-01

    Ankylosing spondylitis is a common, highly heritable inflammatory arthritis affecting primarily the spine and pelvis. In addition to HLA-B*27 alleles, 12 loci have previously been identified that are associated with ankylosing spondylitis in populations of European ancestry, and 2 associated loci have been identified in Asians. In this study, we used the Illumina Immunochip microarray to perform a case-control association study involving 10,619 individuals with ankylosing spondylitis (cases) ...

  15. 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

  16. Normal anti-Klebsiella lymphocytotoxicity in ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

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

    1986-03-01

    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 /sup 51/Cr 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-/sup 51/Cr 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.

  17. Pulmonary function in ankylosing spondylitis: association with clinical variables.

    Science.gov (United States)

    Brambila-Tapia, A J L; Rocha-Muñoz, A D; Gonzalez-Lopez, L; Vázquez-Del-Mercado, M; Salazar-Páramo, M; Dávalos-Rodríguez, I P; De la Cerda-Trujillo, L; Diaz-Toscano, M L; Hernandez-Cuervo, P; Diaz-Rizo, V; Sanchez-Mosco, D; Vazquez-Jimenez, J C; Cardona-Muñoz, E G; Gamez-Nava, J I

    2013-09-01

    To evaluate the association between pulmonary function and clinical variables in ankylosing spondylitis (AS) and to compare the pulmonary function of patients with AS with that of healthy controls, 61 AS patients and 74 healthy controls were included. In AS, we assessed clinical disease indices (BASDAI, BASFI, BASG), morning stiffness, number of hypersensitive entheses, metrology measures, 6-min walking test, acute phase reactants, radiological presence of "bamboo spine," and severity of radiological involvement in sacroiliac and vertebral joints. AS and healthy controls had similar age and gender. All the parameters of pulmonary function were significantly diminished in AS than in healthy controls (p joints and sacroiliac joints, "bamboo spine," disease duration, or chest expansion. A higher frequency of AS patients had a decreased pulmonary function and results of the 6-min walking test. These abnormalities in AS were more related with disease activity than with mobility limitation. PMID:23543327

  18. 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

  19. Acute anterior uveitis, ankylosing spondylitis, back pain, and HLA-B27.

    OpenAIRE

    Beckingsale, A. B.; Davies, J.; Gibson, J. M.; Rosenthal, A. R.

    1984-01-01

    One hundred and sixty-nine patients with acute anterior uveitis were studied for the presence of HLA-B27 tissue type, radiological evidence of ankylosing spondylitis, and a history of back pain. 60% were male; 45% were HLA-B27+. The male:female ratio in the HLA-B27+ group was the same as in the whole group. 24% had radiological evidence of ankylosing spondylitis, and, of these, 83% were HLA-B27+ while 17% were HLA-B27-. There was a definite correlation between the severity of the ankylosing s...

  20. 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.)

  1. 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.

  2. Translation and validation of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) for use in Ukraine.

    Science.gov (United States)

    Nadashkevich, Oleg; Masyk, Oleksiy

    2011-10-01

    The aim of this study was to translate and adapt the original English-language versions of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) into Ukrainian and validate the instruments by administering them to Ukrainian patients with ankylosing spondylitis (AS). After consensual translation, cultural adaptation, and back-translation into English, the Ukrainian versions of BASDAI and BASFI were transformed into numerical rating scales and tested on 87 Ukrainian AS patients meeting the modified 1984 New York criteria for AS. The Ukrainian versions were easily understood by the patients and displayed high levels of internal consistency and good reliability. The BASDAI (Ukrainian version) showed significant correlation with the duration of morning stiffness and the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) and weak correlation with CRP. The BASFI (Ukrainian version) showed significant correlations with Schober's test, occiput-to-wall distance, and chest expansion measure. Both instruments were sensitive to modifications in the treatment regimen. Accordingly, the Ukrainian-language versions of BASDAI and BASFI reported here can be used to monitor the clinical status of Ukrainian patients with AS. PMID:21494807

  3. 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

  4. 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.

  5. Bone mineral density in ankylosing spondylitis. DEXA comparison of control subjects with mild and advanced cases.

    Science.gov (United States)

    Mullaji, A B; Upadhyay, S S; Ho, E K

    1994-07-01

    We have used dual-energy X-ray absorptiometry to measure bone mineral density (BMD) in patients with ankylosing spondylitis comparing 41 healthy control subjects and 33 patients with either mild or advanced ankylosing spondylitis. A Norland XR-28 bone densitometer was used to measure the BMD of the lumbar spine and that of the head, trunk, arms, femoral neck, Ward's triangle, legs, pelvis, and total body. Mild ankylosing spondylitis was defined as that showing no or incipient syndesmophytes between L1 and L5 vertebrae: we studied 16 men of mean age 37 years and six women of mean age 37 years. Advanced ankylosing spondylitis, in 11 men of mean age 42 years, showed a bamboo spine with bridging syndesmophytes across all disc spaces between L1 and L5. The mean BMD of the lumbar spine was significantly different in the patients and control subjects of the same sex (0.01 < p < 0.05, analysis of variance), being significantly reduced compared with control subjects in mild disease (0.001 < p < 0.01, t-test) and significantly increased in advanced disease over control subjects (0.01 < p < 0.05; t-test) and over patients with mild disease (0.001 < p < 0.01; t-test). The relevance of these findings to the aetiology and pathogenesis of spinal deformities and other complications in ankylosing spondylitis is discussed. PMID:8027159

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

    Science.gov (United States)

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

    2013-07-01

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

  7. Successful intubation with McCoy laryngoscope in a patient with ankylosing spondylitis.

    Science.gov (United States)

    Subedi, A; Tripathi, M; Bhattarai, B; Pokharel, K; Dhital, D

    2014-01-01

    Involvement of cervical spine in ankylosing spondylitis limits neck movement resulting in difficult intubation. We report a case of 45-yr-old lady of ankylosing spondylitis with restricted neck movement planned for emergency laparotomy. Grade 3 Cormack and Lehane laryngoscopic view was observed with Macintosh laryngoscope and gum elastic bougie could not be negotiated. At second attempt with McCoy blade, the posterior commissure of the vocal cord could be visualized and intubation was successful. Thus, in absence of flexible laryngoscopes and when awake intubation is not feasible, McCoy blade should be considered an alternative than Macintosh blade to attempt intubation in patients of ankylosing spondylitis with restricted neck movement. PMID:25574990

  8. 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 SciELO Brazil | Language: English Abstract in english 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.

  9. Treatment of ankylosing spondylitis with [224Ra]-Radiumchloride

    International Nuclear Information System (INIS)

    Ankylosing spondylitis (AS) is a chronic disease which in 30-50% of the patients leads to considerable episodes of pain, a remarkable reduction of quality of life and disablement. For treatment mostly nonsteroidal antiphlogistic drugs are used which are able to reduce pain in approximately 80% of the patients only. Those drugs however, have to be withdrawn in approximately 30% of the patients due to its known toxicity (mainly in the gastrointestinal tract). Basis medication (DMARDs) is helpful in a minority of AS patients only. Recently [224Ra]-Radiumchloride, which has been used previously between 1955 and 1990, has been made available again for treatment of AS. Whereas biokinetics, radiation exposure and the risk-profile of [224Ra]-Radiumchloride are documented well by experimental and clinical data, most of the historical studies about the efficacy of this radiopharmaceutical do not fulfill the requirements of modern therapy studies. Therefore as many patients as possible should be recruited for a prospective long-time Phase IV study. A close and well-coordinated cooperation between rheumatologists and nuclear medicine physicians is needed, when [224Ra]-Radiumchloride is used for treatment of AS. (orig.)

  10. Preparation of 224Ra for therapy of ankylosing spondylitis

    International Nuclear Information System (INIS)

    In the medical application of radium-224 for injection the radionuclidic purity of the product is a question of considerable importance. The contamination caused by the long-lived nuclides 226Ra, 228Ra, 227Ac, and 228Th must be limited to minimize their incorporation and the long-term skeletal dose received by the patients. The purification of the source material 228Th for manufacturing 224Ra and the extraction of 224Ra from 228Th are described. The actual trace amounts of the long-lived radioactive impurities in the injection solutions are compared with the maximum permissible body burdens recommended by ICRP. Buchler and Co. (since 1971 Amersham Buchler) is, as far as is known, the only producer of224Ra for injection. A total activity of 10 x 28 ? Ci of 224Ra for the therapy of ankylosing spondylitis is recommended. Taking this total activity, the injection of any long-lived radionuclide from 1967 through 1973 was less than 0.2% of its maximum permissible body burden. (author)

  11. HLA B27 and ankylosing spondylitis in the Israeli population.

    Science.gov (United States)

    Brautbar, C; Porat, S; Nelken, D; Gabriel, K R; Cohen, T

    1977-01-01

    The distribution of 24 HLA antigens of the A and B loci was investigated in 38 Israeli ankylosing spondylitis (AS) patients of various ethnic origins. This was compared with the distribution in rheumatoid arthritis (RA) and osteoarthritis (OA), as well as in 456 controls representing the Jewish population and 260 controls representing the Arab population. Included in the study were Ashkenazi Jews and non-Ashkenazi Jews, as well as Moslem and Christian Arabs. The frequency of HLA B27 among AS patients (79 per cent) was significantly greater (P less than 10(-10)) than among the controls (three per cent). Ashkenazi Jews showed a higher relative risk than non-Ashkenazi Jews and Arabs. Six of the AS patients were offspring of consanguineous marriages, but this was not higher than expected and therefore no indication for rare recessive genes contributing to the disease could be demonstrated. This study confirms the association between AS and B27, and extends our knowledge to the heterogeneous population of Israel not previously investigated. A significant but weak association of B27 with RA was noted. No correlation of other HLA antigens with RA or OA was observed. PMID:266593

  12. ERAP1 in the pathogenesis of ankylosing spondylitis.

    Science.gov (United States)

    Reeves, Emma; Elliott, Tim; James, Edward; Edwards, Christopher J

    2014-12-01

    The endoplasmic reticulum aminopeptidase 1 (ERAP1) performs a major role in antigen processing, trimming N-terminally extended peptides to the final epitope for presentation by major histocompatibility complex class I molecules. Recent genome-wide association studies have identified single nucleotide polymorphisms (SNPs) within ERAP1 as being associated with disease, in particular ankylosing spondylitis (AS). AS is a polygenic chronic inflammatory disease with a strong genetic link to HLA-B27 known for over 40 years. The association of ERAP1 SNPs with AS susceptibility is only observed in HLA-B27-positive individuals, which intersect on the antigen processing pathway. Recent evidence examining the trimming activity of polymorphic ERAP1 highlights its role in generating peptides for loading onto and stabilizing HLA-B27, and the consequent alterations in the interaction of specific NK cell receptors, and the activation of the unfolded protein response as important in the mechanism of disease pathogenesis. Here, we discuss the recent genetic association findings linking ERAP1 SNPs with AS disease susceptibility and the effect of these variants on ERAP1 function, highlighting mechanisms by which AS may arise. The identification of these functional variants of ERAP1 may lead to better stratification of AS patients by providing a diagnostic tool and a potential therapeutic target. PMID:25434650

  13. Infliximab treatment in ankylosing spondylitis: an observational study

    Science.gov (United States)

    Nikas, S; Alamanos, Y; Voulgari, P; Pliakou, X; Papadopoulos, C; Drosos, A

    2005-01-01

    Methods: 35 patients with AS with mean (SD) age 42.5 (12.6) years and mean (SD) disease duration 14.5 (8.0) years were studied for 2 years. Patients entering the study had a negative tuberculin skin test, were fully informed about the treatment, and were followed up regularly. Infliximab, 5 mg/kg weight, was given intravenously at weeks 0, 2, 6, and every 8 weeks thereafter. Data concerning infliximab tolerability, adverse events, interval, and drug discontinuation were all recorded. Clinical improvement according to the BASDAI and the Ankylosing Spondylitis Assessment Study group (ASAS) 20%, 40%, and ASAS 5/6 response criteria were recorded. Results: After 1 year, 20 (57%) patients achieved the BASDAI 50% response criteria, 25 (71%) achieved ASAS 20%, 23 (66%) reached ASAS 40%, and 18 (51%) attained ASAS 5/6. After 2 years' treatment, 11 (31%) patients achieved BASDAI 50% response criteria, 14 (40%) ASAS 20%, 11 (31%) ASAS 40%, and 9 (26%) ASAS 5/6. Clinical improvement was associated with an improved BASFI and reduction of CRP. After 2 years' treatment, "infliximab survival" was 89%. Treatment was well tolerated and adverse events were mild; 3 patients discontinued the study. Conclusion: Infliximab was effective, safe, and well tolerated in patients with AS. PMID:15564309

  14. Ankylosing spondylitis functional and activity indices in clinical practice

    Science.gov (United States)

    Popescu, C; Trandafir, M; B?dic?, AM; Morar, F; Prede?eanu, D

    2014-01-01

    Background: Clinicians have at hand several indices to evaluate disease activity and functionality in ankylosing spondylitis (AS), in order to evaluate the prognostic and the treatment of AS patients. Objectives: to examine the relationship between functional and activity scores in AS; to note whether disease activity is associated with any clinical or laboratory variables. Methods: the study included AS patients, classified according to the revised New York criteria; data recorded: demographics, disease duration, type of articular involvement, HLA B27 presence, history of uveitis, calculation of BASFI, BASDAI and ASDASCRP, quantification of inflammation markers. Results: 50 AS patients; ASDASCRP correlated significantly (p < 0.001) with BASFI (r = 811), BASDAI (r = 0.810) and with erythrocyte sedimentation rate (ESR; r = 0.505); HLA B27 positive patients had a median BASDAI 5 times higher than HLA B27 negative patients (p = 0.033); compared with patients with strictly axial disease form, patients with axial and peripheral disease had a median ESR 3 times higher (p = 0.042) and a median BASDAI 2 times higher (p = 0.050). Conclusions: functional and activity AS indices are strongly correlated in assessing disease severity; inflammation and HLA B27 can predict the high value of these indices; axial and peripheral disease pattern is associated with higher disease activity. PMID:24653763

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

    Directory of Open Access Journals (Sweden)

    A. Gallo

    2011-09-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

  17. 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.

  18. 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.

  19. 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.

  20. Lung parenchymal changes in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    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.

  1. Logistic transmission modeling of HLA and ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Scofield, R.H.; Neas, B.R.; Harley, J.B. [Univ. of Oklahoma, Oklahoma City, OK (United States)

    1994-09-01

    A nonparametric and general method of linkage analysis has been developed and used to evaluate histocompatibility (HLA) linkage to ankylosing spondylitis (AS) from the data of Berg & Moller. The conditional logistic function has been used to establish linkage by stepwise modelling of transmission from parent to progeny. Logistic transmission models have been explored to better understand the relationship of HLA to AS. The alleles at HLA-A and -B were determined in 38 families (32 monoplex and 6 multiplex). We have found that linkage is supported in this data over the random transmission of alleles at only HLA-B. Models constructed at HLA-B are powerful with, for example, coefficients for B27 of 1.9 (S.E. = 0.4) and B40 of 1.6 (S.E. = 0.8) contributing to a model with {chi}{sup 2} = 30 with 2 df and p < 3x10{sup -7}. No models are found supporting linkage at HLA-A and, therefore, the data at HLA-A does not add support for linkage beyond that present at HLA-B (e.g., {chi}{sup 2} for improvement < 1). These results establish that HLA-B is linked to AS. They further provide evidence that the gene responsible for AS is located nearer to HLA-B than it is to HLA-A. Also, the analysis shows that a number of HLA-B alleles may contribute to the risk of AS, beyond the B27 allele which has repeatedly been associated with AS.

  2. Leukemia mortality after X-ray treatment for ankylosing spondylitis

    International Nuclear Information System (INIS)

    Leukemia mortality has been studied in 14,767 adult ankylosing spondylitis patients diagnosed between 1935 and 1957 in the United Kingdom, of whom 13,914 patients received X-ray treatment. By 1 January 1992, there were 60 leukemia deaths among the irradiated patients, almost treble that expected from national rates. Among those irradiated, the ratio of observed to expected deaths for leukemia other than chronic lymphocytic leukemia was greatest in the period 1-5 years after the first treatment (ratio = 11.01, 95% confidence interval 5.26-20.98) and decreased to 1.87 (95% confidence interval 0.94-3.36) in the 25+ year period. There was no significant variation in this ratio with sex or age at first treatment. The ratio for chronic lymphocytic leukemia was slightly but not significantly raised (ratio=1.44, 95% confidence interval 0.62-2.79). Most irradiated patients received all their exposure within a year. Based on 1 in 15 random sample, the mean total marrow dose was 4.38 Gy. Doses were nonuniform, with heaviest doses to the lower spine. The risk for nonchronic lymphocytic leukemia was adequately described by a linear-exponential model that allowed for cell sterilization in heavily exposed parts of the marrow and time since exposure. Ten years after first exposure, the linear component of excess relative risk was 12.37 per Gy (95% confidence interval 2.25-52.07), and it was estimated that cell sterilization reduced the excess relative risk by 47% at 1 Gy (95% confide relative risk by 47% at 1 Gy (95% confidence interval 17%-79%). The average predicted relative risk in the period 1-25 years after exposure to a uniform dose of 1 Gy was 7.00. 20 refs., 2 figs., 8 tabs

  3. 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.

  4. Analysis of the MHC class II encoded components of the HLA class I antigen processing pathway in ankylosing spondylitis.

    OpenAIRE

    Burney, Ro; Pile, Kd; Gibson, K.; Calin, A.; Kennedy, Lg; Sinnott, Pj; Powis, Sh; Wordsworth, Bp

    1994-01-01

    OBJECTIVES: The evaluation of the role of polymorphism within the class II encoded antigen processing genes, LMP2 and TAP, in susceptibility to ankylosing spondylitis (AS). METHODS: Eighty five patients with ankylosing spondylitis, 35 B27 positive healthy controls, and 55 unrelated healthy controls were studied. TAP1 and TAP2 alleles were assigned by ARMS PCR, and LMP2 alleles were assigned by restriction enzyme digestion of a PCR product. RESULTS: The TAP1C allele was increased in the AS gro...

  5. The relation between disease activity, vitamin D levels and bone mineral density in men patients with ankylosing spondylitis

    OpenAIRE

    Ihsane Hmamouchi; Fadoua Allali; Btissam El Handaoui; Hanae Amine; Samira Rostom; Redouane Abouqal; Najia Hajjaj-Hassouni

    2013-01-01

    The aim of this study was to assess the vitamin D status in patients with ankylosing spondylitis (AS), and to investigate the relation between vitamin D levels, bone mineral density (BMD) and disease activity in men with ankylosing spondylitis. Seventy patients with AS and 140 healthy individuals were included in the study. BMD of femur and lumbar spine was measured by DXA. Serum 25OH vitamin D, parathormone, serum calcium, C-reactive protein levels of all participants were also measured. The...

  6. Clinical and Radiographic Features of Adult-onset Ankylosing Spondylitis in Korean Patients: Comparisons between Males and Females

    OpenAIRE

    Jung, Young-ok; Kim, Inje; Kim, Suho; Suh, Chang-hee; Park, Han Jung; Park, Won; Kwon, Seoung Ryul; Jeong, Jae Cheon; Lee, Yun Jong; Ryu, Hee Jung; Park, Young Bae; Lee, Jisoo; Lee, You-hyun; Seo, Young Il; Chung, Won Tae

    2010-01-01

    The objective of this study was to investigate clinical and radiographic features and gender differences in Korean patients with adult-onset ankylosing spondylitis. Multicenter cross-sectional studies were conducted in the rheumatology clinics of 13 Korean tertiary referral hospitals. All patients had a confirmed diagnosis of ankylosing spondylitis according to the modified New York criteria. Clinical, laboratory, and radiographic features were evaluated and disease activities were assessed u...

  7. Serum IgA, acute phase proteins, and glycosylation of alpha 1-acid glycoprotein in ankylosing spondylitis.

    OpenAIRE

    Mackiewicz, A.; Khan, M. A.; Reynolds, T. L.; Linden, S.; Kushner, I.

    1989-01-01

    Several investigators have suggested that gastrointestinal inflammation has a role in the pathogenesis of ankylosing spondylitis. To test this hypothesis markers of gastrointestinal immunostimulation, as manifested by serum IgA concentrations, were compared with serum markers of inflammation, as manifested by acute phase proteins. Serum samples from 45 unrelated Caucasian patients with ankylosing spondylitis (AS) were tested for correlation of serum IgA and six acute phase proteins: C reactiv...

  8. Anti-interleukin-17A monoclonal antibody secukinumab in treatment of ankylosing spondylitis: a randomised, double-blind, placebo-controlled trial.

    OpenAIRE

    Baeten, D.; Baraliakos, X.; Braun, J.; Sieper, J.; Emery, P.; Heijde, D.; Mcinnes, I.; Laar, Jm; Landewe?, R.; Wordsworth, P.; Wollenhaupt, J.; Kellner, H.; Paramarta, J.; Wei, J.; Brachat, A.

    2013-01-01

    BACKGROUND: Ankylosing spondylitis is a chronic immune-mediated inflammatory disease characterised by spinal inflammation, progressive spinal rigidity, and peripheral arthritis. Interleukin 17 (IL-17) is thought to be a key inflammatory cytokine in the development of ankylosing spondylitis, the prototypical form of spondyloarthritis. We assessed the efficacy and safety of the anti-IL-17A monoclonal antibody secukinumab in treating patients with active ankylosing spondylitis. METHODS: We did a...

  9. Brazilian-portuguese version and applicability questionnaire of the mobility index for ankylosing spondyliti Versão em língua portuguesa do Brasil e a reprodutibilidade do questionário de índice de mobilidade para espondilite anquilosante

    OpenAIRE

    Samuel Katsuyuki Shinjo; Roberta Gonçalves; Sérgio Kowalski; Célio Roberto Gonçalves

    2007-01-01

    PURPOSE: To translate and adapt the Bath Ankylosing Spondylitis Methodology Index (BASMI) - a metrological measurement for the assessment of patients with ankylosing spondylitis to Brazilian-Portuguese and to analyze the applicability of the questionnaire. METHODS: The Brazilian-Portuguese version of the Bath Ankylosing Spondylitis Methodology Index was achieved through a translation and back-translation process. This new Bath Ankylosing Spondylitis Methodology Index version was administered ...

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

    OpenAIRE

    1993-01-01

    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....

  11. The indirect costs of ankylosing spondylitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Malinowski, Krzysztof Piotr; Kawalec, Pawe?

    2015-04-01

    The aim of this systematic review was to collect and summarize all current data on the indirect costs related to absenteeism and presenteeism associated with ankylosing spondylitis. The search was conducted using Medline, Embase and Centre for Reviews and Dissemination databases. All collected costs were recalculated to average annual cost per patient, expressed in 2013 prices USD using the consumer price index and purchasing power parity. Identified studies were then analyzed to assess their possible inclusion in the meta-analysis. We identified 32 records. The average annual indirect cost per patient varies among all the identified results from US$660.95 to 45,953.87. The mean annual indirect per patient equals US$6454.76. This systematic review summarizes current data related to indirect costs generated by ankylosing spondylitis; it revealed the great economic burden of the disease for society. We observed a great variety of the considered components of indirect costs and their definitions. PMID:25579502

  12. Genetic aspects of susceptibility, severity, and clinical expression in ankylosing spondylitis.

    OpenAIRE

    Brown, Ma; Crane, Am; Wordsworth, Bp

    2002-01-01

    While twin studies have previously demonstrated high heritability of susceptibility to ankylosing spondylitis (AS), it is only recently that the involvement of genetic factors in determining the severity of the disease has been demonstrated. The genes involved in determining the rate of ankylosis in AS are likely to be different from those involved in the underlying immunologic events, and represent important potential targets for treatment of AS. This article will describe the progress that ...

  13. 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.)

  14. 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.

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

    OpenAIRE

    Caliri, A.; Furfari, P.; Balestrieri, A.; Filippis, L. G.; Africa, A.; 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 ...

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

    OpenAIRE

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

    2008-01-01

    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 ...

  17. Cellular immunity to cartilage proteoglycans: relevance to the pathogenesis of ankylosing spondylitis.

    OpenAIRE

    Jobanputra, P.; Choy, E. H.; Kingsley, G. H.; Sieper, J.; Palacios-boix, A. A.; Heinega?rd, D.; Panayi, G. S.

    1992-01-01

    Cellular immunity to cartilage proteoglycans may be responsible for sustaining chronic inflammation in ankylosing spondylitis. This hypothesis was examined by measuring peripheral blood and synovial fluid mononuclear cell proliferation in five preparations of human cartilage proteoglycan monomer in vitro. Peripheral blood mononuclear cells from 25 patients and synovial fluid mononuclear cells from five patients were compared with those from normal and disease control subjects matched for age....

  18. A Sub-Pathway Based Method to Identify Candidate Agents for Ankylosing Spondylitis

    OpenAIRE

    Ming Li; Xiaodong Zhu; Yushu Bai; Ziqiang Chen; Chuanfeng Wang; Yu Chen; Yingchuan Zhao; Kai Chen

    2012-01-01

    The need for new therapeutics for Ankylosing Spondylitis (AS) is highlighted by the general lack of efficacy for most agents currently available for this disease. Many recent studies have detailed molecular pathways in AS, and several molecule-targeting agents are undergoing evaluation. We aimed to explore the mechanism of AS and identify biologically active small molecules capable of targeting the sub-pathways which were disregulated in the development of AS. By using the GSE25101 microarray...

  19. Fatigue assessment and its impact in the quality of life of patients with ankylosing spondylitis.

    Science.gov (United States)

    Schneeberger, Emilce Edith; Marengo, María Florencia; Dal Pra, Fernando; Maldonado Cocco, José Antonio; Citera, Gustavo

    2015-03-01

    The most frequently reported symptoms by patients with ankylosing spondylitis (AS) are pain, stiffness, and fatigue. Previous studies have estimated a 63 % prevalence of fatigue in AS, with a low correlation of fatigue with pain and functional capacity. The objective of this study is to assess fatigue prevalence in AS patients and establish the main associated factors. A case-control study including AS patients according to New York modified criteria was carried out. The control group included individuals of the general population without rheumatic conditions, matched by gender, age, and socioeconomic level. Disease-related variables were recorded. Functional capacity, disease activity, and quality of life were assessed using Bath Ankylosing Spondylitis Funcional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and ankylosing spondylitis quality of life (ASQoL). CES-D questionnaire was used to evaluate depression and fatigue severity scale (FSS) to evaluate fatigue. Sixty-four consecutive AS patients and 95 controls were included. Patients' median age was 44 years (interquartile range (IQR), 33.25-53), 89.1 % were male, and had a median disease duration of 17 years (IQR, 10.3-25). Fatigue prevalence in AS was 73.4 % compared to 30.5 % in the control group (p?analysis using fatigue as the dependent variable, depression was the only associated variable (p?=?0.01). No association with age, gender, disease duration, BASDAI, BASFI, or presence of comorbidities was found. Finally, BASDAI fatigue question correlated with the FSS (r?=?0.55). Fatigue was significantly more prevalent in AS than in healthy controls. The main determinant factor of fatigue was the presence of depression, explaining 30 % of its variability. Recognizing these factors could have important therapeutic implications. PMID:24870035

  20. Ankylosing spondylitis: a difficult diagnosis in patients on long-term renal replacement therapy.

    OpenAIRE

    Segoloni, Giuseppe Paolo; Piccoli, Giorgina Barbara; Biancone, Luigi

    2002-01-01

    We report the case of a 48-year-old male, whose musculoskeletal manifestations, previously related to long-term renal replacement therapy (RRT), were diagnosed as ankylosing spondylitis when symptoms changed their pattern on daily hemodialysis (DHD). The patient started RRT in 1981; in 1985 he received a cadaver graft, which failed in 1987. Secondary hyperparathyroidism, amyloid geoids, bilateral carpal tunnel syndrome and high aluminium levels were present. Musculoskeletal pain, reported sin...

  1. Increased expression of carbonic anhydrase I in the synovium of patients with ankylosing spondylitis

    OpenAIRE

    Cui Yazhou; Sun Shui; Yan Xinfeng; Zhao Yan; Han Jinxiang; Chang Xiaotian

    2010-01-01

    Abstract Background One of the most distinctive features of ankylosing spondylitis (AS) is new bone formation and bone resorption at sites of chronic inflammation. Previous studies have indicated that the hyperplasia and inflammation of synovial tissues are significantly related to the pathogenic process of AS. The present study used a proteomic approach to identify novel AS-specific proteins by simultaneously comparing the expression profiles of synovial membranes from patients with AS, rheu...

  2. Evaluation of Clinical Findings, Quality of Life and Depression in Ankylosing Spondylitis Patients with MEFV Mutation

    OpenAIRE

    Durmus?, Dilek; Alayli, Gamze; Cengi?z, K?vanc?; Bag?ci, Hasan; Akyol, Yes?im; I?lhanli, I?lker; Cantu?rk, Ferhan

    2008-01-01

    Objective: The aim of this study is to compare MEFV gene mutation carrier Ankylosing Spondylitis (AS) patients with non-carrier AS patients with respect to clinical findings and quality of life (QOL) measures.Materials and Methods: Fifty-five AS patients fulfilled the modified New York criteria were enrolled in the study. Patients were grouped as MEFV gene mutation negative patients (Group I) and MEFV gene mutation positive patients (Group II). Visual analague scale (VAS) was used to assess t...

  3. 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...

  4. Efficacy and safety of apremilast, an oral phosphodiesterase 4 inhibitor, in ankylosing spondylitis.

    OpenAIRE

    Pathan, E.; Abraham, S.; Rossen, E.; Withrington, R.; Keat, A.; Charles, Pj; Paterson, E.; Chowdhury, M.; Mcclinton, C.; Taylor, Pc

    2013-01-01

    OBJECTIVES: To evaluate the efficacy and safety of an oral phosphodiesterase 4 inhibitor, apremilast, in treatment of ankylosing spondylitis (AS) by monitoring symptoms and signs in a pilot study including exploratory investigation of effects of PDE4 inhibition on blood biomarkers of bone biology. METHODS: In this double-blind, placebo-controlled, single-centre, Phase II study, patients with symptomatic AS with active disease on MRI were randomised to apremilast 30 mg BID or placebo over 12 w...

  5. Four cases of ankylosing spondylitis in medieval skeletal series from Croatia.

    Science.gov (United States)

    Slaus, Mario; Novak, Mario; Cavka, Mislav

    2012-12-01

    Osteological changes consistent with ankylosing spondylitis were observed in three males and one female skeleton recovered from four medieval sites-Velim, Koprivno, Buje, and Rijeka-all situated on Croatia's eastern Adriatic coast and its immediate hinterland. The skeletons present changes in the spine, ribs, sacrum, and innominates that are typical of ankylosing spondylitis that is a progressive, inflammatory disease of connective tissue calcification. The disease most commonly affects the sacroiliac joints, the joints of the spine, and the costovertebral joints. In the final stages of the disease, the vertebral bodies remodel and together with the associated syndesmophytes form a continuous, smooth bone surface that is sometimes referred to as "bamboo spine." The prevalence of this disorder in the analyzed Croatian samples is 4/303 or 1.3% and thus corresponds with frequencies recorded in modern European populations. Differential diagnosis rules out the possibility of DISH, rheumatoid arthritis, and melorheostosis. These are the first cases of ankylosing spondylitis identified in Croatian archaeological series. PMID:22210271

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

    Science.gov (United States)

    Shiue, Ivy

    2014-08-01

    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

  7. Quantitative radio-isotope scanning of the sacroiliac joints in ankylosing spondylitis

    International Nuclear Information System (INIS)

    A method for applying 99mTc-MDP for dynamic and static quantitative radioisotope scanning (QRS) of the sacroiliac joints (SI) in early progressive sacroiliitis in ankylosing spondylitis (AS) is described. In a prospective study, 2 groups of male AS patients were investigated, one with increased elevated erythrocytic sedimentation rate (ERS) (group A, n = 7) and one with normal ERS (group B, n = 8). In both groups an increased uptake of the radiotracer was found in the static part of the study versus a control group C (n = 9). An increased uptake versus group C was also found for group A in the dynamic part of the study (p = 0.01) while there was no significant difference dynamically between group B and C. The results of the dynamic study in group A indicate ERS to be a parameter of inflammatory activity in the SI joints. The study also seems to indicate QRS to be a valuable diagnostic method in early AS without definite radiographic changes in the SI joints. (orig.)

  8. Usage of Conventional PCR Technology for the Detection of HLA-B27 Allele: A Significant Molecular Marker of Ankylosing Spondylitis

    OpenAIRE

    Sharma, Narotam; Sharma, Veena; Masood, Tariq; Nautiyal, Satish Chandra; Sailwal, Shivani; Singh, Rajesh K.; Kushwaha, Rajeev K.; Singh, R. K.

    2012-01-01

    Ankylosing spondylitis is a chronic inflammatory disease that has been linked to the human leukocyte antigen class I allele HLA-B27. More than 90 % of patients with ankylosing spondylitis possess the HLA-B27 allele, but only 1 % of people with HLA-B27 develop the disease. Ankylosing spondylitis predominately affects young males. The present study was planned to find out the involvement of HLA-B27 specific allele in relation to age and sex in symptomatic suspected patients of ankylosing spon...

  9. 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.

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

  11. Evaluation of the short-term efficacy of NSAIDs on patients with active ankylosing spondylitis in daily practice: a 3-month, longitudinal, observational study.

    Science.gov (United States)

    Cinar, Muhammet; Dinc, Ayhan; Simsek, Ismail; Erdem, Hakan; Koc, Bayram; Pay, Salih; Kilic, Selim

    2010-01-01

    The objective of the study was to investigate the response rate to non-steroidal anti-inflammatory drugs (NSAIDs) and the clinical parameters that might predict this response in patients with active ankylosing spondylitis. This is a prospective, observational, 3-month study that was conducted in a single center. Ninety-five consecutive patients with active ankylosing spondylitis were included in the study. Full dose NSAIDs (indometacin 150 mg daily or acemetacin [corrected] 180 mg daily) were given to patients. Relevant clinical data of all patients' were recorded at the beginning and on three consecutive monthly visits. At the end of the study period, patients who respond to NSAIDs were determined. Demographic, clinical, and laboratory parameters that might influence the response to the NSAIDs were investigated. The response rate to the full-dose NSAIDs according to the ASAS20 in patients with active ankylosing spondylitis was found as 29.5%. Similarly, 20.0% of the patients were responders according to the ASAS40 criteria, whereas 5.6% of the patients responded according to the 5-out-of-6 criteria at week 12. Patients who responded to the treatment were found to be younger at the study entry (P = 0.001) and had shorter disease duration (P < 0.001). Due to the markedly lower rate of response to the NSAIDs in patients with active ankylosing spondylitis, early identification of those patients who does not respond to NSAIDs and subsequent decision regarding the institution of second-line treatments (anti-TNF) may be of great value in the prevention of irreversible changes that might develop in most of the patients. PMID:19466421

  12. Assessment of Cardiac Functional Alterations of Ankylosing Spondylitis Patients without Cardiovascular Risk Factors

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    Alper Kepez

    2013-08-01

    Full Text Available Introduction: The aim of this study is to evaluate cardiac functional alterations of ankylosing spondylitis patients without any cardiovascular risk factors.Patients and Methods: Thirty seven consecutive akylosing spondylitis patients without any cardiovascular risk factors constituted our study patient population (age: 41.4 ± 11.1 years, 28 male. Electrocardiographs (ECG of all patients were obtained and all patients underwent comprehensive transthoracic echocardiographic examination. QRS durations, p wave dispersion and corrected QT dispersion (QTcd values were calculated from 12-lead ECG’s. Data reflecting left ventricular systolic and diastolic functions were obtained from echocardiographic examinations. Data of patients were compared with the data of 28 age-and gender matched healthy control subjects (age: 40.1 ± 10.5 years, 19 male.Results: There were no significant differences between patients and controls regarding QRS durations, p wave dispersion and QTcd values. There were also no significant differences between patients and controls regarding parameters reflecting left ventricular systolic and diastolic functions. Annular velocities at mitral and tricuspid annulus levels evaluated with pulsed-wave tissue Doppler imaging were also similar as well. Two (7.2% subjects in the control group and 2 (5.4% patients in the akylosing spondylitis group had minimal aortic regurgitation (p= 0.51. Conclusion: We could not demonstrate any electrocardiographic or echocardiographic evidence of structural myocardial alterations in a small sample of akylosing spondylitis patients free of cardiovascular risk factors. Effects of frequently encountered co-existent cardiovascular risk factors of ankylosing spondylitis patients might have contributed to the conflicting literature data related with this topic.

  13. Finnish HLA studies confirm the increased risk conferred by HLA?B27 homozygosity in ankylosing spondylitis

    OpenAIRE

    Jaakkola, E.; Herzberg, I.; Laiho, K.; Barnardo, Mc; Pointon, Jj; Kauppi, M.; Kaarela, K.; Tuomilehto-wolf, E.; Tuomilehto, J.; Wordsworth, Bp; Brown, Ma

    2005-01-01

    OBJECTIVE: To determine the influence of HLA-B27 homozygosity and HLA-DRB1 alleles in the susceptibility to, and severity of, ankylosing spondylitis in a Finnish population. METHODS: 673 individuals from 261 families with ankylosing spondylitis were genotyped for HLA-DRB1 alleles and HLA-B27 heterozygosity/homozygosity. The frequencies of HLA-B27 homozygotes in probands from these families were compared with the expected number of HLA-B27 homozygotes in controls under Hardy-Weinberg equilibri...

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

    Directory of Open Access Journals (Sweden)

    Stephanie Hennigan

    2008-07-01

    Full Text Available Stephanie Hennigan, Christoph Ackermann, Arthur KavanaughCenter for Innovative Therapy, Division of Rheumatology, Allergy and Immunology, University of California, La Jolla, California, USAIntroduction: Ankylosing spondylitis (AS is an idiopathic chronic inflammatory disease that has prominent effects on the spine and peripheral joints. In addition, extraarticular manifestations such as enthesitis and acute anterior uveitis may be clinically important. In recent years, the therapy of AS has changed, largely due to the introduction of inhibitors of the proinflammatory cytokine tumor necrosis factor (TNF. Adalimumab, a human monoclonal antibody specifically for TNF, is the most recent of the TNF blocking agents that have been approved for the treatment of active, nonsteroidal antiinflammatory drug (NSAID-refractory patients with AS.Aims: To evaluate the evidence for the therapeutic value of adalimumab in ankylosing spondylitis.Evidence review: There is clear evidence that adalimumab, administered 40 mg subcutaneously every 2 weeks, substantially improves the signs and symptoms of NSAID-refractory, active AS when compared with placebo treatment. There is ample evidence that adalimumab causes significant improvements in physical health status and overall AS-specific, health-related quality of life and physical functioning, which consequently leads to better work productivity. There is substantial evidence that adalimumab improves spinal and sacroiliac joint inflammation in AS patients. Initial results from clinical trials suggest that there is no increased risk of serious infections or malignancies in adalimumab-treated patients with AS. The most common adverse events were injection-site reactions. Limited economic evidence suggests that adalimumab 40 mg may be cost effective when used according to current valid treatment guidelines. Place in therapy: Adalimumab is an effective treatment for patients with active AS.Key words: adalimumab, ankylosing spondylitis, TNF inhibitor, evidence, treatment

  15. [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 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

  16. Ankylosing spondylitis associated with Sweet’s syndrome: a case report

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    Mansouri Samia

    2013-01-01

    Full Text Available Abstract Introduction Sweet’s syndrome is an acute neutrophilic dermatosis characterized by a diffuse dermal infiltrate of mature neutrophils. In most cases, it occurs as an isolated phenomenon (idiopathic Sweet’s syndrome but it can be drug induced or associated with a variety of underlying diseases such as infections, neoplasms, and chronic inflammatory diseases. The association between Sweet’s syndrome and ankylosing spondylitis is rare. Only a few cases have been reported in the literature. We report a new case in which we describe an outbreak of acute neutrophilic dermatosis revealing ankylosing spondylitis. Case presentation A 33-year-old Moroccan man presented with large-joint polyarthralgia, inflammatory pain in his buttocks and lower lumbar spine, fever and skin lesions. On examination, the patient had a low-grade fever, six tender but not swollen joints, limitation of motion of the lumbar spine, and painful erythematous maculopapules over his face, neck, and hands. Laboratory tests showed hyperleukocytosis, and elevated erythrocyte sedimentation rate and C-reactive protein. The immunological tests and infectious disease markers were negative. Investigations for an underlying neoplastic disease remained negative. Magnetic resonance imaging showed a bilateral sacroiliitis. Skin biopsy findings were consistent with Sweet’s syndrome. The diagnosis of Sweet’s syndrome associated with ankylosing spondylitis was established. Nonsteroid anti-inflammatory drugs were started and the patient showed rapid clinical and biological improvement. Conclusion Three observations of the association between Sweet’s syndrome and spondylarthropathy have been reported in the literature. The cause of this association remains unclear. Some hypotheses have been developed, but further studies are needed to confirm or refute them.

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

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    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. 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.

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

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    Yakup Tomak

    2012-09-01

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

  20. Analysis of killer immunoglobulin-like receptor genes in ankylosing spondylitis.

    OpenAIRE

    Harvey, D.; Pointon, Jj; Sleator, C.; Meenagh, A.; Farrar, C.; Sun, Jy; Senitzer, D.; Middleton, D.; Brown, Ma; Wordsworth, Bp

    2009-01-01

    OBJECTIVES: To assess the possible association of killer immunoglobulin-like receptor (KIR) genes, specifically KIR3DL1, KIR3DS1 and KIR3DL2, with ankylosing spondylitis (AS). METHODS: 14 KIR genes were genotyped in 200 UK patients with AS and 405 healthy controls using multiplex polymerase chain reaction. Sequence-specific oligonucleotide probes were used to subtype 368 cases with AS and 366 controls for 12 KIR3DL2 alleles. Differences in KIR genotypes and KIR3DL2 allele frequencies were ass...

  1. Vertebral hemangioma in the X-ray radiography of Andersson lesion in ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Dihlmann, W.; Delling, G.

    The vertebral cavernous hemangioma is described as the number five cause in the etiology of the Andersson lesion (vertebral-discal destruction in ankylosing spondylitis). In one case of a completely stiffened spine, radiographs showed a vertebral hemangioma with a cockade-like appearance instead of the typical coarse-striated osseous structure. Histologic necropsy results were those of a cavernous vertebral hemangioma. The immobile rigid spine, that is, the pathologically disturbed function appears to have a strong influence on the form, structure and pathology.

  2. Profiling of HLA-B Alleles for Association Studies with Ankylosing Spondylitis in the Chinese Population

    OpenAIRE

    Yi, Lin; Wang, Jiucun; Guo, Xinjian; Espitia, Maribel G.; Chen, Enuo; Assassi, Shervin; Jin, Li; Zou, Hejian; Reveille, John D.; Zhou, Xiaodong

    2013-01-01

    Human leucocyte antigen (HLA) B*27 is a susceptibility allele to ankylosing spondylitis (AS). However, major AS-associated subtypes of HLA-B*27 and other HLA-B alleles vary in different ethnic populations. Herein, we examined HLA-B alleles in a total of 360 AS patients and 350 controls of Chinese Han ancestry. The HLA-B genotyping was performed with sequence-based typing (SBT) method. Six HLA-B*27 subtypes B*27:04, B*27:05, B*27:07, B*27:08, B*27:10 and B*27:15 were observed in the cohorts. H...

  3. 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...

  4. HLA class II antigens (DR, DQ LOCI) and peripheral arthritis in ankylosing spondylitis.

    OpenAIRE

    Sanmarti?, R.; Ercilla, M. G.; Branco?s, M. A.; Cid, M. C.; Collado, A.; Rote?s-querol, J.

    1987-01-01

    Fifty one patients with ankylosing spondylitis (AS) were typed for HLA-A, B, C, DR, and DQ antigens. The antigen frequencies were compared with those of a normal population and with a B27 positive control group. All but one of the patients with AS were HLA-B27 positive. A positive linkage disequilibrium between Cw1, Cw2, DR1, and the B27 antigen was observed. Patients with AS showed a significant increase in DQw2 antigen compared with the B27 positive control group. No differences in antigeni...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1977-06-01

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

  6. Ankylosing spondylitis: a chronic inflammatory disease with iron overload in granulocytes and platelets.

    OpenAIRE

    Feltelius, N.; Lindh, U.; Venge, P.; Ha?llgren, R.

    1986-01-01

    The cellular stores of iron in granulocytes and platelets isolated from 29 patients with ankylosing spondylitis were measured by the nuclear microprobe technique. The mean iron content in polymorphonuclear cells (PMNs) was 32 (SD 3) micrograms/g dry weight and in platelets 11 (2.6) micrograms/g dry weight. Corresponding values for age and sex matched healthy controls were 5.2 (1.9) and 4.6 (0.8) micrograms/g (p less than 0.001). Significant correlations were found in the patient group between...

  7. Vertebral hemangioma in the X-ray radiography of Andersson lesion in ankylosing spondylitis

    International Nuclear Information System (INIS)

    The vertebral cavernous hemangioma is described as the number five cause in the etiology of the Andersson lesion (vertebral-discal destruction in ankylosing spondylitis). In one case of a completely stiffened spine, radiographs showed a vertebral hemangioma with a cockade-like appearance instead of the typical coarse-striated osseous structure. Histologic necropsy results were those of a cavernous vertebral hemangioma. The immobile rigid spine, that is, the pathologically disturbed function appears to have a strong influence on the form, structure and pathology. (orig.)

  8. Polysegmental lumbar posterior wedge osteotomies for correction of kyphosis in ankylosing spondylitis

    OpenAIRE

    Royen, B. J.; Kleuver, M.; Slot, G. H.

    1998-01-01

    Between 1984 and 1993 we treated 21 consecutive patients who had progressive thoracic kyphosis due to ankylosing spondylitis by polysegmental posterior lumbar wedge osteotomies. In 19 patients we used the Universal Spinal Instrumentation System and in the last 2 patients the H-frame. The average correction in 20 of 21 patients at follow-up was 25.6° (range 0°–52°), with a mean segmental correction of 9.5° and a mean loss of correction after operation of 10.7° (range 0°–36°). There ...

  9. Infliximab therapy in patients with ankylosing spondylitis: an open label 12 month study

    OpenAIRE

    Temekonidis, T.; Alamanos, Y.; Nikas, S.; Bougias, D.; Georgiadis, A.; Voulgari, P.; Drosos, A.

    2003-01-01

    Patients and methods: Twenty five patients (24 male, 1 female; mean (SD) age 36.0 (10.5); disease duration 13.8 (8.5) years) with AS fulfilling the modified New York criteria for AS were investigated. Twenty two (88%) patients were HLA-B27 positive. All patients had active axial disease (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ?30/100) and C reactive protein (CRP) ?10 mg/l, despite adequate treatment. Intravenous infliximab (5 mg/kg) was given at weeks 0, 2, 6, and eve...

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

    OpenAIRE

    Peeters, A. J.; 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...

  11. Difficult intubation in a case of ankylosing spondylitis: a case report.

    Directory of Open Access Journals (Sweden)

    Kamarkar U

    1998-04-01

    Full Text Available A case of severe ankylosing spondylitis involving the entire spine was to be operated for lumbar osteotomy. She had fixed rigidity of the cervical spine with minimal rotational movement, inability to lie down supine and severe restrictive lung disease with hypoxemia (pO2 = 65 mmHg. An awake intubation was performed and the patient was operated under general anaesthesia in the prone position. Intraoperative "wake-up" test was performed to judge whether extent of straightening was excessive. Postoperatively, she was electively ventilated and extubated uneventfully after 24 hours.

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

    Scientific Electronic Library Online (English)

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

    2003-10-01

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

  13. 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.

  14. Lung parenchyma changes in ankylosing spondylitis: demonstration with high resolution CT and correlation with disease duration

    International Nuclear Information System (INIS)

    Objective: To analyze the spectrum of the lung parenchyma changes in ankylosing spondylitis (AS) with high resolution computed tomography (HRCT) and correlate the findings with disease duration. Material and methods: Twenty patients (18 male, 2 female) with the diagnosis of AS according to New York criteria were included in the study. None of the patients had history of tuberculosis, prolonged inorganic dust exposure and hospitalization for pneumonia. Seven of the patients were smokers, three patients were ex-smokers, and 10 patients were nonsmokers. The patients were assigned to three groups depending on disease duration. Group 1: patients with disease duration ?5 years (n: four patients), group 2: patients with disease duration ?6 years but ?10 years (n: four patients), group 3: patients with disease duration ?11 years (n: 12 patients). HRCT and pulmonary function tests (PFT) were performed in all patients. Results: HRCT demonstrated pathology in 17 patients (85%). Two patients in group 1, 4 patients in group 2 and 11 patients in group 3 had pulmonary parenchyma changes. Emphysema (9/20), septal thickening (9/20) and pleural thickening (9/20) were the most common changes followed by nodule (8/20) and subpleural band formation (7/20). Three patients had apical fibrosis (AF). Septal and pleural thickening (both 4/10) were the most common changes when only nonsmokers were considered. Among nine patients with emphysema three were nonsmokers. Conclusion: There ise nonsmokers. Conclusion: There is a wide spectrum in pulmonary parenchyma changes in AS. These changes begin in early stages of the disease and increase with disease duration. Although smoking complicates the spectrum of changes in pulmonary parenchyma, they are predominately in the form of interstitial inflammation

  15. Lung parenchyma changes in ankylosing spondylitis: demonstration with high resolution CT and correlation with disease duration

    Energy Technology Data Exchange (ETDEWEB)

    Senocak, Oezlem E-mail: emine.senocak@deu.edu.tr; Manisali, Metin; Oezaksoy, Dinc; Sevinc, Can; Akalin, Elif

    2003-02-01

    Objective: To analyze the spectrum of the lung parenchyma changes in ankylosing spondylitis (AS) with high resolution computed tomography (HRCT) and correlate the findings with disease duration. Material and methods: Twenty patients (18 male, 2 female) with the diagnosis of AS according to New York criteria were included in the study. None of the patients had history of tuberculosis, prolonged inorganic dust exposure and hospitalization for pneumonia. Seven of the patients were smokers, three patients were ex-smokers, and 10 patients were nonsmokers. The patients were assigned to three groups depending on disease duration. Group 1: patients with disease duration {<=}5 years (n: four patients), group 2: patients with disease duration {>=}6 years but {<=}10 years (n: four patients), group 3: patients with disease duration {>=}11 years (n: 12 patients). HRCT and pulmonary function tests (PFT) were performed in all patients. Results: HRCT demonstrated pathology in 17 patients (85%). Two patients in group 1, 4 patients in group 2 and 11 patients in group 3 had pulmonary parenchyma changes. Emphysema (9/20), septal thickening (9/20) and pleural thickening (9/20) were the most common changes followed by nodule (8/20) and subpleural band formation (7/20). Three patients had apical fibrosis (AF). Septal and pleural thickening (both 4/10) were the most common changes when only nonsmokers were considered. Among nine patients with emphysema three were nonsmokers. Conclusion: There is a wide spectrum in pulmonary parenchyma changes in AS. These changes begin in early stages of the disease and increase with disease duration. Although smoking complicates the spectrum of changes in pulmonary parenchyma, they are predominately in the form of interstitial inflammation.

  16. 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.

  17. Solid-phase Edman degradation analysis of HLA-B27 molecules in healthy individuals and ankylosing spondylitis patiens.

    Czech Academy of Sciences Publication Activity Database

    Ivašková, E.; Flieger, M.; Stod?lková, E.; Sedlá?ková, M.; Man, P.; Votruba, J.; Pohl, L.; ?apková, Jana; Ivanyi, P.

    Rio de Janeiro : ImmunoRIO, 2007. ---. [Immuno RIO 2007, International Congrass of Immunology /13./. 21.08.2007-25.08.2007, Rio de Janeiro] Institutional research plan: CEZ:AV0Z50520514; CEZ:AV0Z50520701 Keywords : HLA-B27 * ankylosing spondylitis * Edman degradation analysis Subject RIV: EB - Genetics ; Molecular Biology

  18. Assessment of disability with the World Health Organisation Disability Assessment Schedule II in patients with ankylosing spondylitis

    OpenAIRE

    Tubergen, A.; Landewe, R.; Heuft-dorenbosch, L.; Spoorenberg, A.; Heijde, D.; Tempel, H.; Linden, S.

    2003-01-01

    Objective: To investigate in ankylosing spondylitis (AS) whether the newly developed World Health Organisation Disability Assessment Schedule II (WHODAS II) is a useful instrument for measuring disability, to assess its responsiveness in relation to other traditional disease specific instruments, and to identify factors that are associated with both short term and long term scores on the WHODAS II.

  19. The use of low-dose etanercept as an alternative therapy for treatment of ankylosing spondylitis: a case series.

    Science.gov (United States)

    Moghimi, Jamileh; Sheikhvatan, Mehrdad; Semnani, Vahid

    2012-08-01

    During recent decades, biological medications play a crucial role for treating rheumatologic disorders and thus are strongly recommended for initial treatment of ankylosing spondylitis. However, because of high cost of biological drugs, the use of these drugs has been limited. In current series, we tried to assess safety of low-dose etanercept as a common usable biological drug in patients with ankylosing spondylitis. In a case-series study, 4 men with ankylosing spondylitis were treated with low-dose etanercept (25 mg/2 weeks) plus methotrexate (10 mg/week). Safety was assessed by measuring rate of differences in severity of clinical manifestations and level of C-reactive protein (CRP). After the completion of treatment with low-dose etanercept, inflammatory low back pain and morning stiffness was reduced lower than 30 min in all patients. Only one patient had baseline high serum ESR and positive CRP that was changed to negative following treatment protocol. At one-year follow-up, all participants continued their regular treatment regimen with the etanercept survival rate 100%. Neither side effects related to drug nor clinical complications were observed within the follow-up period. Our findings suggest that low-dose etanercept (25 mg/2 weeks) has an acceptable safety and effectiveness profile in individuals with ankylosing spondylitis and can be good alternative instead of conventional therapy with etanercept (25 mg two times per week). PMID:21553278

  20. Factors influencing health status and disability of patients with ankylosing spondylitis in the Czech Republic.

    Science.gov (United States)

    Forejtová, S; Mann, H; Stolfa, J; Vedral, K; Fenclová, I; Némethová, D; Pavelka, K

    2008-08-01

    The aim of the study was to evaluate factors that influence health status and work disability in patients with ankylosing spondylitis (AS) in the Czech Republic. Data were collected in a retrospective fashion directly from patients with AS using mailed questionnaires containing questions regarding sociodemographic characteristics of patients, the course of their disease, therapy, rehabilitation, quality of life, and ability to work. HAQ-DI (Health Assessment Questionnaire-Disability Index) and BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) were also included in the questionnaires; 1,008 questionnaires were suitable for further statistical analysis. The average age +/- SD of patients was 50.2 +/- 10.7 years, the average symptom duration was 23.0 +/- 11.6 years. Mean time from first symptoms to diagnosis was 9.1 years. Full disability had been awarded to 303 patients (30%) at some point of their disease. Twenty seven percent of patients reported receiving full disability pension for 10 or more years. Four hundred fifty six subjects (45%) were currently or had been previously receiving partial disability pension. Receiving disability pension was more frequent among men (64%) compared to women (56%) (P = 0.012), despite the fact that women had higher BASDAI (P or =4 (current cutoff value for initiation of biological therapy), but only 1% of patients were treated by anti TNF alpha agents within the last year. Seven hundred ninety one patients underwent spa treatment in the previous year; 96% of them experienced improvement of their health condition. PMID:18247079

  1. [Mapping study of ankylosing spondylitis on HLA region in Jilin population of China].

    Science.gov (United States)

    Wang, Ya-Wen; Zhu, Xiao-Quan; Song, Yu-Guo; Sun, Liang; Yang, Ze

    2007-07-01

    To find the susceptible genes of ankylosing spondylitis in Chinese population, we select 11 SNPs on gene HLA gene family that has strong linkage of ankylosing spondylitis in 6p21.3. By case-control study in 79 AS patients and 132 healthy subjects, the distribution of TNF-alpha-850 genotype TT is higher in AS group than that in normal control group (P=0.027); Mutational allele T has a significant statistically difference between AS group and normal control group (P=0.002). By linkage disequilibrium study, there are 5 SNPs present the linkage disequilibrium and the region is 15 kb, including gene LTA, TNF-alpha, LST1 and NCR3; In the haplotypes of the 5 SNPs , the distribution of haplotype TCTTC has statistical difference between AS group and normal control group (chi2=7.406, P=0.0065), the haplotype contains mutational allele T of TNF-alpha-850. The result hints that there may be susceptible sites of AS in this 15 kb region, which may be TNF-alpha-850 C-->T mutation or other sites that around the TNF-alpha-850. PMID:17646145

  2. [Danish recommendations on treatment of ankylosing spondylitis and spondyloarthritis based on multinational project initiative.

    DEFF Research Database (Denmark)

    Pedersen, Susanne; Madsen, Ole

    2008-01-01

    INTRODUCTION: The multinational initiative "3e Initiative in Rheumatology - Multi-national Recommendations for the Management of Ankylosing Spondylitis 2006-7" served the primary purpose of providing specific recommendations for the management of ankylosing spondylitis and spondyloarthritis patients in daily practice. MATERIAL AND METHODs: The scientific committees from the ten participating countries selected nine clinical questions regarding diagnosis, monitoring and pharmacologic non-biologic treatment, and the Danish group chose 2 additional questions about non-pharmacologic treatment. Systematic literature searches were performed in Medline by 3 international and a Danish bibliographic fellow. Outcome data were extracted and processed by use of routine methods from clinical epidemiology and statistics. The evidence was presented to the Danish rheumatologists. The participants were divided into three groups, which each proposed recommendations. After a final plenary discussion, a voting session took place. Subsequently, agreement was obtained, and the strength of the recommendations was graded. RESULTS: The bibliographic fellows identified 2,709 relevant manuscripts and included 477 of these in the analysis. All 186 Danish rheumatologists were invited, and 26 (14,0%) participated in the meeting held in Copenhagen, December 2006. The individual recommendations were endorsed by 68-100% of the participants. CONCLUSION: Within the framework of the multinational 3e project, it was possible to develop Danish recommendations for AS patients by combining an evidence-based approach and the experience of clinical rheumatologists.

  3. Danish recommendations on treatment of ankylosing spondylitis and spondyloarthritis based on multinational project initiative

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Madsen, Ole Rintek

    2008-01-01

    INTRODUCTION: The multinational initiative "3e Initiative in Rheumatology - Multi-national Recommendations for the Management of Ankylosing Spondylitis 2006-7" served the primary purpose of providing specific recommendations for the management of ankylosing spondylitis and spondyloarthritis patients in daily practice. MATERIAL AND METHODs: The scientific committees from the ten participating countries selected nine clinical questions regarding diagnosis, monitoring and pharmacologic non-biologic treatment, and the Danish group chose 2 additional questions about non-pharmacologic treatment. Systematic literature searches were performed in Medline by 3 international and a Danish bibliographic fellow. Outcome data were extracted and processed by use of routine methods from clinical epidemiology and statistics. The evidence was presented to the Danish rheumatologists. The participants were divided into three groups, which each proposed recommendations. After a final plenary discussion, a voting session took place. Subsequently, agreement was obtained, and the strength of the recommendations was graded. RESULTS: The bibliographic fellows identified 2,709 relevant manuscripts and included 477 of these in the analysis. All 186 Danish rheumatologists were invited, and 26 (14,0%) participated in the meeting held in Copenhagen, December 2006. The individual recommendations were endorsed by 68-100% of the participants. CONCLUSION: Within the framework of the multinational 3e project, it was possible to develop Danish recommendations for AS patients by combining an evidence-based approach and the experience of clinical rheumatologists Udgivelsesdato: 2008/12/1

  4. [A case of psoriatic arthritis associated with ankylosing spondylitis treated with bilateral total hip arthroplasty].

    Science.gov (United States)

    Yamada, K; Imaizumi, T; Takada, N

    1998-12-01

    We report a case of a 40-year-old male with psoriatic arthritis associated with ankylosing spondylitis. At the age of 34, the patient suffered pain in his hips, knees, ankles, neck and low back 3 years after the onset of psoriasis vulgaris. The hip pain gradually became severe despite the medical treatment and physical therapy. On admission, the skin lesion of diffuse erythematous plaques with scales was observed on the trunk and extremities. Motion of the spine was markedly limited. We also noted limitation of motion in the bilateral hips and remarkable gait disturbance. In laboratory findings, rheumatoid factor and HLA-B 27 antigen were negative. Radiographs of the cervical spine showed typical bamboo spine as seen in ankylosing spondylitis. Obliteration of the sacroiliac joints and joint space narrowing in the hips with reactive sclerosis were revealed on the pelvic film. Bilateral cementless total hip arthroplasty with adductor tenotomy resulted in complete pain relief and a marked improvement in gait function 18 months after surgery. The appropriate reconstructive surgery was extremely helpful to increase daily activities of the patient in this case. PMID:10047723

  5. 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 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

  6. Management of a case of ankylosing spondylitis for total hip replacement surgery with the use of ultrasound-assisted central neuraxial blockade

    Science.gov (United States)

    Goyal, Rakhee; Singh, Shivinder; Shukla, Ravindra Nath; Singhal, Anuj

    2013-01-01

    Management of a case of ankylosing spondylitis can be very challenging when the airway and the central neuraxial blockade, both are difficult. Ultrasound-assisted central neuraxial blockade may lead to predictable success in the field of regional anaesthesia. We present a young patient with severe ankylosing spondylitis where conventional techniques failed and ultrasound helped in successful combined spinal–epidural technique for total hip replacement surgery. PMID:23716771

  7. Evaluation of Clinical Findings, Quality of Life and Depression in Ankylosing Spondylitis Patients with MEFV Mutation

    Directory of Open Access Journals (Sweden)

    Dilek DURMU?

    2008-12-01

    Full Text Available Objective: The aim of this study is to compare MEFV gene mutation carrier Ankylosing Spondylitis (AS patients with non-carrier AS patients with respect to clinical findings and quality of life (QOL measures.Materials and Methods: Fifty-five AS patients fulfilled the modified New York criteria were enrolled in the study. Patients were grouped as MEFV gene mutation negative patients (Group I and MEFV gene mutation positive patients (Group II. Visual analague scale (VAS was used to assess the activity pain and pain at rest. Disease activity and functional capacity of patients were evaluated by using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI and Bath Ankylosing Spondylitis Functional Index (BASFI. QOL and depression was assessed by using Short Form 36 (SF-36 and Beck Depression Inventory (BDI respectively. Results: Thirty-two patients (28 males, 4 females were in group I and 23 patients (18 males, 5 females were in group II. VAS for pain at rest, VAS for acivity pain, BASDAI and BASFI scores of group II was significantly higher than those of group I (p<0.01. When two groups were compared for SF-36 subscales and BDI scores, except social function, all scores were significantly lower in group II . VAS for pain at rest, VAS for acivity pain, BASDAI scores, BASFI scores and duration of disease was significantly correlated with BDI scores and all SF-36 subscales (p<0.0001. The MEFV mutations determined in group II patients were E148Q in 8 patients, M694V in 8 patients, M680I in three patients, V726A in two patients, M694V/M680I in one patient, M694V/E148Q in one patient.Conclusion: In our study, we found that clinical findings and QOL are worse at MEFV gene mutation carrier AS patients. In conclusion we think that ?t is beneficial to diagnose these patients earlier, plan and maintain the treatment according to this condition. Turk J Phys Med Rehab 2008;54:148-51.

  8. 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...

  9. 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.

  10. [Problem oriented learning (POL) in rehabilitation on the example of a patient with ankylosing spondylitis].

    Science.gov (United States)

    Horn, K; Gülich, M; Lay, W; Morfeld, M; Schwarzkopf, S R; Mau, W

    2007-06-01

    Through innovative teaching and learning methods relevant topics in rehabilitation can be conveyed effectively. Therefore, in this paper a papercase for problem-oriented learning (POL) is presented concerning rehabilitation in rheumatology, exemplified by a patient with ankylosing spondylitis. This papercase can be applied in the integrated course Rehabilitation, Physical Medicine and Naturopathic Treatment, the curricular part of teaching rehabilitation during the medical training according to the 9 (th) revision of the Federal Medical Licensing Regulations (Approbationsordnung). In addition the teaching material presented can be used in other courses, such as elective courses for non-medical professionals of the interdisciplinary rehabilitation team. First experiences gathered with the papercase in the Health and Nursing Sciences study programme of the Faculty of Medicine of Martin-Luther-University Halle-Wittenberg are reported. PMID:17582557

  11. Blind confirmation in Leiden of Geczy factor on the cells of Dutch patients with ankylosing spondylitis

    International Nuclear Information System (INIS)

    A follow-up blind study, of the ability of cross-reactive antisera to distinguish between the cells of Dutch patients with ankylosing spondylitis (AS) and normal controls, was performed in Leiden. Of the 45 cell samples tested, 29 were fresh peripheral blood mononuclear (PBM) cells while 15 were cryopreserved PBM. No false positives but one false negative was identified among the 45 samples, and the negative was confirmed after the recoded cryopreserved cells from this patient were retested. It is concluded that the cross-reactive antisera raised in Sydney give good discrimination between patients and normals. Factors affecting the success of the 51Cr-release cytotoxicity assay, and possible reasons for the failure of others to confirm these observations, are briefly discussed

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

    Science.gov (United States)

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

    2014-12-01

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

  13. Non-HLA genes in ankylosing spondylitis: what meta-analyses have shown?

    Science.gov (United States)

    Chatzikyriakidou, Anthoula; Voulgari, Paraskevi V; Drosos, Alexandros A

    2014-01-01

    HLA-B27 association with ankylosing spondylitis (AS) is one of the strongest ever reported in the literature. However, only a small proportion of 5-8% of HLA-B27 positive individuals of the general population develops the disease. In recent years, polymorphisms of many non-HLA genes were reported to be associated with AS. In this review, we summarise the current knowledge of non-HLA genetic factors contributing to AS susceptibility based on meta-analyses in order to overcome the limitations of individual genetic studies e.g. the small samples' sizes, the small samples' origin diversities, and the low statistical power of statistical analyses. PMID:25068597

  14. 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.

  15. Higher frequency of peripheral blood follicular regulatory T cells in patients with new onset ankylosing spondylitis.

    Science.gov (United States)

    Shan, Yuxing; Qi, Changlin; Zhao, Jixue; Liu, Yijun; Gao, Hui; Zhao, Ding; Ding, Fupeng; Wang, Jing; Jiang, Yanfang

    2015-02-01

    Follicular helper T (TFH) cells and B cells are linked to the pathogenesis of ankylosing spondylitis (AS). Follicular regulatory T (TFR) cells suppress TFH cell and germinal center B cell numbers in vivo. The role of TFR cells in AS is unknown. The frequency of peripheral blood inducible FOXP3+CXCR5+CD4+TFR cells and CXCR5+CD4+TFH cells were taken from 20 onset AS patients and 10 healthy controls, and were examined by flow cytometry, their disease activity were measured by the Bath Ankylosing Spondylitis Disease Activity Index. The concentrations of serum interleukin (IL)-21, immunoglobulin G, immunoglobulin A, immunoglobulin M and C-reactive protein were examined, and the values of erythrocyte sedimentation rate were measured. The frequency of peripheral blood FOXP3+CXCR5+CD4+TFR cells, CXCR5+CD4+TFH cells, the ratio of FOXP3+CXCR5+CD4+TFR/CXCR5+CD4+TFH cells and the concentration of serum IL-21 in the AS patients were significantly higher than those in the healthy controls (P ratio of FOXP3+CXCR5+CD4+TFR/CXCR5+CD4+TFH cells still significantly rose in those patients after standard treatment (P = 0.0006, P < 0.0001), the concentration of serum IL-21 decreased after treatment (P = 0.0049), accompanied by significantly minimized disease activities. Furthermore, the TFR cells were negatively correlated with serum immunoglobulin A in those patients before treatment (r = -0.582, P = 0.0071), and the frequency of TFR cells was negatively correlated with that of TFH cells and the concentration of serum IL-21 after treatment (r = -0.550, P = 0.046; r = -0.581, P = 0.0371). TFR cells might participate in the pathogenesis of AS, and might be responsible for controlling the autoantibodies, the frequency and function of TFH cells to inhibit the development of AS. PMID:25345823

  16. 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.

  17. Anterior fracture dislocation of the odontoid peg in ankylosing spondylitis as a cause for rhinolalia clausa: a case study.

    Science.gov (United States)

    Hilton, J M; Tassone, P; Hanif, J; Blagnys, B

    2008-01-01

    We present an unusual cause of rhinolalia clausa secondary to an oropharyngeal mass. A 69-year-old male presented to the otorhinolaryngology clinic with a one year history of a 'plummy' voice. He had a longstanding history of severe ankylosing spondylitis. Examination revealed an obvious hyponasal voice and a smooth hard mass in the midline of the posterior nasopharyngeal and oropharyngeal walls. Subsequent computed tomography scans and lateral plain neck X-ray showed a fracture dislocation of the odontoid peg, secondary to ankylosing spondylitis, which had eroded through the body of the C1 vertebra to lie anteriorly, resulting in the aforementioned impression into the pharyngeal mucosa. The radiological images, the role of the nasal airways in phonation and the causes of hyponasal speech are discussed. PMID:17466090

  18. Drug Retention Rates and Treatment Discontinuation among Anti-TNF-? Agents in Psoriatic Arthritis and Ankylosing Spondylitis in Clinical Practice

    OpenAIRE

    Fabbroni, Marta; Cantarini, Luca; Caso, Francesco; Costa, Luisa; Pagano, Veronica Anna; Frediani, Bruno; Manganelli, Stefania; Galeazzi, Mauro

    2014-01-01

    Objective. The study aim was to determine treatment persistence rates and to identify causes of discontinuation in psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients in clinical practice. Methods. Patients treated with adalimumab (ADA), etanercept (ETA), or infliximab (INF) were retrospectively included. Treatment persistence rates were analyzed by means of a stepwise logistic regression. Differences between therapy duration were assessed by means of an analysis of variance mo...

  19. Antibodies to human tissue transglutaminase and alterations of vitamin D metabolism in ankylosing spondylitis and psoriatic arthritis

    OpenAIRE

    Teichmann, Joachim; Voglau, Marcus J.; Lange, Uwe

    2009-01-01

    Abstract Both in ankylosing spondylitis (ASP) and psoriatic arthritis (PsA), osteopenia is present in one-third of women and men, whereas osteoporosis mainly affects men, even in their 30 s. Subclinical gut inflammation has been described in patients with AS or PsA. Joint involvement also occurs with other gastrointestinal diseases such as celiac disease. We tested the hypothesis, whether elevated serum levels of human anti-tissue-transglutaminase-IgA (htTG) are associated with ch...

  20. Destructive Dural Ectasia of Dorsal and Lumbar Spine with Cauda Equina Syndrome in a Patient with Ankylosing Spondylitis

    OpenAIRE

    Hoydonck, Marijke; Vlam, Kurt; Westhovens, Rene; Luyten, Frank P.; Lories, Rik J.

    2010-01-01

    We present a patient with longstanding ankylosing spondylitis complicated with cauda equina syndrome. The patient suffered from increasing pain in the leg with reduced sensitivity and extremely cold feet associated with incontinence. Diagnostic workup revealed dural ectasia, arachnoiditis and a spinal inflammatory mass leading to extensive vertebral bone destruction. Of interest, this was not only found in the lumbar spine region (which is typical in cases of cauda equina syndrome associated ...

  1. Translation and validation of non-English versions of the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire

    OpenAIRE

    Revicki Dennis; Twiss James; Meads David M; McKenna Stephen P; Doward Lynda C; Wong Robert L; Luo Michelle P

    2007-01-01

    Abstract Background The Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire is a unidimensional, disease-specific measure developed in the UK and the Netherlands. This study describes its adaptation into other languages. Methods The UK English ASQOL was translated into US English; Canadian French and English; French; German; Italian; Spanish; and Swedish (dual-panel methods). Cognitive debriefing interviews were conducted with AS patients. Psychometric/scaling properties were assesse...

  2. The relation between disease activity, vitamin D levels and bone mineral density in men patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Ihsane Hmamouchi

    2013-01-01

    Full Text Available The aim of this study was to assess the vitamin D status in patients with ankylosing spondylitis (AS, and to investigate the relation between vitamin D levels, bone mineral density (BMD and disease activity in men with ankylosing spondylitis. Seventy patients with AS and 140 healthy individuals were included in the study. BMD of femur and lumbar spine was measured by DXA. Serum 25OH vitamin D, parathormone, serum calcium, C-reactive protein levels of all participants were also measured. The disease activity was evalu ated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, and functional status by Bath Ankylosing Spondylitis Functional Index (BASFI. The mean 25(OHD level was 17.5+9.7 ng/mL in AS patients and 21.9+7.7 ng/mL in controls (P<0.001. In comparison with the control group, AS patients showed significantly higher CRP, and a significant reduction of vitamin D. In AS group, 62 patients (88.6% had Vitamin D deficiency, and 35 patients (50% were osteoporotic. Vitamin D was negatively correlated to BASDAI without any changes after adjustment for age, duration of disease, sunlight exposure, and total taking steroids (r=-0.32, P<0.001.We found a high incidence of vitamin D deficiency in our patients. Our study suggests that vitamin D deficiency in male AS may indirectly lead to osteoporosis by causing an increase in the inflammatory activity. Monitoring vitamin D levels would be useful in order to determine the patients under osteoporosis risk.

  3. 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...

  4. Significant association between insertion/deletion polymorphism of the angiotensin-convertig enzyme gene and ankylosing spondylitis

    Science.gov (United States)

    Inan?r, Ahmet; Yigit, Serbulent; Tural, Sengul; Ozturk, Sibel Demir; Akkanet, Songul; Habibo?lu, Abdulkadir

    2012-01-01

    Purpose Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease that characteristically affects the sacroiliac joints and the spine. Also iritis and uveitis can be serious complications of AS that can damage the eye and impair vision. The exact pathogenesis of AS remains poorly understood but genetic factors play a key role in its development. Human leukocyte antigen B27 (HLA-B27) is the major genetic susceptibility marker in AS. To our knowledge, angiotensin converting enzyme (ACE) gene I/D polymorphisms have not yet been investigated in AS patients in Turkish population.This study was conducted in Turkish patients with AS to determine the frequency of I/D polymorphism genotypes of angiotensin converting enzyme gene. Methods Genomic DNA obtained from 262 persons (122 patients with ankylosing spondylitis and 140 healthy controls) was used in the study. ACE I/D polymorphism genotypes were determined by using polymerase chain reaction with specific primers. Results There was statistically significant difference between the groups with respect to genotype distribution (p<0.001). When we examine ACE genotype frequencies according to the clinical characteristics there was a statistically significant association between DD genotype and ocular involvement (p=0.04) also sacroiliac joint involvement (p=0.03). Conclusions As a result of our study, angiotensin converting enzyme gene I/D polymorphism DD genotype could be a genetic marker in ankylosing spondylitis in a Turkish study population. PMID:22876137

  5. Treatment of ankylosing spondylitis with [{sup 224}Ra]-Radiumchloride; Therapie der Spondylitis ankylosans mit [{sup 224}Ra]-Radiumchlorid

    Energy Technology Data Exchange (ETDEWEB)

    Reiners, C. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Wuerzburg (Germany); Braun, J. [Rheumazentrum Ruhrgebiet Herne (Germany)

    2001-07-01

    Ankylosing spondylitis (AS) is a chronic disease which in 30-50% of the patients leads to considerable episodes of pain, a remarkable reduction of quality of life and disablement. For treatment mostly nonsteroidal antiphlogistic drugs are used which are able to reduce pain in approximately 80% of the patients only. Those drugs however, have to be withdrawn in approximately 30% of the patients due to its known toxicity (mainly in the gastrointestinal tract). Basis medication (DMARDs) is helpful in a minority of AS patients only. Recently [{sup 224}Ra]-Radiumchloride, which has been used previously between 1955 and 1990, has been made available again for treatment of AS. Whereas biokinetics, radiation exposure and the risk-profile of [{sup 224}Ra]-Radiumchloride are documented well by experimental and clinical data, most of the historical studies about the efficacy of this radiopharmaceutical do not fulfill the requirements of modern therapy studies. Therefore as many patients as possible should be recruited for a prospective long-time Phase IV study. A close and well-coordinated cooperation between rheumatologists and nuclear medicine physicians is needed, when [{sup 224}Ra]-Radiumchloride is used for treatment of AS. (orig.) [German] Die meist chronisch, oft auch in Schueben verlaufende Spondylitis ankylosans (AS) fuehrt bei 30-50% der Patienten zu betraechtlichen Schmerzen und einer nicht selten erheblichen Einschraenkung der Lebensqualitaet und Behinderung. Die am haeufigsten zur Therapie verwendeten nichtsteroidalen Antiphlogistika koennen nur bei etwa 80% der Patienten die Schmerzen lindern. Allerdings muessen diese Medikamente bei 20-30% der AS-Patienten wegen ihrer bekannten Toxizitaet - vor allem im Gastrointestinaltrakt - abgesetzt werden. Basistherapeutika (DMARDs) helfen bei der AS nur sehr begrenzt. Mit [{sup 224}Ra]-Radiumchlorid steht seit kurzem ein bereits in den Jahren 1945-1990 fuer die Behandlung der AS verwendetes Radiopharmakon wieder zur Verfuegung. Waehrend die Biokinetik, Strahlenexposition und das Risikoprofil von [{sup 224}Ra]-Radiumchlorid durch experimentelle und klinische Daten gut belegt sind, genuegen viele der aelteren Untersuchungen zur Wirksamkeit des Radiotherapeutikums nicht den Massstaeben, die heute an Therapiestudien zu legen sind. Aus diesem Grunde ist es wichtig, dass moeglichst viele Patienten in eine prospektive Langzeit-Anwendungsbeobachtungsstudie eingebracht werden. Bei der Anwendung von [{sup 224}Ra]-Radiumchlorid ist eine enge und gut aufeinander abgestimmete Kooperation zwischen Rheumatologen und Nuklearmedizinern erforderlich. (orig.)

  6. Ankylosing Spondylitis

    Science.gov (United States)

    ... a diagnosis, but both have some limitations. Medical History The medical history involves answering questions, such as ... Commonly used NSAIDs include aspirin, ibuprofen, and naproxen sodium. Ophthalmologist. A medical doctor specializing in diagnosing and ...

  7. Ankylosing spondylitis

    Science.gov (United States)

    The course of the disease is hard to predict. Symptoms may come and go at any time. Most people ... Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology . 9th ed. Philadelphia, PA: Elsevier Saunders; ...

  8. Ankylosing spondylitis and symptom-modifying vs disease-modifying therapy.

    Science.gov (United States)

    Akkoc, Nurullah; van der Linden, Sjef; Khan, Muhammad Asim

    2006-06-01

    The main objectives of medical therapy in ankylosing spondylitis (AS) are to relieve pain, stiffness and fatigue and to prevent structural damage. The Assessment in Ankylosing Spondylitis Working Group has proposed different domains with specific instruments to assess the efficacy of therapeutic agents classified as symptom-modifying and disease-controlling antirheumatic drugs. Non-steroidal antiinflammatory drugs (NSAIDs) are still the first-line treatment in the management of AS, and they are effective in controlling symptoms such as pain and stiffness and maintaining mobility in many patients. A recent randomized trial suggested that the progression of radiological damage occurs less on continuous use of celecoxib compared with on-demand use. If such findings were confirmed by other studies, the therapeutic value of NSAIDs in AS may extend beyond symptom control. However, for each individual patient, the expected advantages of treatment with NSAIDs should be weighted against any possible gastrointestinal and cardiovascular disadvantages. Disease-modifying antirheumatic drugs (DMARDs) are widely used for second-line therapy in AS, but the evidence for their efficacy is poor. The term 'DMARD' has been borrowed from rheumatoid arthritis, and none of the DMARDs have been shown to prevent or significantly decrease the rate of progression of structural damage which is required to be qualified as a disease-controlling antirheumatic drug for AS. Sulphasalazine is the most extensively studied DMARD and studies suggest some degree of clinical benefit confined to peripheral joint involvement, but no evidence of benefit in axial disease. Methotrexate, which is the gold standard DMARD in rheumatoid arthritis, does not seem to have a substantial therapeutic effect in AS on axial or peripheral joint involvement. Leflunomide appears to exert little beneficial effect, if any, even on peripheral joint involvement. There is also good evidence that local therapy with corticosteroids is effective and may be used in selected patients. Oral corticosteroids may be somewhat effective in relieving the symptoms of AS, but this has not been formally studied. Small studies have reported favourable results with intravenous methylprednisolone pulse therapy, but the effect is temporary. Pamidronate and thalidomide have been used in some preliminary trials but need further studies to assess their potential role in treating AS patients resistant or intolerant to other forms of treatment. Treatment with tumour necrosis factor blockers is not discussed in this review. PMID:16777581

  9. 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.)

  10. 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

  11. Monitoring ankylosing spondylitis therapy by dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging

    International Nuclear Information System (INIS)

    The effects of different therapies on enthesitis/osteitis in active ankylosing spondylitis (AS) were evaluated by magnetic resonance imaging (MRI). The aim was to assess the role of quantitative MRI in the evaluation of AS treatment efficacy. Thirty patients with active spondylitis or bilateral sacroilitis were selected and followed up for 1 year. Ten of the patients were treated only with non-steroidal anti-inflammatory drugs, 10 patients additionally received at baseline an intravenous pulse of glucocorticoids and 10 patients were treated with regular infusions of infliximab. Disease activity was measured according to clinical instruments and laboratory tests. For each patient, one selected inflamed lesion was followed from baseline through control visits quantitatively by diffusion-weighted imaging (DWI) measuring the apparent diffusion coefficient (ADC) and by dynamic contrast-enhanced imaging (DCEI) with evaluation of the enhancement factor (fenh) and enhancement gradient (genh). Clinical and quantitative MRI parameters diminished significantly with regression of the inflammatory activity. The improvement in AS was most pronounced in patients treated with infliximab; after 12 months the ADC diminished from an average of 1.31 to 0.88 x 10-3 mm2/s, fenh from 1.85 to 0.60, and genh from 3.09 to 1.40 %/s. Diffusion-weighted imaging and DCEI were shown to be effective in quantifying changes in inflammatective in quantifying changes in inflammation in skeletal lesions during the treatment of AS, and could therefore be convenient for assessing treatment efficacy. To the best of our knowledge this is the first time DWI was used to evaluate the activity of skeletal inflammation in rheumatic diseases such as AS. (orig.)

  12. Suppression subtractive hybridization reveals differentially expressed genes in supraspinous ligaments of patients with ankylosing spondylitis.

    Science.gov (United States)

    Zhang, Ying; Hu, Xu; Zhang, Chao; Zhou, Yue; Chu, Tong-Wei

    2015-06-01

    Ankylosing spondylitis (AS) is a severe chronic inflammatory disease that may ultimately result in the development of a 'bamboo?like' spine. Although the pathological changes that occur in AS have been extensively investigated, the mechanism underlying spinal fusion during AS remains elusive. Differentially expressed genes (DEGs) in paraspinal tissues from patients with AS compared with those from healthy controls were therefore investigated. Polymerase chain reaction (PCR)?based suppression subtractive hybridization was performed using total mRNA from the supraspinal ligaments of three patients with AS and three patients with spinal fractures as controls. From this, 27 genes were identified in all of the three independent forward libraries, which were defined as DEGs associated with AS. Reverse transcription?quantitative PCR demonstrated that six DEGs were overexpressed in the tissues from patients with AS compared with those from individuals in the control group, including those encoding transforming growth factor ? types I and III receptor, vascular endothelial growth factor, matrix metalloproteinase?3, core?binding factor ?1 and bone morphogenetic protein 2. Western blot analysis showed increased expression in all six of these proteins in the samples from patients with AS compared with those in the control groups. These findings suggested that changes in the expression of these genes and proteins are associated with the development of spinal fusion during the pathogenesis of AS. Furthermore, these genes may be novel markers of the risk of developing AS, in addition to being targets for the treatment of this disease. PMID:25632965

  13. Activating killer immunoglobulin-like receptors genes are associated with increased susceptibility to ankylosing spondylitis.

    Science.gov (United States)

    Díaz-Peña, R; Vidal-Castiñeira, J R; Mulero, J; Sánchez, A; Queiro, R; López-Larrea, C

    2015-05-01

    The aim of this study was to analyse the association of specific killer cell immunoglobulin-like receptors (KIR) genes and haplotypes with susceptibility to ankylosing spondylitis (AS) and its different clinical manifestations in a Spanish population. The presence or absence of all KIR genes was studied for their association with AS. A total of 176 patients with AS and 435 healthy control subjects were selected for this study based on clinical criteria. The commercial KIR-sequence-specific oligonucleotides (SSO) typing kit was used to investigate KIR typing. Frequencies of KIR2DS1 and KIR3DS1 genes were increased significantly in patients compared with healthy controls [52·8 versus 38·2%, PBonf KIR2DS1 and KIR3DS1, in addition to human leucocyte antigen (HLA)-B27, may play an important role in the pathogenesis of AS. However, we show that the contribution of the KIR genes to AS susceptibility extends beyond the association with individual KIRs, with an imbalance between activating and inhibitory KIR genes seeming to influence the susceptibility to AS. PMID:25491925

  14. Prevalence and risk factors of low bone mineral density in juvenile onset ankylosing spondylitis.

    Science.gov (United States)

    Bao, Jun; Chen, Yi; Bao, Yi-Xiao

    2014-08-01

    The objective of this study is to assess the prevalence and risk in patients with juvenile onset ankylosing spondylitis (JoAS) complicated with low bone mineral density (BMD). A total of 112 children and adolescents with JoAS were enrolled in the study. Bone mass was measured from the lumbar spine and the left proximal femur using dual-energy X-ray absorptiometry. According to the 2007 International Society of Clinical Densitometry definitions, a Z score of less than -2 was termed as "low BMD." Stepwise regression analysis was used to investigate associations between low BMD and disease-related factors including gender, age, weight, height, body mass index, disease duration, HLA-B27 antigen, grades of sacroiliitis, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), patient global assessment (PGA), spine pain, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Low BMD was found in 18 (16.1 %) cases in at least one of the two measured regions. Lumbar spine BMD had negative correlations with BASDAI, BASFI, spine pain, ESR, and CRP (P Hip BMD significantly negatively correlated with BASDAI and PGA (P BMD, which may be related to high disease activity. PMID:24854154

  15. Vertebral fractures in patients with ankylosing spondylitis. A retrospective analysis of 66 patients

    International Nuclear Information System (INIS)

    Purpose: Retrospective analysis of vertebral fractures in patients with ankylosing spondylitis (AS) for the evaluation of associations with mortality, concurrent neurological deficits, and other complications. Materials and Methods: Image analysis (conventional radiographs, CT, MRI) was applied to all patients with AS admitted between 1997 and 2007 due to vertebral fractures to determine fracture location and classification. Patient characteristics, trauma mechanism, neurological symptoms, and other complications were documented. Results: 66 patients (54 male, age 64 ± 11 years) were enrolled in the study. 74 % of patients suffered from minor trauma. 51 % and 56 % had cervicothoracic and thoracolumbar fractures, respectively, while 8 % had multi-level fractures. 63 % of patients suffered combined vertebrodiscal fractures. 70 % revealed neurological symptoms, significantly correlating with spinal stenosis (p 0.024; Odds ratio 4.265) and hyperlordosis (p = 0.014; OR 4.806). 68 % developed complications with non-combined fractures (p =.042; OR 4.954) and paravertebral hematomas (p =.009; OR 16.969) representing independent risk factors. The female gender (p = 0.005; OR 15.617) and conservative therapy (p = 0.040; OR.094) exerted significant influence on the mortality rate. Conclusion: Vertebral fractures frequently occur in patients with AS after minor trauma and often lead to neurological symptoms, which in turn are associated with spinal stenosis and hyperlordosis. Paith spinal stenosis and hyperlordosis. Paravertebral hematomas and non-combined fractures are accompanied by higher incidences of other complications. The female gender entails a higher mortality rate. (orig.)

  16. Functionally distinct ERAP1 allotype combinations distinguish individuals with Ankylosing Spondylitis.

    Science.gov (United States)

    Reeves, Emma; Colebatch-Bourn, Alexandra; Elliott, Tim; Edwards, Christopher J; James, Edward

    2014-12-01

    For more than 40 y, expression of HLA-B27 has been strongly associated with the chronic inflammatory disease Ankylosing Spondylitis (AS); however, the mechanisms underlying this association are still unknown. Single nucleotide polymorphisms within the aminopeptidase endoplasmic reticulum aminopeptidase 1 (ERAP1), which is essential for trimming peptides before they are presented to T cells by major histocompatibility complex (MHC) class I molecules, have been linked with disease. We show that ERAP1 is a highly polymorphic molecule comprising allotypes of single nucleotide polymorphisms. The prevalence of specific ERAP1 allotypes is different between AS cases and controls. Both chromosomal copies of ERAP1 are codominantly expressed, and analysis of allotype pairs provided clear stratification of individuals with AS versus controls. Functional analyses demonstrated that ERAP1 allotype pairs seen in AS cases were poor at generating optimal peptide ligands for binding to murine H-2K(b) and -D(b) and the AS-associated HLA-B*2705. We therefore provide strong evidence that polymorphic ERAP1 alters protein function predisposing an individual to AS via its influence on the antigen processing pathway. PMID:25422414

  17. Adipokines, biomarkers of endothelial activation, and metabolic syndrome in patients with ankylosing spondylitis.

    Science.gov (United States)

    Genre, Fernanda; López-Mejías, Raquel; Miranda-Filloy, José A; Ubilla, Begoña; Carnero-López, Beatriz; Blanco, Ricardo; Pina, Trinitario; González-Juanatey, Carlos; Llorca, Javier; González-Gay, Miguel A

    2014-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease associated with accelerated atherosclerosis and increased risk of cardiovascular (CV) disease. AS patients also display a high prevalence of features clustered under the name of metabolic syndrome (MeS). Anti-TNF- ? therapy was found to be effective to treat AS patients by suppressing inflammation and also improving endothelial function. Previously, it was demonstrated that a short infusion of anti-TNF- ? monoclonal antibodyinfliximab induced a rapid and dramatic reduction in serum insulin levels and insulin resistance along with a rapid improvement of insulin sensitivity in nondiabetic AS patients. The role of adipokines, MeS-related biomarkers and biomarkers of endothelial cell activation and inflammation seem to be relevant in different chronic inflammatory diseases. However, its implication in AS has not been fully established. Therefore, in this review we summarize the recent advances in the study of the involvement of these molecules in CV disease or MeS in AS. The assessment of adipokines and biomarkers of endothelial cell activation and MeS may be of potential relevance in the stratification of the CV risk of patients with AS. PMID:24757680

  18. Comparison of Venous Thromboembolism after Total Hip Arthroplasty between Ankylosing Spondylitis and Osteoarthritis

    Science.gov (United States)

    Shi, Dongquan; Xu, Xingquan; Song, Kai; Xu, Zhihong; Dai, Jin; Chen, Dongyang; Jiang, Qing

    2014-01-01

    Objective. Ankylosing spondylitis (AS), an inflammatory rheumatic disease, will gradually lead to severe hip joint dysfunction. Total hip arthroplasty is a useful method to improve patients' quality of life. The aim of this study was to compare the incidence and risk factors of deep vein thrombosis (DVT) between AS and hip osteoarthritis. Methods. In a retrospective study, a total of 149 subjects who underwent cementless THA were studied. Clinical data, biochemical data, and surgery-related data were measured between AS and OA groups. Results. The incidence of DVT in AS group was lower than that of OA group, although no significant difference was detected (P = 0.89). The patients of AS group were much younger (P < 0.0001) and thinner (P = 0.018) compared with those of OA group. AS patients had higher ejection fraction (EF) (P = 0.016), higher platelet counts (P < 0.0001), and lower hypertension rate (P = 0.0004). The values of APTT, PT, and INR in AS patients were higher than those in OA patients (all P < 0.0001). The values of D-dimer and APTT were both significantly higher in DVT subjects than those in non-DVT subjects. Conclusion. AS patients potentially had a lower incidence of DVT compared with OA patients. PMID:24995324

  19. 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.

  20. What factors determine patients' preference for tumour necrosis factor inhibitors in ankylosing spondylitis?

    Science.gov (United States)

    Fajri, Dessy W; Brand, Caroline A; Dharmage, Shyamali C; Martin, Belinda J; Buchanan, Russell R C; Schachna, Lionel

    2009-05-01

    Tumour necrosis factor inhibitor (TNFi) therapy, either intravenous (IV) or subcutaneous (SQ), demonstrates similar efficacy in ankylosing spondylitis (AS). The objective of this study was to examine factors influencing patient preference of TNFi. Fifty-nine (79.7%) participants were male with mean age 43.9 years and disease duration of 22.0 years. Fifty-nine patients (79.7%) agreed with the statement 'My doctor gave me a choice and I made a decision based on my personal preference'. Patients commenced first on IV TNFi most commonly cited reduced frequency of injections (96.6%), administration by a trained professional (89.7%) and use of infusion time for leisure activities (86.2%). Patients commenced on SQ TNFi cited flexibility with timing of treatment (80%), shortened administration time (73.3%) and the convenience of home therapy (73.3%). Shared clinical decision-making between clinicians and patients may be desirable for AS patients commencing TNFi therapy. PMID:19219481

  1. Relevant factors on the degree of anterior uveitis in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Guo-Xiang Song

    2014-07-01

    Full Text Available AIM: To investigate the association between the degree of anterioruveitis and related factors including inflammatory markers as well as sacroiliac joint imaging in patients with ankylosing spondylitis(AS. METHODS: Anterior changes evaluated by slit lamp, erythrocyte sedimentation rate(ESR, C-reactive protein(CRPand magnetic resonance imaging of 55 cases with AS associateduveitis were retrospectively analyzed. A modified endotoxin-induced uveitis(EIUclinical standard was used for uveitis grading. SPARCC sacroiliac scoring was used to evaluate bone edema of sacroiliac joint. The correlation between the degree of uveitis and sacroiliitis was assessed.RESULTS: In the 55 patients with AS, EIU grading scored 2-10, and SPARCC index scored 0-22. Further analysis showed that the severity of uveitis was significantly correlated with ESR(r=0.869, Pr=0.485, Pr=0.237, P=0.081.CONCLUSION: Local autoimmunity of uveitis and sacroiliac joint inflammation with subsequent bone formation in AS might be mutually independent processes.

  2. Atherosclerosis and cardiovascular disease in the spondyloarthritides, particularly ankylosing spondylitis and psoriatic arthritis.

    Science.gov (United States)

    Papagoras, Charalampos; Voulgari, Paraskevi V; Drosos, Alexandros A

    2013-01-01

    The spondyloarthritides (SpA) are a group of idiopathic inflammatory diseases affecting the axial and/or peripheral skeleton. Recent evidence points towards an increased mortality and morbidity due to cardiovascular disease, especially within the two major forms of SpA, ankylosing spondylitis and psoriatic arthritis. Several studies have identified alterations of the lipid profile, insulin sensitivity and other metabolic cardiovascular risk factors in SpA patients. An array of vascular morphologic and functional abnormalities has also been reported in these diseases, supporting the hypothesis of accelerated atherosclerosis in SpA. Inflammation appears to be a major player, involved both in the impairment of the classic cardiovascular risk factors, as well as directly in the process of endothelial injury, dysfunction and ultimately atherosclerosis. Multiple studies in rheumatoid arthritis have suggested that effective suppression of inflammation with synthetic disease-modifying anti-rheumatic drugs or with biologics may also exert favourable effects in the cardiovascular risk. Although such evidence is currently lacking for SpA, there is little doubt that physicians caring for patients with SpA should aim at controlling both inflammation and traditional cardiovascular risk factors. Such an integrated approach is expected to benefit patients in multiple levels. PMID:23406817

  3. 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

  4. 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)

  5. Spinal cord stimulator placement in a patient with complex regional pain syndrome and ankylosing spondylitis: a novel approach with dual benefits.

    Science.gov (United States)

    Okpareke, Ikenna; Young, Adam C; Amin, Sandeep

    2014-05-15

    Spinal cord stimulation is a treatment modality used to treat various chronic pain conditions, including complex regional pain syndrome (CRPS). We present a case in which spinal cord stimulation was used for the treatment of lower extremity CRPS in a patient with ankylosing spondylitis. Preoperative imaging demonstrated fusion of the lumbothoracic spine with obliteration of the interlaminar spaces. The sacral hiatus remained open and was used to access the epidural space, facilitating the placement of 2 thoracic epidural electrodes. The resulting stimulation controlled not only the patient's lower extremity CRPS pain but also alleviated his chronic axial pain secondary to ankylosing spondylitis. PMID:25611990

  6. Long term investigation of late effects in ankylosing spondylitis patients treated with radium-224

    Energy Technology Data Exchange (ETDEWEB)

    Wick, R.R. [GSF - National Research Center for Environment and Health, Inst. of Radiobiology, Neuherberg (Germany); Nekolla, E.A. [Federal Office for Radiation Protection (BfS), Neuherberg (Germany)

    2005-07-01

    An epidemiological study has been carried out on 1462 ankylosing spondylitis (AS) patients followed since 1971 at the GSF - National Research Center for Environment and Health. The aim of the study was to ascertain the late health effects occurring in these patients who had received repeated intravenous injections of the short lived {alpha}-emitter {sup 224}radium between 1948 and 1975 (excluding patients treated additionally with X-rays). The then usual therapeutic protocol consisted of a total of 10 to 12 injections of 1.036 MBq (28 {mu}Ci) of {sup 224}Ra each, given at weekly intervals. This resulted in a cumulative {alpha}-dose of 0.56 to 0.67 Gy to the marrow-free skeleton (bone surface dose: {proportional_to} 5.5 Gy) of a 70-kg-man (standard man). These patients have been followed together with a control group of 1324 ankylosing spondylitis patients not treated with radioactive drugs and/or X-rays. Up to August 2004, causes of death have been ascertained for 913 exposed patients and 971 controls (mean follow-up time {proportional_to} 26 yr in the exposed group or {proportional_to} 24 yr in the control group). In the exposed group there has been a total of 251 malignant diseases (vs. 277.0 expected cases) and 233 cases (vs. 302.4 exp.) among the controls. In the exposure group 16 cases of kidney cancer (vs. 8.7 cases expected, p = 0.02), 6 cases of liver cancer (vs. 3.3 exp., p = 0.12), and 4 cases of thyroid cancer (vs. 1.1 exp., p = 0.03) were observed. The most striking observation, however, were the 16 cases of leukaemia in the exposure group (vs. 6.5 cases expected, p = 0.001) compared to only 10 cases of leukaemia in the control group (vs. 7.1 cases expected, p = 0.2). Further subclassification of the leukaemias demonstrated a high increase of myeloid leukaemia in the exposure group (10 cases obs. vs. 2.8 cases exp., p <0.001), and particularly, of myeloid leukaemia (7 cases observed vs. 1.7 expected, p = 0.002), whereas in the control group the number of observed cases is within the expected range (3 myeloid leukaemias vs. 2.9 cases exp.). Out of these 7 cases of acute myeloid leukaemia, 4 cases have been observed at doses comparable to those of the {sup 224}Ra treatment practised currently with the pharmaceutical SpondylAT registered (10 injections of 1 MBq each), in one case the {sup 224}Ra-dose was the 0.6fold, in another case 1.6fold, whereas in one case the total dose could not be verified exactly. Similar higher incidences of leukaemia have not been found in another group of patients treated with higher doses or dose rates of {sup 224}Ra, observed by Spiess and co-workers. However, the enhanced leukaemia incidence in our exposed group is in line with results from animal experiments in mice having been injected with bone seeking alpha-emitters given at low dose rates. (orig.)

  7. Long term investigation of late effects in ankylosing spondylitis patients treated with radium-224

    International Nuclear Information System (INIS)

    An epidemiological study has been carried out on 1462 ankylosing spondylitis (AS) patients followed since 1971 at the GSF - National Research Center for Environment and Health. The aim of the study was to ascertain the late health effects occurring in these patients who had received repeated intravenous injections of the short lived ?-emitter 224radium between 1948 and 1975 (excluding patients treated additionally with X-rays). The then usual therapeutic protocol consisted of a total of 10 to 12 injections of 1.036 MBq (28 ?Ci) of 224Ra each, given at weekly intervals. This resulted in a cumulative ?-dose of 0.56 to 0.67 Gy to the marrow-free skeleton (bone surface dose: ? 5.5 Gy) of a 70-kg-man (standard man). These patients have been followed together with a control group of 1324 ankylosing spondylitis patients not treated with radioactive drugs and/or X-rays. Up to August 2004, causes of death have been ascertained for 913 exposed patients and 971 controls (mean follow-up time ? 26 yr in the exposed group or ? 24 yr in the control group). In the exposed group there has been a total of 251 malignant diseases (vs. 277.0 expected cases) and 233 cases (vs. 302.4 exp.) among the controls. In the exposure group 16 cases of kidney cancer (vs. 8.7 cases expected, p = 0.02), 6 cases of liver cancer (vs. 3.3 exp., p = 0.12), and 4 cases of thyroid cancer (vs. 1.1 exp., p = 0.03) were observed. The most striking observation, however, were the 16observation, however, were the 16 cases of leukaemia in the exposure group (vs. 6.5 cases expected, p = 0.001) compared to only 10 cases of leukaemia in the control group (vs. 7.1 cases expected, p = 0.2). Further subclassification of the leukaemias demonstrated a high increase of myeloid leukaemia in the exposure group (10 cases obs. vs. 2.8 cases exp., p 224Ra treatment practised currently with the pharmaceutical SpondylAT registered (10 injections of 1 MBq each), in one case the 224Ra-dose was the 0.6fold, in another case 1.6fold, whereas in one case the total dose could not be verified exactly. Similar higher incidences of leukaemia have not been found in another group of patients treated with higher doses or dose rates of 224Ra, observed by Spiess and co-workers. However, the enhanced leukaemia incidence in our exposed group is in line with results from animal experiments in mice having been injected with bone seeking alpha-emitters given at low dose rates. (orig.)

  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. Comparison of the antibody responses to the 77 Klebsiella capsular types in ankylosing spondylitis and various rheumatic diseases.

    OpenAIRE

    Sahly, H.; Kekow, J.; Podschun, R.; Schaff, M.; Gross, W. L.; Ullmann, U.

    1994-01-01

    The production of antibodies to Klebsiella capsular polysaccharides was measured in sera from either HLA-B27-positive (HLA-B27+) or HLA-B27-negative (HLA-B27-) patients with classical ankylosing spondylitis (n = 54). These sera were compared with sera from patients with various rheumatic diseases (n = 82) and HLA-B27+ or HLA-B27- healthy individuals (n = 85). All sera were analyzed by means of an enzyme-linked immunosorbent assay specific to each of the 77 Klebsiella serotypes. The sera from ...

  10. Persistence of HLA-B27 cross-reactive bacteria in bowel flora of patients with ankylosing spondylitis.

    OpenAIRE

    Prendergast, J. K.; Mcguigan, L. E.; Geczy, A. F.; Kwong, T. S.; Edmonds, J. P.

    1984-01-01

    Previous studies have shown that antisera raised in rabbits to certain enteric bacteria (cross-reactive bacteria) are capable of specifically lysing in a 51chromium-release lymphocytotoxicity test the lymphocytes of HLA-B27-positive (B27+) patients with ankylosing spondylitis (AS). This study investigated the clinical relevance of this finding by ascertaining whether Escherichia coli isolated from the rectal swabs of 20 B27+ AS patients (B27+ AS+) and 46 controls (35 B27- AS- and 11 B27+ AS-)...

  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. Plasma soluble urokinase plasminogen activator receptor (suPAR) levels in ankylosing spondylitis.

    Science.gov (United States)

    Toldi, Gergely; Szalay, Balázs; Bek?, Gabriella; Kovács, László; Vásárhelyi, Barna; Balog, Attila

    2013-01-01

    Recent studies demonstrated that soluble urokinase plasminogen activator receptor (suPAR) is a valuable marker in the recognition of an inflammatory response. Ongoing inflammation leads to elevated plasma suPAR levels. We aimed to characterize plasma suPAR levels in ankylosing spondylitis (AS) patients compared to healthy individuals in order to reveal if suPAR could be used as a clinical marker of inflammation in AS. We measured plasma suPAR and C-reactive protein (CRP) levels as well as erythrocyte sedimentation rate (ESR) in 33 AS patients at various stages of disease duration and activity and 29 healthy controls. CRP and ESR values were higher in AS patients than in healthy individuals, while suPAR values were comparable (median [interquartile range]: 2.97 [2.57-3.80] ng/mL vs. 2.80 [2.06-3.42] ng/mL, P>0.05). In AS patients, a correlation was detected between BASDAI scores and CRP as well as ESR values but not suPAR levels (P=0.0005, r=0.57 and P=0.01, r=0.43, respectively). Unlike in many other inflammatory conditions, plasma suPAR levels do not reflect inflammation in AS. To assess the inflammatory status in AS, ESR and particularly CRP values are still more appropriate clinical markers. In line with earlier findings, our results indicate that, unlike suPAR, both of these markers are positively correlated with disease activity in AS. PMID:22999906

  14. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-09-15

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

  16. 18F-Fluoride PET/CT for detection of sacroiliitis in ankylosing spondylitis

    International Nuclear Information System (INIS)

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

  17. 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.

  18. 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

    Directory of Open Access Journals (Sweden)

    Wong Robert L

    2009-04-01

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

  19. Bilateral ankylosis of the jaw treated with total alloplastic replacement using the TMJ concepts system in a patient with ankylosing spondylitis.

    Science.gov (United States)

    Manemi, R V; Fasanmade, A; Revington, P J

    2009-03-01

    Minimal documentation exists regarding bilateral temporomandibular joint (TMJ) involvement in ankylosing spondylitis (AS) and surgical management of this specific manifestation. Use of TMJ concepts prostheses in AS patients has not been previously described. This case demonstrates that TMJ replacement with prosthetic joints in AS is technically possible and appropriate. PMID:19019507

  20. 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 HPLC and 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

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

    Scientific Electronic Library Online (English)

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

    2014-03-01

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

  2. Adverse Events of Anti-Tumor Necrosis Factor ? Therapy in Ankylosing Spondylitis

    Science.gov (United States)

    Tong, Qiang; Cai, Qing; de Mooij, Tristan; Xu, Xia; Dai, Shengming; Qu, Wenchun; Zhao, Dongbao

    2015-01-01

    Objective This study aims to investigate the prevalence of short-term and long-term adverse events associated with tumor necrosis factor-? (TNF-?) blocker treatment in Chinese Han patients suffering from ankylosing spondylitis (AS). Methods The study included 402 Chinese Han AS patients treated with TNF-? blockers. Baseline data was collected. All patients were monitored for adverse events 2 hours following administration. Long-term treatment was evaluated at 8, 12, 52 and 104 weeks follow-up for 172 patients treated with TNF-? blockers. Results Short-term adverse events occurred in 20.15% (81/402), including rash (3.5%; 14/402), pruritus (1.2%; 5/402), nausea (2.2%; 9/402), headache (0.7%; 3/402), skin allergies (4.0%; 16/402), fever (0.5%; 2/402), palpitations (3.0%; 12/402), dyspnea (0.5%; 2/402), chest pain (0.2%; 2/402), abdominal pain (1.0%; 4/402), hypertension (2.2%; 9/402), papilledema (0.5%; 2/402), laryngeal edema (0.2%; 1/402) and premature ventricular contraction (0.2%; 1/402). Long-term adverse events occurred in 59 (34.3%; 59/172) patients, including pneumonia (7.6%; 13/172), urinary tract infections (9.9%; 17/172), otitis media (4.7%; 8/172), tuberculosis (3.5%; 17/172), abscess (1.2%; 2/172), oral candidiasis (0.6%; 1/172), elevation of transaminase (1.7%; 3/172), anemia (1.2%; 2/172), hematuresis (0.6%; 1/172), constipation (2.3%; 4/172), weight loss (0.6%; 1/172), exfoliative dermatitis (0.6%; 1/172). CRP, ESR and disease duration were found to be associated with an increased risk of immediate and long-term adverse events (P<0.05). Long-term treatment with Infliximab was associated with more adverse events than rhTNFR-Fc (P<0.01). Conclusion This study reports on the prevalence of adverse events in short-term and long-term treatment with TNF-? blocker monotherapy in Chinese Han AS patients. Duration of disease, erythrocyte sedimentation rate, and c-reactive protein serum levels were found to be associated with increased adverse events with anti-TNF-? therapy. Long-term treatment with Infliximab was associated with more adverse events than rhTNFR-Fc. PMID:25764452

  3. 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

  4. Ankylosing spondylitis and undifferentiated spondyloarthritis in Kuwait: a comparison between Arabs and South Asians.

    Science.gov (United States)

    Uppal, S S; Abraham, Mini; Chowdhury, R I; Kumari, Rakesh; Pathan, E M; Al Rashed, A

    2006-03-01

    The objectives of this study were to describe and compare the clinical characteristics of ankylosing spondylitis (AS) and undifferentiated spondyloarthritis (USpA) in Middle East Arab (MEA) and South Asian (SA) patients diagnosed in our unit. Fifty-eight consecutive patients diagnosed with SpA were studied after classifying them into MEA and SA. They were further classified as per disease diagnosis. Excluding three patients with miscellaneous ethnicity, there were 29 MEA and 26 SA patients. Seventy-two percent of MEA patients were males (vs 92% of SA patients). Of the 29 patients with MEA ethnicity, 17 had AS and 9 had USpA. Of the 26 patients with SA ethnicity, 10 had AS and 14 had USpA. Fifty-nine percent of MEA patients had AS (vs 39% of SA patients). Mean age at onset in AS patients was similar in the two ethnic groups. However, in patients with USpA, mean age at onset was somewhat lower at 21.8 years in the MEA group compared with 29.4 years in the SA group. Family history in first-degree relatives was significantly more common in MEA patients. Weight loss, inflammatory spinal pain, gluteal pain, and enthesopathy were equally common in both ethnic groups. Knee, ankle, and metatarsophalangeal joint involvement was less common in MEA patients. There were no significant differences in the occurrence of syndesmophytes, bamboo spine, and sacroiliitis in the two ethnic groups. HLA-B27 positivity rates in MEA patients were 87% for AS and 67% for USpA compared to 75 and 71%, respectively, in SA patients. It is concluded that some significant new findings have arisen from this study: the majority of MEA patients presented with AS, whereas the majority of SA patients had a picture of USpA. Family history was more common in MEA patients. Peripheral arthritis was less common in MEA patients. Worldwide, this is the first study to show that there are significant differences in the clinical expression of the various SpA in MEA patients compared to SA patients. PMID:16240074

  5. Ankylosing spondylitis, late osteoarthritis, vascular calcification, chondrocalcinosis and pseudo gout: toward a possible drug therapy.

    Science.gov (United States)

    Mebarek, S; Hamade, E; Thouverey, C; Bandorowicz-Pikula, J; Pikula, S; Magne, D; Buchet, R

    2011-01-01

    In this review we consider diseases associated with pathological mineralization/ossification, namely, ankylosing spondylitis (AS), osteoarthritis (OA), generalized artery calcification of infancy (GACI), vascular calcification as well as chondrocalcinosis (CC) and pseudo gout. Deciphering the key enzymes implicated in the calcification process is an objective of prime importance and the ultimate goal is to synthesize inhibitors of these enzymes in order to provide efficient alternate therapeutic strategies that will slow down the pathologic mineralization and complement the arsenal of anti-inflammatory drugs. One of the difficulties in the definition of diseases associated with pathologic mineralization/ossification lies in the controversial relationship between the type of calcification and the nature of the disease. Here, we propose to clarify this relationship by making a distinction between diseases associated with hydroxyapatite (HA) and calcium pyrophosphate dihydrate (CPPD) deposits. AS, OA, GACI and vascular calcification are usually characterized by mineralization/ossification associated with HA deposits, while CC and pseudo gout are mostly characterized by CPPD deposits. Although both HA and CPPD deposits may occur concomitantly, as in chronic pyrophosphate arthritis or in OA with CPPD, they are formed as a result of two antagonistic processes indicating that treatment of distinct diseases can be only achieved by disease-specific drug therapies. The hydrolysis of PPi, an inhibitor of HA formation, is mostly controlled by tissue non-specific alkaline phosphatase TNAP, while PPi production in the extracellular medium is controlled by ANK, a PPi transporter, and/or NPP1 which generates PPi from nucleotide triphosphates. Low PPi concentration may lead to a preferential deposition of HA while high PPi concentration will favor the formation of CPPD deposits. Thus, HA and CCPD deposition cannot occur concomitantly because they are determined by the Pi/PPi ratio which, in turn, depends on the relative activities of antagonistic enzymes, TNAP hydrolyzing PPi or ANK and NPP1 producing PPi. TNAP inhibitors could prevent HA formation in AS, in late OA, in GACI, as well as in vascular calcifications, while ANK or NPP1 inhibitors could slow down CCPD deposition in CC and pseudo gout. PMID:21517761

  6. 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 SciELO Cuba | Language: Spanish Abstract in spanish 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.

  7. 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.

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

    Scientific Electronic Library Online (English)

    Fernando Augusto, Chiuchetta.

    2010-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Fernando Augusto Chiuchetta

    2010-06-01

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

  10. Is there a preferred method for scoring activity of the spine by magnetic resonance imaging in ankylosing spondylitis?

    DEFF Research Database (Denmark)

    van der Heijde, Désirée; Landewé, Robert

    2007-01-01

    This report summarizes the discussion during a module update at OMERACT 8 on scoring methods for activity in the spine on magnetic resonance imaging. The conclusion was that the 3 available scoring methods are all very good with respect to discrimination and feasibility: the Ankylosing Spondylitis spine MRI score for activity (ASspiMRI-a), the Berlin method (a modification of the ASspiMRI-a), and the Spondyloarthritis Research Consortium of Canada Magnetic Resonance Imaging Index for Assessment of Spinal Inflammation in AS (SPARCC). All 3 methods were judged to be similar with respect to responsiveness and discrimination, although the differences in between-reader intraclass correlation coefficients (ICC) were judged to be relevant (the SPARCC method provided consistently higher ICC). The Berlin and SPARCC methods were preferred most frequently. The development of a new method combining the best elements of all methods is an additional possibility.

  11. [Welfare as the goal of the analgesic pharmacotherapy accompanying biological treatment in patients with rheumatoid arthritis and ankylosing spondylitis].

    Science.gov (United States)

    Tomasiewicz, Beata; Hurkacz, Magdalena; Jarzibowski, Jaros?aw; Wiela-Hoje?ska, Anna

    2014-11-01

    Therapy of chronic rheumatic diseases, such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS) needs a comprehensive approach to the patient, based on the control of pain and improvement in overall condition, which affects the quality-of-life. This requires optimizing the treatment with non-steroidal anti-inflammatory drugs (NSAIDs) or analgesics and control of adverse drug reactions. The aim of the study was to evaluate the efficacy and safety of pain pharmacotherapy in patients with rheumatoid arthritis and ankylosing spondylitis treated as the basic pharmacotherapy-biological drugs, the analysis of awareness of pharmacovigilance and evaluation of analgesic treatment costs. Material and methods. Examined group consisted of 102 people with RA or AS received biological therapy. Test method was questionnaire with closed and open questions. Results. 86.2% of respondents used a pain medication (41%--an ad hoc basis, but 23%--at least once a day), while 79.4%--NSAIDs (33%--an ad hoc basis and 17%--at least once a day). In 85.3% of those not observed adverse effects of pain pharmacotherapy. 5 persons declared abdominal pain. Most of the patients complied with the recommendations of the doctor in the pain treatment. For the third respondents the cost of pharmacotherapy of pain was monthly 1-10 zl, but 6% of patients paying for drugs from 50-60 and above 60 zl monthly. Conclusions. Biological treatment in RA and AS is effective but requires additional analgesic therapy. Adverse effects seen during pharmacological treatment of chronic pain in rheumatic diseases are, in practice sporadic. Therapeutic patient education with chronic diseases is proper. Costs borne by the patient's pain relief in this group are not too high. PMID:25546988

  12. Brazilian-portuguese version and applicability questionnaire of the mobility index for ankylosing spondyliti / Versão em língua portuguesa do Brasil e a reprodutibilidade do questionário de índice de mobilidade para espondilite anquilosante

    Scientific Electronic Library Online (English)

    Samuel Katsuyuki, Shinjo; Roberta, Gonçalves; Sérgio, Kowalski; Célio Roberto, Gonçalves.

    Full Text Available SciELO Brazil | Language: English Abstract in portuguese OBJETIVO: Traduzir e adaptar para a língua portuguesa do Brasil o Bath Ankylosing Spondylitis of Metrodology Index (BASMI) - instrumento de mensuração metrológica de pacientes com espondilite anquilosante - além de avaliar a reprodutibilidade deste questionário. MÉTODOS: O Bath Ankylosing Spondyliti [...] s of Metrodology Index em versão língua portuguesa do Brasil foi obtida após processo de tradução e retro-tradução. Essa nova versão foi aplicada em 25 pacientes consecutivos com espondilite anquilosante, que preenchiam os critérios modificados de Nova Iorque de 1984 e que estavam em acompanhamento na Unidade de Espondiloartropatia Soronegativa do Serviço de Reumatologia da Faculdade de Medicina de Universidade de São Paulo, de maio a novembro de 2005. Para avaliar a reprodutibilidade, o questionário foi aplicado aos pacientes por dois observadores fixos e independentes: A e B (Reumatologistas), no mesmo dia, para avaliar teste interobservador. Após 14 dias, o observador A reaplicou o questionário aos mesmos pacientes para avaliação de teste intra-observador. Todas as entrevistas foram feitas no período de manhã. O coeficiente de correlação de Pearson foi usado para avaliação da reprodutibilidade. RESULTADOS: Não houve conflito quanto a tradução e re-tradução do questionário Bath Ankylosing Spondylitis of Metrodology Index. Também não houve a necessidade de adaptação cultural. Todos os componentes do Bath Ankylosing Spondylitis of Metrodology Index apresentaram coeficiente estatisticamente significante para reprodutibilidade intra e interobservadores, com escores, respectivamente, variando entre 0,85 a 1,00, e 0,80 a 0,94. DISCUSSÃO: O Bath Ankylosing Spondylitis of Metrodology Index, versão para a língua portuguesa do Brasil, mostrou-se ser um instrumento reprodutível para ser utilizado na avaliação do índice de mobilidade de pacientes brasileiros com espondilite anquilosante. Abstract in english PURPOSE: To translate and adapt the Bath Ankylosing Spondylitis Methodology Index (BASMI) - a metrological measurement for the assessment of patients with ankylosing spondylitis to Brazilian-Portuguese and to analyze the applicability of the questionnaire. METHODS: The Brazilian-Portuguese version o [...] f the Bath Ankylosing Spondylitis Methodology Index was achieved through a translation and back-translation process. This new Bath Ankylosing Spondylitis Methodology Index version was administered to 25 consecutive patients with ankylosing spondylitis who met the 1984 New York criteria for ankylosing spondylitis and were followed in the Soronegative Spondyloarthropathy Unit of the Rheumatology Division, São Paulo University Medical School, from May to November 2005. In order to evaluate the applicability of the questionnaire, it was administered to patients by 2 separate observers, A and B (Rheumatologists), enabling inter-observer test analysis. After 2 weeks, the second interview was administered to the same patients by observer A only to analyze the intra-observer test. All interviews were conducted in the morning. The Pearson coefficient correlation was used to evaluate applicability. RESULTS: There was no conflict stemming from translation and re-translation of Bath Ankylosing Spondylitis Methodology Index questionnaire, and cross-cultural adaptation proved unnecessary. All components had statistically significant coefficients for intra- and inter-observational applicability, with scores ranging from 0.85 to 1.00 and 0.80 to 0.94, respectively. DISCUSSION: The Brazilian-Portuguese version of the Bath Ankylosing Spondylitis Methodology Index proved to be an applicable instrument for analyzing the mobility index of Brazilian patients with ankylosing spondylitis.

  13. Brazilian-portuguese version and applicability questionnaire of the mobility index for ankylosing spondyliti Versão em língua portuguesa do Brasil e a reprodutibilidade do questionário de índice de mobilidade para espondilite anquilosante

    Directory of Open Access Journals (Sweden)

    Samuel Katsuyuki Shinjo

    2007-01-01

    Full Text Available PURPOSE: To translate and adapt the Bath Ankylosing Spondylitis Methodology Index (BASMI - a metrological measurement for the assessment of patients with ankylosing spondylitis to Brazilian-Portuguese and to analyze the applicability of the questionnaire. METHODS: The Brazilian-Portuguese version of the Bath Ankylosing Spondylitis Methodology Index was achieved through a translation and back-translation process. This new Bath Ankylosing Spondylitis Methodology Index version was administered to 25 consecutive patients with ankylosing spondylitis who met the 1984 New York criteria for ankylosing spondylitis and were followed in the Soronegative Spondyloarthropathy Unit of the Rheumatology Division, São Paulo University Medical School, from May to November 2005. In order to evaluate the applicability of the questionnaire, it was administered to patients by 2 separate observers, A and B (Rheumatologists, enabling inter-observer test analysis. After 2 weeks, the second interview was administered to the same patients by observer A only to analyze the intra-observer test. All interviews were conducted in the morning. The Pearson coefficient correlation was used to evaluate applicability. RESULTS: There was no conflict stemming from translation and re-translation of Bath Ankylosing Spondylitis Methodology Index questionnaire, and cross-cultural adaptation proved unnecessary. All components had statistically significant coefficients for intra- and inter-observational applicability, with scores ranging from 0.85 to 1.00 and 0.80 to 0.94, respectively. DISCUSSION: The Brazilian-Portuguese version of the Bath Ankylosing Spondylitis Methodology Index proved to be an applicable instrument for analyzing the mobility index of Brazilian patients with ankylosing spondylitis.OBJETIVO: Traduzir e adaptar para a língua portuguesa do Brasil o Bath Ankylosing Spondylitis of Metrodology Index (BASMI - instrumento de mensuração metrológica de pacientes com espondilite anquilosante - além de avaliar a reprodutibilidade deste questionário. MÉTODOS: O Bath Ankylosing Spondylitis of Metrodology Index em versão língua portuguesa do Brasil foi obtida após processo de tradução e retro-tradução. Essa nova versão foi aplicada em 25 pacientes consecutivos com espondilite anquilosante, que preenchiam os critérios modificados de Nova Iorque de 1984 e que estavam em acompanhamento na Unidade de Espondiloartropatia Soronegativa do Serviço de Reumatologia da Faculdade de Medicina de Universidade de São Paulo, de maio a novembro de 2005. Para avaliar a reprodutibilidade, o questionário foi aplicado aos pacientes por dois observadores fixos e independentes: A e B (Reumatologistas, no mesmo dia, para avaliar teste interobservador. Após 14 dias, o observador A reaplicou o questionário aos mesmos pacientes para avaliação de teste intra-observador. Todas as entrevistas foram feitas no período de manhã. O coeficiente de correlação de Pearson foi usado para avaliação da reprodutibilidade. RESULTADOS: Não houve conflito quanto a tradução e re-tradução do questionário Bath Ankylosing Spondylitis of Metrodology Index. Também não houve a necessidade de adaptação cultural. Todos os componentes do Bath Ankylosing Spondylitis of Metrodology Index apresentaram coeficiente estatisticamente significante para reprodutibilidade intra e interobservadores, com escores, respectivamente, variando entre 0,85 a 1,00, e 0,80 a 0,94. DISCUSSÃO: O Bath Ankylosing Spondylitis of Metrodology Index, versão para a língua portuguesa do Brasil, mostrou-se ser um instrumento reprodutível para ser utilizado na avaliação do índice de mobilidade de pacientes brasileiros com espondilite anquilosante.

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

    International Nuclear Information System (INIS)

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

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

    Scientific Electronic Library Online (English)

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

    2010-12-01

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

  16. The relationship between disease activity measured by the BASDAI and psychological status, stressful life events, and sleep quality in ankylosing spondylitis.

    Science.gov (United States)

    Jiang, Yutong; Yang, Mingcan; Wu, Husheng; Song, Hui; Zhan, Feng; Liu, Shengyun; Gao, Guanmin; Liu, Zhangsuo; Hu, Zhaoxian; He, Peigen; Zhang, Shengtao; Hu, Zaiying; Lin, Zhiming; Zhang, Yanli; Li, Yinong; Shen, Lingxun; Huang, Anbing; Liao, Zetao; Cao, Shuangyan; Wei, Yanlin; Li, Li; Li, Qiuxia; Lv, Qing; Qi, Jun; Huang, Jianlin; Li, Tianwang; Jin, O; Pan, Yunfeng; Gu, J

    2015-03-01

    Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is a standard instrument regularly used to assess disease activity of patients with ankylosing spondylitis (AS). However, the well-being of a patient is also affected by impairment of function as well as psychological status and other factors. The objective of this study was to evaluate if psychological status, stressful life events, and sleep quality contribute significantly to BASDAI. Six hundred eighty-three AS patients satisfying the Modified New York Criteria for AS were recruited from the rheumatology clinics of seven hospitals in China. Patients with other concomitant disorders were excluded. Participants were requested to complete a set of clinical examinations and the following questionnaires: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Zung Self-Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index Questionnaire (PSQI), Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S), and Social Readjustment Rating Scale (SRRS). Spearman correlation analysis showed that BASDAI was highly associated with degree and duration of morning stiffness, overall pain, nocturnal back pain, overall back pain, anxiety, and BASFI (all P??0.05). Multiple stepwise regression analysis indicated that overall pain was the maximal statistical contribution in predicting disease activity (standardized coefficient, 0.335). In hierarchic multiple regression analysis, psychological variables added an only additional 2.7 % to the overall R (2) beyond that accounted for by demographic and medical variables, resulting in a final R (2) of 53.5 %. Although BASDAI is a very good measurement of pain and stiffness and to a certain extent effect of functional impairment in AS, it barely takes into account psychological status, stress life events, and sleep quality These factors should be evaluated by other modalities. PMID:24946723

  17. Patients with Ankylosing Spondylitis and Low Disease Activity because of Anti-TNF-Alpha Therapy Have Higher TRAIL Levels Than Controls: A Potential Compensatory Effect

    OpenAIRE

    Fernanda Genre; Xf Pez-mej Xed As, Raquel L.; Javier Rueda-Gotor; Miranda-filloy, Jos Xe A.; Ubilla, Bego Xf A.; Beatriz Carnero-López; Natalia Palmou-Fontana; Xf Mez-acebo, In Xe S. G.; Ricardo Blanco; Trinitario Pina; Rodrigo Ochoa; Carlos González-Juanatey; Javier Llorca; Gonz Xe Lez-gay, Miguel A.

    2014-01-01

    Objective. TRAIL is a potential biomarker of cardiovascular (CV) disease. Ankylosing spondylitis (AS) is a chronic inflammatory disease associated with metabolic syndrome (MeS) and accelerated atherosclerosis. We assessed whether disease activity, systemic inflammation, and MeS features were associated with circulating TRAIL levels in AS patients undergoing TNF-? antagonist infliximab therapy and if infliximab infusion modified TRAIL levels. Methods. We measured TRAIL serum levels in 30 nond...

  18. Atherosclerosis in male patients with ankylosing spondylitis: the relation with methylenetetrahydrofolate reductase (C677T) gene polymorphism and plasma homocysteine levels.

    Science.gov (United States)

    Geçene, Muharrem; Tuncay, Figen; Borman, P?nar; Yücel, Dogan; Senes, Mehmet; Y?lmaz, Behice Kaniye

    2013-06-01

    The aim of this study was to determine the intima-media thickness (IMT) in carotid arteries and to assess the relation of these values with plasma homocysteine (pHcy) levels and methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism in patients with Ankylosing spondylitis (AS). Serum lipids, vitamin B12, folic acid, pHcy and acute phase protein levels were measured in all cases. MTHFR C677T gene polymorphisms were determined, and IMT of main carotid artery were evaluated ultrasonographically in all subjects. Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity score and Bath Ankylosing Spondylitis Metrology Index were used to assess disease activity and spinal mobility. Fifty AS patients (mean age of 36.6 ± 4.79 years) and 50 control subjects (36.34 ± 4.72 years) were included in the study. Plasma homocysteine levels of AS patients and control group were also similar (14.26 ± 9.96 vs. 11.81 ± 5.53 ?mol/L). Hyperhomocysteinemia was present in 11 subjects in patient group (22.0 %), while it was seen in 5 subjects in the control group (10.0 %). The MTHFR C677T genotype distribution was as follows: CC 31 (62 %), CT 14 (28 %), TT 5 (10 %) in AS patients. The mean carotid IMT values were also found to be similar between the groups. The most important factor influencing pHcy level was found as MTHFR 677TT genotype. We indicated no difference of atherosclerosis indices revealed by IMT values and pHcy levels AS patients and control subjects. But an association between MTHFR 677 gene polymorphism and pHcy levels was concluded, which may suggest that MTHFR 677 TT polymorphism may be a potential prognostic factor for cardiovascular disease in patients with AS. PMID:23247802

  19. 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

  20. 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

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

    International Nuclear Information System (INIS)

    Mortality up to 1 January 1983 has been studied in 14,106 patients with ankylosing spondylitis given a single course of X-ray treatment during 1935-54. For neoplasms other than leukaemia or colon cancer, mortality was 28% greater than that of members of the general population of England and Wales, and this increase is likely to have been a direct consequence of the treatment. The proportional increase reached a maximum of 71% between 10.0 and 12.4 years after irradiation and then declined. There were only a 7% increase in mortality from these tumours more than 25.0 years after irradiation and only for cancer of the oesophagus was the relative risk significantly raised in this period. Neither the magnitude of the relative risk, nor its temporal pattern following treatment, were greatly influenced by the age of the patient at first treatment. For leukaemia there was a threefold increase in mortality that is also likely to have been due to the radiotherapy. For colon cancer mortality was increased by 30%. For non-neoplastic conditions there was a 51% increase in mortality that was likely to be associated with the disease itself rather than its treatment. (author)

  2. Trends in long term mortality in ankylosing spondylitis treated with a single course of X-rays

    International Nuclear Information System (INIS)

    Mortality up to 1 January 1983 has been studied in 14,106 patients with ankylosing spondylitis given a single course of x-ray treatment. For leukaemia there was a threefold increase in mortality. The relative risk was at its highest between 2.5 and 4.9 years after the treatment and then declined, but the increase did not disappear completely, and the risk was still nearly twice that of the general population more than 25.0 years after treatment. For neoplasms other than leukaemia or colon cancer, mortality was 28% greater than that of the general population of England and Wales. The proportional increase reached a maximum of 71% between 10.0 and 12.4 years after irradiation and then declined. There was only a 7% increase in mortality from these tumours more than 25.0 years after irradiation and only for cancer of the oesophagus was the relative risk significantly raised in this period. (author)

  3. Intra-Tester and Inter-Tester Reliability of Chest Expansion Measurement in Clients with Ankylosing Spondylitis and Healthy Individuals

    Science.gov (United States)

    Senjyu, Hideaki; Williams, Linda; White, Colin

    2004-01-01

    The purpose of this study was to examine the intra-tester and inter-tester reliability of chest expansion (CE) using a tape measure, in people with ankylosing spondylitis (AS) and healthy subjects. Twenty-two subjects with AS with a mean age of 41.4 years and 25 healthy subjects with a mean age of 41.0 years were tested in two arm positions: hands on head and arms at the sides, the tape measure being placed at the level of xiphisternum. There were three testers for subjects with AS and two testers for healthy subjects. Three trials in both arm positions were recorded by each tester on two separate occasions which were 10 minutes apart. Results showed intraclass correlation coefficients (ICC) for intra-tester reliability good (0.85 to 0.97) across the occasions. Intraclass correlation coefficients for inter-tester reliability were also very good (0.93 to 0.97). As reliability is good it is suggested that CE can be used for monitoring disease progression and efficacy of intervention with confidence within tester and between testers.

  4. IGF-1 and ADMA levels are inversely correlated in nondiabetic ankylosing spondylitis patients undergoing anti-TNF-alpha therapy.

    Science.gov (United States)

    Genre, Fernanda; López-Mejías, Raquel; Rueda-Gotor, Javier; Miranda-Filloy, José A; Ubilla, Begoña; Villar-Bonet, Aurelia; Carnero-López, Beatriz; Gómez-Acebo, Inés; Blanco, Ricardo; Pina, Trinitario; González-Juanatey, Carlos; Llorca, Javier; González-Gay, Miguel A

    2014-01-01

    Like rheumatoid arthritis, ankylosing spondylitis (AS) is also an inflammatory disease associated with accelerated atherosclerosis and the presence of metabolic syndrome (MeS) features. AS patients often display osteoporosis as well as new bone formation. Insulin-like growth factor 1 (IGF-1) is a protein involved in both inflammation and bone metabolism. In the present study we assessed whether disease activity, systemic inflammation, MeS features, adipokines, and biomarkers of endothelial activation were associated with IGF-1 and insulin-like growth factor binding protein-3 (IGFBP-3) levels in a series of 30 nondiabetic AS patients without CV disease undergoing TNF-? antagonist-infliximab therapy. All determinations were made in the fasting state, immediately before an infliximab infusion. Although no association of IGF-1 and IGFBP-3 levels with angiopoietin-2 or osteopontin was found, an inverse correlation between IGF-1 levels and asymmetric dimethylarginine (ADMA), an endogenous endothelial nitric oxide synthase inhibitor that impairs nitric oxide production and secretion promoting endothelial dysfunction, was found (r=-0.397; P=0.04). However, no significant association was found between IGF-1 and IGFBP-3 levels and disease activity, systemic inflammation, metabolic syndrome features, or adipokines. In conclusion, in nondiabetic patients with AS undergoing periodic anti-TNF-? therapy, IGF-1 and ADMA are inversely correlated. PMID:25295265

  5. 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.

  6. 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

    2015-12-01

    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:25778059

  7. 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.

  8. Serum fatty acid profiles and potential biomarkers of ankylosing spondylitis determined by gas chromatography-mass spectrometry and multivariate statistical analysis.

    Science.gov (United States)

    Chen, Rui; Han, Su; Dong, Daming; Wang, Yansong; Liu, Qingpeng; Xie, Wei; Li, Mi; Yao, Meng

    2015-04-01

    Ankylosing spondylitis (AS) is a common chronic inflammatory rheumatic disease. Early and accurate detection is essential for effective disease treatment. Recently, research has focused on genomics and proteomics. However, the associated metabolic variations, especially fatty acid profiles, have been poorly discussed. In this study, the gas chromatography-mass spectrometry (GC-MS) approach and multivariate statistical analysis were used to investigate the metabolic profiles of serum free fatty acids (FFAs) and esterified fatty acids (EFAs) in AS patients. The results showed that significant differences in most of the FFA (C12:0, C16:0, C16:1, C18:3, C20:4, C20:5, C22:5 and C22:6) and EFA (C12:0, C16:1, C18:0, C18:1, C18:2, C18:3, C20:4 and C22:6) concentrations were found between the AS patients and healthy controls (p?

  9. 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.

  10. Association of HLA-B27 and ERAP1 with ankylosing spondylitis susceptibility in Beijing Han Chinese.

    Science.gov (United States)

    Zhang, Z; Dai, D; Yu, K; Yuan, F; Jin, J; Ding, L; Hao, Y; Liang, F; Liu, N; Zhao, X; Long, J; Xi, Y; Sun, Y-Y

    2014-05-01

    This study investigated the genetic polymorphisms of HLA-B27, together with polymorphisms on endoplasmic reticulum aminopeptidase 1 (ERAP1), and susceptibility for ankylosing spondylitis (AS) in the Beijing Han population. A case-control study was carried out for 602 AS patient samples and 619 matched controls of Han Chinese. HLA-B27 genotyping was performed by polymerase chain reaction-sequence specific primers (PCR-SSP), and four ERAP1 SNPs (rs27037, rs27980, rs27582, and rs27434) were selected and genotyped on the Sequenom iPlex platform (Sequenom, San Diego, CA). Association analysis was performed using the likelihood ratio ?(2) test. This study identified four HLA-B27 alleles in Beijing Han AS patients, B*27:02, B*27:04, B*27:05, and B*27:07, of which B*27:05 was the most significant geographical different subtype among AS patients in Chinese. Our results confirmed that HLA-B27 was strongly associated with AS (P=1.9 × 10(-150) ), and the most strongly associated alleles were B*27:04, B*27:05, and B*27:02. Our study also confirmed a weak association between ERAP1 (rs27434) and AS. We also observed that for HLA-B*27:02 and HLA-B*27:04 positive AS patients, rs27434 and rs27582 were associated with AS. In contrast, for HLA-B27-negative and HLA-B*27:05-positive AS patients, this association was not observed. This is the first study to show that both B27 and ERAP1 are AS genetic susceptibility genes in Beijing Han. Interactions between ERAP1 and HLA-B*27:02 and B*27:04 may play an important role in the AS pathogenesis. PMID:24666027

  11. 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?

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

    Science.gov (United States)

    Muñoz-Ortego, Juan; Vestergaard, Peter; Rubio, Josep Blanch; Wordsworth, Paul; Judge, Andrew; Javaid, M Kassim; Arden, Nigel K; Cooper, Cyrus; Díez-Pérez, Adolfo; Prieto-Alhambra, Daniel

    2014-08-01

    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?

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

    Science.gov (United States)

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

    2014-07-01

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

  14. Effect of HLA-B*27 and its subtypes on clinical manifestations and severity of ankylosing spondylitis in Iranian patients.

    Science.gov (United States)

    Fallahi, Sasan; Mahmoudi, Mahdi; Nicknam, Mohammad Hossein; Gharibdoost, Farhad; Farhadi, Elham; Saei, Azad; Nourijelyani, Keramat; Ahmadzadeh, Nooshin; Jamshidi, Ahmad Reza

    2013-12-01

    The aim of this study was to assess the role of HLA-B*27 and it's subtypes in determining severity and clinical manifestations of ankylosing spondylitis (AS).A total of 163 AS patients were assessed for clinical manifestations and severity using structured questionnaires. HLA-B*27 screening and B*27 sub-typing were performed by PCR.One hundred twenty two patients (74.8%) were B*27 positive. The male to female ratio, peripheral arthritis, steroid use, intense dorsal kyphosis and decrease of cervical slope had a significantly higher frequency in B*27 positive patients compared to B*27 negative ones (p=0.01, 0.001, 0.01, 0.04 and 0.04, respectively). However, the age of diagnosis was significantly lower in B*27 positive patients (p=0.005). Trend in uveitis and some severity markers including: BASMI and ASQoL were toward higher values in B*27 positive group with no significant difference. After controlling confounding variables, significant relationship was found only between B*27 and BASMI (p=0.01). B*27 subtypes in patients were included B*2705: 48.4%, B*2702: 42.6%, B*2704: 5.7% and B*2707: 3.3%. No significant differences were seen for severity markers and clinical manifestations between subtypes; although trend toward lower values of severity markers, less intense dorsal kyphosis and less decrease of cervical slope were observed in B*2704 and B*2707 versus other polymorphisms.Clinical features and severity of AS is influenced by HLA-B*27. Trend toward higher severity markers in B*2705 and B*2702 versus other polymorphisms might be subject of interest for evaluation in other ethnicities with concentration to other novel susceptibility genes co-inherited in each B*27 subtype. PMID:23996708

  15. The relationship between depressive symptoms, illness perceptions and quality of life in ankylosing spondylitis in comparison to rheumatoid arthritis.

    Science.gov (United States)

    Hyphantis, Thomas; Kotsis, Konstantinos; Tsifetaki, Niki; Creed, Francis; Drosos, Alexandros A; Carvalho, André F; Voulgari, Paraskevi V

    2013-05-01

    Anxiety and depressive symptoms as well as cognitive variables are important in determining outcome in rheumatic diseases. We aimed to compare psychological distress symptoms and illness perceptions in ankylosing spondylitis (AS) and rheumatoid arthritis (RA) and to test whether their associations with health-related quality of life (HRQoL) were similar in these rheumatologic disorders. In 55 AS and 199 RA patients, we administered the Patient Health Questionnaire (PHQ-9), the Symptom Check-List and the Brief-Illness Perception Questionnaire to assess psychological variables and the World Health Organization Quality of Life Instrument, Short Form to assess HRQoL. We used hierarchical regression analyses to determine the associations between psychological variables and HRQoL after adjusting for demographic variables and disease parameters. The prevalence of clinically significant depressive symptoms (PHQ-9 ? 10) was 14.8 % in AS and 25.1 % in RA patients, but adjustment for demographics rendered these differences in depressive symptoms' severity non-significant. Psychological distress levels and HRQoL were similar in both disorders. Illness concern (b = -0.37) was the only significant independent correlate of physical HRQoL in AS. In RA, depression (b = -0.25), illness concern (b = -0.14) and worries about the consequences of the disease (b = -0.31) were the independent correlates of physical HRQoL. These findings suggest that cognitive variables are important correlates of HRQoL in AS, whereas in RA depressive symptoms and illness perceptions equally contribute to HRQoL. Our data encourage the design of psychotherapeutic trials targeting disease-related cognitions in AS in an attempt to improve patient's physical HRQoL. PMID:23329349

  16. Association between Ankylosing Spondylitis and the miR-146a and miR-499 Polymorphisms

    Science.gov (United States)

    Chen, Jing Feng; Wang, Tian Yang; Wang, Ling Ling; Tang, Li Li; Lin, Xian-yang; Zhang, Chun-wu; Chen, Bi-cheng

    2015-01-01

    miRNAs are small, non-coding RNAs that regulate the expression of multiple target genes at the post-transcriptional level. Single-nucleotide polymorphisms (SNPs) in miRNA sequences may alter miRNA expression and have been implicated in the pathogenesis of multiple forms of arthritis, including rheumatoid arthritis (RA) and osteoarthritis. The present study explored the association between ankylosing spondylitis (AS) and two single nucleotide polymorphisms (SNPs), miR-146a rs2910164G>C and miR-499 rs3746444T>C, in a Han Chinese population. A case–control study consisting of 102 subjects with AS and 105 healthy controls was designed. The two miRNA SNPs were identified by direct sequencing. Subsequently, their gene and genotype frequencies were compared with healthy controls. A significant difference was observed in the miR-146a rs2910164G>C SNP. The frequency of the G allele was markedly higher in the AS patients than in the healthy controls (P = 0.005, Pc = 0.01, OR = 1.787), and the frequency of the GG genotype was higher in AS patients than in controls (P = 0.014, Pc = 0.042, OR = 2.516). However, no significant association was found between the miR-499 rs3746444T>C variant and susceptibility to AS. This is the first study to address the association between the miR-146a rs2910164G>C and miR-499 rs3746444T>C polymorphisms and AS, and it suggests a potential pathogenic factor for AS. Further studies are needed to validate our findings in a larger series, as well as in other ethnic backgrounds. PMID:25836258

  17. Disease-associated polymorphisms in ERAP1 do not alter endoplasmic reticulum stress in patients with ankylosing spondylitis.

    Science.gov (United States)

    Kenna, T J; Lau, M C; Keith, P; Ciccia, F; Costello, M-E; Bradbury, L; Low, P-L; Agrawal, N; Triolo, G; Alessandro, R; Robinson, P C; Thomas, G P; Brown, M A

    2015-01-01

    The mechanism by which human leukocyte antigen B27 (HLA-B27) contributes to ankylosing spondylitis (AS) remains unclear. Genetic studies demonstrate that association with and interaction between polymorphisms of endoplasmic reticulum aminopeptidase 1 (ERAP1) and HLA-B27 influence the risk of AS. It has been hypothesised that ERAP1-mediated HLA-B27 misfolding increases endoplasmic reticulum (ER) stress, driving an interleukin (IL) 23-dependent, pro-inflammatory immune response. We tested the hypothesis that AS-risk ERAP1 variants increase ER-stress and concomitant pro-inflammatory cytokine production in HLA-B27(+) but not HLA-B27(-) AS patients or controls. Forty-nine AS cases and 22 healthy controls were grouped according to HLA-B27 status and AS-associated ERAP1 rs30187 genotypes: HLA-B27(+)ERAP1(risk), HLA-B27(+)ERAP1(protective), HLA-B27(-)ERAP1(risk) and HLA-B27(-)ERAP1(protective). Expression levels of ER-stress markers GRP78 (8?kDa glucose-regulated protein), CHOP (C/EBP-homologous protein) and inflammatory cytokines were determined in peripheral blood mononuclear cell and ileal biopsies. We found no differences in ER-stress gene expression between HLA-B27(+) and HLA-B27(-) cases or healthy controls, or between cases or controls stratified by carriage of ERAP1 risk or protective alleles in the presence or absence of HLA-B27. No differences were observed between expression of IL17A or TNF (tumour necrosis factor) in HLA-B27(+)ERAP1(risk), HLA-B27(+)ERAP1(protective) and HLA-B27(-)ERAP1(protective) cases. These data demonstrate that aberrant ERAP1 activity and HLA-B27 carriage does not alter ER-stress levels in AS, suggesting that ERAP1 and HLA-B27 may influence disease susceptibility through other mechanisms. PMID:25354578

  18. 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.)

  19. 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

  20. Assessment of disability with the World Health Organisation Disability Assessment Schedule II in patients with ankylosing spondylitis

    Science.gov (United States)

    van Tubergen, A; Landewe, R; Heuft-Dorenbosch, L; Spoorenberg, A; van der Heijde, D; van der Tempel, H; van der Linden, S

    2003-01-01

    Objective: To investigate in ankylosing spondylitis (AS) whether the newly developed World Health Organisation Disability Assessment Schedule II (WHODAS II) is a useful instrument for measuring disability, to assess its responsiveness in relation to other traditional disease specific instruments, and to identify factors that are associated with both short term and long term scores on the WHODAS II. Methods: Patients with AS from a randomised controlled trial assessing the efficacy of spa treatment (n=117) and from a five year longitudinal observational study (n=97) participated. The patients completed several questionnaires, including the WHODAS II. After a three week course of spa treatment, 31 patients again completed all questionnaires to assess responsiveness. To determine to what degree the WHODAS II reflects some AS oriented measures on disease activity, functioning, and quality of life, correlation coefficients between the WHODAS II and these other questionnaires were calculated. Responsiveness was calculated by the effect size (ES) and standardised response mean (SRM). Linear regression analysis was performed to explore which factors might be associated with short term changes on the WHODAS II and to investigate (in the observational study) which factors of WHODAS II might predict disability five years later. Results: Mean score on the WHODAS II was 23.9 (SD 15.5 (range 0.0-76.1)). Scores on the WHODAS II were significantly correlated with all disease specific questionnaires measured (all p<0.001). The WHODAS II showed a comparable short term responsiveness score (SRM 0.41; ES 0.39). In regression analysis these short term changes on the WHODAS II were significantly associated with changes in functioning (ß coefficient 4.25, 95% confidence interval (95% CI) 1.24 to 7.26, p=0.007). In the observational study, disease activity (ß coefficient 0.35, 95% CI 0.17 to 0.53, p<0.000) as well as functioning (ß coefficient 0.23, 95% CI 0.09 to 0.38, p=0.002) seemed to significantly predict disability (WHODAS II) after five years. Conclusion: The WHODAS II is a useful instrument for measuring disability in AS in that it accurately reflects disease specific instruments and that it shows similar responsiveness scores. In AS, a short term change on the WHODAS II is associated with a change in physical function. At the group level, disease activity and physical functioning may predict disability after five years. PMID:12525383

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

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

  3. 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.

  4. How well are the ASAS/OMERACT Core Outcome Sets for Ankylosing Spondylitis implemented in randomized clinical trials? A systematic literature review.

    Science.gov (United States)

    Bautista-Molano, Wilson; Navarro-Compán, Victoria; Landewé, Robert B M; Boers, Maarten; Kirkham, Jamie J; van der Heijde, Désirée

    2014-09-01

    This study aims to investigate how well the Assessment of SpondyloArthritis international Society (ASAS)/Outcome Measures in Rheumatology Clinical Trials (OMERACT) core set and response criteria for ankylosing spondylitis (AS) have been implemented in randomized controlled trials (RCTs) testing pharmacological and non-pharmacological interventions. A systematic literature search was performed up to June 2013 looking for RCTs in patients with axial spondyloarthritis (SpA) (AS and non-radiographic axial SpA). The assessed domains and instruments belonging to the core sets for disease-controlling anti-rheumatic therapy (DC-ART) and symptom-modifying anti-rheumatic drugs (SMARDs) were extracted. Results were reported separately for those trials published until 2 years after the publication of the core set (1 April 2001; 'control trials') and those trials published at least 2 years after the publication date ('implementation trials'). One hundred twenty-three articles from 99 RCTs were included in the analysis, comparing 48 'control trials' and 51 'implementation trials'. Regarding DC-ART core set, the following domains were significantly more frequently assessed in the 'implementation group' in comparison to the 'control group': 'physical function' (100 vs 41.7 %; p???0.001), 'peripheral joints/entheses' (100 vs 33.3 %; p???0.001) and 'fatigue' (100 vs 0 %; p???0.001). Three instruments were significantly more used in the 'implementation group': Bath Ankylosing Spondylitis Functional Index (BASFI) (100 vs 8.3 %; p?=???0.001), CRP (92.3 vs 58.3 %; p?=?0.01) and Bath Ankylosing Spondylitis Metrology Index (BASMI) (53.8 vs 0 %; p?=?0.001). Regarding SMARD core set domains, physical function (92 vs 23 %; p???0.001) and fatigue (84 vs 17 %; p???0.001), as well as the instruments BASFI (88 vs 14 %; p???0.001) and BASMI (52 vs 0 %; p???0.001), increased significantly in the 'implementation group'. Twenty per cent of trials from the 'implementation group' but none from the 'control group' included all domains of the core set. In conclusion, this study provides evidence for the implementation of the ASAS/OMERACT core set in RCTs of both DC-ART and SMARD. This applies to the use of the domains and, to a lesser extent, to the specific instruments. PMID:24970597

  5. 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)

    Available data on patients with ankylosing spondylitis who received a single treatment course with X-rays were reviewed in a previous study to estimate radiation doses in tissues and organs giving rise to excess leukemias and cancers of heavily irradiated sites. These estimates are discussed and it is concluded that they are extremely crude being based on very limited data and on a number of assumptions. It is probable that they are accurate to within a factor of 2. 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. Thus work 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. (U.K.)

  6. CT- and fluoroscopy-guided percutaneous screw fixation of a "carrot-stick" spinal fracture in an elderly man with ankylosing spondylitis.

    Science.gov (United States)

    Huwart, Laurent; Amoretti, Nicolas

    2013-12-01

    We present a case of percutaneous fixation of a "carrot-stick" spinal fracture in an elderly patient with ankylosing spondylitis (AS). A surgical stabilization was not possible in this 83-year-old man with comorbidities. Under local anesthesia, percutaneous screw fixation of a transdiscal shear fracture at the level T10-T11 was performed using computed tomography (CT) and fluoroscopy guidance. Two 4.0-mm Asnis III cannulated screws were placed to fix facet joints using transfacet pedicle pathway. The procedure time was 30 min. Using the visual analog scale (VAS), pain decreased from 10, preoperatively, to 1 after the procedure. Radiographic fusion was observed at a 3-month post-procedural CT scan. CT- and fluoroscopy-guided percutaneous screw fixation of spinal fractures could potentially be an alternative to surgery in elderly AS patients with poor performance status. PMID:23842576

  7. Adhesive arachnoiditis causing cauda equina syndrome in ankylosing spondylitis: CT and MRI demonstration of dural calcification and a dorsal dural diverticulum

    International Nuclear Information System (INIS)

    We present the radiological features of a 42-years-old man with long-standing inactive ankylosing spondylitis (AS), demonstrating that arachnoiditis is a cause of a cauda equina syndrome (CES) in this disease. CT showed a dorsal arachnoid diverticulum causing scalloped erosion of the laminae, and punctate and curvilinear dural calcification. MRI revealed adhesion and convergence of the cauda equina dorsally into the arachnoid pouch, causing the dural sca to appear empty canal. To the best of our knowledge, dural calcification on CT is a new finding in AS, which may be related to the CES. Our findings support the hyopthesis that chronic adhesive arachnoiditis with subsequent loss of meningeal elasticity may be the main cause of CES in AS. (orig.)

  8. Adhesive arachnoiditis causing cauda equina syndrome in ankylosing spondylitis: CT and MRI demonstration of dural calcification and a dorsal dural diverticulum

    Energy Technology Data Exchange (ETDEWEB)

    Bilgen, I.G.; Yunten, N.; Ustun, E.E. [Ege Univ., Dept. of Radiology, Izmir (Turkey); Oksel, F.; Gumusdis, G. [Ege Univ., Dept. of Rheumatology, Izmir (Turkey)

    1999-07-01

    We present the radiological features of a 42-years-old man with long-standing inactive ankylosing spondylitis (AS), demonstrating that arachnoiditis is a cause of a cauda equina syndrome (CES) in this disease. CT showed a dorsal arachnoid diverticulum causing scalloped erosion of the laminae, and punctate and curvilinear dural calcification. MRI revealed adhesion and convergence of the cauda equina dorsally into the arachnoid pouch, causing the dural sca to appear empty canal. To the best of our knowledge, dural calcification on CT is a new finding in AS, which may be related to the CES. Our findings support the hyopthesis that chronic adhesive arachnoiditis with subsequent loss of meningeal elasticity may be the main cause of CES in AS. (orig.)

  9. Case-Only Designs for Exploring the Interaction Between FCRL4 Gene and Suspected Environmental Factors in Patients with Ankylosing Spondylitis.

    Science.gov (United States)

    Ding, Ning; Hu, Yanting; Zeng, Zhen; Liu, Si; Liu, Li; Yang, Ting; Wu, Shanshan; Fan, Dazhi; Xu, Shengqian; Xu, Jianhua; Wang, Jing; Pan, Faming

    2015-04-01

    The aim of this study was to explore the interaction between FCRL4 gene and environmental factors in patients with ankylosing spondylitis. Two hundred ninety-seven ankylosing spondylitis (AS) Han Chinese patients were selected who were diagnosed at the Department of Rheumatology, First Affiliated Hospital, Anhui Medical University, in accordance with the modified New York criteria. The single nucleotide polymorphism (SNP) was genotyped by multiplex SNaPshot technique. The interaction between FCRL4 gene and ten environmental factors in AS patients was assessed by using a case-only study. The interaction between FCRL4 gene (rs2777963) and environmental factors was analyzed by chi-square test and logistic models. p values, odds ratio, and 95 % confidence intervals (CIs) were used for estimating the effects of interaction. Odds ratio (OR) for the interaction of gene ×?environment (G?×?E) between drinking group and non-drinking group was 2.61 [95 % CI (1.30, 5.23), p?=?0.007], with statistical significance. Within the cooking oil group, there also may be an interaction of G?×?E between main animal oil and main plant oil [OR?=?10.55, 95 % CI (5.55, 20.04), p?

  10. What Is Ankylosing Spondylitis?

    Science.gov (United States)

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  11. Efficacy and Safety of Celecoxib in Chinese Patients with Ankylosing Spondylitis: A 6-Week Randomized, Double-Blinded Study with 6-Week Open-Label Extension Treatment

    Science.gov (United States)

    Huang, Feng; Gu, Jieruo; Liu, Yi; Zhu, Ping; Zheng, Yi; Fu, Jin; Pan, Sharon; Le, Shi

    2014-01-01

    Background Nonsteroidal anti-inflammatory drugs are the first-line option for treating ankylosing spondylitis (AS) in China. However, no large-scale controlled trials have been conducted in this ethnic population. Objective To evaluate the efficacy and safety of 6 weeks’ treatment with celecoxib in patients with AS in China. Methods This Phase 3, double-blind, parallel-group study randomized patients with AS aged ?18 to 65 years 1:1 to receive celecoxib 200 mg once daily or diclofenac sustained release 75 mg once daily. After 6 weeks, patients could use celecoxib 400 mg once daily or maintain blinded therapy. The primary efficacy end point was mean change from baseline at Week 6 for Patient’s Global Assessment of Pain Intensity score (100-mm visual analog scale). Noninferiority was established if the upper bound of the CI was diclofenac (n = 108), respectively. The 2-sided 95% CI for the treatment difference (celecoxib – diclofenac) was –2.2 to 8.8. Overall, 4.2% and 6.7% of patients in the celecoxib and diclofenac groups, respectively, reported treatment-related adverse events. All were mild to moderate in severity. Conclusions Celecoxib 200 mg once daily is noninferior to diclofenac sustained release 75 mg once daily for pain treatment in Chinese patients with AS. ClinicalTrials.gov identifier: NCT00762463. PMID:25516774

  12. 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

  13. 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

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

    Science.gov (United States)

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

    2014-04-01

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

  15. 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

  16. Imbalance between HAT and HDAC Activities in the PBMCs of Patients with Ankylosing Spondylitis or Rheumatoid Arthritis and Influence of HDAC Inhibitors on TNF Alpha Production

    Science.gov (United States)

    Toussirot, Eric; Abbas, Wasim; Khan, Kashif Aziz; Tissot, Marion; Jeudy, Alicia; Baud, Lucile; Bertolini, Ewa; Wendling, Daniel; Herbein, Georges

    2013-01-01

    Objective Acetylation or deacetylation of histone proteins may modulate cytokine gene transcription such as TNF alpha (TNF). We evaluated the balance between histone deacetytlase (HDAC) and histone acetyltransferase (HAT) in patients with rheumatoid arthritis (RA) or ankylosing spondylitis (AS) compared to healthy controls (HC) and determined the influence of HDAC inhibitors (trichostatin A -TSA- or Sirtinol -Sirt-) on these enzymatic activities and on the PBMC production of TNF. Methods 52 patients with RA, 21 with AS and 38 HC were evaluated. HAT and HDAC activities were measured on nuclear extracts from PBMC using colorimetric assays. Enzymatic activities were determined prior to and after ex vivo treatment of PBMC by TSA or Sirt. TNF levels were evaluated in PBMC culture supernatants in the absence or presence of TSA or Sirt. Results HAT and HDAC activities were significantly reduced in AS, while these activities reached similar levels in RA and HC. Ex vivo treatment of PBMC by HDACi tended to decrease HDAC expression in HC, but Sirt significantly reduced HAT in RA. TNF production by PBMC was significantly down-regulated by Sirt in HC and AS patients. Conclusion HAT and HDAC were disturbed in AS while no major changes were found in RA. HDACi may modulate HDAC and HAT PBMC expression, especially Sirt in RA. Sirtinol was able to down regulate TNF production by PBMC in HC and AS. An imbalance between HAT and HDAC activities might provide the rationale for the development of HDACi in the therapeutic approach to inflammatory rheumatic diseases. PMID:24039666

  17. Antibody activity in ankylosing spondylitis sera to two sites on HLA B27.1 at the MHC groove region (within sequence 65-85), and to a Klebsiella pneumoniae nitrogenase reductase peptide (within sequence 181-199)

    OpenAIRE

    1990-01-01

    74 overlapping peptides of varying lengths from Klebsiella pneumoniae nitrogenase reductase (residues 181-199) and from the HLA B27.1 molecule (residues 65-85) were synthesized and tested by ELISA against sera from HLA B27+ ankylosing spondylitis (AS) patients, and sera from HLA B27+ and HLA B27- healthy first-degree relatives. Antibody activity in AS sera to Klebsiella peptides of four to eight amino acids was maximal with the peptide NSRQTDR. Activity to HLA B27 peptides was maximal with th...

  18. Autoantibodies to HLA B27 in the sera of HLA B27 patients with ankylosing spondylitis and Reiter's syndrome. Molecular mimicry with Klebsiella pneumoniae as potential mechanism of autoimmune disease

    OpenAIRE

    1987-01-01

    Ankylosing spondylitis (AS) and Reiter's syndrome (RS) both show a strong correlation with the HLA B27 haplotype. We studied whether sharing of homologous amino acid sequences in the HLA B27 antigen with an invading microbe might occur, and if so, what is the biological significance of such homology. In a computer search of the Dayhoff data bank, we found a homology of six consecutive amino acids between HLA B27.1 antigen residues 72-77 and Klebsiella pneumoniae nitrogenase residues 188-193. ...

  19. 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

  20. Avaliação do ombro em pacientes portadores de espondilite anquilosante por meio de ultra-som Evaluation of the shoulder in patients with ankylosing spondylitis with ultrasound

    Directory of Open Access Journals (Sweden)

    Ciro Yoshida Junior

    2008-04-01

    Full Text Available OBJETIVO: Descrever as principais alterações nos ombros de pacientes portadores de espondilite anquilosante (EA por meio de ultra-som (US e correlacionar os achados de imagem com a idade e o tempo de doença. MÉTODOS: Foram selecionados 35 pacientes com diagnóstico clínico de EA. Os pacientes foram submetidos a exame de ultra-sonografia dos ombros, sendo avaliados os tendões do manguito rotador quanto à sua ecotextura e espessura, o tendão do bíceps, a articulação acromioclavicular, os tubérculos umerais, a bursa subacromial-subdeltóidea, e a face posterior da articulação glenoumeral. Foram colhidos dados de tempo de doença, presença de dor nos ombros e freqüência das alterações das estruturas avaliadas. Os dados foram comparados com a idade e o tempo de doença, utilizando-se teste qui-quadrado e teste t de Student. RESULTADOS: Foi observada prevalência de 20% de alterações no manguito rotador, sendo 10% de tendinose/calcificação tendínea e 10% de rupturas tendíneas. A espessura média dos tendões do manguito rotador foi de 5,8 mm. As alterações ósseas nos tubérculos do úmero ocorreram em 84,3% dos ombros e as alterações acromioclaviculares em 54,3% dos ombros. CONCLUSÃO: Não há modificação da espessura dos tendões do manguito rotador relacionadas com o tempo de doença. Os principais achados de US, que se correlacionam com o tempo de doença na EA, são alterações ósseas nos tubérculos umerais e na articulação acromioclavicular. Não houve relação entre tempo de doença e presença de lesão tendínea.PURPOSE: To describe shoulder involvement and its prevalence with ultrasound in patients with ankylosing spondylitis and correlate the findings with age and duration of disease. METHODS: Ultrasound scans of both shoulders were performed in thirty five selected patients with clinical diagnosis of ankylosing spondylitis. Rotator cuff texture and thickness were evaluated as well as the biceps tendon, acromioclavicular joint, humeral head tuberosities, subacromial-subdeltoid bursa, and posterior glenohumeral joint. Besides the prevalence of shoulder involvement, information about presence of pain and duration of disease were registered. The data were compared with age and duration of disease using chi-square and Student's t tests. RESULTS: The prevalence of rotator cuff disease was 20%; with 10% of tendinosis/tendon calcification and 10% of partial/full thickness tears. The mean rotator cuff thickness was 5.8 mm. Irregularities of the humeral head tuberosities were present in 84.3% of shoulders and acromioclavicular irregularities were present in 54.3% of shoulders. CONCLUSION: There was no change in rotator cuff thickness related with duration of disease. Bony irregularities in humeral head tuberosities and acromioclavicular joint were the main finding associated with duration of disease. There was no relation between duration of disease and presence of tendinous disease.

  1. Proposal for levels of evidence schema for validation of a soluble biomarker reflecting damage endpoints in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis, and recommendations for study design

    DEFF Research Database (Denmark)

    Maksymowych, W.P.; Fitzgerald, O.

    2009-01-01

    OBJECTIVE: At OMERACT 8 a framework for levels of evidence was proposed for the validation of biomarkers as surrogate outcome measures. We aimed to adapt this scheme in order to apply it in the setting of soluble biomarkers proposed to replace the measurement of damage endpoints in rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). We also aimed to generate consensus on minimum standards for the design of longitudinal studies aimed at validating biomarkers. METHODS: Before the meeting, the Soluble Biomarker Working Group prepared a preliminary framework and discussed various models for association and prediction related to the statistical strength domain. In addition, 3 Delphi exercises addressing longitudinal study design for RA, PsA, and AS were conducted within the working group and members of the Assessments in SpondyloArthritis International Society (ASAS) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). This formed the basis fordiscussions among OMERACT 9 participants. RESULTS: The proposed framework was accepted by consensus. In the study design domain a requirement for both prospective observational studies and randomized controlled trials (RCT) in different drug classes was noted. A template for determining the level of statistical strength was proposed. The addition of a new domain on biomarker assay performance was considered essential, and participants suggested that for any biomarker this domain should be addressed first, i.e., before starting clinical validation studies. Participants agreed on most elements of a longitudinal study design template. Where consensus was lacking the working group has drafted solutions that constitute a basis for prospective validation studies. CONCLUSION: The OMERACT 9 Soluble Biomarker Group has successfully formulated a levels of evidence scheme and a study design template that will provide guidance to conduct validation studies in the setting of soluble biomarkers proposed to replace the measurement of damage endpoints in RA, PsA, and AS Udgivelsesdato: 2009/8

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

    Science.gov (United States)

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

    2014-12-01

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

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

    Science.gov (United States)

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

    2013-11-01

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

  4. Increased occurrence of spinal fractures related to ankylosing spondylitis: a prospective 22-year cohort study in 17,764 patients from a national registry in Sweden

    Directory of Open Access Journals (Sweden)

    Robinson Yohan

    2013-01-01

    Full Text Available Abstract Background Ankylosing spondylitis (AS is a rheumatoid disease leading to progressive ossification of the spinal column. Patients suffering from AS are highly susceptible to unstable vertebral fractures and often require surgical stabilisation due to long lever arms. Medical treatment of these patients improved during the last decades, but until now it is unknown whether the annual number of spinal fractures changed during the last years. Since the annual count of fracture is an effective measure for efficacy of injury prevention and patient safety in AS patients, the current recommendations of activity have to be revised accordingly. Methods Data for all patients with AS treated as inpatients between 01/01/1987 and 31/12/2008 were extracted from the Swedish National Hospital Discharge Registry (SNHDR. The data in the registry are collected prospectively, recording all inpatient admissions throughout Sweden. The SNHDR uses the codes for diagnoses at discharge according to the Swedish versions of the International Classification of Diseases (ICD-9 and ICD-10. Results During the years from 1987 to 2008 17,764 patients with AS were treated as inpatients; of these 724 patients were treated due to spinal fractures. The annual number of cervical, thoracic and lumbar fractures in the registry increased until 2008 (r?=?0.94. Conclusions Despite the improved treatment of AS the annual number of vertebral fractures requiring inpatient care increased during the last two decades. Possible explanations are population growth, greater awareness of fractures, improved diagnostics, improved emergency care reducing fatalities, and a higher activity level of patients receiving modern medical therapy. Obviously the improvement of medical treatment did not reduce the susceptibility of these patients to unstable fractures. Thus the restrictive injury prevention recommendations for patients with AS cannot be defused, but must be critically revised to improve patient safety.

  5. Avaliação do ombro em pacientes portadores de espondilite anquilosante por meio de ultra-som / Evaluation of the shoulder in patients with ankylosing spondylitis with ultrasound

    Scientific Electronic Library Online (English)

    Ciro, Yoshida Junior; Edson Shinji, Kubota; Themis Mizerkowski, Torres; Rozana Mesquita, Ciconelli; Artur da Rocha Corrêa, Fernandes.

    2008-04-01

    Full Text Available OBJETIVO: Descrever as principais alterações nos ombros de pacientes portadores de espondilite anquilosante (EA) por meio de ultra-som (US) e correlacionar os achados de imagem com a idade e o tempo de doença. MÉTODOS: Foram selecionados 35 pacientes com diagnóstico clínico de EA. Os pacientes foram [...] submetidos a exame de ultra-sonografia dos ombros, sendo avaliados os tendões do manguito rotador quanto à sua ecotextura e espessura, o tendão do bíceps, a articulação acromioclavicular, os tubérculos umerais, a bursa subacromial-subdeltóidea, e a face posterior da articulação glenoumeral. Foram colhidos dados de tempo de doença, presença de dor nos ombros e freqüência das alterações das estruturas avaliadas. Os dados foram comparados com a idade e o tempo de doença, utilizando-se teste qui-quadrado e teste t de Student. RESULTADOS: Foi observada prevalência de 20% de alterações no manguito rotador, sendo 10% de tendinose/calcificação tendínea e 10% de rupturas tendíneas. A espessura média dos tendões do manguito rotador foi de 5,8 mm. As alterações ósseas nos tubérculos do úmero ocorreram em 84,3% dos ombros e as alterações acromioclaviculares em 54,3% dos ombros. CONCLUSÃO: Não há modificação da espessura dos tendões do manguito rotador relacionadas com o tempo de doença. Os principais achados de US, que se correlacionam com o tempo de doença na EA, são alterações ósseas nos tubérculos umerais e na articulação acromioclavicular. Não houve relação entre tempo de doença e presença de lesão tendínea. Abstract in english PURPOSE: To describe shoulder involvement and its prevalence with ultrasound in patients with ankylosing spondylitis and correlate the findings with age and duration of disease. METHODS: Ultrasound scans of both shoulders were performed in thirty five selected patients with clinical diagnosis of ank [...] ylosing spondylitis. Rotator cuff texture and thickness were evaluated as well as the biceps tendon, acromioclavicular joint, humeral head tuberosities, subacromial-subdeltoid bursa, and posterior glenohumeral joint. Besides the prevalence of shoulder involvement, information about presence of pain and duration of disease were registered. The data were compared with age and duration of disease using chi-square and Student's t tests. RESULTS: The prevalence of rotator cuff disease was 20%; with 10% of tendinosis/tendon calcification and 10% of partial/full thickness tears. The mean rotator cuff thickness was 5.8 mm. Irregularities of the humeral head tuberosities were present in 84.3% of shoulders and acromioclavicular irregularities were present in 54.3% of shoulders. CONCLUSION: There was no change in rotator cuff thickness related with duration of disease. Bony irregularities in humeral head tuberosities and acromioclavicular joint were the main finding associated with duration of disease. There was no relation between duration of disease and presence of tendinous disease.

  6. Efficacy of etanercept on rheumatic signs and pulmonary function tests in advanced ankylosing spondylitis: results of a randomised double-blind placebo-controlled study (SPINE)

    Science.gov (United States)

    Dougados, M; Braun, J; Szanto, S; Combe, B; Elbaz, M; Geher, P; Thabut, G; Leblanc, V; Logeart, I

    2011-01-01

    Objectives Patients with advanced ankylosing spondylitis (AS) experience disability because of reduced spinal mobility and pulmonary function impairment. This placebo-controlled study evaluated the effect of etanercept (ETN) in patients with advanced AS. Methods A multicentre randomised double-blind placebo-controlled trial of 12 weeks' duration was performed. Patients had definite (modified New York criteria), active (Bath AS Disease Activity Index (BASDAI) ?40), severe (radiological intervertebral bridges) AS refractory to non-steroidal anti-inflammatory drugs and were antitumour necrosis factor naive. They were treated with ETN 50 mg once weekly or identical placebo (PBO). Results Of the 95 patients screened, 82 were randomised to receive ETN (n=39) or PBO (n=43). At baseline the disease was active (mean BASDAI 61.0±13.4, C reactive protein (CRP) 20.7±25.5 mg/l) and severe (mean Bath AS Metrology Index (BASMI) 5.7±1.3, mSASSS 36.5±20.5); forced pulmonary vital capacity (FVC) was 3.3±0.7 l. Improvement in BASDAI (normalised net incremental area under the curve between baseline and week 12, primary end point) was significantly greater in the ETN group than in the PBO group (?19.8±16.5 vs ?11.0±16.4, p=0.019). Moreover, at week 12, ETN gave better results than PBO for the BASDAI (?26.4±19.7 vs ?14.4±19.7; p=0.008), total back pain (?29.2±24.0 vs ?14.9±24.0; p=0.010), BASFI (?21.7±17.6 vs ?10.1±17.6; p=0.004), BASMI (?0.6±0.6 vs ?0.2±0.6; p=0.011), CRP level (?15.7±14.2 vs ?1.3±14.2; p<0.001) and FVC (+160±280 ml vs ?20±280 ml; p=0.006). Conclusions ETN has short-term efficacy for patients with advanced AS, as was previously reported for less advanced disease. The efficacy is observed for the main symptoms (pain) and on markers of inflammation (CRP), as well as disease severity in terms of spinal mobility and pulmonary function. PMID:21317434

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

    Directory of Open Access Journals (Sweden)

    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.

  8. A case of infliximab-induced lupus in a patient with ankylosing spondylitis: is it safe switch to another anti-TNF-? agent?

    Science.gov (United States)

    Santiago, Tânia; Santiago, Mariana Galante; Rovisco, João; Duarte, Cátia; Malcata, Armando; da Silva, José António Pereira

    2013-12-01

    Anti-TNF-? therapies are the latest class of medications found to be associated with drug-induced lupus, a distinctive entity known as anti-TNF-?-induced lupus (ATIL) (Williams et al., Rheumatology (Oxford) 48:716-20, 2009; De Rycke et al., Lupus 14:931-7, 2005; De Bandt et al., Clin Rheumatol 22:56-61, 2003). With the widespread use of these agents, it is likely that the incidence of ATIL will increase. The onset of ATIL in patients with rheumatoid arthritis and Crohn's disease has been described, but the literature regarding the occurrence of this entity in patients with ankylosing spondylitis (AS) is scarce (De Bandt et al., Clin Rheumatol 22:56-61, 2003; Ramos-Casals et al., Autoimmun Rev 9:188-93, 2010; Perez-Garcia et al., Rheumatology 45:114-116, 2006). To our knowledge, few reports of switching anti-TNF-? therapy after ATIL in AS have been reported (Akgül et al., Rheumatol Int, 2012). Therefore, it is not clear whether the development of ATIL should prohibit switch to another therapy, since patients may respond to another anti-TNF-? agent (Akgül et al., Rheumatol Int, 2012; Bodur et al., Rheumatol Int 29:451-454, 2009; Mounach et al., Clin Exp Rheumatol 26:1116-8, 2008; Williams and Cohen, Int J Dermatol 50:619-625, 2011; Ye et al., J Rheumatol 38:1216, 2011; Wetter and Davis, Mayo Clin Proc 84:979-984, 2009; Cush, Clin Exp Rheumatol 22:S141-147, 2004; Kocharla and Mongey, Lupus 18:169-7, 2009). A lack of published experience of successful anti-TNF-? switching is a cause of concern for rheumatologists faced with this challenging clinical scenario. We report the case of a 69-year-old woman with AS who developed infliximab-induced lupus, which did not recur despite the subsequent institution of etanercept. The authors review and discuss ATIL and the possible implications for subsequent treatment with alternative anti-TNF-? agents. PMID:23955767

  9. 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.

  10. 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.

  11. Genetics Home Reference: Ankylosing spondylitis

    Science.gov (United States)

    ... influence the risk of developing this disorder. The HLA-B gene provides instructions for making a protein that ... an important role in the immune system. The HLA-B gene is part of a family of genes ...

  12. 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

  13. 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 SciELO Portugal | Language: Portuguese Abstract in portuguese 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.

  14. An open-source, self-explanatory touch screen in routine care. Validity of filling in the Bath measures on Ankylosing Spondylitis Disease Activity Index, Function Index, the Health Assessment Questionnaire and Visual Analogue Scales in comparison with paper versions

    DEFF Research Database (Denmark)

    Schefte, David B; Hetland, Merete

    2009-01-01

    OBJECTIVE: The Danish DANBIO registry has developed open-source software for touch screens in the waiting room. The objective was to assess the validity of outcomes from self-explanatory patient questionnaires on touch screen in comparison with the traditional paper form in routine clinical care. METHODS: Fifty-two AS patients and 59 RA patients completed Visual Analogue Scales (VASs) for pain, fatigue and global health, and Bath measures on Ankylosing Spondylitis Disease Activity Index (BASDAI) and Function Index (BASFI) (AS patients) or HAQs (RA patients) on touch screen and paper form in random order with a 1-h interval. Intra-class correlation coefficients (ICCs), 95% CIs and smallest detectable differences (SDDs) were calculated. RESULTS: ICC ranged from 0.922 to 0.988 (P < 0.001). The mean differences (95% CI) were: BASDAI [-0.5 (-14.5, 13.5) mm]; BASFI [-1.1 (-10.6, 8.4) mm]; Item 5 [-1.7 (-23.6, 20.2) mm] and Item 6 [-0.7 (-14.7, 13.3) mm] from BASDAI; HAQ score [0.023 (-0.183, 0.229)]. For VAS -0.4 to -2.8 mm (no significance for all except VAS global and VAS fatigue in RA). SDD for BASDAI was 14.0 mm; BASFI 9.5 mm; Item 5 21.8 mm; Item 6 14.0 mm; HAQ 0.206; VAS 11.1-18.8 mm. CONCLUSIONS: Self-explanatory touch screens based on the DANBIO open-source system generates valid results in AS and RA patients on completion of BASDAI, BASFI, HAQ and VAS scores for pain, fatigue and global health when compared with the traditional paper form. Implementation of touch screens in clinical practice is feasible and patients need no instruction.

  15. 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

  16. 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

  17. 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 SciELO Brazil | Languages: English, Portuguese Abstract in portuguese 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.

  18. 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.

  19. 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?.

  20. 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 ...

  1. 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.)

  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. Pyogenic spondylitis

    OpenAIRE

    Cheung, W. Y.; Luk, Keith D. K.

    2011-01-01

    Pyogenic spondylitis is a neurological and life threatening condition. It encompasses a broad range of clinical entities, including pyogenic spondylodiscitis, septic discitis, vertebral osteomyelitis, and epidural abscess. The incidence though low appears to be on the rise. The diagnosis is based on clinical, radiological, blood and tissue cultures and histopathological findings. Most of the cases can be treated non-operatively. Surgical treatment is required in 10-20% of patients. Anterior d...

  5. 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.)

  6. Higher LPS-stimulated TNF-alpha mRNA levels in peripheral blood mononuclear cells from Chinese ankylosing spondylitis patients with -308G/A polymorphism in promoter region of tumor necrosis factor: association with distinct A33/B58/Cw10 haplotypes.

    Science.gov (United States)

    Lu, Ming-Chi; Yang, K L; Tung, Chien-Hsueh; Huang, Kuang-Yung; Yu, Hui-Chun; Liu, Su-Qin; Lai, Ning-Sheng

    2008-12-01

    To investigate the effects of TNF-alpha -308, -238 promoter polymorphisms on TNF-alpha transcription in B27 positive Chinese patients with ankylosing spondylitis (AS). The possible relationship between polymorphisms, MHC antigens, and quantitative TNF-alpha mRNA expression were evaluated. Single nucleotide polymorphisms (SNPS) of TNF-alpha -308 and -238 were performed by PCR-amplification refractory mutation system method (PCR-ARMS) in sixty-seven B27-positive AS patients and 60 HLA-B27 positive healthy controls in Chinese. Quantitative measurement of TNF-alpha mRNA in peripheral blood mononuclear cells was performed with real time RT-PCR. The polymorphisms were correlated to quantitative TNF-alpha mRNA, and MHC antigens (determined by SSP method) in AS patients. The prevalence rate of both -308G/A and -238G/A TNF-alpha promoter polymorphisms in patients were not significantly different from those in normal subjects. However, a significant high LPS-stimulated TNF-alpha mRNA expression was found in peripheral blood mononuclear cells from patients with promoter -308G/A polymorphism (TNF2) as compared to those in -308G/G genotype (TNF1). Furthermore, -308G/A polymorphism in patients was found to be tightly associated with distinct haplotypes of A33/B58/Cw10 [12 out of 14 -308G/A patients (85.7%) versus none in 53 -308G/G patients], independent of B27 antigen. HLA-A33-B58-Cw10 haplotypes associated TNF-alpha promoter -308G/A polymorphism might play an important role in disease pathogenesis of AS in Chinese population, partially related to a driving force of a higher TNF-alpha production. It confirms once again the importance and complexity of MHC related molecules in disease pathogenesis of AS. PMID:18719920

  7. MRI characteristics of tuberculous spondylitis

    International Nuclear Information System (INIS)

    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.

  8. 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.

  9. Infectious spondylitis and its differential diagnosis

    International Nuclear Information System (INIS)

    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.)

  10. Differential diagnosis between tuberculous and pyogenic spondylitis using MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kim, K. W.; Ha, D. K.; Shon, M. Y.; Kim, S.; Lim, M. A.; Kwon, K. R.; Kim, S. S. [Sunlin Presbyterian Hospital, Pohang (Korea, Republic of); Byon, W. M.; Cho, K. H. [Yongnam Univ. College of Medicine, Kyongsan (Korea, Republic of); Lee, C. W. [Dongguk Univ. College Medicine, Pohang (Korea, Republic of)

    1997-07-01

    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.

  11. 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

  12. Diagnosis of pyogenic spondylitis

    International Nuclear Information System (INIS)

    We report on the diagnosis of pyogenic spondylitis in 59 cases. They included 50 cases that underwent detailed orthopaedic examination, among which 13 presented spondylosis deformans. We also examined 10 cases of spinal compression fracture, and seven of suspected pyogenic spondylitis. MRI examination confirmed pyogenic spondylitis in 34 cases overall. Cases that were difficult or late to diagnose included those with fever of unknown origin, and those in which orthopaedic differential diagnosis was necessary. These results suggest that we need clearer diagnostic criteria and methods for pyogenic spondylitis. (author)

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

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

    Science.gov (United States)

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  15. 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.

  16. Infliximab treatment in ankylosing spondylitis: an observational study

    OpenAIRE

    Nikas, S.; Alamanos, Y.; Voulgari, P.; Pliakou, X.; Papadopoulos, C.; Drosos, A.

    2004-01-01

    Methods: 35 patients with AS with mean (SD) age 42.5 (12.6) years and mean (SD) disease duration 14.5 (8.0) years were studied for 2 years. Patients entering the study had a negative tuberculin skin test, were fully informed about the treatment, and were followed up regularly. Infliximab, 5 mg/kg weight, was given intravenously at weeks 0, 2, 6, and every 8 weeks thereafter. Data concerning infliximab tolerability, adverse events, interval, and drug discontinuation were all recorded. Clinical...

  17. MR imaging of tuberculous spondylitis

    International Nuclear Information System (INIS)

    8 cases of tuberculous spondylitis were evaluated with MRI. In addition, 3 cases of pyogenic spondylitis and 15 cases of vertebral metastases were also evaluated to assess the possibility of differentiation from tuberculous spondylitis. The active tuberculous spondylitis showed low intensity on T1 weighted images and high intensity on T2 weighted images. On the other hand, non-active tuberculous spondylitis showed almost isointensity to normal vertebral bodies on both T1 and T2 weighted images. In the evaluation of tuberculous spondylitis, MRI is valuable to assess the activity of the lesion and compression of spinal cord. From the viewpoint of differential diagnosis, the presence of intervertebral disc involvement strongly suggests spondylitis against vertebral metastasis. As a rule, differential diagnosis between tuberculous and pyogenic spondylitis is difficult on MRI alone. (author)

  18. 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.

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

    International Nuclear Information System (INIS)

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

  20. 18F-FDG PET/CT imaging of pyogenic and tuberculous spondylitis: correlation with MRI

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, S. M.; Lee, I. S.; Lee, J. S.; Kim, S. J.; Nam, H. Y.; Kim, I. J.; Kim, Y. K. [Pusan National University Hospital, Pusan (Korea, Republic of)

    2007-07-01

    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 and tuberculous spondylitis. Therefore, PET/CT may be a helpful and complementary method to MRI for differentiating pyogenic and tuberculous spondylitis.

  1. 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

  2. The value of computed tomography in nonspecific spondylitis

    International Nuclear Information System (INIS)

    The computed tomographic symptoms of nonspecific spondylitis, observed in 14 patients, are described. In 9 patients the spondylitis occurred as complication following operations for lumbar disc hernias. The most common computed-tomographic symptoms were: edematous dilatation of the paravertebral soft tissues, osteolytic destructive changes of the discal surfaces of the vertebral bodies, low densitometric values of the affected disc, soft-tissue masses in the spinal canal. Computed tomography is considered as a method of crucial importance for early and accurate diagnosis of nonspecific spondylitis. The method is of particular value also in the dynamic study of the evolution of the inflammatory process. An optimal organization scheme is suggested of an early diagnosis of nonspecific spondilytis, includung computed tomography, bone scintigraphy, conventional roentgenography and CT-guided puncture

  3. Clinical and radiological findings in spondylitis and its pathogenesis

    International Nuclear Information System (INIS)

    Very often spondylitis is recognized too late. The diagnostic difficulties and the frequency of wrong diagnosis result from uncharacteristic clinical findings and the different courses of the disease. In the beginning there are no distinct X-ray findings. Although the formerly bad prognosis of spondylitis has been improved by use of antibiotics, the early diagnosis is necessary to keep away avoidable unjuries from the health of the patient and dangerous complications. Only the exact knowledge of the disease and its reported clinical and radiographic findings and the basic pathoanatomical changes renders a successful therapy with further improvement of possible prognosis. (orig.)

  4. CT differential diagnosis of spondylitis in childhood and adolescence

    International Nuclear Information System (INIS)

    Full text: The aim of this study was to systematize the most important criteria for early and exact diagnosis of spondylitis in childhood and adolescence. The authors present cases (proved by blood samples and histologically) of spondylitis (specific, non-specific, chronic recurrent multifocal osteomyelitis), plasmacytomas, eosinophilic granuloma, metastases, aseptic necrosis in children from 9 to 17 years old, examined by conventional and helical CT. After ascertaining of osteolythical changes in the vertebral bodies, the diagnostic algorithm dictates to analyze the number of the vertebra involved, the presence of lesions in the vertebral arches, the intervertebral spaces and soft tissues. The clinical courses of the visual changes in infectious spondylitis are various and often are non-specific. In the absence of convincing blood sample changes in the aspect of differential diagnosis, there should be thought of a wide variety of diseases

  5. Danske anbefalinger for behandling af ankyloserende spondylitis og spondylartritis udarbejdet i et internationalt projektsamarbejde

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Madsen, Ole Rintek

    2008-01-01

    INTRODUCTION: The multinational initiative "3e Initiative in Rheumatology - Multi-national Recommendations for the Management of Ankylosing Spondylitis 2006-7" served the primary purpose of providing specific recommendations for the management of ankylosing spondylitis and spondyloarthritis patients in daily practice. MATERIAL AND METHODs: The scientific committees from the ten participating countries selected nine clinical questions regarding diagnosis, monitoring and pharmacologic non-biologic treatment, and the Danish group chose 2 additional questions about non-pharmacologic treatment. Systematic literature searches were performed in Medline by 3 international and a Danish bibliographic fellow. Outcome data were extracted and processed by use of routine methods from clinical epidemiology and statistics. The evidence was presented to the Danish rheumatologists. The participants were divided into three groups, which each proposed recommendations. After a final plenary discussion, a voting session took place. Subsequently, agreement was obtained, and the strength of the recommendations was graded. RESULTS: The bibliographic fellows identified 2,709 relevant manuscripts and included 477 of these in the analysis. All 186 Danish rheumatologists were invited, and 26 (14,0%) participated in the meeting held in Copenhagen, December 2006. The individual recommendations were endorsed by 68-100% of the participants. CONCLUSION: Within the framework of the multinational 3e project, it was possible to develop Danish recommendations for AS patients by combining an evidence-based approach and the experience of clinical rheumatologists Udgivelsesdato: 2008/12/1

  6. Pyogenic spondylitis : MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Cho, So Yeon; Kim, Young Hoon; Chung, Hye Won; Kang, Heung Sik [Seoul National University, Seoul (Korea, Republic of). Coll. of Medicine

    1998-03-01

    The purpose of this study is to determine the MR imaging findings of pyogenic spondylitis. In 31 patients with pathologically or clinically proven pyogenic spondylitis, MR images (31, T1-weighted; 30, T2-weighted; 31, Gd-enhancement pattern) of involved vertebral bodies and intervertebral discs, as well as paravertebral soft tissue abnormality. With regard to vertebral bodies, MR imaging findings of pyogenic spondylitis are low signal intensity on T1-weighted images, and high or intermediate signal intensity on T2-weighted images, together with diffuse enhancement. For intervertebral discs, signal intensity was low on T1-weighted images, high on T2-weighted images, and peripheral or diffuse enhancement was seen. Diffusely enhanced small paravertebral soft tissue abnormality was also present. (author). 15 refs., 4 figs.

  7. Pyogenic spondylitis : MR imaging findings

    International Nuclear Information System (INIS)

    The purpose of this study is to determine the MR imaging findings of pyogenic spondylitis. In 31 patients with pathologically or clinically proven pyogenic spondylitis, MR images (31, T1-weighted; 30, T2-weighted; 31, Gd-enhancement pattern of involved vertebral bodies and intervertebral discs, as well as paravertebral soft tissue abnormality. With regard to vertebral bodies, MR imaging findings of pyogenic spondylitis are low signal intensity on T1-weighted images, and high or intermediate signal intensity on T2-weighted images, together with diffuse enhancement. For intervertebral discs, signal intensity was low on T1-weighted images, high on T2-weighted images, and peripheral or diffuse enhancement was seen. Diffusely enhanced small paravertebral soft tissue abnormality was also present. (author). 15 refs., 4 figs

  8. Clinical course of pyogenic spondylitis

    International Nuclear Information System (INIS)

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

  9. Radiographic observation for tuberculous spondylitis

    International Nuclear Information System (INIS)

    Radiographic observation of 152 cases of tuberculous spondylitis selected from total 194 cases of tuberculous arthritis during the past 6 years and 8 months, was carried out to study. 1. The youngest one was 15 months old male infant of active tuberculous spondylitis. The active tuberculous spondylitis under 10 years of age were 50 percent (28 cases). 2. The ratio of male to female was 1.5:1 3. The most common site of involvement was the lumbar spine which was 44.1 percent of the total tuberculous spondylitis. The next were thoracic spine (33.6%), and thoraco-lumber spine (13.1%). 4. The most common roentgenographic findings are bony destructions of the vertebral bodies which were 97.4 percent. The next were joint space narrowing (93.4%), osteoporosis (79.6%), kyphosis (34.2%), fusion deformity of the vertebral body (25.7%), and cold abscess shadow (16.4%). 5. The most of patients (88.8%) had or have been pulmonary tuberculous lesions. 6. In annual incidence, the number of patients were not changed greatly

  10. 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)

  11. Radiological evaluation of tuberculous spondylitis with computed tomography

    International Nuclear Information System (INIS)

    Spinal tuberculosis is curable disease, and early diagnosis is mandatory for early treatment. We reviewed conventional radiographers and computed tomograms (CT) from Histopathologically confirmed 30 cases of spinal tuberculosis, and compared these findings with radiologic findings from 2 cases of pyogenic spondylitis and 4 cases of metastasis. The results were as follows: 1. The frequent site of involvement were thromboembolic junction and low lumbar vertebrae, and the most frequent type is multisegmented subligamentous type (93.3%). 2. CT was not of great use in the differential diagnosis of the tuberculosis. Dominant CT findings of tuberculous spondylitis were anterior vertebral body destruction, paravertebral soft-tissue mass and thick walled abscess formation occasionally containing calcification and disc space narrowing in the setting of an indolent or relatively benign course. 3. CT is the best modality for imaging the extent and anatomy of the destructive process, the degree of canal encroachment, and the change of adjacent vital structure. So CT was particularly useful in pre-operative planning of debridement and stabilization surgery. 4. The most common causes of neurologic manifestations in tuberculous spondylitis were the compression of spinal cord by sequestrated bony fragments and disc material, granulation tissue or abscess in the spinal canal.

  12. 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)

  13. 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 ...

  14. 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

    2014-11-20

    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

  15. Diagnosis of pyogenic spondylitis using MRI and percutaneous nucleotomy

    International Nuclear Information System (INIS)

    The study assessed the usefulness of MRI and percutaneous nucleotomy in 13 patients with pyogenic spondylitis. The MRI manifestations obtained from 21 MRI scanning were analyzed according to disease stage. In 10 patients in the acute stage (ranging from 0.5 to 5 months after the onset), the adjacent vertebrae to the intervertebral disc were shown as low intensities on T1-weighted images and the vertebrae surrounding the intervertebral disc or above or below it were shown as high intensities on T2-weighted images. The areas shown as high intensities on T2-weighted images were restricted to the surrounding of the intervertebral disc early after the onset, and extended to the adjacent vertebrae above or below the intervertebral disc. Tumor-like findings in the para-spinal canal were seen in 6 patients. In the other 3 patients in the chronic stage, the areas shown as high intensities on T2-weighted images were surrounded with areas shown as low or no intensities. Roentgenologically proven osteosclerosis was shown as low or no intensities. In healing stage, areas shown as low intensities on T1-weighted images became band-like, and those shown as high intensities on T2-weighted images disappeared. Percutaneous nucleotomy, performed in 9 patients, was capable of diagnosing pyogenic spondylitis in 8 patients (88.9%). In conclusion, MRI was an extremely useful procedure in the early diagnosis of pyogenic spondylitis, as well as the assessment of the therapeutic effects and heaessment of the therapeutic effects and healing process. Percutaneous nucleotomy was effective in the confirmation diagnosis of this disease. (N.K.)

  16. Diagnosis of pyogenic spondylitis using MRI and percutaneous nucleotomy

    Energy Technology Data Exchange (ETDEWEB)

    Suda, Yoshiaki; Yamagishi, Masaaki (National Defence Medical Coll., Tokorozawa, Saitama (Japan))

    1994-06-01

    The study assessed the usefulness of MRI and percutaneous nucleotomy in 13 patients with pyogenic spondylitis. The MRI manifestations obtained from 21 MRI scanning were analyzed according to disease stage. In 10 patients in the acute stage (ranging from 0.5 to 5 months after the onset), the adjacent vertebrae to the intervertebral disc were shown as low intensities on T1-weighted images and the vertebrae surrounding the intervertebral disc or above or below it were shown as high intensities on T2-weighted images. The areas shown as high intensities on T2-weighted images were restricted to the surrounding of the intervertebral disc early after the onset, and extended to the adjacent vertebrae above or below the intervertebral disc. Tumor-like findings in the para-spinal canal were seen in 6 patients. In the other 3 patients in the chronic stage, the areas shown as high intensities on T2-weighted images were surrounded with areas shown as low or no intensities. Roentgenologically proven osteosclerosis was shown as low or no intensities. In healing stage, areas shown as low intensities on T1-weighted images became band-like, and those shown as high intensities on T2-weighted images disappeared. Percutaneous nucleotomy, performed in 9 patients, was capable of diagnosing pyogenic spondylitis in 8 patients (88.9%). In conclusion, MRI was an extremely useful procedure in the early diagnosis of pyogenic spondylitis, as well as the assessment of the therapeutic effects and healing process. Percutaneous nucleotomy was effective in the confirmation diagnosis of this disease. (N.K.).

  17. Tuberculous spondylitis in elderly Japanese patients

    International Nuclear Information System (INIS)

    Although the number of patients with tuberculous spondylitis in Japan is increasing slowly, the proportion of the elderly among these patients is increasing more quickly. The purpose of this study was to describe the clinical features and diagnostic imaging findings in elderly tuberculous spondylitis patients in order to enhance diagnosis of the condition in the elderly population. We conducted a retrospective review of 23 patients over 70 years of age previously diagnosed with tuberculous spondylitis. Clinical signs and symptoms, including local pain, fever, and neurological deficits, were analyzed. Routine laboratory tests, including the erythrocyte sedimentation rate, the white blood cell count, and the C-reactive protein level were also reviewed. The results of plain X-rays and magnetic resonance imaging were studied. Patients' signs and symptoms were as follows: local pain in 19 patients (83%); fever in 7 patients (30%) and no fever in 16 patients (70%); and neurological deficits in 13 patients (57%). C-Reactive protein was less than 1.0 mg/dl in 6 patients (26%). Radiography revealed several changes in the affected vertebrae; 3 patients had atypical changes involving only a single vertebra. It is difficult to diagnose tuberculous spondylitis in the elderly because there are atypical symptoms, a scarcity of inflammatory changes, and degenerative changes normally seen in the elderly may mask the radiographic changes due to tuberculous spondylitis. Tuberculous spon tuberculous spondylitis. Tuberculous spondylitis should be considered a possibility in the differential diagnosis of back pain in the elderly, especially in countries with a significant history of tuberculosis in the population. (author)

  18. 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

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

    International Nuclear Information System (INIS)

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

  20. 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)

  1. Computed tomography and magnetic resonance imaging in tuberculous spondylitis. Review and own findings; Computertomographie und Magnetresonanztomographie bei tuberkuloeser Spondylitis. Literaturuebersicht und eigene Beobachtungen

    Energy Technology Data Exchange (ETDEWEB)

    Kirchner, T.H. [Frankfurt Univ. (Germany). Klinikum; Bochum Univ. (Germany). Klinik fuer Radiologische Diagnostik und Nuklearmedizin; Kirchner, J.; Liermann, D. [Bochum Univ. (Germany). Klinik fuer Radiologische Diagnostik und Nuklearmedizin; Schneider, M. [Frankfurt Univ. (Germany). Senkenbergisches Inst. fuer Pathologie; Luecke, R. [Bochum Univ. (Germany). Abt. fuer Hand- und Rheumachirurgie; Vogl, T.; Jacobi, V. [Frankfurt Univ. (Germany). Klinikum

    2000-10-01

    Purpose. The findings of tuberculous spondylitis in MRT have been described extensively. Nevertheless, the diagnostic value of both methods in the diagnosis of this severe manifestation of the tuberculous disease was not yet defined definitely. Materials. We performed a review of the recent literature and a retrospective analysis of the findings in ten patients with proven tuberculous spondylitis. Here we evaluated 10 CT and 6 MRT. Results. Major findings in computed tomography (n=10) were osseous sequestration (8/10), subperiostal bone apposition (6/10), abscess of the surrounding tissue (8/10) and calcification of the masses (3/10). In all cases which were examined by MRT (n=6) marrow edema was seen. Affection of the soft tissue was described by means of MRT in 5/6 patients. All patients showed rim enhancement. Conclusions. MRT shows signs of infection (bone marrow edema) which is an early but rather unspecific finding. The commonness of osseous lesions in advanced tuberculous spondylitis suggests a benefit of computed tomography in the later stages. Both methods are complementary in the differential diagnosis of tuberculous and non-specific spondylitis. (orig.) [German] Ziel. Obwohl zahlreiche Veroeffentlichungen Befunde der tuberkuloesen Spondylitis in der Magnetresonanztomographie beschreiben, wurde der Stellenwert beider Methoden in der Diagnosestellung dieser schwerwiegenden Manifestation der Tuberkulosekrankheit bislang noch nicht endgueltig definiert. Ziel der vorgelegten Arbeit ist die Darstellung der in der Literatur berichteten Befunde sowie eigener Beobachtungen. Material. Wir berichten von den computertomographischen und magnetresonanztomographischen Befunden an 10 Patienten mit gesicherter tuberkuloeser Spondylitis. Es wurden 10 Computertomographien und 6 Magnetresonanztomographien ausgewertet. Die Beurteilung erfolgte anhand der in einer Literaturuebersicht aufgefuehrten Befundmuster. Ergebnisse. Die wichtigsten computertomographischen Befunde stellen Knochensequester (8/10), subperiostale Knochenlamellen (6/10), Weichteilaffektionen in unterschiedlicher Auspraegung (8/10) und hierhin gelegene Kalzifikationen (3/10) dar. In allen mittels Magnetresonanztomographie untersuchten Faellen fand sich ein Knochenmarksoedem sowie eine randstaendige Signalintensitaetssteigerung (6/6). Weichteilprozesse wurden in 5/6 Faellen beschrieben. Schlussfolgerung. Waehrend die Magnetresonanztomographie durch den - allerdings relativ unspezifischen - Nachweis des Knochenmarkoedems Vorteile in der Fruehdiagnostik besitzt, hat die Computertomographie den Vorteil, in fortgeschrittenen Stadien relativ charakteristische osteoreparative Veraenderungen (subperiostale Knochenappositionen) als wichtiges differentialdiagnostisches Zeichen nachweisen zu koennen. Beide Verfahren ergaenzen sich somit. (orig.)

  2. [Sports and recreational activities as a form of functional treatment of patients with ankylosing spondilytis].

    Science.gov (United States)

    Grubisi?, Frane; Grazio, Simeon; Znika, Matea

    2007-01-01

    Ankylosing spondylitis is a chronic inflammatory rheumatic disease that primarily affects the sacroiliac joints and spine, although it may involve entheses, peripheral joints and extraarticular organs. Disease treatment is directed toward the suppression of the inflammatory process and the improvement of the musculoskeletal system function. There are several treatment modalities: education of the patient and members of the family, pharmacological treatment, physical therapy and, in some cases, surgical treatment. An important segment of various modalities of physical therapy belongs to kinesitherapy, sports and recreation whose duration and intensity largely depends not only on the actual functional impairments, but also on the presence of some other disease or contraindications. Kinesitherapy is directed toward maintenance and improvement of the function of the spine, thoracic cavity and large synovial joints as well as the prevention of deformities or contractures. Kinesitherapy and sports programmes may involve individual or group approach. Patients are encouraged to participate in sports activities that may imitate or substitute specific forms of exercises. PMID:18949929

  3. Tuberculous spondylitis vs pyogenic spondylitis: focusing on the discriminative MR findings for differentiation

    International Nuclear Information System (INIS)

    The purpose of this study is to analyze the most discriminative MR findings for making the differential diagnosis of tuberculous and pyogenic spondylitis. Sixty MR scans of 18 pyogenic spondylitis patients and 42 tuberculous spondylitis patients were retrospectively reviewed. The statistical analysis was performed using stepwise discriminant analysis and Student's T-test. The patients with tuberculous spondylitis had a significantly higher incidence of MRI findings as follows (? < 0.05): smooth margin of a paraspinal mass/abscess in 67% [28/42] of the tuberculous spondylitis patients vs 6% [1/8] in the pyogenic spondylitis patients, mild endplate erosion in 52% [22/42] vs 38% [7/18], respectively, the presence of paraspinal mass/abscess in 100% [42/42] vs 6% [1/18], respectively, central dark signal intensity of the abscess in 86% [36/42] vs 39% [7/18]), respectively, subligamentous spread in 81% [34/42] vs 50% [9/18]), respectively, severe vertebral collapse in 20% [8/42] vs 11% [2/18]), respectively, and posterior extension in 62% [26/42] vs 33% [6/18]), respectively. Among of them, the significant discriminative MR findings were the margin of a paraspinal mass, the grade of endplate erosion and the presence of absence of a paraspinal mass in that order. In the differentiation of tuberculous and pyogenic spondylitis, the margin of the paraspinal mass, the grade of endplate erosion and the presence or absence of a paraspinal mass are the most three discirminating MRmass are the most three discirminating MR findings in that order

  4. Tuberculous spondylitis vs pyogenic spondylitis: focusing on the discriminative MR findings for differentiation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, So Young; Hong, Suk Joo; Lee, Chang Yoon; Chung, Kyoo Byung; Park, Cheol Min [College of Medicine, Korea University, Seoul (Korea, Republic of)

    2007-02-15

    The purpose of this study is to analyze the most discriminative MR findings for making the differential diagnosis of tuberculous and pyogenic spondylitis. Sixty MR scans of 18 pyogenic spondylitis patients and 42 tuberculous spondylitis patients were retrospectively reviewed. The statistical analysis was performed using stepwise discriminant analysis and Student's T-test. The patients with tuberculous spondylitis had a significantly higher incidence of MRI findings as follows ({rho} < 0.05): smooth margin of a paraspinal mass/abscess in 67% [28/42] of the tuberculous spondylitis patients vs 6% [1/8] in the pyogenic spondylitis patients, mild endplate erosion in 52% [22/42] vs 38% [7/18], respectively, the presence of paraspinal mass/abscess in 100% [42/42] vs 6% [1/18], respectively, central dark signal intensity of the abscess in 86% [36/42] vs 39% [7/18]), respectively, subligamentous spread in 81% [34/42] vs 50% [9/18]), respectively, severe vertebral collapse in 20% [8/42] vs 11% [2/18]), respectively, and posterior extension in 62% [26/42] vs 33% [6/18]), respectively. Among of them, the significant discriminative MR findings were the margin of a paraspinal mass, the grade of endplate erosion and the presence of absence of a paraspinal mass in that order. In the differentiation of tuberculous and pyogenic spondylitis, the margin of the paraspinal mass, the grade of endplate erosion and the presence or absence of a paraspinal mass are the most three discirminating MR findings in that order.

  5. 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

  6. Diagnostic clues for spondylitis in acute brucellosis

    OpenAIRE

    Nazlim Aktug-Demir; Servet Kolgelier; Serap Ozcimen; Sua Sumer; Demir, Lutfi S.; Inkaya, Ahmet C.

    2014-01-01

    Objectives: To determine the diagnostic factors for brucellar spondylitis. Methods: This retrospective study included 227 consecutive brucellosis patients admitted to the Infectious Diseases and Clinical Microbiology clinics of Adiyaman State Hospital and Adiyaman 82nd Year State Hospital, Adiyaman, Turkey between January 2010 and December 2012. Acute brucellosis was diagnosed by standard tube agglutination test and/or growth of Brucella spp. in appropriately prepared culture media (Bactec). ...

  7. Tuberculous Spondylitis: Contrast enhanced MR imaging

    International Nuclear Information System (INIS)

    This retrospective study was conducted to evaluate the value of administration of IV gadopentetate dimeglumine for MR imaging of tuberculous spondylitis. The authors reviewed MR images both with and without contrast enhancement of 22 patients with tuberculous spondylitis. Evaluation of signal characteristics, enhancement patterns, and difference of delineation between pre- and postcontrast enhancement was made on 4 compartments the vertebral body, intervertebral disc, paravertebral space, and extradural space. The spinal tuberculous lesions revealed relatively low or isosignal intensity on T1-weighted image and high signal intensity on T2-weighted image. The tuberculous lesions of vertebral body showed enhancement of mixed pattern, and rim-enhancement pattern was predominant in the other 3 compartment, suggesting abscess. The contrast enhanced MR image showed better demarcation of the extents of tuberculous lesions comparing with noncontrast image, especially at the vertebral body and intervertebral disc. The nature of tuberculous involvement was better visualized at the extradural space and paravertebral space on postcontrast image. We conclude Gd-DTPA enhanced MR image can give information for more detailed delineation, extents, and nature of involvement in the tuberculous spondylitis

  8. 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

  9. Atlantoaxial subluxation as an early manifestation in an adolescent with undifferentiated spondyloarthritis: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Jea Andrew

    2011-07-01

    Full Text Available Abstract Introduction Atlantoaxial instability has been described as a manifestation of ankylosing spondylitis (juvenile and adult onset, reactive arthritis, juvenile idiopathic arthritis, and rheumatoid arthritis; however, it has rarely been reported as an early manifestation of these disorders. We present this case report to increase awareness of the condition in the hope that earlier recognition of this disease may prevent further serious injury. Case presentation We report the case of a 17-year-old Hispanic adolescent woman who was initially diagnosed with undifferentiated spondyloarthritis due to peripheral arthritis, enthesitis, a positive human leukocyte antigen B27 result, and inflammatory spinal pain lasting two months. Our patient experienced persistent and worsening occipitocervical pain and signs of myelopathy three months after diagnosis; consequently, we found atlantoaxial instability along with cervical spine bone erosion and pannus formation. She was treated surgically with a C1-2 posterior instrumented fusion and at six weeks post-operatively was started on tumor necrosis factor ? blockade. Her occipitocervical symptoms subsided following surgery and initiation of immunomodulation. Conclusions Our report serves to emphasize to pediatric and adult general practitioners, pediatricians, internists, family physicians, pediatric and adult rheumatologists and spine surgeons that atlantoaxial subluxation may be an early manifestation of spondyloarthritis, and that the condition is treatable by surgical intervention and immunomodulation.

  10. Patients with ankylosing spondylitis have increased sick leave—a registry-based case–control study over 7 yrs

    OpenAIRE

    Stro?mbeck, Britta; Jacobsson, Lennart T. H.; Bremander, Ann; Englund, Martin; Heide, Anders; Turkiewicz, Aleksandra; Petersson, Ingemar F.

    2009-01-01

    Objectives. Using prospectively collected registry data to investigate sick leave (sickness benefit and sickness compensation) over a 7-yr period in patients with AS in comparison with population-based controls matched for age, sex and residential area.

  11. 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

  12. 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...

  13. Primary pyogenic spondylitis following kyphoplasty: a case report

    Directory of Open Access Journals (Sweden)

    Heyse Thomas J

    2011-03-01

    Full Text Available Abstract Introduction Only ten cases of primary pyogenic spondylitis following vertebroplasty have been reported in the literature. To the best of our knowledge, we present the first reported case of primary pyogenic spondylitis and spondylodiscitis caused by kyphoplasty. Case presentation A 72-year old Caucasian man with an osteoporotic compression fracture of the first lumbar vertebra after kyphoplasty developed sensory incomplete paraplegia below the first lumbar vertebra. This was caused by myelon compression following pyogenic spondylitis with a psoas abscess. Computed tomography guided aspiration of the abscess cavity yielded group C Streptococcus. The psoas abscess was percutaneously drained and laminectomy and posterior instrumentation with an internal fixator from the eleventh thoracic vertebra to the fourth lumbar vertebra was performed. In a second operation, corpectomy of the first lumbar vertebra with cement removal and fusion from the twelfth thoracic vertebra to the second lumbar vertebra with a titanium cage was performed. Six weeks postoperatively, the patient was pain free with no neurologic deficits or signs of infection. Conclusion Pyogenic spondylitis is an extremely rare complication after kyphoplasty. When these patients develop recurrent back pain postoperatively, the diagnosis of pyogenic spondylitis must be considered.

  14. Espondilitis anquilopoyética / Spondylite ankilopoiétique / Ankylopoietic spondylitis

    Scientific Electronic Library Online (English)

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

    2009-12-01

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

  15. 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.

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

  17. Clinical results of 31 patients with pyogenic spondylitis

    International Nuclear Information System (INIS)

    We studied 31 patients with pyogenic spondylitis who were treated at our hospital from 1996 to 2004. They consisted of 17 male and 14 female patients ranging in age from 37 to 76 years (mean: 63 years). The follow-up period ranged from six to 26 months (mean: 13 months). Sixteen cases were treated conservatively with antibiotics and brace, and 15 cases surgically. Twenty patients (64.5%) had an impaired immune system secondary to diabetes mellitus, cancer, renal or hepatic failure. The infection in 18 patients (58.4%) was caused by organisms. The source of the infection was confirmed in seven (22.6%) with the urinary tract being the most frequent source. MRI is very sensitive and often quite specific for spinal infection. But it is difficult to evaluate the healing phase of chronic pyogenic spondylitis. (author)

  18. 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.

  19. Treatment for Multiple Aspergillus Spondylitis Including a Hip Joint

    OpenAIRE

    Oh, In-soo; Seo, Jun-yeong; Ha, Kee-yong; Kim, Yoon-chung

    2009-01-01

    Multiple aspergillus spondylitis (AS) is a life threatening infection that occurs more commonly in immunocompromised patients, and is commonly treated with antifungal agents. However, there is relatively little information available on the treatment of multiple AS. The authors encountered a 46-year-old man suffering from low back and neck pain with radiculomyelopathy after a liver transplant. The patient had concomitant multiple AS in the cervico-thoraco-lumbar spine and right hip joint, as c...

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

    OpenAIRE

    Akar, O?mer; Sucu, Hasan Kamil

    2012-01-01

    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 kyphopl...

  1. MR imaging manifestations and staging of pyogenic spondylitis

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Shinohara, Akira; Ueno, Yutaka; Marumo, Keishi

    2014-08-01

    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 infection and treated with once-weekly teriparatide administration is presented. Vertebral body erosion in cortical and cancellous areas by the infection was rapidly repaired after 6 weeks of once-weekly teriparatide treatment. Treatment with once-weekly teriparatide appears to be a new strategy for patients with severe osteoporosis suffering from pyogenic spondylitis. PMID:25187868

  3. A Case of Pyogenic Spondylitis after Surgery for Oral Floor Cancer

    Directory of Open Access Journals (Sweden)

    Takamitsu Mano

    2014-05-01

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

  4. 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.

  5. 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.)

  6. Magnetic resonance imaging of pyogenic spondylitis complicating neurological symptoms

    International Nuclear Information System (INIS)

    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.)

  7. The contribution of disease activity on functional limitations over time through psychological mediators: a 12-month longitudinal study in patients with ankylosing spondylitis

    OpenAIRE

    Jang, Jennifer H.; Green, Charles E.; Assassi, Shervin; Reveille, John D.; Ward, Michael M.; Weisman, Michael H.; Nicassio, Perry M.

    2011-01-01

    Objectives. To explore whether helplessness, internality and depression would mediate the relationship between disease activity and functional limitations in patients with AS in a 12-month longitudinal study.

  8. 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

  9. 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 ...

  10. A case of infliximab-induced lupus in a patient with ankylosing spondylitis: is it safe switch to another anti-TNF-? agent?

    OpenAIRE

    Santiago, T.; Santiago, Mg; Rovisco, J.; Duarte, C.; Malcata, A.; Pereira Da Silva, Ja

    2013-01-01

    Anti-TNF-? therapies are the latest class of medications found to be associated with drug-induced lupus, a distinctive entity known as anti-TNF-?-induced lupus (ATIL) (Williams et al., Rheumatology (Oxford) 48:716-20, 2009; De Rycke et al., Lupus 14:931-7, 2005; De Bandt et al., Clin Rheumatol 22:56-61, 2003). With the widespread use of these agents, it is likely that the incidence of ATIL will increase. The onset of ATIL in patients with rheumatoid arthritis and Crohn's disease has been de...

  11. Tuberculosis of the sternum in patients with infective spondylitis

    Scientific Electronic Library Online (English)

    W, Haynes; S, Govender.

    Full Text Available SciELO South Africa | Language: English Abstract in english 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.

  12. New surgical technique and distraction osteogenesis for ankylosed dental movement.

    Science.gov (United States)

    Agabiti, Ivo; Capparè, Paolo; Gherlone, Enrico Felice; Mortellaro, Carmen; Bruschi, Giovanni B; Crespi, Roberto

    2014-05-01

    Dental ankylosis often presents a significant vertical alveolar defect that is an esthetic problem for prosthetic rehabilitation. Moreover, surgical-orthodontic treatment by corticotomies and distraction devices provides special attention to avoid the loss of blood supply to the segment; furthermore, gingival recessions may appear because the gingival tissues cannot proliferate as fast as the immediate repositioning of the tooth. This case report presents a surgical technique for buccal, palatal, and vertical movements, and examines the effects of a tooth/arch-borne tooth distractor appliance, for the alignment of ankylosed teeth. The slow movements of tooth and bone block and fine cut simplifies orthodontic treatment in patients and makes it possible to achieve complex movements in a relatively short period. The reported dislocation procedure allows a use of buccal-lingual vertical osteotomy with horizontal osteotomy to correct tooth positions via bony block movement maintaining gingival tissues in position. The used sonic saw have proven to be a valuable alternative to manual or rotating tools, oscillating saws, or piezoelectric units because it is faster and easier for surgical approach. PMID:24777021

  13. 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

  14. Rheumatological presentation of developmental bone diseases

    Energy Technology Data Exchange (ETDEWEB)

    Kalifa, Gabriel; Cohen, Pierre alain; Hamidou, Amine

    2000-02-01

    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.

  15. Clinical trial on shortening conservative treatment period for pyogenic spondylitis at our hospital

    International Nuclear Information System (INIS)

    We report a clinical trial of percutaneous drainage associated with hyperbaric oxygen therapy for pyogenic spondylitis. The patients included 17 males and four females who were treated at our hospital for pyogenic spondylitis. The subjects were divided into two groups; 19 cases treated with conventional rest and antibiotic dosage (Group A) and 12 cases treated with CT-assisted percutaneous dranage (Group B). Nine patients also underwent hyperbaric oxygen therapy. We evaluated the period to C reactive protein (CRP) normalization. Group A required an average of 59.7 days to CRP normalization from the start of treatment. On the other hand, Group B required an average of 27.1 days. In addition, combination of hyperbaric oxygen treatment shortened this time by 14 days in Group A and 11 days in Group B. In conclusion, percutaneous drainage combined with hyperbaric oxygen therapy is useful for shortening the treatment period for pyogenic spondylitis. (author)

  16. Magnetic resonance imaging of pyogenic spondylitis and its suggestive images of healing by conservative treatment

    Energy Technology Data Exchange (ETDEWEB)

    Kashimoto, Osamu [Miyagi Prefectural Takukyoen, Sendai (Japan)

    1999-03-01

    MRI shows various images according to the healing process in pyogenic spondylitis. The images indicate activities of inflammation. Signs of healing were decided as follows. T2-weighted image shows no high signal intensity at the focus in intercorporal space. Area of diffuse enhancement with Gadolinium-DTPA becomes smaller or diminished. Thirteen cases treated conservatively were evaluated prospectively for healing process using these signs. The MR images correlated with symptoms and the results of blood examination in twelve cases. MRI adds more confidence to the judgment of healing in the case of pyogenic spondylitis with no symptoms and normal results of blood examination. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Cheol Mok; Shin, Myung Jin; Kim, Sung Moon; Lee, Sang Hoon; Lee, Sang Min; Shin, Ji Hoon [Ulsan University College of Medicine, Seoul (Korea, Republic of); Kwon, Sonn Tae [Chungnam National University Graduate School, Taejon (Korea, Republic of); Bae, Sang Jin [Inje University Sanggyepaik Hospital, Seoul (Korea, Republic of)

    2003-06-01

    To determine the diagnostic value of CT-guided biopsy or aspiration of the spine and paraspinal soft tissue in infectious spondylitis. Between January 2000 and June 2002, 58 patients underwent 67 biopsies and/or aspirations under CT guidance to identify the organism causing infectious spondylitis, and were included in this study. Nine underwent rebiopsy. In all patients, MR images were available before biopsy and/or aspiration. In 63 of 67 procedures, the specimens or aspirates obtained were prepared for culture and smear, and for histological examination, four procedures involved aspiration only. In ten patients with suspected tuberculosis, a polymerase chain reaction test was performed. For all procedures, the transpedicular, transcostovertebral or paravertebral route was involved, according to the level and shape of the lesions, and 14-, 16-, or 18-gauge core biopsy needles and/or 20-gauge aspiration needles were employed. Lesions involved a paravertebral (n=17), psoas (n=8) or epidural (n=1) abscess; an intervertebral disc (n=20); or a vertebral body (n=21). The levels at the mid-thoracic spine were T4-T10 (n=11); at the thoracolumbar junction, T11-L1 (n=14); at the lumbar spine, L1-L4 (n=25); and at the lumbo-sacral junction, L5-S1 (n=17). In nine of 58 patients, rebiopsy was performed. Diagnosis was confirmed in 22 of 58 patients (38%), and was as follows: tuberculous spondylitis (n=17), pyogenic spondylitis (n=4), and fungal spondylitis (n=1). Thirty-six unconfirmed cases were diagnosed as nonspecific inflammation (n=21), fibrosis involving cortical bone (n=1), necrotic material (n=5) and inadequate specimen without evidence of malignancy (n=9). Only one of the nine cases in which biopsy was repeated was confirmed as tuberculous spondylitis. Diagnosis was confirmed in 7 of 17 paravertebral abscesses (41%), 8 of 21 vertebral bodies (38%), 6 of 20 intervertebral discs (30%) and 1 of 8 psoas abscesses (13%). In infectious spondylitis, the overall diagnostic yield of CT-guided needle biopsy and/or aspiration is relatively low, but the procedure seems to be effective for excluding malignancy. In identifying the organisms involved in infectious spondylitis, a paravertebral lesion is in a more favoured location than a psoas lesion.

  18. Magnetic resonance imaging of pyogenic spondylitis and its suggestive images of healing by conservative treatment

    International Nuclear Information System (INIS)

    MRI shows various images according to the healing process in pyogenic spondylitis. The images indicate activities of inflammation. Signs of healing were decided as follows. T2-weighted image shows no high signal intensity at the focus in intercorporal space. Area of diffuse enhancement with Gadolinium-DTPA becomes smaller or diminished. Thirteen cases treated conservatively were evaluated prospectively for healing process using these signs. The MR images correlated with symptoms and the results of blood examination in twelve cases. MRI adds more confidence to the judgment of healing in the case of pyogenic spondylitis with no symptoms and normal results of blood examination. (author)

  19. 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.

  20. 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...

  1. Early

    OpenAIRE

    Houssiau, F. A.; Vasconcelos, C.; D Cruz, D.; Sebastiani, G. D.; Ramon Garrido, E.; Danieli, M. G.; Abramovicz, D.; Blockmans, D.; Mathieu, A.; Direskeneli, H.; Galeazzi, M.; Gul, A.; Levy, Y.; Petera, P.; Popovic, R.

    2004-01-01

    Arthritis Rheum. 2004 Dec;50(12):3934-40. Early response to immunosuppressive therapy predicts good renal outcome in lupus nephritis: lessons from long-term followup of patients in the Euro-Lupus Nephritis Trial. Houssiau FA, Vasconcelos C, D'Cruz D, Sebastiani GD, de Ramon Garrido E, Danieli MG, Abramovicz D, Blockmans D, Mathieu A, Direskeneli H, Galeazzi M, Gül A, Levy Y, Petera P, Popovic R, Petrovic R, Sinico RA, Cattaneo R, Font J, Depresseux G, Cosyns JP, Cervera R. Univers...

  2. Pulmonary miliary tuberculosis complicated with tuberculous spondylitis; an extraordinary rare association: a case report

    OpenAIRE

    Palama, Eleni; Golias, Christos; Illiadis, Iosif; Charalabopoulos, Konstantinos

    2009-01-01

    In the last decade a significant rise in the prevalence of tuberculosis as well as in its extrapulmonary manifestations is detected worldwide. The central nervous system, the genitourinary tract, the organs of the abdomen and the skeletal system, are common sites of infection. Misdiagnosis and delay in treatment are common events. Herein, we present a case of a 78-year-old man non-smoker, with miliary tuberculosis complicated with tuberculous spondylitis. The patient presented with anemia and...

  3. Case report 396: Osseous sequelae of tuberculous spondylitis as demonstrated by computed tomography

    International Nuclear Information System (INIS)

    A case has been presented of tuberculous spondylitis in a 41-year-old woman from Saudi Arabia. CT studies, demonstrating large exostoses projecting from the involved fourth lumbar vertebral body, were obtained nine months after treatment was given for tuberculous spondylitis. The CT scans obtained before and after treatment showed significant change between the two studies nine months apart. The large psoas abscesses and the the abscesses tracking longitudinally beneath the anterior spinal ligament at the time of the initial involvement were demonstrated dramatically. A plain film of the lumbar spine before treatment showed involvement of the vertebral bodies of L3 and L4 as well as the intervening disk cartilage. The differential diagnosis in such a pattern of osteophytosis was considered. The issue of hyperostosis developing in tuberculous spondylitis and the possible cause were discussed and the authors speculated that the chronicity of the tuberculous process permits reparative woven bone to be deposited on the scaffolding of dead bone, thus giving a sclerotic appearance which is secondary to ischemic necrosis of the affected bone. The authors also stressed that the extreme hyperostosis in this case may relate to successful chemotherapy. According to the authors no previous report of such changes as demonstrated on CT following successful chemotherapy are available in the literature. (orig.)

  4. Frequency and magnetic resonance imaging patterns of tuberculous spondylitis lesions in adults

    International Nuclear Information System (INIS)

    To find out the frequency and patterns of various lesions in tuberculous spondylitis in adults on magnetic resonance imaging (MRI). Study Design: Case series. Place and Duration of Study: Radiology Department, Military Hospital (MH) Rawalpindi, from September 2006 to March 2007. Methodology: Patients with features suggestive of tuberculous spondylitis underwent plain T1- weighted and T2 -weighted images and T1-weighted contrast enhanced images in both axial and sagittal sections. The data was analyzed in terms of frequency and patterns of various lesions of tuberculous spondylitis causing abnormal signals in spinal and paraspinal areas. Mean + standard deviation were calculated for numerical data using SPSS version 15. Results: Out of 75 patients, 39 were females. The mean age was 42.4 years. Involvement occurred through SV1 vertebral levels. Most common involvement was seen in the thoracic vertebrae (40%) followed by lumbar vertebrae. The most common MRI feature was abnormal signal intensities appearing hypointense on T1W and hyperintense on T2W sequences with heterogeneous enhancement of the vertebral body in all patients. The characteristic findings of spinal tuberculosis included destruction of two adjacent vertebral bodies and opposing end plates, destruction of intervening disc, and occurrence of paravertebral and epidural abscesses. Conclusion: MR imaging of spinal tuberculosis, characteristically show contiguous involvement of two vertebrae along with the inteement of two vertebrae along with the intervening disc, skip lesions, and paraspinal collections and provides critical information about the involvement of spinal cord and the extent of the disease. (author)

  5. Differentiation between tuberculous and pyogenic spondylitis on Gd-enhanced MR imaging : focus on the patterns of disc enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Seung Bae; Shin, Young Yeol; Lee, Sang Yong; Lee, Jeong Min; Han, Young Min; Chung, Gyung Ho; Kim, Chong Soo [Chonbuk National Univ. Hospital, Chonju (Korea, Republic of)

    2001-09-01

    The purpose of this study was to analyze the patterns of intervertebral disc enhancement seen in tuberculous and pyogenic spondylitis, and to evaluate their utility in differentiating between the two groups. Magnetic resonance images obtained in 31 consecutive infectious spondylitis patients (43 discs) in whom intervention occurred due to infected vertebral bodies, were retrospectively analysed. Nineteen of the patients had tuberculosis and 12 were infected by pyogenic organisms. After analysis, the patterns of disc enhancement revealed by contrast-enhanced T1-weighted axial and sagittal MR imaging were classified as of four types : Type I, non-enhancing; Type II, enhancement of the peripheral margin of the disc; Type III, enhancement of the peripheral margin and central area adjacent to the cortical vertebral endplate; Type IV, general enhancement and/or destruction of the disc. There were 19 cases of tuberculous spondylitis involving 28 intervertebral discs, and the enhancement patterns observed were as follows : Type I : n=4, 14%, Type II : n-17, 61%, Type III : n=1, 4%, Type IV : n=6, 21%. Twelve cases of pyogenic spondylitis involved 15 intervertebral discs ; the enhancement patterns observed in these cases were as follows : Type I : n=1, 7%, Type II : n=2, 13%, Type III : n=10, 67%, Type IV : n=2 13%. Careful analysis of the patterns of disc enhancement occurring in infectious spondylitis can be useful for differentiating between the tuberculous and pyogenic varieties of this condition.

  6. Differentiation between tuberculous and pyogenic spondylitis on Gd-enhanced MR imaging : focus on the patterns of disc enhancement

    International Nuclear Information System (INIS)

    The purpose of this study was to analyze the patterns of intervertebral disc enhancement seen in tuberculous and pyogenic spondylitis, and to evaluate their utility in differentiating between the two groups. Magnetic resonance images obtained in 31 consecutive infectious spondylitis patients (43 discs) in whom intervention occurred due to infected vertebral bodies, were retrospectively analysed. Nineteen of the patients had tuberculosis and 12 were infected by pyogenic organisms. After analysis, the patterns of disc enhancement revealed by contrast-enhanced T1-weighted axial and sagittal MR imaging were classified as of four types : Type I, non-enhancing; Type II, enhancement of the peripheral margin of the disc; Type III, enhancement of the peripheral margin and central area adjacent to the cortical vertebral endplate; Type IV, general enhancement and/or destruction of the disc. There were 19 cases of tuberculous spondylitis involving 28 intervertebral discs, and the enhancement patterns observed were as follows : Type I : n=4, 14%, Type II : n-17, 61%, Type III : n=1, 4%, Type IV : n=6, 21%. Twelve cases of pyogenic spondylitis involved 15 intervertebral discs ; the enhancement patterns observed in these cases were as follows : Type I : n=1, 7%, Type II : n=2, 13%, Type III : n=10, 67%, Type IV : n=2 13%. Careful analysis of the patterns of disc enhancement occurring in infectious spondylitis can be useful for differentiating between the tuberculous and pyogenic varg between the tuberculous and pyogenic varieties of this condition

  7. 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

  8. Complications: How Is a Person Affected?

    Science.gov (United States)

    ... Affected? Although ankylosing spondylitis (AS) and related diseases (SpA), sometimes collectively called spondylitis for short, are conditions ... the affected areas for short periods Try gentle massage of the neck and shoulder area Try deep ...

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

    Science.gov (United States)

    2014-02-06

    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

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

    OpenAIRE

    Chiba Kazuhiro; Toyama Yoshiaki; Watanabe Kota; Yoshioka Kenji; Matsumoto Morio

    2011-01-01

    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 ...

  11. 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).

  12. 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...

  13. Prevalence, physical activity and work in patients with spondyloarthritis

    OpenAIRE

    Haglund, Emma

    2013-01-01

    Spondyloarthritis (SpA) is a group of interrelated inflammatory rheumatic diseases with the sub-diagnoses ankylosing spondylitis (AS), psoriatic arthritis (PsA), arthritis-associated inflammatory bowel disease (Aa-IBD), undifferentiated SpA (USpA), where stiffness and pain are key symptoms. Insidious onset back pain, morning stiffness, waking up at night, and improvement from exercise are common characteristics. The disease is life-long, often with early onset, and can cause limitations in ph...

  14. Pulmonary miliary tuberculosis complicated with tuberculous spondylitis; an extraordinary rare association: a case report

    Science.gov (United States)

    Palama, Eleni; Golias, Christos; Illiadis, Iosif

    2009-01-01

    In the last decade a significant rise in the prevalence of tuberculosis as well as in its extrapulmonary manifestations is detected worldwide. The central nervous system, the genitourinary tract, the organs of the abdomen and the skeletal system, are common sites of infection. Misdiagnosis and delay in treatment are common events. Herein, we present a case of a 78-year-old man non-smoker, with miliary tuberculosis complicated with tuberculous spondylitis. The patient presented with anemia and a left shoulder pain, accompanied by rigor and fever 37.5°C-38°C of one month duration. This entity is extremely rare, since only two similar cases have been reported in the English literature according to PubMed search. PMID:19918444

  15. [Vertebral column growth in children after surgical correction of severe kyphosis in tuberculosis spondylitis].

    Science.gov (United States)

    Pershin, A A; Mushkin, A Iu

    2008-01-01

    The growth of the unit of vertebrae and intact vertebrae outside and within the instrumental fixation area was studied in children operated on for tuberculosis spondylitis complicated by severe kyphotic deformity. There was a considerable growth retardation of blocked vertebrae after radical spinal repair from the growth of intact vertebrae. Instrumental fixation of the vertebral column after its radical reconstruction causes no considerable retardation of the vertical growth of intact vertebral bodies; however, it leads to the advanced growth of their anterior versus posterior portions, which mediates a supplementary self-correction of residual kyphosis during growth. When compression implants are presented in the body for 2 years or more, most children develop degeneration of intervertebral risks within the fixation area. PMID:19227323

  16. Differentiation between tuberculous and pyogenic spondylitis : MR imaging characteristics of paraspinal mass

    International Nuclear Information System (INIS)

    To determine the MR imaging findings for the differentiation of tuberculous spondylitis(TS) and pyogenic spondylitis(PS) with emphasis on the shape and MR signal characteristics or paraspinal mass. We obtained spin-echo T1- and T2-weighted MR images of 63 surgically proved cases of TS and 15 cases of PS. Gadopentetate dimeglumine(Gd)-enhanced T1-weighted MR images in 37 cases of TS and in all 15 cases of Ps were also obtained. Paraspinal mass formation, the size, shape and Gd-enhancing pattern of this mass and penetration of paraspinal ligaments by inflammatory tissue were analyzed. Paraspinal mass was found in both TS(63/63) and PS(9/15). The mean longitudinal dimension of this mass was 4.3 vertebral body heights in TS and 1.8 in PS. The margin of the mass was smooth in TS due to subligamentous spread of inflammation, while PS showed an irregular margin and invaded the para-aortic or para-caval space(9/15) due to penetration of inflammatory tissue through the paraspinal ligament. In the lumbar spine, however, TS showed focal penetration of the paraspinal ligament and formed psoas abscesses. After Gd enhancement, TS showed irregular thick or uniformly thin rim enhancement(35/37), suggesting caseation necrosis and cold abscess, while PS showed diffuse enhancement, suggesting abundant granulation tissue. MR imagining findings helpful for the differentiation of TS and PS were size, shape an enhancing pattern of paraspinal mass and penetration of paraspinal ligament by ind penetration of paraspinal ligament by inflammatory tissue

  17. Differentiation between tuberculous and pyogenic spondylitis : MR imaging characteristics of paraspinal mass

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Heung Sik; Yeon, Kyung Mo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-06-01

    To determine the MR imaging findings for the differentiation of tuberculous spondylitis(TS) and pyogenic spondylitis(PS) with emphasis on the shape and MR signal characteristics or paraspinal mass. We obtained spin-echo T1- and T2-weighted MR images of 63 surgically proved cases of TS and 15 cases of PS. Gadopentetate dimeglumine(Gd)-enhanced T1-weighted MR images in 37 cases of TS and in all 15 cases of Ps were also obtained. Paraspinal mass formation, the size, shape and Gd-enhancing pattern of this mass and penetration of paraspinal ligaments by inflammatory tissue were analyzed. Paraspinal mass was found in both TS(63/63) and PS(9/15). The mean longitudinal dimension of this mass was 4.3 vertebral body heights in TS and 1.8 in PS. The margin of the mass was smooth in TS due to subligamentous spread of inflammation, while PS showed an irregular margin and invaded the para-aortic or para-caval space(9/15) due to penetration of inflammatory tissue through the paraspinal ligament. In the lumbar spine, however, TS showed focal penetration of the paraspinal ligament and formed psoas abscesses. After Gd enhancement, TS showed irregular thick or uniformly thin rim enhancement(35/37), suggesting caseation necrosis and cold abscess, while PS showed diffuse enhancement, suggesting abundant granulation tissue. MR imagining findings helpful for the differentiation of TS and PS were size, shape an enhancing pattern of paraspinal mass and penetration of paraspinal ligament by inflammatory tissue.

  18. Orthodontic treatment of an ankylosed maxillary central incisor through single-tooth osteotomy by using interdental space regained from microimplant anchorage.

    Science.gov (United States)

    Chae, Jong-Moon; Paeng, Jun-Young

    2012-02-01

    This case report describes the treatment of a boy, aged 13.6 years, whose ankylosed maxillary left central incisor had been avulsed and replanted 2.5 years earlier. Ankylosis of the tooth and adjacent alveolar process led to the development of infraocclusion, migration of adjacent teeth, midline deviation, and a vertical alveolar bone defect. Initially, distal tooth movement in the maxillary arch was performed with microimplant anchorage to gain space for repositioning the ankylosed tooth. Then a single-tooth osteotomy was performed in 1 surgical stage to allow for inferior repositioning of the tooth and bone. The ankylosed tooth was successfully leveled in the maxillary arch with a harmonic gingival margin. The total treatment period was 18 months, and the results were acceptable at 14 months after debonding. PMID:22284297

  19. Reevaluation of some double-blind, randomized studies of dexibuprofen (Seractil): a state-of-the-art overview. Studies in patients with lumbar vertebral column syndrome, rheumatoid arthritis, distortion of the ankle joint, gonarthrosis, ankylosing spondylitis, and activated coxarthrosis.

    Science.gov (United States)

    Rahlfs, V W; Stat, C

    1996-12-01

    This article presents a reevaluation of studies previously performed regarding the efficacy and safety of dexibuprofen (Seractil; S(+)-ibuprofen) for use in patients with inflammatory or degenerative diseases. Using appropriate standardized measures (univariate and multivariate analysis with the Mann-Whitney statistic with confidence intervals), the authors were able to compare the effects of treatment in different diseases. For the primary criterion and for the combined analysis of all efficacy criteria, one-sided equivalence was proved in all six studies reviewed. PMID:9013382

  20. [Pott triad and Schmorl nodules. A historical overview of kyphosis with special reference to tuberculous spondylitis and Scheuermann disease].

    Science.gov (United States)

    Rauschmann, M A; Habermann, B; Engelhardt, M; Schwetlick, G

    2001-12-01

    This report provides an overview of the history of the different types of kyphosis (arcuated and angulated forms). Especially tuberculous spondylitis and Scheuermann's disease are pointed out from among the large group of kyphotic diseases. Therefore, Beckhterew's disease, the combination of rickets and kyphosis as well as the dysraphic diseases and constitutional kyphosis caused by faulty posture are only mentioned. These two special types of kyphosis (Scheuermann's disease and tuberculous spondylitis) are presented from the first description with diagnostic findings, the ideas of pathogenesis and aspects of treatment through to the different periods of medical history. This article describes the way of thinking and discussing of opinion leaders at the beginning of the century and the influence of new techniques and developments (asepsis, antisepsis, anesthesia, bacteriology, X-ray, antibiotics) on the differential diagnosis and therapy. It is impossible to give a complete overview of all aspects during the centuries concerning tuberculous spondylitis or arcuated kyphosis. The authors of this article have focussed their studies on developments from the first descriptions until World War II, based mainly on literature from German journals and historical books from the library of the German Museum for Orthopedic History and Science. PMID:11803742

  1. 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.)

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

    International Nuclear Information System (INIS)

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

  3. 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.)

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

    Scientific Electronic Library Online (English)

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

    2011-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Rho, Byung Hak; Byun, Woo Mok; Park, Won Gyu [College of Medicine, Yeungnam University, Taegu (Korea, Republic of); And Others

    2000-09-01

    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/mm{sup 2}. Signal intensity characteristics were evaluated in terms of the contrast ratio (CR) and signal-to-noise ratio (SNR) of bone marrow. Diffusion-weighted MR imaging showed that signal intensity in group A was hypointense to adjacent normal vertebral bodies, but in group B, hyperintensity was noted. In group C, signal intensity was variable, while in group D, hyperintensity was again noted. Diffusion-weighted imaging revealed that in group A, bone marrow CR had a negative value, while in groups B and D, this value was positive (p less than 0.01). The SNR of group D was lower than that of group B, but the difference was not statistically significant (p greater than 0.01). Diffusion-weighted MR imaging revealed that the signal intensity of metastatic compression fracture and spondylitis was hyperintense to adjacent normal vertebral bodies, that of acute benign compression fracture was hypointense, and that of chronic benign compression fracture was variable. This modality is therefore useful for differentiating between metastatic compression fracture, spondylitis and acute benign compression fracture. (author)

  6. 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)

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

    Directory of Open Access Journals (Sweden)

    Lind-Albrecht G

    2007-01-01

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

  8. Pregnancy in patients with rheumatic disease: anti-inflammatory cytokines increase in pregnancy and decrease post partum

    OpenAIRE

    Ostensen, M.; Forger, F.; Nelson, J.; Schuhmacher, A.; Hebisch, G.; Villiger, P.

    2004-01-01

    Objective: To investigate changes in the levels of circulating cytokines with a focus on the Th1/Th2 balance during and after pregnancy in patients with rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), and ankylosing spondylitis (AS).

  9. 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

  10. [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

  11. 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 SciELO Chile | Language: Spanish Abstract in spanish [...] 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.

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

    International Nuclear Information System (INIS)

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

  13. Tuberculous Spondylitis in Russia and Prominent Role of Multidrug-Resistant Clone Mycobacterium tuberculosis Beijing B0/W148.

    Science.gov (United States)

    Vyazovaya, Anna; Mokrousov, Igor; Solovieva, Natalia; Mushkin, Alexander; Manicheva, Olga; Vishnevsky, Boris; Zhuravlev, Viacheslav; Narvskaya, Olga

    2015-04-01

    Extrapulmonary and, in particular, spinal tuberculosis (TB) constitutes a minor but significant part of the total TB incidence. In spite of this, almost no studies on the genetic diversity and drug resistance of Mycobacterium tuberculosis isolates from spinal TB patients have been published to date. Here, we report results of the first Russian and globally largest molecular study of M. tuberculosis isolates recovered from patients with tuberculous spondylitis (TBS). The majority of 107 isolates were assigned to the Beijing genotype (n = 80); the other main families were T (n = 11), Ural (n = 7), and LAM (n = 4). Multidrug resistance (MDR) was more frequently found among Beijing (90.5%) and, intriguingly, Ural (71.4%) isolates than other genotypes (5%; P < 0.001). The extremely drug-resistant (XDR) phenotype was exclusively found in the Beijing isolates (n = 7). A notable prevalence of the rpoB531 and katG315 mutations in Beijing strains that were similarly high in both TBS (this study) and published pulmonary TB (PTB) samples from Russia shows that TBS and PTB Beijing strains follow the same paradigm of acquisition of rifampin (RIF) and isoniazid (INH) resistance. The 24-locus mycobacterial interspersed repetitive unit-variable-number tandem-repeat (MIRU-VNTR) subtyping of 80 Beijing isolates further discriminated them into 24 types (Hunter Gaston index [HGI] = 0.83); types 100-32 and 94-32 represented the largest groups. A genotype of Russian successful clone B0/W148 was identified in 30 of 80 Beijing isolates. In conclusion, this study highlighted a crucial impact of the Beijing genotype and the especially prominent role of its MDR-associated successful clone B0/W148 cluster in the development of spinal MDR-TB in Russian patients. PMID:25645851

  14. 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)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1976-11-01

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

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

    Science.gov (United States)

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

    1976-11-01

    HLA-B27 is a transplantation antigen found in a high proportion of patients with ankylosing spondylitis. Recently, an association has been shown to exist between HLA-B27 and acute uveitis, even in the absence of ankylosing spondylitis. We have examined the HLA antigen profile of 45 patients with acute nongranulomatous anterior uveitis and have confirmed this relation. In addition, using 90mtechnetium stannous pyrophosphate we have been able to demonstrate abnormal bone scan in 19 of 30 patients studied. Such abnormalities are limited to the sacroiliac joints but are otherwise the same as those seen in overt ankylosing spondylitis. Seven of the 19 patients did not have HLA-B27. These factors suggest that acute anterior uveitis may often represent a manifestation of a spondylitic diathesis even in the complete absence of any suggestive symptomatic or radiologic change and, in some cases, even though the antigenic marker HLA-B27 may be absent. PMID:988770

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  19. HLA-B*27 typing by sequence specific amplification without DNA extraction.

    OpenAIRE

    Sayer, D. C.; Cassell, H. S.; Christiansen, F. T.

    1999-01-01

    HLA-B27 appears to play a direct role in the pathogenesis of ankylosing spondylitis and almost all patients with this disease have HLA-B27. Therefore, a diagnosis of ankylosing spondylitis can virtually be excluded in the absence of HLA-B27. Many techniques have been used for HLA-B*27 typing. Of these, molecular methods are the most sensitive and specific but require extracted DNA as the testing material. A technique where HLA-B*27 is amplified directly from whole blood using sequence specifi...

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

    Directory of Open Access Journals (Sweden)

    Luciano Farage

    2002-03-01

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

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

    Scientific Electronic Library Online (English)

    Luciano, Farage; Johnny Wesley Gonçalves, Martins; Miguel, Farage Filho.

    2002-03-01

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

  2. 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

  3. Secukinumab: first global approval.

    Science.gov (United States)

    Sanford, Mark; McKeage, Kate

    2015-02-01

    Secukinumab (Cosentyx™) is a fully human monoclonal antibody against interleukin-17A, formulated for intravenous and subcutaneous administration. It received its first global approval in Japan on 26 December 2014 for the treatment of psoriasis and psoriatic arthritis in adults who are not adequately responding to systemic therapies (except for biologic agents). In the USA and the EU, secukinumab was approved in early 2015 for the treatment of patients with moderate-to-severe plaque psoriasis. Secukinumab is also being investigated in patients with ankylosing spondylitis and rheumatoid arthritis. This article summarizes the milestones in the development of secukinumab leading to its first approval for the treatment of adult patients with psoriasis and psoriatic arthritis. PMID:25648267

  4. 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.

  5. Socioeconomic burden of immune-mediated inflammatory diseases--focusing on work productivity and disability.

    Science.gov (United States)

    Jacobs, Philip; Bissonnette, Robert; Guenther, Lyn C

    2011-11-01

    Chronic disabling conditions, such as immune-mediated inflammatory diseases (IMID), adversely affect patients in terms of physical suffering and pain, impaired function, and diminished quality of life. These persistent relapsing diseases have a significant influence on individual employment status and work-related productivity. In addition to the significant burden on patients and their families, IMID represent a sizable burden to society due to high healthcare and non-healthcare related costs. Non-healthcare related, or indirect, costs - primarily associated with decreased work productivity, disability payments, and early retirements - are typically greater contributors than direct healthcare costs to the total costs associated with IMID. This article discusses the socioeconomic impact of several IMID, including rheumatoid arthritis, inflammatory bowel disease, ankylosing spondylitis, and psoriasis. PMID:22045980

  6. 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.

  7. 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

  8. 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%.

  9. Role of Adipokines in Atherosclerosis: Interferences with Cardiovascular Complications in Rheumatic Diseases

    OpenAIRE

    Morena Scotece; Javier Conde; Amp Xf Mez, Rodolfo G.; Amp Xf Pez, Ver Amp Xf Nica L.; Pino, Jes Amp Xfa S.; Antonio González; Francisca Lago; Amp Xf Mez-reino, Juan J. G.; Oreste Gualillo

    2012-01-01

    Patients with rheumatic diseases have an increased risk of mortality by cardiovascular events. In fact, several rheumatic diseases such as rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, and ankylosing spondylitis are associated with a higher prevalence of cardiovascular diseases (CVDs). Although traditional cardiovascular risk factors have been involved in the pathogenesis of cardiovascular diseases in rheumatic patients, these alterations do not completely explain the en...

  10. Intermediate filaments in synovial lining cells in rheumatoid arthritis and other arthritides are of vimentin type.

    OpenAIRE

    Osung, O. A.; Chandra, M.; Holborow, E. J.

    1982-01-01

    Cryostat section of synovial tissue from patients with rheumatoid arthritis, ankylosing spondylitis, osteoarthrosis, pigmented villonodular synovitis, and from a normal knee were studied by indirect immunofluorescence with guinea-pig antibodies to the intermediate filament proteins prekeratin, vimentin, and desmin. Staining for vimentin, but absence of prekeratin and desmin, was demonstrated in synovial lining cells. Antivimentin antibody also stained synovial tissue fibroblasts and vascular ...

  11. How to prescribe physical exercise in rheumatology

    OpenAIRE

    Maddali Bongi, S.; Del Rosso, A.

    2011-01-01

    Physical exercise, aiming to improve range of movement, muscle strength and physical well being, lately substituted the immobilization previously prescribed in rheumatic diseases. International guidelines, recommendations of Scientific Societies, and structured reviews regard physical exercise as of pivotal importance in treating rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, fibromyalgia syndrome, osteoporosis, and to be considered in connective tissue diseases. Therapeutic ex...

  12. 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

  13. 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 ... M01AE02 M02AA12 Indications: Rheumatoid arthritis, Osteoarthritis , Ankylosing spondylitis, Juvenile arthritis, etc. ...

  14. Outcome measures in rheumatoid arthritis: the OMERACT process.

    Science.gov (United States)

    Brooks, Peter; Boers, Maarten; Simon, Lee S; Strand, Vibeke; Tugwell, Peter

    2007-05-01

    The development of valid outcome measures is essential for appropriate management of any condition, but particularly chronic rheumatic diseases, such as rheumatoid arthritis. Over the last 15 years, Outcome Measures in Arthritis Clinical Trials has been dedicated to developing such measures in a variety of musculoskeletal conditions, including rheumatoid arthritis, osteoarthritis, osteoporosis, ankylosing spondylitis and gout. PMID:20477671

  15. 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 ...

  16. 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.

  17. Osteoporosis and rheumatic diseases

    OpenAIRE

    Maruotti, N.; Corrado, A.; 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 ...

  18. Enteropathic Arthritis

    Science.gov (United States)

    ... the IBD component of the disease. In some cases, the entire spine can become involved as well. Is There a Cure? Currently, there is no ... and inflammation is occurring - tend to be self-limiting, often subsiding after 6 ... also offer a wide variety of Educational Materials on ankylosing spondylitis ...

  19. A cadaveric study on sacroiliac joint injection.

    Science.gov (United States)

    Zou, Yu-Cong; Li, Yi-Kai; Yu, Cheng-Fu; Yang, Xian-Wen; Chen, Run-Qi

    2015-02-01

    The scope of this study was to explore the possibility as well as the feasibility of sacroiliac joint injection following simple X-ray clip location. For the cadaveric study, 10 fixed sacroiliac joint (SIJ) sectional specimens, 4 dried cadaveric pelvises and 21 embalmed adult cadaveric pelvises were dissected, followed by an injection of contrast agent into the joint. The irrigation of the agent was observed through CT scanning. For the radiologic study, 188 CT scans of ankylosing spondylitis patients (143 male, 45 female) were collected from 2010 to 2012, in Nanfang Hospital. What was measured was (1) Distance between the posterior midline and sagittal synovium; (2) Length of the sagittal synovium; (3) Distance between the midpoint of the sagittal synovium and posterior superior iliac spine; and (4) Distance between the superficial skin vertical to the sagittal synovium point were measured. For the practice-based study: 20 patients (17 males and 3 females) with early ankylosing spondylitis, from Nanfang Hospital affiliated with Southern Medical University were recruited, and sacroiliac joint unguided injections were done on the basis of the cadaveric and radiologic study. Only the inferior 1/3(rd) portion parallel to the posterior midline could be injected into since the superior 2/3(rd) portion were filled with interosseous ligaments. Thirteen of the 20 patients received successful injections as identified by CT scan using the contrast agent. Sacroiliac joint injection following simple X-ray clip location is possible and feasible if the operation is performed by trained physicians familiar with the sacroiliac joint and its surrounding anatomic structures. PMID:25692437

  20. Magnetic resonance imaging of the axial skeleton in rheumatoid disease.

    Science.gov (United States)

    Hermann, Kay-Geert A; Bollow, Matthias

    2004-12-01

    The axial skeleton is a target for both spondyloarthritis and rheumatoid arthritis. While conventional radiography allows the clear documentation of the late stages of inflammatory changes, magnetic resonance imaging (MRI) is sensitive enough to depict early inflammatory lesions. It is, therefore, of particular importance for radiologists and clinicians to know the MRI appearances of inflammatory changes of the axial skeleton in rheumatoid diseases. Typical lesions in ankylosing spondylitis and related conditions comprise spondylitis (Romanus lesion), spondylodiscitis (Andersson lesion), arthritis of the apophyseal joints, the costovertebral and costotransverse joints, and insufficiency fractures of the ankylosed vertebral spine (non-inflammatory type of Andersson lesion). Sacroiliitis is associated with chronic changes such as sclerosis, erosions, transarticular bone bridges, periarticular accumulation of fatty tissue and ankylosis. In addition, acute findings include capsulitis, juxta-articular osteitis and the enhancement of the joint space after contrast medium administration. Another important sign of spondyloarthritis is enthesitis, which affects the interspinal and supraspinal ligaments of the vertebral spine and the interosseous ligaments in the retroarticular space of the sacroiliac joints. The main site of manifestation of spinal involvement in rheumatoid arthritis is the cervical spine. Typical changes are the destruction of the atlantoaxial complex by pannus tissue with subsequent atlantoaxial subluxation, basilar impression and erosion of the dens axis. Changes in the lower segments of the cervical spine are destruction of the apophyseal joints resulting in the so-called stepladder phenomenon. Because of the uniform response of the discovertebral complex to different noxae, a number of different conditions must be distinguished on the basis of the patient's clinical findings and history in combination with their imaging appearance. These conditions comprise degenerative disc disease, septic spondylodiscitis, Scheuermann's disease, Paget's disease and diffuse idiopathic skeletal hyperostosis (DISH). PMID:15501188

  1. One-year prospective outcome analysis and complications following total replacement of the temporomandibular joint with the TMJ Concepts system.

    Science.gov (United States)

    Sidebottom, A J; Gruber, E

    2013-10-01

    Total replacement of the temporomandibular joint (TMJ) is increasingly accepted as the gold standard for reconstruction of irreparably damaged or ankylosed joints. The TMJ Concepts system (TMJ Concepts, Ventura, USA) has the longest follow-up of the 2 systems used in the UK. A total of 74 patients had placement of TMJ Concepts prostheses. The primary diagnoses were degenerative disease, multiple previous operations, injury, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and ankylosis. Of these, 12 were revisions of previous replacements (3 after multiple operations). Over the year there was a significant mean (SD) reduction in pain score (10 cm visual analogue scale) from 72 (2.5) to 8 (1.7) (pTMJ replacement gives good early improvements in function and pain with few complications. Of the 74 patients, 71 were very pleased to have had the procedure. One was dissatisfied despite complete pain relief and improvement in mouth opening from 3 to 30 mm, and 2 were ambivalent (one had infection, revision, and permanent weakness of the temporal branch of the facial nerve). PMID:23618995

  2. Tuberculous spondylitis following BCG vaccination

    International Nuclear Information System (INIS)

    A case of a rare form of BCG osteomyelitis in the spine is presented. After vaccination, the disease started with a lymphadenitis. Later an abscess extended from the pelvic along the psoas muscles into the retroperitoneum. The soft tissue mass extended paraspinally and epidural involvement was also apparent. The vertebral involvement was detected by CT. The radiological findings are discussed with reference to the literature. (orig.)

  3. Early Menopause (Premature Menopause)

    Science.gov (United States)

    ... chromosome. The ovaries don't form normally, and early menopause results. Genetics. Women with a family history of early menopause are ... vaginal dryness, and decreased sex drive. For some women with early menopause, these symptoms are quite severe. In addition, women ...

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

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

  6. 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.

  7. 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.

  8. Comments on radiology of the 'seronegative spondylarthritides'

    Energy Technology Data Exchange (ETDEWEB)

    Schacherl, M.; Stollenwerk, R.

    1981-09-01

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

  9. Comments on radiology of the 'seronegative spondylarthritides'

    International Nuclear Information System (INIS)

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

  10. Early breast cancer

    International Nuclear Information System (INIS)

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

  11. Early-Onset Alzheimer's

    Science.gov (United States)

    ... have discovered that, in some people, certain rare genes may cause Alzheimer’s symptoms to start early. When genetics is the ... down through family members and may affect several generations. This is why early-onset Alzheimer’s is sometimes called “familial” Alzheimer’s. Diagnosis: It may ...

  12. 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.

  13. 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…

  14. Early Retirement Payoff

    Science.gov (United States)

    Fitzpatrick, Maria D.; Lovenheim, Michael F.

    2014-01-01

    As public budgets have grown tighter over the past decade, states and school districts have sought ways to control the growth of spending. One increasingly common strategy employed to rein in costs is to offer experienced teachers with high salaries financial incentives to retire early. Although early retirement incentive (ERI) programs have been…

  15. Spondylitic changes in long-finned pilot whales (Globicephala melas) stranded on Cape Cod, Massachusetts, USA, between 1982 and 2000.

    Science.gov (United States)

    Sweeny, Melinda M; Price, Janet M; Jones, Gwilym S; French, Thomas W; Early, Greg A; Moore, Michael J

    2005-10-01

    The primary bone pathology diagnoses recognized in cetacea are osteomyelitis and spondylosis deformans. In this study, we determined the prevalence, type, and severity of vertebral pathology in 52 pilot whales, a mass stranding species that stranded on Cape Cod, Massachusetts, between 1982 and 2000. Eleven whales (21%) had hyperostosis and ossification of tendon insertion points on and between vertebrae, chevron bones, and costovertebral joints, with multiple fused blocks of vertebrae. These lesions are typical of a group of interrelated diseases described in humans as spondyloarthropathies, specifically ankylosing spondylitis, which has not been fully described in cetacea. In severe cases, ankylosing spondylitis in humans can inhibit mobility. If the lesions described here negatively affect the overall health of the whale, these lesions may be a contributing factor in stranding of this highly sociable species. PMID:16456160

  16. 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.

  17. Chromosome aberrations induced in patients treated with telecobalt therapy for mammary carcinoma

    International Nuclear Information System (INIS)

    The yields of dicentric and ring chromosomes were recorded during telecobalt therapy for mammary carcinoma. The data were fitted to a power or a quadratic function and were compared with those obtained in patients treated for ankylosing spondylitis and nuclear dockyard workers as well as with the results of an in vitro blood irradiation. As expected, the aberration yield for the same absorbed dose level is much greater after irradiation of ankylosing spondylitis than after irradiation for mammary carcinoma; lymphocytes exposed in vitro display the highest rate of aberration. A deviation of the aberrations observed in cells of the mammary carcinoma patients from the theoretical Poisson distribution also indicates that not all lymphocytes in the body has been exposed under these conditions

  18. 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.)

  19. Synovial histopathology of psoriatic arthritis, both oligo- and polyarticular, resembles spondyloarthropathy more than it does rheumatoid arthritis

    OpenAIRE

    Kruithof, Elli; Baeten, Dominique; Rycke, Leen; Vandooren, Bernard; Foell, Dirk; Roth, Johannes; Can?ete, Juan D.; Boots, Annemieke M.; Veys, Eric M.; Keyser, Filip

    2005-01-01

    At present only few biological data are available to indicate whether psoriatic arthritis (PsA) is part of the spondyloarthropathy (SpA) concept, whether it is a separate disease entity or a heterogeneous disease group with oligoarticular/axial forms belonging to SpA and polyarticular forms resembling rheumatoid arthritis (RA). To address this issue with regard to peripheral synovitis, we compared the synovial characteristics of PsA with those of ankylosing spondylitis (AS)/undifferentiated S...

  20. Perspectives on autoimmunity

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, I.R.

    1987-01-01

    The contents of this book are: HLA and Autoimmunity; Self-Recognition and Symmetry in the Immune System; Immunology of Insulin Dependent Diabetes Mellitus; Multiple Sclerosis; Autoimmunity and Immune Pathological Aspects of Virus Disease; Analyses of the Idiotypes and Ligand Binding Characteristics of Human Monoclonal Autoantibodies to DNA: Do We Understand Better Systemic Lupus Erythematosus. Autoimmunity and Rheumatic Fever; Autoimmune Arthritis Induced by Immunization to Mycobacterial Antigens; and The Interaction Between Genetic Factors and Micro-Organisms in Ankylosing Spondylitis: Facts and Fiction.

  1. Increased Soluble CD4 in Serum of Rheumatoid Arthritis Patients Is Generated by Matrix Metalloproteinase (MMP)-Like Proteinases

    OpenAIRE

    Tseng, Wen-yi; Huang, Yi-shu; Chiang, Nien-yi; Chou, Yeh-pin; Wu, Yeong-jian Jan; Luo, Shue-fen; Kuo, Chang-fu; Lin, Ko-ming; Lin, Hsi-hsien

    2013-01-01

    Higher soluble CD4 (sCD4) levels in serum have been detected in patients of infectious and chronic inflammatory diseases. However, how and why sCD4 is produced remains poorly understood. We establish sensitive ELISA and WB assays for sCD4 detection in conditioned medium of in vitro cell culture system and serum of chronic inflammatory patients. Serum samples from patients with systemic lupus erythematosus (SLE) (n?=?79), rheumatoid arthritis (RA) (n?=?59), ankylosing spondylitis (AS) ...

  2. 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...

  3. 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...

  4. Preliminary evaluation of learning via the AI/LEARN/Rheumatology interactive videodisc system.

    OpenAIRE

    Mitchell, J. A.; Bridges, A. J.; Reid, J. C.; Cutts, J. H.; Hazelwood, S.; Sharp, G. C.

    1992-01-01

    AI/LEARN/Rheumatology is a level three videodisc system to teach clinical observational skills in three important diseases: rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. The AI/LEARN software was developed on an independent authoring system called GALE designed for MS-DOS based computers. The purpose of this paper is to present preliminary data about the efficacy of teaching by the use of an interactive videodisc system as evaluated by examinations centered upon disease-or...

  5. Erosive spondylopathy.

    OpenAIRE

    Courtois, C.; Fallet, G. H.; Vischer, T. L.; Wettstein, P.

    1980-01-01

    Seven patients with chronic dorsolumbar pain, stiffness and some restriction of spinal movements are described. Multiple lesions of the vertebral bodies were present. The lesions occurred at various levels and all had similar radiological characteristics, often returning to normal after several years. Vertebral changes of this type may be seen in patients with ankylosing spondylitis but for a variety of cogent reasons presented in this report our patients did not readily fall into this diagno...

  6. Spondyloarthritis: Clinical Suspicion, Diagnosis, and Sports

    OpenAIRE

    Harper, Brock E.; Reveille, John D.

    2009-01-01

    Spondyloarthritis (SpA), a family of inflammatory back diseases including ankylosing spondylitis, is an important and underrecognized cause of chronic back pain in younger patients who are likely to participate in sports and athletic activities. These diseases are characterized by the presence of inflammatory back pain – lumbar or buttock/hip pain lasting longer than 3 months associated with improvement with activity, worsening with rest, relief with NSAIDs, and morning stiffness lasting lo...

  7. Spondylosclerosis hemispherica

    International Nuclear Information System (INIS)

    We have observed 87 cases of spondylosclerosis hemispherica. This lesion has a multiple aetiology, including bacterial causes (florid or low grade infections), stress due to scoliosis, ankylosing spondylitis, dorsal disc prolapse or diffuse disc degeneration. In the majority of cases it is possible to ascertain the aetiology from a consideration of the clinical and serological findings, together with ordinary radiography, conventional tomography or computed tomography. Appropriate treatment can then be given. (orig.)

  8. Spondylosclerosis hemispherica

    Energy Technology Data Exchange (ETDEWEB)

    Dihlmann, W.; Delling, G.

    1983-05-01

    We have observed 87 cases of spondylosclerosis hemispherica. This lesion has a multiple aetiology, including bacterial causes (florid or low grade infections), stress due to scoliosis, ankylosing spondylitis, dorsal disc prolapse or diffuse disc degeneration. In the majority of cases it is possible to ascertain the aetiology from a consideration of the clinical and serological findings, together with ordinary radiography, conventional tomography or computed tomography. Appropriate treatment can then be given.

  9. Transgenic mice over-expressing carbonic anhydrase I showed aggravated joint inflammation and tissue destruction

    OpenAIRE

    Zheng Yabing; Wang Lin; Zhang Wei; Xu Hengwei; Chang Xiaotian

    2012-01-01

    Abstract Background Studies have demonstrated that carbonic anhydrase I (CA1) stimulates calcium salt precipitation and cell calcification, which is an essential step in new bone formation. Our study had reported that CA1 encoding gene has a strong association with rheumatoid arthritis (RA) and ankylosing spondylitis (AS), two rheumatic diseases with abnormal new bone formation and bone resorption in joints. This study investigated the effect of CA1 on joint inflammation and tissue destructio...

  10. A variant of diffuse idiopathic skeletal hyperostosis: a case report.

    Science.gov (United States)

    Abdelwahab, I F; Zwass, A

    1987-01-01

    The case of an elderly man with a bamboo-like spine is presented. Because the patient's osteoporosis prevented proper evaluation of the sacroiliac and apophyseal joints on plain radiographs, the case originally was misdiagnosed in an outpatient clinic as ankylosing spondylitis. A further work-up showed the integrity of the apophyseal and sacroiliac joints, as well as cortical hyperostosis of the midcervical spine consistent with the diagnosis of diffuse idiopathic skeletal hyperostosis (DISH). PMID:3038225

  11. Efficacy and safety of pamidronate in Modic type 1 changes: study protocol for a prospective randomized controlled clinical trial

    OpenAIRE

    Cecchetti, Stella; Pereira, Bruno; Roche, Antoine; Deschaumes, Christophe; Abdi, Dihya; Coudeyre, Emmanuel; Dubost, Jean-jacques; Mathieu, Sylvain; Malochet-guinamand, Sandrine; Tournadre, Anne; Couderc, Marion; Vayssade, Marielle; Daron, Coline; Soubrier, Martin

    2014-01-01

    BACKGROUND: Erosive degenerative disc disease, also known as Modic type 1 changes, is usually characterized by low back pain with an inflammatory pain pattern, as seen in spondyloarthropathies. Intravenous pamidronate has proven to be effective in patients with ankylosing spondylitis who are refractory to nonsteroidal antiinflammatory drugs, and in painful bone diseases in general, such as Paget's disease, fibrous dysplasia or vertebral fractures. We therefore hypothesize that pamidronate wou...

  12. Physical Therapy and Surgery

    OpenAIRE

    Valle-onate, Rafael; Ward, Michael M.; Kerr, Gail S.

    2012-01-01

    Physical therapy and orthopedic surgery are important components in the treatment of ankylosing spondylitis (AS). Supervised physical therapy is more effective that individual or unsupervised exercise in improving symptoms, but controlled trials suggest than combined inpatient and outpatient therapy provides the greatest improvement. Recommendations for exercise are universal, but the best types and sequence of therapies are not known. Total hip replacement is the surgery most commonly perfor...

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

    OpenAIRE

    Am, Reimold

    2012-01-01

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

  14. Intronic Variants in the NFKB1 Gene May Influence Hearing Forecast in Patients with Unilateral Sensorineural Hearing Loss in Meniere's Disease

    OpenAIRE

    Cabrera, Sonia; Sanchez, Elena; Requena, Teresa; Martinez-bueno, Manuel; Benitez, Jesus; Perez, Nicolas; Trinidad, Gabriel; Soto-varela, Andre?s; Santos-perez, Sofi?a; Martin-sanz, Eduardo; Fraile, Jesus; Perez, Paz; Alarcon-riquelme, Marta E.; Batuecas, Angel; Espinosa-sanchez, Juan M.

    2014-01-01

    Meniere's disease is an episodic vestibular syndrome associated with sensorineural hearing loss (SNHL) and tinnitus. Patients with MD have an elevated prevalence of several autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis and psoriasis), which suggests a shared autoimmune background. Functional variants of several genes involved in the NF-?B pathway, such as REL, TNFAIP3, NFKB1 and TNIP1, have been associated with two or more immune-mediated dis...

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

    OpenAIRE

    Charalampos Papagoras; Voulgari, Paraskevi Amp Nbsp V.; 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...

  16. Role of intraoperative Iso-C based navigation in challenging spine trauma

    OpenAIRE

    Jaiswal Ashish; Shetty Ajoy; Rajasekaran S

    2007-01-01

    Background: Pedicle screw fixation is the most preferred method of stabilizing unstable spinal fractures. Pedicle screw placement may be difficult in presence of fractured posterior elements, deformed spine, gross instability and spinal pathology. Challenging spine-fracture fixation is defined as the presence of one or more of the following: 1) obscured topographical landmarks as in ankylosing spondylitis, 2) fractures in occipitocervical or cervicothoracic regions and 3) preexisting altered...

  17. Quantitative analysis of the anterolateral ossification mass in diffuse idiopathic skeletal hyperostosis of the thoracic spine

    OpenAIRE

    Verlaan, J. J.; Westerveld, L. A.; Keulen, J. W.; Bleys, R. L. A. W.; Dhert, W. J.; Herwaarden, J. A.; Moll, F. L.; Oner, F. C.

    2011-01-01

    Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic condition leading to ossification of spinal ligaments and has been shown to behave similarly to ankylosing spondylitis (AS) often leading to unstable hyperextension fractures. Currently, no quantitative data are available on the spatial relationship between the bridging anterolateral ossification mass (ALOM) and the vertebral body/intervertebral disc to explain the propensity in DISH to fracture through the vertebral body instead o...

  18. Stiffness in total knee arthroplasty

    OpenAIRE

    Schiavone Panni, Alfredo; Cerciello, Simone; Vasso, Michele; Tartarone, Mario

    2009-01-01

    Stiffness is a relatively uncommon complication after total knee arthroplasty. It has been defined as a painful limitation in the range of movement (ROM). Its pathogenesis is still unclear even if some risk factors have been identified. Patient-related conditions may be difficult to treat. Preoperative ROM is the most important risk factor, but an association with diabetes, reflex sympathetic dystrophy, and general pathologies such as juvenile rheumatoid arthritis and ankylosing spondylitis h...

  19. Towards a better understanding of the role of psychological variables in arthritis outcome research

    OpenAIRE

    Boonen, Annelies

    2010-01-01

    In the previous issue of Arthritis Research and Therapy, Brionez and colleagues show that helplessness, depression, and passive coping account for significant variability in self-reported functional limitations in patients with ankylosing spondylitis, beyond the effect of age, inflammation and radiographic damage. Since the perspective of the patients in the experience of health is increasingly important, insight into the type of psychological variables, the pathways by which they influence h...

  20. 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...

  1. Osteoimmunology and osteoporosis

    OpenAIRE

    Geusens, Piet; Lems, Willem F.

    2011-01-01

    The concept of osteoimmunology is based on growing insight into the links between the immune system and bone at the anatomical, vascular, cellular, and molecular levels. In both rheumatoid arthritis (RA) and ankylosing spondylitis (AS), bone is a target of inflammation. Activated immune cells at sites of inflammation produce a wide spectrum of cytokines in favor of increased bone resorption in RA and AS, resulting in bone erosions, osteitis, and peri-inflammatory and systemic bone loss. Peri-...

  2. The early universe

    International Nuclear Information System (INIS)

    A review of some current basic problems in observational and theoretical cosmology with special reference to recent investigations concerning the early universe and the possible involvement of developments in particle physics is presented. (author)

  3. Overview of Early Intervention

    Science.gov (United States)

    ... eligible babies and toddlers learn the basic and brand-new skills that typically develop during the first ... Services in Natural Environments Transition to Preschool Public Awareness & the Referral System Early Intervention, Then and Now ...

  4. Early Detection Research Worldwide

    Science.gov (United States)

    Genetic research on cancer has grown tremendously in the last decade, and the increase in the number of published research articles has been truly phenomenal. However, molecular and genetic research focusing on the early detection of cancer is still lagging.

  5. 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%.

  6. Early childhood aggression

    OpenAIRE

    Alink, Lenneke Rosalie Agnes

    2006-01-01

    In this thesis the development, stability, and correlates of early childhood aggression were investigated. The normative development was examined in a general population sample using questionnaires completed by the parents of 12-, 24-, and 36-month-old children and again one year later. Results showed an early childhood aggression curve, with increasing rates of aggression in the second year of life and decreasing rates in the fourth year. One-year stabilities were moderate for 12-month-olds ...

  7. Early bile duct cancer

    OpenAIRE

    Cha, Jae Myung; Kim, Myung-hwan; Jang, Se Jin

    2007-01-01

    Bile duct cancers are frequently diagnosed as advanced diseases. Over half of patients with advanced bile duct cancer present with unresectable malignancies and their prognosis has been very poor even after curative resections. Although there has been a need to diagnose bile duct cancer at its early stage, it has been a difficult goal to achieve due to our lack of knowledge regarding this disease entity. Early bile duct cancer may be defined as a carcinoma whose invasion is confined within th...

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

  9. Familial Mediterranean fever and seronegative arthritis.

    Science.gov (United States)

    Akkoc, Nurullah; Gul, Ahmet

    2011-10-01

    Familial Mediterranean fever (FMF) is characterized by recurrent, self-limited episodes of polyserositis, with articular involvement also being a common manifestation. The pattern and joint predilection of arthritis show many similarities to those of spondyloarthritis. Moreover, case series suggest an increased prevalence of ankylosing spondylitis or spondyloarthritis among FMF patients. FMF is caused by mutations in the MEFV gene encoding pyrin, which is believed to be involved in regulation of interelukin-1? activation. Recent studies conducted in populations with a high background carrier rate of MEFV variants have reported an increased frequency of M694V among AS patients with no personal or family history of FMF. These findings are of interest, as both candidate gene and genome-wide association studies suggest that the interleukin-1 cytokine pathway may be implicated in the pathogenesis of ankylosing spondylitis. Therefore, association of M694V with ankylosing spondylitis can be recognized as a geographic region-specific risk factor affecting a common inflammatory pathway in the disease pathogenesis. PMID:21695514

  10. MR-imaging in sero-negative spondyloarthritides

    International Nuclear Information System (INIS)

    In twenty-five patients with a clinical diagnosis of suspected sacroiliitis conventional radiography, CT and MRI were performed. In ten patients no abnormalities were demonstrated. In thirteen cases CT and MRI revealed sacrioiliitis. In two patients with normal plain films and CT para- and intraarticular changes of signal intensity suggested suspicious sacroiliitis. MRI can be considered as an important imaging modality for early diagnosis of sacroiliitis. In eighteen patients with a firm diagnosis of ankylosing spondylitis and plain films of the thoracolumbar junction suggesting destructive Romanus and Anderson inflammatory lesions MRI was done. Two distinct groups of inflammatory changes were found. In ten patients MRI findings compatible with active inflammatory enthesitis were revealed at the disco-vertebral junction. In eight cases focal and linear changes of signal intensity within the intervertebral disks suggested an active inflammation. Using MRI the spectrum of inflammatory changes in sero-negative spondylitis can be presented. In sixteen patients with definite clinical diagnosis (psoriatic arthritis - thirteen cases and Reither's syndrome - three cases) plain films and MRI of small hand joints were performed. The patients fell into two distinct groups. In the first MRI findings could not be differentiated from those seen in rheumatoid arthritis. In nine cases the distribution and extent of soft tissue findings were different, similar to changes seen in enthdifferent, similar to changes seen in enthesitis. Therefore, on the basis of MRI findings in small peripheral joints easier differential diagnosis between sero-negative spondyloarthritides and rheumatoid arthritis is possible. In five patients with a diagnosis of Reither's syndrome having clinical signs of enthesitis plain films and MRI of calcaneus were done. MRI revealed findings compatible with active inflammation which resembled those seen at the attachment of the annulus fibrosus and collateral ligaments of the small hand joints. (orig.)

  11. 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.

  12. 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.

  13. GYNAECOLOGICAL DISORDERS: EARLY SCREENING

    Directory of Open Access Journals (Sweden)

    Rajesh Laik

    2013-06-01

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

  14. 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.

  15. 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.

  16. Early Developments, 1998.

    Science.gov (United States)

    Little, Loyd, Ed.

    1998-01-01

    This document consists of the two 1998 issues of a journal reporting new research in early child development conducted by the Frank Porter Graham Child Development Center at the University of North Carolina at Chapel Hill. In the Spring 1998 issue, articles highlight the Center's diverse cross-cultural projects and global research, training and…

  17. Early Developments, 1999.

    Science.gov (United States)

    Little, Loyd, Ed.

    1999-01-01

    This document consists of the three 1999 issues of a journal reporting new research in early child development conducted by the Frank Porter Graham Child Development Center at the University of North Carolina at Chapel Hill. Articles in the Winter 1999 issue focus on the transition to kindergarten and first grade, including adjustment issues;…

  18. Early Developments, 2000.

    Science.gov (United States)

    Little, Loyd, Ed.

    2000-01-01

    This document consists of the three 2000 issues of a journal reporting new research in early child development conducted by the Frank Porter Graham Child Development Center at the University of North Carolina at Chapel Hill. Articles in the spring 2000 issue focus on a follow-up study of the Abecedarian Project, children of depressed mothers,…

  19. Isolation in Early Childhood.

    Science.gov (United States)

    Rogers, Sinclair

    This paper presents information on isolated children and describes a study being undertaken to examine the role of isolation in reported cases of child abuse and neglect. The effects of extreme isolation on language and psychological development are emphasized. The importance of early socialization is seen in relation to normal development.…

  20. Supporting Early School Success

    Science.gov (United States)

    Daniels, Denise H.

    2011-01-01

    Child development research shows that during the 5 to 7 shift, children make a major transition from early childhood to middle childhood ways of thinking, feeling, and behaving. At the same time, their entry into formal schooling thrusts them into new roles and responsibilities, often in unfamiliar settings with unfamiliar people. These challenges…

  1. Early breast cancer

    International Nuclear Information System (INIS)

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

  2. 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.

  3. Early childhood interventions and outcomes

    OpenAIRE

    Waldfogel, Jane

    1999-01-01

    Recent advances in brain research have provided new evidence that early experience matters and have greatly increased interest in the effects of early childhood interventions on outcomes for children. This paper reviews what is now known about the potential benefits and potential ill effects of early childhood interventions, with particular attention to evidence from the Rand study of early interventions, recent studies of the Head Start programme, and the NICHD study of early child care. The...

  4. Samuel Goudsmit - Early Influences

    Science.gov (United States)

    Goudsmit, Esther

    2010-03-01

    Samuel Goudsmit, born in 1902 in The Hague, Netherlands, earned his Ph.D. at the University of Leiden in 1926 with Paul Ehrenfest. The present talk will describe some aspects of his background and early formative years in order to provide context for the broad range of his professional life. Sam belonged to a large tribe of paternal and maternal uncles, aunts and first cousins; including his parents, grandparents and sister Ro, they numbered forty. Sam was the first of the tribe to be educated beyond high school. Early interests as a child and later as a university student in the Netherlands prefigured his significant and diverse contributions in several realms including not only physics but also teaching, Egyptology and scientific Intelligence. Bibliographic sources will include: The American Institute of Physics' Oral History Transcripts and photographs from the Emilio Segre visual archives, memoirs and conversations of those who knew Sam and also letters to his daughter, Esther.

  5. Early science learning

    OpenAIRE

    Krnel, Dus?an; Bajd, Barbara

    2010-01-01

    The article reports some of the findings of rather comprehensive research conducted on the preschool education in Slovenia, in which 810 preschool teachers participated. As regards the early natural science teaching the results show that the level of science literacy is on the increase, that the respondents are well aware of the scientific knowledge, its formation and acquisition; further, they also adopt a positive attitude towards natural science teaching at the preschool ...

  6. Early Years Policy

    OpenAIRE

    Jane Waldfogel; Elizabeth Washbrook

    2011-01-01

    In this paper, we analyze the role that early years policy might play in narrowing educational attainment gaps. We begin by examining gaps in school readiness between low-, middle-, and high-income children, drawing on data from new large and nationally representative birth cohort studies in the US and UK. We find that sizable income-related gaps in school readiness are present in both countries before children enter school and then decompose these gaps to identify the factors that account fo...

  7. Early history of ESPEN.

    Science.gov (United States)

    Clark, R; Vinnars, E

    1994-02-01

    Since the European Society of Parenteral and Enteral Nutrition (ESPEN) is now well established as a major international scientific organisation, it may be of interest to recall how the Society came to be formed and how it evolved during its first few years. A chronological view will be given of the way ESPEN was organised during the early years, followed by a commentary on the development of its many roles. PMID:16843357

  8. Early DNA Sequencing

    Science.gov (United States)

    Two sequencing techniques were developed independently in the 1970s. The method developed by Fred Sanger used chemically altered 'dideoxy' bases to terminate newly synthesized DNA fragments at specific bases (either A, C, T, or G). These fragments are then size-separated, and the DNA sequence can be read. This animation from Cold Spring Harbor Laboratory's Dolan DNA Learning Center presents early DNA sequencing through a series of illustrations of the processes involved.

  9. Early bioenergetic evolution.

    Science.gov (United States)

    Sousa, Filipa L; Thiergart, Thorsten; Landan, Giddy; Nelson-Sathi, Shijulal; Pereira, Inês A C; Allen, John F; Lane, Nick; Martin, William F

    2013-07-19

    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 regard to the possible temporal sequence of events, we focus on: (i) alkaline hydrothermal vents as the far-from-equilibrium setting, (ii) the Wood-Ljungdahl (acetyl-CoA) pathway as the route that could have underpinned carbon assimilation for these processes, (iii) biochemical divergence, within the naturally formed inorganic compartments at a hydrothermal mound, of geochemically confined replicating entities with a complexity below that of free-living prokaryotes, and (iv) acetogenesis and methanogenesis as the ancestral forms of carbon and energy metabolism in the first free-living ancestors of the eubacteria and archaebacteria, respectively. In terms of the main evolutionary transitions in early bioenergetic evolution, we focus on: (i) thioester-dependent substrate-level phosphorylations, (ii) harnessing of naturally existing proton gradients at the vent-ocean interface via the ATP synthase, (iii) harnessing of Na(+) gradients generated by H(+)/Na(+) antiporters, (iv) flavin-based bifurcation-dependent gradient generation, and finally (v) quinone-based (and Q-cycle-dependent) proton gradient generation. Of those five transitions, the first four are posited to have taken place at the vent. Ultimately, all of these bioenergetic processes depend, even today, upon CO2 reduction with low-potential ferredoxin (Fd), generated either chemosynthetically or photosynthetically, suggesting a reaction of the type 'reduced iron ? reduced carbon' at the beginning of bioenergetic evolution. PMID:23754820

  10. PHOBOS, the Early Years

    International Nuclear Information System (INIS)

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

  11. 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

  12. Bilobate anterior epidural extension of vertebral lesion : MRI features

    Energy Technology Data Exchange (ETDEWEB)

    Park, Dong Woo; Lee, Chae Guk [Pusan Paik Hospital, Pusan (Korea, Republic of)

    1994-11-15

    To determine the value of bilobate anterior epidrual extension(AEE) on MRI in differential diagnosis of tuberculous spondylitis, pyogenic spondylitis and malignant tumor. SE T1-, T2- and Gd-DTPA enhanced T1-weighted, sagittal and axial MR images of 39 patients(40 vertebral lesions), including 16 tuberculous spondylitis, 7 pyogenic spondylitis(8 lesions, consisting of 2 separate lesion of 1 patient), and 16 malignant vertebral tumors(15 metastases, 1 lymphoma) with an AEE were reviewed. The frequency of bilobate AEE shown as double-convexity in the anterior epidural space on axial scans was evaluated in the above vertebral diseases. The bilobate AEE on the axial scans was seen in 12 out of the 16 tuberculous spondylitis(75%) and 1 out of 8 pyogenic spondylitis(13%), and 10 out of the 16 malignant tumor including 15 metastasis and 1 lymphoma(63%). The bilobate AEE of vertebral lesions is suggestive of tuberculous spondylitis or malignant tumor rather than pyogenic spondylitis. This pattern seems to be related with the preservation of the structures, including midline septum, PLL(Posterior longitudinal ligament), lateral membrane and fibrous membrane, limiting and surrounding the extension of the tuberculous spondylitis and malignant tumor, and with the early penetration or disruption of PLL, midline septum, lateral and fibrous membranes in the pyogenic spondylitis.

  13. Bilobate anterior epidural extension of vertebral lesion : MRI features

    International Nuclear Information System (INIS)

    To determine the value of bilobate anterior epidrual extension(AEE) on MRI in differential diagnosis of tuberculous spondylitis, pyogenic spondylitis and malignant tumor. SE T1-, T2- and Gd-DTPA enhanced T1-weighted, sagittal and axial MR images of 39 patients(40 vertebral lesions), including 16 tuberculous spondylitis, 7 pyogenic spondylitis(8 lesions, consisting of 2 separate lesion of 1 patient), and 16 malignant vertebral tumors(15 metastases, 1 lymphoma) with an AEE were reviewed. The frequency of bilobate AEE shown as double-convexity in the anterior epidural space on axial scans was evaluated in the above vertebral diseases. The bilobate AEE on the axial scans was seen in 12 out of the 16 tuberculous spondylitis(75%) and 1 out of 8 pyogenic spondylitis(13%), and 10 out of the 16 malignant tumor including 15 metastasis and 1 lymphoma(63%). The bilobate AEE of vertebral lesions is suggestive of tuberculous spondylitis or malignant tumor rather than pyogenic spondylitis. This pattern seems to be related with the preservation of the structures, including midline septum, PLL(Posterior longitudinal ligament), lateral membrane and fibrous membrane, limiting and surrounding the extension of the tuberculous spondylitis and malignant tumor, and with the early penetration or disruption of PLL, midline septum, lateral and fibrous membranes in the pyogenic spondylitis

  14. Osteoporosis in inflammatory joint diseases.

    Science.gov (United States)

    Roux, C

    2011-02-01

    Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are two inflammatory joint diseases characterized by bone complications including osteoporosis. In RA, periarticular bone loss, bone erosions, and systemic osteoporosis are observed, with an increased risk of fractures. Determinants of fractures are underlying conditions (as RA has a female preponderance and an increased prevalence with age), severity of the disease, and use of glucocorticoids. However, bone loss can occur even in glucocorticoid-naive patients. Prospective data show that the optimal control of inflammation in RA is associated with decrease in structural damage and bone loss. RA illustrates the role of inflammation on bone resorption. In AS, osteoporosis is an early event and vertebral fracture risk is increased. Bone loss is related mainly to inflammation, as the disease can occur in young male adult populations, and glucocorticoids are not used in this disease. However, AS is characterized by progressive stiffness and ankylosis of the spine and illustrates also the potential role of inflammation on local bone formation. PMID:20552328

  15. 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.

  16. 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.)

  17. The Perils of Early Motherhood.

    Science.gov (United States)

    Sawhill, Isabel V.

    2002-01-01

    Suggests that preventing early childbearing among those who are still young and unmarried is likely to yield significant social benefits, including the restoration of marriage, discussing whether marriage is the solution to the problem of early motherhood. Explains the need for strong efforts to prevent early childbearing, examining teen pregnancy…

  18. 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

  19. 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.

  20. [Early onset diabetes mellitus].

    Science.gov (United States)

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

    2013-12-01

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