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Sample records for ankylosing spondylitis disease

  1. Prevalence of occult inflammatory bowel disease in ankylosing spondylitis.

    Science.gov (United States)

    Costello, P B; Alea, J A; Kennedy, A C; McCluskey, R T; Green, F A

    1980-10-01

    Fifty-five patients with ankylosing spondylitis and 16 control patients matched for sex and age were examined for evidence of occult inflammatory bowel disease. In all patients evaluation included history and physical examination, barium enema, sigmoidoscopy, and rectal biopsy. The results of this study suggest that there is no increased prevalence of occult inflammatory bowel disease in patients with ankylosing spondylitis.

  2. ANKYLOSING SPONDYLITIS - AN ALARMING RISK OF VENOUS THROMBOEMBOLIC DISEASE

    OpenAIRE

    Dr. Darpanarayan Hazra; Dr. Shahid Mahdi; Dr. Amit Madan; Dr. Neeraj Bhalla

    2017-01-01

    Venous thrombo-embolic disease (VTE) is a potentially life threatening clinical event. Ankylosing spondylitis (AS) is a chronic inflammatory disease with a significantly increased risk of developing VTE. Management of acute proximal deep venous thrombosis (DVT) depends on the clinical status of the affected limb, extent of the thrombus and comorbidities of the patient. Semba and Dake introduced Catheter directed thrombolysis (CDT) to treat 21 patients of DVT in 1994. CDT is a life or limb sav...

  3. Temporo-mandibular joint disease in ankylosing spondylitis.

    Science.gov (United States)

    Davidson, C; Wojtulewski, J A; Bacon, P A; Winstock, D

    1975-01-01

    The occurrence of temporo-mandibular joint (TMJ) disease in ankylosing spondylitis is not widely recognized and its incidence is disputed. Seventy-nine patients attending two routine rheumatology clinics were therefore examined by dental surgeon and nine (11-5 per cent) were considered to have specific TMJ involvement. These patients were older than the remainder, and had more extensive spinal and peripheral joint disease. Symptoms were mild and the predominant clinical feature was restricted mouth opening, which could present considerable difficulties during emergency anaesthesia. Bilateral condylectomy was undertaken in one patient with some benefit. Images PMID:1124959

  4. Imaging in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Lambert, Robert G W

    2012-01-01

    Imaging is an integral part of the management of patients with ankylosing spondylitis and axial spondyloarthritis. Characteristic radiographic and/or magnetic resonance imaging (MRI) findings are key in the diagnosis. Radiography and MRI are also useful in monitoring the disease. Radiography...... in the spine and sacroiliac joints, but its clinical utility is limited due to its use of ionizing radiation and lack of ability to assess the soft tissues. It is exciting that with continued dedicated research and the rapid technical development it is likely that even larger improvements in the use of imaging...

  5. THE BASIC PRINCIPLES OF TREATMENT OF ANKYLOSING SPONDYLITIS (BECHTEREW'S DISEASE

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    Shandor Fedorovich Erdes

    2013-01-01

    Full Text Available The history of treatment of ankylosing spondylitis (AS and the reasons behind the development of modern approaches to its therapy are briefly described. The main tasks and principles of non-pharmacological and drug therapies for ASare briefly reported. The need for therapeutic physical training is emphasized, since its role in maintaining the functional status in this group of patients has been proved. The lecture casts doubt on effectiveness of physiotherapy andother physical techniques because of the poor evidence base. The lecture emphasizes the disease-modifying role of nonsteroidal anti-inflammatory drugs and requirement to receive them constantly for patients with Bechterew's disease. Meanwhile, the basic anti-inflammatory drugs in patients with this disease are reported to play an auxiliary role and to have no effect on disease progression. The pronounced clinical effectiveness of all tumor necrosis factor α inhibitors is emphasized; certain differences in their therapeutical effect are described. The problems of surgical treatment, which deal with correction of disease complications or undesirable effects, are discussed.

  6. Evolution of Juvenile Ankylosing Spondylitis

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    Ye.V. Prohorov

    2013-02-01

    Full Text Available Evolution of juvenile ankylosing spondylitis tend to follow a more frequent involvement in the pathological process of elbow and ankle joints, development of enthesiopathies, changes of intraarticular meniscal horns, forming of Baker’s cysts, cartilage flaps and systemic osteoporosis, and total value of all these signs 13 times exceeds thereof in patients with with the debut of disease in adulthood, but for juvenile ankylosing spondylitis vertebral lesion is less common. Age dimorphism of the use of certain groups of drugs and physiotherapy facilities is observed.

  7. Mortality in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Exarchou, Sofia; Lie, Elisabeth; Lindström, Ulf

    2016-01-01

    OBJECTIVES: Information on mortality in ankylosing spondylitis (AS) is scarce. Our study therefore aimed to assess: (1) mortality in AS versus the general population, and (2) predictors of death in the AS population. METHODS: Nationwide cohorts of patients with AS diagnosed at rheumatology or int...

  8. Imaging in ankylosing spondylitis

    NARCIS (Netherlands)

    Maksymowych, Walter P.; Landewé, Robert

    2006-01-01

    The introduction of symptomatically highly effective anti-tumour necrosis factor alpha therapies for ankylosing spondylitis (AS) has generated interest in the use of imaging to evaluate the potential structure-modifying properties of these agents. Several approaches have been developed to score the

  9. Critical appraisal of the guidelines for the management of ankylosing spondylitis: disease-modifying antirheumatic drugs.

    Science.gov (United States)

    Soriano, Enrique R; Clegg, Daniel O; Lisse, Jeffrey R

    2012-05-01

    Surprisingly, little data are available for the use of disease-modifying antirheumatic drugs in ankylosing spondylitis. Sulfasalazine has been the best studied. Efficacy data for individual agents (including pamidronate) and combinations of agents are detailed in this review. Intriguingly, these agents continue to be used with some frequency, even in the absence of efficacy data. To answer these questions, additional systematic studies of these agents in ankylosing spondylitis are needed and will likely need to be done by interested collaborative groups such as SPARTAN.

  10. Development of an ASAS-endorsed disease activity score (ASDAS) in patients with ankylosing spondylitis

    NARCIS (Netherlands)

    Lukas, C.; Landewé, R.; Sieper, J.; Dougados, M.; Davis, J.; Braun, J.; van der Linden, S.; van der Heijde, D.

    2009-01-01

    To develop a new index for disease activity in ankylosing spondylitis (ASDAS) that is truthful, discriminative and feasible, and includes domains/items that are considered relevant by patients and doctors. Eleven candidate variables covering six domains of disease activity, selected by ASAS experts

  11. Disease activity in longstanding ankylosing spondylitis: a correlation of clinical and magnetic resonance imaging findings.

    Science.gov (United States)

    Goh, L; Suresh, P; Gafoor, A; Hughes, P; Hickling, P

    2008-04-01

    We evaluated magnetic resonance imaging (MRI) changes in ankylosing spondylitis (AS) patients with longstanding disease and investigated whether there is any relationship between MRI findings and validated methods of disease assessment. A total of 34 AS patients with disease duration greater than 10 years were included in this observational cross-sectional study (26 men, 8 women). The main outcome measures were Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Global assessment (BASG), Bath Ankylosing Spondylitis Metrology Index (BASMI), MRI of the thoracic and lumbar spine (AS spi MRI A) and measurement of serum erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), plasma viscosity (PV) and immunoglobulin A (Ig A). The median scores for the acute lesions based on AS spi MRI A scoring system was 2.5 (0-4.12). The respective mean ESR and CRP were 36 (SD, 24.00) mm/h and 14.19 (SD, 24.00) mg/l with the median PV of 1.8 (1.75-1.87). The median BASG, BASFI and BASDAI were 4.55 (2.37-5.55), 4.40(2.31-5.47) and 4.32 (3.07-6.48), respectively. No significant correlations were found between the acute MRI scores and each of the clinical instruments and laboratory markers of inflammation. In this study, majority of AS patients with longstanding disease had very low AS spi MRI A scores or no evidence of spinal inflammatory lesions. Our study would suggest that MRI should be used along with other measures of disease activity in the assessment of symptomatic AS patients with longstanding disease.

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

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    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.

  13. Disease flare of ankylosing spondylitis presenting as reactive arthritis with seropositivity: a case report

    Directory of Open Access Journals (Sweden)

    Manoj EM

    2012-02-01

    Full Text Available Abstract Introduction Concurrent rheumatoid factor seropositivity is occasionally detected in ankylosing spondylitis and often causes confusion in clinical routine. Overlap between various seronegative arthritides is a known but uncommon association. Differentiation of spondyloarthropathy from rheumatoid arthritis is important, since the natural history, complications, treatments and prognosis of the two diseases differ significantly. Case presentation Here, we report the case of a 47-year-old Sri Lankan man who had a long history of intermittent joint pains worsening following a recent episode of self-resolving non-bloody diarrhea. Subsequently, he developed a skin rash suggestive of keratoderma blenorrhagica and circinate balanitis. He had classical radiological evidence of ankylosing spondylosis (previously undiagnosed associated with human leukocyte antigen B27 antigen, but was positive for rheumatoid factor. Conclusions A disease flare of ankylosing spondylitis prompted by a minor diarrheal illness showing well documented features of reactive arthritis is remarkable. The prognostic implications of seropositivity in spondyloarthritis are discussed.

  14. 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.

  15. The Association of Acromegaly and Ankylosing Spondylitis

    OpenAIRE

    Alpaslan Tuzcu; Ayse Dicle Turhanoglu; Mithat Bahçeci; Hatice Öztürkmen Akay; Zülfü Karabulut

    2004-01-01

    Coexistence of acromegaly and anklosing spondylitis had been rarelyreported. Only two case reports were described coexistence of two diseasesin literature. These two diseases have some similar clinical andradiographic features. Calcaneal epin formation, enteshopathy and caudeequina syndrome can be seen both acromegaly and ankylosing spondylitis.Our case had clinical and radiological features of both acromegaly andankylosing spondylitis. Acral enlargement, coarsening of feature,malocclusion, n...

  16. Scintigraphic findings in ankylosing spondylitis

    International Nuclear Information System (INIS)

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

    1977-01-01

    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

  17. 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.

  18. Anxiety and depression correlate with disease and quality-of-life parameters in Chinese patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Xu X

    2016-05-01

    Full Text Available Xujuan Xu,1,* Biyu Shen,2,3,* Aixian Zhang,4 Jingwei Liu,3 Zhanyun Da,4 Hong Liu,4 Zhifeng Gu4 1Department of Nursing, Affiliated Hospital of Nantong University, 2School of Nursing, Nantong University, 3Department of Nursing, The Second Affiliated Hospital of Nantong University, 4Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong, People’s Republic of China *These authors contributed equally to this work Aim: To evaluate the relationship between mental and physical health in Chinese patients with ankylosing spondylitis (AS and to identify the predictors of psychological status.Methods: Patients with AS (n=103 and healthy controls (n=121 were surveyed between 2010 and 2011 (cross-sectional study. The Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, pain visual analog scale, Health Assessment Questionnaire, revised Self-Rating Anxiety Scale, revised Self-Rating Depression Scale, and Short-Form 36 questionnaire were administered.Results: The frequency of anxiety and depression in patients with AS was higher than that in healthy controls (P<0.001. Severe disease status and reduced quality of life (QoL were associated with anxiety and depression. Disease activity and somatic pain were more severe in the anxious and depressed subgroups. Impaired physical functioning (assessed by Bath Ankylosing Spondylitis Functional Index was higher in the anxious and depressed subgroups, while measures of spinal mobility (assessed by Bath Ankylosing Spondylitis Metrology Index were not associated with depression. Lower QoL was observed in the depressed subgroup.Conclusion: Low socioeconomic status, lack of health insurance, and fatigue contributed to depression in Chinese patients with AS. These patients may require a psychological care approach that is different from those of other countries. Keywords: ankylosing spondylitis, disease activity

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

    DEFF Research Database (Denmark)

    Madsen, Ole R; Rytter, Anne; Hansen, Lonnie B

    2010-01-01

    The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Function Index (BASFI) and the Bath Ankylosing Spondylitis Global Score (BAS-G) (ranges 0-10) have gained widespread in use as self-reported measures of disease activity, functional impairment and ove...

  20. The Association of Acromegaly and Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Alpaslan Tuzcu

    2004-01-01

    Full Text Available Coexistence of acromegaly and anklosing spondylitis had been rarelyreported. Only two case reports were described coexistence of two diseasesin literature. These two diseases have some similar clinical andradiographic features. Calcaneal epin formation, enteshopathy and caudeequina syndrome can be seen both acromegaly and ankylosing spondylitis.Our case had clinical and radiological features of both acromegaly andankylosing spondylitis. Acral enlargement, coarsening of feature,malocclusion, non-suppressed growth hormone levels with oral glucosetolerance test and evidence of pituitary adenoma were support diagnose ofacromegaly. Morning stiffness, positive Schober and Moll test, elevatederythrocyte sedimentation rate and grade 4 sacroiletis of the patient lead usto diagnose ankylosing spondylitis at the same time. In this case report, weaim to discuss interesting coexistence of two disease

  1. Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome

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    Şenol Kobak

    2013-01-01

    Full Text Available Ankylosing spondylitis is a chronic inflammatory disease characterized by inflammatory lower back pain and morning stiffness and accompanied by spine and sacroiliac joint involvement. Klinefelter's syndrome is a genetic condition that only affects males. Affected males have an extra X chromosome. This paper reports a 30-years-old male on followup with the diagnosis of Klinefelters syndrome. The patient admitted with complaints of inflammatory lower back, and neck pain and morning stiffness and was diagnosed with ankylosing spondylitis. Nonsteroidal anti-inflammatory drug and salazopyrine treatment resulted in significant regression in his complaints.

  2. Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome.

    Science.gov (United States)

    Kobak, Senol; Yalçin, Murat; Karadeniz, Muamer; Oncel, Guray

    2013-01-01

    Ankylosing spondylitis is a chronic inflammatory disease characterized by inflammatory lower back pain and morning stiffness and accompanied by spine and sacroiliac joint involvement. Klinefelter's syndrome is a genetic condition that only affects males. Affected males have an extra X chromosome. This paper reports a 30-years-old male on followup with the diagnosis of Klinefelters syndrome. The patient admitted with complaints of inflammatory lower back, and neck pain and morning stiffness and was diagnosed with ankylosing spondylitis. Nonsteroidal anti-inflammatory drug and salazopyrine treatment resulted in significant regression in his complaints.

  3. 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

  4. Quantitative metagenomics reveals unique gut microbiome biomarkers in ankylosing spondylitis.

    Science.gov (United States)

    Wen, Chengping; Zheng, Zhijun; Shao, Tiejuan; Liu, Lin; Xie, Zhijun; Le Chatelier, Emmanuelle; He, Zhixing; Zhong, Wendi; Fan, Yongsheng; Zhang, Linshuang; Li, Haichang; Wu, Chunyan; Hu, Changfeng; Xu, Qian; Zhou, Jia; Cai, Shunfeng; Wang, Dawei; Huang, Yun; Breban, Maxime; Qin, Nan; Ehrlich, Stanislav Dusko

    2017-07-27

    The assessment and characterization of the gut microbiome has become a focus of research in the area of human autoimmune diseases. Ankylosing spondylitis is an inflammatory autoimmune disease and evidence showed that ankylosing spondylitis may be a microbiome-driven disease. To investigate the relationship between the gut microbiome and ankylosing spondylitis, a quantitative metagenomics study based on deep shotgun sequencing was performed, using gut microbial DNA from 211 Chinese individuals. A total of 23,709 genes and 12 metagenomic species were shown to be differentially abundant between ankylosing spondylitis patients and healthy controls. Patients were characterized by a form of gut microbial dysbiosis that is more prominent than previously reported cases with inflammatory bowel disease. Specifically, the ankylosing spondylitis patients demonstrated increases in the abundance of Prevotella melaninogenica, Prevotella copri, and Prevotella sp. C561 and decreases in Bacteroides spp. It is noteworthy that the Bifidobacterium genus, which is commonly used in probiotics, accumulated in the ankylosing spondylitis patients. Diagnostic algorithms were established using a subset of these gut microbial biomarkers. Alterations of the gut microbiome are associated with development of ankylosing spondylitis. Our data suggest biomarkers identified in this study might participate in the pathogenesis or development process of ankylosing spondylitis, providing new leads for the development of new diagnostic tools and potential treatments.

  5. Employment perspectives of patients with ankylosing spondylitis

    NARCIS (Netherlands)

    Chorus, A.M.J.; Boonen, A.; Miedema, H.S.; Linden, S. van der

    2002-01-01

    Objectives: To assess the labour market position of patients with ankylosing spondylitis (AS) in relation to disease duration and to identify potential factors in relation to withdrawal from the labour force. Methods: A cross sectional mail survey was conducted among 658 patients with AS.

  6. Pre-ankylosing spondylitis. Histopathological report.

    Science.gov (United States)

    Pasion, E G; Goodfellow, J W

    1975-02-01

    A novel explanation for the natural history of joint destruction in the early phase of ankylosing spondylitis is proposed on the basis of the clinical history, x-ray appearance, operative findings, and histopathology of a young patient believed to be suffering from the peripheral form of this disease.

  7. Radon within therapeutic strategies of ankylosing spondylitis

    International Nuclear Information System (INIS)

    Herold, M.; Lind-Albrecht, G.

    2008-01-01

    For more than fifty years patients with rheumatic diseases have been treated in the thermal gallery of Bad Gastein, main indication is ankylosing spondylitis. Experiences of this kind of spa treatment on several hundred patients and randomised controlled clinical trials document the positive treatment effect of spa therapy with Radon which lasts for up to 40 weeks. (author) [de

  8. Relationship of work disability between the disease activity, depression and quality of life in patients with ankylosing spondylitis.

    Science.gov (United States)

    Sağ, Sinem; Nas, Kemal; Sağ, Mustafa Serdar; Tekeoğlu, İbrahim; Kamanlı, Ayhan

    2018-02-02

    In this study, our objective was to determine the work productivity and work disability of the patients with ankylosing spondylitis (AS) and to investigate the relation of these parameters with disease activity, anxiety, depression and quality of life. Fifty patients with the diagnosis of AS and 30 healthy control were included in the study. In patients with AS, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used to evaluate the disease activity; Bath Ankylosing Spondylitis Metrology Index (BASMI) was used to evaluate the spinal mobility and Bath Ankylosing Spondylitis Functional Index (BASFI) was used to determine the functional status. In addition, the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire and The Short Form (SF-36) Health Survey was used to evaluate the health status, Hospital Anxiety and Depression Scale (HADS) was used for the evaluation of depression and anxiety and Work Productivity and Activity Impairment Questionnaire: Specific Health Problem v2.0 (WPAI:SHP) was used to evaluate the work productivity. In AS patients duration of disease at the diagnosis was 7.24 ± 6.23 years. The time lost at work due to the disease, decrease in the work productivity and impairment in the time off daily activities were worse in the patient group compared with the control group (pwork productivity was correlated with BASDAI and depression; difficulty in time-off activities was correlated with BASFI and anxiety and depression was correlated with BASDAI (pwork productivity was correlated with the subparameter vitality in SF-36, difficulty in time off activities was correlated with general health status, social functions, vitality and mental health (pworking conditions and the factors related to the disease had a significant correlation with work productivity. Factors related to the psychology and the disease were also correlated with the working conditions.

  9. Postural control is altered in patients with ankylosing spondylitis.

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    Vergara, Martin E; O'Shea, Finbar D; Inman, Robert D; Gage, William H

    2012-05-01

    Ankylosing spondylitis is a chronic inflammatory disorder that can lead to increased axial and peripheral joint stiffness, impairing joint mobility. Impaired axial mobility due to vertebral ankylosis may result in changes in standing postural control. Little research has addressed changes in standing postural control in the ankylosing spondylitis population, nor how these issues might affect clinical understanding and treatment. Sixteen ankylosing spondylitis patients, and 17 healthy controls participated. Each individual completed two 120-second quiet standing trials with eyes open and eyes closed, while standing upon two force platforms. Net center of pressure displacement and mean power frequency in the frontal and sagittal planes were calculated. A Spearman's rank correlation analysis was performed between net center of pressure measures and several clinical measures of disease activity. Frontal plane net center of pressure displacement and frequency content, and sagittal plane net center of pressure displacement were significantly greater within the ankylosing spondylitis patient group. Ankylosing spondylitis patients demonstrated a significant increase in frontal plane net center of pressure displacement in the eyes-closed condition. Net center of pressure displacement and frequency were significantly correlated to the Bath Ankylosing Spondylitis Functional Index, and individual components of the Bath Ankylosing Spondylitis Metrology Index. Quiet standing postural control was altered particularly so in the frontal plane in patients with ankylosing spondylitis, which may be associated with increased fall risk. Posturographic measures of postural control may serve as valuable clinical tools for the monitoring of disease progression and disease status in ankylosing spondylitis. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Overview of Ankylosing Spondylitis

    Science.gov (United States)

    ... Contact Us Community Message Boards & Forums Support Groups Orlando Living with Spondylitis Your Stories The Faces of ... with tears of joy as I left a meeting room this afternoon. Here is the story... Read ...

  11. [Vitamin D levels in ankylosing spondylitis: does deficiency correspond to disease activity?].

    Science.gov (United States)

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

    2014-01-01

    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 < 0.01). We conclude that patients with AS appear to have lower vitamin D levels versus healthy controls; however, the cause is unclear. Existing studies do not demonstrate a consistent link between vitamin D levels and disease activity in AS. Further studies are in need to determine if a causative link exists between vitamin D deficiency and AS. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  12. TNF blockers inhibit spinal radiographic progression in ankylosing spondylitis by reducing disease activity

    DEFF Research Database (Denmark)

    Molnar, Christoph; Scherer, Almut; Baraliakos, Xenofon

    2018-01-01

    OBJECTIVES: To analyse the impact of tumour necrosis factor inhibitors (TNFis) on spinal radiographic progression in ankylosing spondylitis (AS). METHODS: Patients with AS in the Swiss Clinical Quality Management cohort with up to 10 years of follow-up and radiographic assessments every 2 years w...

  13. Arthritis of the middle ear in ankylosing spondylitis.

    OpenAIRE

    Magarò, M; Ceresia, G; Frustaci, A

    1984-01-01

    A case of ankylosing spondylitis with aortic valve disease and hearing loss is described. A series of radiographic and audiometric investigations showed the hearing loss to be of a conductive type. It seemed most likely that the hearing loss was related to an inflammatory involvement of the ossicular joints due to the primary disease. No other case of conductive hearing loss has previously been reported due to otoarthritis in ankylosing spondylitis. This is important both theoretically and pr...

  14. The reliability and validity of a Venezuelan version of the Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).

    Science.gov (United States)

    Rauseo Vera, Mayra; Gutiérrez-González, Luis Arturo; Maldonado, Irama; Al Snih, Soham

    2017-09-21

    Spondyloarthropathies (SpA) are disabling diseases with a prevalence of 1.9% in the general population. The indices designed for monitoring the disease should be valid, reliable and cross-culturally adapted for decision-making concerning the appropriate treatment. Changing an adjective or pronoun in a self-administered questionnaire could be the big difference in condensing an idea in a few words and transmitting that concept to all those who share the same language. To develop a Venezuelan version of the original English version of the BASDAI/BASFI and to evaluate its reliability and validity in Venezuelan patients with SpA. Certified linguists were needed for the translation of a Venezuelan version of the BASDAI/BASFI. The evaluation of reliability and validity was performed by calculating correlation coefficients in addition to Cronbach's alpha correlation between the BASDAI score and the clinical parameters (for example: erythrocyte sedimentation rate, C-reactive protein, modified Schöber test, occiput-to-wall distance and enthesis count). We studied 40 patients including 31 men (77.5%) and 9 women (22.5%). The mean age was 35.9 years ± standard deviation (SD) 12.01 and the disease duration was 11.5 years (± SD 9.5). The most common diagnoses were undifferentiated spondyloarthritis (45%), ankylosing spondylitis (27.5%) and psoriatic arthritis (20%). The incidences of reactive arthritis, ankylosing spondylitis and juvenile Reiter's syndrome were 2.5% each. The test-retest reliability of the BASDAI and BASFI was high (R = 0.99 and 0.99, respectively; P<.0001). The internal consistency for the BASDAI was high (Cronbach's alpha = 0.88; P=.002) and the intraclass correlation coefficient for internal consistency: 0.9867 (P=.001). Internal consistency for the BASFI: Cronbach's alpha = 0.7985 (P=.002), intraclass correlation coefficient for internal consistency: 0.9055 (P=.001). Construct validity of the BASDAI was high for general well-being of the patient (R = 0

  15. Responsiveness of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and clinical and MRI measures of disease activity in a 1-year follow-up study of patients with axial spondyloarthritis treated with tumour necrosis factor alpha inhibitors

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Sørensen, Inge Juul; Hermann, Kay-Geert A

    2010-01-01

    To investigate construct validity and responsiveness of the novel ankylosing spondylitis (AS) disease activity score (ASDAS) in patients with spondyloarthritis (SpA).......To investigate construct validity and responsiveness of the novel ankylosing spondylitis (AS) disease activity score (ASDAS) in patients with spondyloarthritis (SpA)....

  16. LABORATORY BIOMARKERS FOR ANKYLOSING SPONDYLITIS

    Directory of Open Access Journals (Sweden)

    E. N. Aleksandrova

    2017-01-01

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory disease from a group of spondyloarthritis (SpA, which is characterized by lesions of the sacroiliac joints and spine with the common involvement of entheses and peripheral joints in the pathological process. Advances in modern laboratory medicine have contributed to a substantial expansion of the range of pathogenetic, diagnostic, and prognostic biomarkers of AS. As of now, there are key pathogenetic biomarkers of AS (therapeutic targets, which include tumor necrosis factor-α (TNF-α, interleukin 17 (IL-17, and IL-23. Among the laboratory diagnostic and prognostic biomarkers, HLA-B27 and C-reactive protein are of the greatest value in clinical practice; the former for the early diagnosis of the disease and the latter for the assessment of disease activity, the risk of radiographic progression and the efficiency of therapy. Anti-CD74 antibodies are a new biomarker that has high sensitivity and specificity values in diagnosing axial SpA at an early stage. A number of laboratory biomarkers, including calprotectin, matrix metalloproteinase-3 (MMP-3, vascular endothelial growth factor, Dickkopf-1 (Dkk-1, and C-terminal telopeptide of type II collagen (CTX II do not well reflect disease activity, but may predict progressive structural changes in the spine and sacroiliac joints in AS. Blood calprotectin level monitoring allows the effective prediction of a response to therapy with TNF inhibitors and anti-IL-17А monoclonal antibodies. The prospects for the laboratory diagnosis of AS are associated with the clinical validation of candidate biomarkers during large-scale prospective cohort studies and with a search for new proteomic, transcriptomic and genomic markers, by using innovative molecular and cellular technologies.

  17. rs657075 (CSF2 Is Associated with the Disease Phenotype (BAS-G of Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Wei-Chiao Chen

    2017-01-01

    Full Text Available Ankylosing spondylitis (AS is a systemic autoimmune disease mainly affecting the lumbar spine and sacroiliac joints, and exhibits peripheral inflammatory arthropathy. More than 25 loci have been identified as associated with AS. Because both AS and rheumatoid arthritis (RA are autoimmune diseases that may share some common genetic factors, we therefore examined if the newly identified RA genetic polymorphisms were associated with AS in a Taiwanese population. In this study, we enrolled 475 AS patients and 11,301 healthy subjects from a Taiwanese biobank as controls. Although none of single-nucleotide polymorphisms (SNPs were associated with the susceptibility to AS, the AS disease index Bath AS Global (BAS-G clinical phenotype was observed as significantly correlated to the AA genotype of rs657075 (CSF2. The significance remains after gender/age/disease duration adjustment and after group categorization by human leukocyte antigen-B 27 (HLA-B27 genotype. We further investigated the possible functions of rs657075 through bioinformatics approaches. Results revealed that polymorphism of rs657075 is able to influence the expression of acyl-CoA synthetase long-chain family member 6 (ACSL6. In conclusion, our study indicated that rs657075 (CSF2 is strongly associated with the AS disease index Bath AS Global (BAS-G clinical phenotype.

  18. The Link between Ankylosing Spondylitis, Crohn’s Disease, Klebsiella, and Starch Consumption

    Directory of Open Access Journals (Sweden)

    Taha Rashid

    2013-01-01

    Full Text Available Both ankylosing spondylitis (AS and Crohn’s disease (CD are chronic and potentially disabling interrelated conditions, which have been included under the group of spondyloarthropathies. The results of a large number of studies support the idea that an enteropathic pathogen, Klebsiella pneumoniae, is the most likely triggering factor involved in the initiation and development of these diseases. Increased starch consumptions by genetically susceptible individuals such as those possessing HLA-B27 allelotypes could trigger the disease in both AS and CD by enhancing the growth and perpetuation of the Klebsiella microbes in the bowel. Exposure to increased levels of these microbes will lead to the production of elevated levels of anti-Klebsiella antibodies as well as autoantibodies against cross-reactive self-antigens with resultant pathological lesions in the bowel and joints. Hence, a decrease of starch-containing products in the daily dietary intake could have a beneficial therapeutic effect on the disease especially when used in conjunction with the currently available medical therapies in the treatment of patients with AS and CD.

  19. [Juvenile-onset ankylosing spondylitis].

    Science.gov (United States)

    Menkes, C J; Job-Deslandre, C; Feldmann, J L

    1984-02-16

    Ankylosing spondylitis (AS) with juvenile onset (under 17 years of age) is not infrequent. Thirty-six cases were studied, amounting to 18% of patients hospitalized between 1977 and 1981. The following criteria were used for diagnosis: radiologic sacroiliitis (typical AS), presence of HLA B27 and/or pelvic or vertebral clinical manifestations (possible AS). 31 patients (85%) were boys. Mean age at onset was 12.3 +/- 2.8 years. In three cases, AS was found in a member of the family of the propositus and in one case there was cutaneous psoriasis. Usually (29 cases) onset was in the lower limbs: arthritis of the knee (14 cases), hip (9 cases), ankle (7 cases) or painful heel (4 cases). During the course (with a mean follow-up of 11.2 +/- 7 years), 35 patients exhibited peripheral joint diseases and 25 had axial involvement. Ocular involvement was present in 5 cases. 10 patients had a modification of respiratory function. Radiologic sacroiliitis was found in 31 patients but with a delay of 5.3 +/- 2.6 years. Vertebral radiologic lesions were only seen in 11 patients. Radiologic hip involvement was frequent (20 cases) with complete destruction in 6 patients. Erosion and ossification of the calcaneum were observed in 15 cases. The ESR was above 20 mm/first hour in 26 cases (72%). 81% of these patients were HLA B27 positive. Functional prognosis was good: 16 patients (51.6%) led an almost normal life, 6 were bedridden (Steinbrocker's grade IV), 3 had severe impairment (grade III) and 6 had slight impairment (grade II).(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Posttraumatic stress disorder and correlates of disease activity among veterans with ankylosing spondylitis.

    Science.gov (United States)

    Liew, Jean; Lucas Williams, J; Dobscha, Steven; Barton, Jennifer L

    2017-10-01

    The objective of this retrospective study was to evaluate the prevalence of comorbid Posttraumatic stress disorder (PTSD) and the association of PTSD with pain, disease activity, and medication use in ankylosing spondylitis (AS). Veterans with one or more visit to an outpatient rheumatology clinic at a single Veterans Affairs site during a 2-year study period were identified by ICD codes for AS and included if there was documentation of AS diagnosis by a rheumatologist. Data were collected on PTSD diagnosis, demographics, pain scores, disease activity by the Bath AS Disease Activity Index (BASDAI), and medication use. Characteristics were compared by PTSD status using t tests for continuous variables and Chi-square or Fischer's exact test for categorical variables. Of 113 Veterans with AS, 20 (18%) had a diagnosis of PTSD. Those with PTSD were significantly younger, 52 ± 17 years, as compared to those without PTSD, 59 ± 14 years (p = 0.04). BASDAI was recorded for 30% with a mean score of 4.3 ± 2.0. Those with PTSD had higher mean pain and BASDAI scores as compared to those without PTSD (p = 0.06 for both comparisons). Prescribed medications were similar for both groups in regards to synthetic disease modifying antirheumatic drugs (DMARDs), biologics, and opioids, although those with PTSD were significantly more likely to receive NSAIDs (p = 0.03). Veterans with AS and comorbid PTSD were younger and had higher reported pain and disease activity scores compared to those without PTSD in this single site study. These findings underscore the importance of identifying PTSD in patients with AS.

  1. Lower etanercept levels are associated with high disease activity in ankylosing spondylitis patients at 24 weeks of follow-up

    NARCIS (Netherlands)

    Kneepkens, E. L.; Krieckaert, C. L. M.; van der Kleij, D.; Nurmohamed, M. T.; van der Horst-Bruinsma, I. E.; Rispens, T.; Wolbink, G. J.

    2015-01-01

    Previous data have shown that etanercept levels are associated with clinical response in rheumatoid arthritis. However, for ankylosing spondylitis (AS), data regarding this topic are inconclusive. To investigate the relationship between etanercept levels and clinical response in patients with AS.

  2. Assessment of Quality of Life, Psychological and Functional Status and Disease Activity in Patients with Ankylosing Spondylitis and Fibromyalgia

    Directory of Open Access Journals (Sweden)

    Mehmet Caglayan

    2016-03-01

    Full Text Available Objective: Anxiety and depression are psychological dis­orders which frequently accompany and affect the course of rheumatic diseases. Quality of life is also affected by psychological status. In this study, we aimed to assess psychological status and quality of life in patients with an­kylosing spondylitis (AS and fibromyalgia (FM and in­vestigate their association with functional status, disease activity and physical limitation. Method: Thirty-seven patients with AS and thirty-four patients with FM were included in this study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI and Bath Ankylosing Spondylitis Functional Index (BAS­FI were used for assessment of disease activity and physical functions respectively. The Ankylosing Spondy­litis Quality of Life (ASQoL questionnaire was used for disease-related quality of life in AS patients. Fibromyalgia Impact Questionnaire (FIQ was used for assessment of functional status in FM patients. Nottingham Health Pro­file (NHP and the Hospital Anxiety and Depression Scale (HADS were, respectively, used for assessment of qual­ity of life and psychological status in groups. Results: There was no significant difference between the groups in HADS-total, HADS-depression and HADS-anxiety scores (p>0.05. However, patients with FM had significantly higher NHP-total and NHP-pain scores com­pared to patients with AS (p<0.05. Conclusion: There was no significant difference be­tween the two groups in psychological distress. Higher NHP-pain scores in patients with FM might have been caused by lower pain threshold in these patients. The generalizability of our findings is also limited because of the relatively small sample size. J Clin Exp Invest 2016; 7 (1: 41-46

  3. The effects of balneotherapy on disease activity, functional status, pulmonary function and quality of life in patients with ankylosing spondylitis.

    Science.gov (United States)

    Aydemir, Koray; Tok, Fatih; Peker, Fatma; Safaz, Ismail; Taskaynatan, Mehmet Ali; Ozgul, Ahmet

    2010-01-01

    This study aimed to determine the effects of balneotherapy on disease activity, functional status, metrology index, pulmonary function and quality of life in patients with ankylosing spondylitis (AS). The study included 28 patients (27 male and 1 female) diagnosed with AS according to modified New York criteria. The patients were treated with balneotherapy for 3 weeks (30 min/day, 5 days/week). The patients were evaluated using the global index, Bath ankylosing spondylitis disease activity index (BASDAI), disease functional index (BASFI), metrology index (BASMI), chest expansion measures, pulmonary function testing, and the medical outcomes study-short form-36 Health Survey (SF-36) (measure of quality of life) before balneotherapy and 1 month after treatment. Post balneotherapy BASDAI and global index decreased, BASMI parameters improved, chest expansion increased, and some SF-36 parameters improved; however, none of these changes were statistically significant (P > 0.05), except for the decrease in BASMI total score (P balneotherapy 6 patients had restrictive pulmonary disorder, according to pulmonary function test results. Pulmonary function test results in 3 (50%) patients were normalized following balneotherapy; however, as for the other index, balneotherapy did not significantly affect pulmonary function test results. The AS patients' symptoms, clinical findings, pulmonary function test results, and quality of life showed a trend to improve following balneotherapy, although without reaching significant differences. Comprehensive randomized controlled spa intervention studies with longer follow-up periods may be helpful in further delineating the therapeutic efficacy of balneotherapy in AS patients.

  4. Smoking quantity determines disease activity and function in Chinese patients with ankylosing spondylitis.

    Science.gov (United States)

    Zhang, Hui; Wan, Wei; Liu, Jing; Dai, Shengming; Zou, Yaohong; Qian, Qiaoxia; Ding, Yue; Xu, Xia; Ji, Hengdong; He, Hongjun; Zhu, Qi; Yang, Chengde; Ye, Shuang; Jiang, Lindi; Tang, Jianping; Tong, Qiang; He, Dongyi; Zhao, Dongbao; Li, Yuan; Ma, Yanyun; Zhou, Jingru; Mei, Zhendong; Chen, Xiangxiang; Yuan, Ziyu; Zhang, Juan; Wang, Xiaofeng; Yang, Yajun; Jin, Li; Gao, Ying; Zhou, Xiaodong; Reveille, John D; Zou, Hejian; Wang, Jiucun

    2018-06-01

    The objective of this study was to systemically and comprehensively evaluate the associations between smoking and disease outcomes in patients with ankylosing spondylitis (AS). Information on smoking, clinical features, and sociodemographic characteristics was collected by a questionnaire administered directly to the patient. Group differences were analyzed by t test or chi-square test. Logistic regression analysis was conducted with the Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), C-reactive protein, and erythrocyte sedimentation rate as the dependent variables and different stratification of smoking duration, smoking intensity, and cumulative smoking as independent variables. In order to compare our results with previous studies, meta-analysis was performed to calculate standardized mean difference (SMD) for relationship between outcomes and smoking status. A total of 1178 AS patients were analyzed. Compared with non-smokers, the risk of having active disease (BASDAI ≥ 4) was higher in patients who smoked at least 15 years, or 15 cigarettes per day, or 15 pack-years (OR = 1.70 [1.06, 2.73], 1.75 [1.08, 2.82], and 1.97 [1.06, 3.67], respectively); and smokers had increasing risk of BASDAI ≥ 4 with increasing years of smoking, or cigarettes per day, or pack-years (p -trend  = 0.010, 0.008 and 0.006, respectively). The risk of having active disease was higher in patients who smoked at least 15 cigarettes per day or 15 pack-years (OR = 1.74 [1.06, 2.84] and 2.89 [1.56, 5.35], respectively), with increasing number of cigarettes per day and pack-years. Smokers had an increased risk of BASFI ≥ 4 (p -trend  = 0.040 and 0.007, respectively). By meta-analysis, current, former and ever smokers had significantly higher BASDAI (SMD = 0.34 [0.18, 0.48], 0.10 [0.01, 0.19], and 0.27 [0.20, 0.34], respectively) and BASFI (SMD = 0.35 [0.16, 0.55], 0.30 [0.22, 0.39], and 0.35 [0.21, 0.50], respectively) compared to

  5. 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.

  6. Spinal fractures in ankylosing spondylitis: prevalence, prevention and management

    NARCIS (Netherlands)

    Vosse, D.; Lems, W.F.; Geusens, P.P.

    2013-01-01

    In patients with ankylosing spondylitis (AS), the risk of vertebral fractures (VFs) is increased. Case finding and fractures in patients with AS is a clinical challenge for several reasons. First, back pain and hyperkyphosis are mostly attributed to disease-related inflammation and structural damage

  7. Aerobic capacity and its correlates in patients with ankylosing spondylitis.

    Science.gov (United States)

    Hsieh, Lin-Fen; Wei, James Cheng-Chung; Lee, Hsin-Yi; Chuang, Chih-Cheng; Jiang, Jiunn-Song; Chang, Kae-Chwen

    2016-05-01

    To evaluate aerobic capacity in patients with ankylosing spondylitis (AS) and determine possible relationships between aerobic capacity, pulmonary function, and disease-related variables. Forty-two patients with AS and 42 healthy controls were recruited in the study. Descriptive data, disease-related variables (grip strength, lumbosacral mobility, occiput-to-wall distance, chest expansion, finger-to-floor distance, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Global Score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and hemoglobin), and chest and thoracic spine x-rays were collected in each patient with AS. All subjects took standard pulmonary function and exercise tolerance tests, and forced vital capacity (FVC) and aerobic capacity were recorded. Both aerobic capacity and FVC in patients with AS were significantly lower than those in normal subjects (P aerobic capacity. There was significant correlation between aerobic capacity, vital capacity, chest expansion, Schober's test, cervical range of motion, and BASFI in patients with AS. Neither aerobic capacity nor vital capacity correlated with disease duration, ESR, CRP, and hemoglobin. Significantly reduced aerobic capacity and FVC were observed in patients with AS, and there was significant correlation between aerobic capacity, vital capacity, chest expansion, and BASFI. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  8. Ankylosant spondylitis association and diffuse idiopathic skeletal hyperostosis (DISH)

    International Nuclear Information System (INIS)

    Medina, Yimi; Restrepo Suarez, Jose Felix; Calvo Paramo, Enrique

    2000-01-01

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

  9. Diagnostic capabilities of quantitative bone scintigraphy in ankylosing spondylitis: A comparison with radiography

    International Nuclear Information System (INIS)

    Mlatschkov, C.; Mlatschkova, D.; Andreev, T.

    1989-01-01

    In 576 patients quantitative scintigraphy of the sacroiliac joints and the spinal cord with 99m Tc-pyrophosphate was performed. 328 were patients with proven ankylosing spondylitis according to the New York criteria. 120 were patients with a clinically and roentgenologically suspected ankylosing spondylitis and 128 persons formed a healthy control group. The count rate in small regions of interest (ROI) in the sacroiliac joints, the spinal cord and the os sacrum were compared on the basis of indexes. The scintigraphic data of patients with ankylosing spondylitis were compared with the healthy control group and with the radiographic findings and radiologic staging of the disease. In a longitudinal follow-up study during 1 to 6 years these investigations were continued together with clinical and roentgenological checks. Quantitative bone scintigraphy provides characteristic indexes for ankylosing spondylitis, indicating the increased mineral metabolism of the sacroiliac joints and the spinal cord. Skeletal scintigraphy is recommended for early detection and monitoring of ankylosing spondylitis. (author)

  10. The relationship between disease activity, quality of life, and personality types in rheumatoid arthritis and ankylosing spondylitis patients.

    Science.gov (United States)

    Donisan, T; Bojincă, V C; Dobrin, M A; Bălănescu, D V; Predețeanu, D; Bojincă, M; Berghea, F; Opriș, D; Groșeanu, L; Borangiu, A; Constantinescu, C L; Ionescu, R; Bălănescu, A R

    2017-07-01

    We hypothesized that clinical outcomes might be influenced by personality type (A, B, C, D) in rheumatoid arthritis (RA) and ankylosing spondylitis (AS). One hundred ninety-four patients (104 with RA, 90 with AS) participated in a questionnaire study. We evaluated health-related quality of life (HRQoL) using the Medical Outcome Study Short-Form 36 (SF-36), personality type A/B with the Jenkins Activity Survey, type C with the State-Trait Anger Expression Inventory Anger-in Scale, type D with the Type D Personality Scale, and disease activity with Disease Activity Score with 28 joints for RA and Bath Ankylosing Spondylitis Disease Activity Index for AS. We used Pearson's correlation coefficient, independent samples t tests, and multivariate analyses of variance. In the RA group, type D personality was significantly correlated with 7/12 SF-36 components. AS patients with type D personality had deficits in all SF-36 subscales. Type D was related with higher disease activity in RA and AS. Both RA and AS type C patients had more active disease forms and negatively affected HRQoL subscales. In the RA group, type A personality did not correlate with HRQoL, but it positively influenced pain visual analog scale scores. In AS patients, type A personality was linked with higher HRQoL and with less active disease. Type C and type D personality types were correlated with decreased HRQoL and higher disease activity in RA and AS patients. Type A personality was associated with less active disease and higher HRQoL in AS patients and with less pain in RA patients.

  11. Disease activity, quality of life and indirect costs of reduced productivity at work, generated by Polish patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Paweł Kawalec

    2016-02-01

    Full Text Available Objectives: The aim of the study was to investigate the association between activity of ankylosing spondylitis (AS and decrease in quality of life as well as productivity loss of affected patients in a specified group of patients in the Polish setting. Material and methods : An questionnaire survey was conducted using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI to assess disease activity, as well as the Work Productivity and Activity Impairment Questionnaires to assess productivity loss; quality of life was presented as utility calculated using the EuroQol 5 questionnaire and also measured on a visual analogue scale (VAS. Indirect costs were assessed with the human capital approach implying gross domestic product per capita or gross value added per worker in Poland in 2014 and were expressed in Polish zlotys (PLN as well as in euros. Correlation was presented using Spearman’s rank correlation coefficient. Results : We performed our analysis based on 78 full questionnaires collected. A mean BASDAI score of 5.91 in the analysed group of patients was detected and mean utility of 0.5135 was observed. Average quality of life measured on the visual analogue scale was 46.55. Mean number of days off work was 45.26 days per year and mean on-the-job productivity loss was 49.29%. Average annual indirect costs per patient were €4241 (17 686 PLN calculated using gross domestic product and €10 172 (42 417 PLN estimated using gross value added. Total productivity loss was significantly correlated with disease activity (strong correlation of 0.6005 and utility (moderate correlation of –0.3698. Conclusions : Ankylosing spondylitis causes a great decrease in quality of life as well as patients’ productivity loss associated with both absenteeism and presenteeism. The greater the disease activity is, the lower is the utility, the lower is the quality of life measured on the VAS, and the greater are the total annual indirect costs. Total

  12. Multicenter validation of the value of BASFI and BASDAI in Chinese ankylosing spondylitis and undifferentiated spondyloarthropathy patients

    OpenAIRE

    Lin, Zhiming; Gu, Jieruo; He, Peigen; Gao, Jiesheng; Zuo, Xiaoxia; Ye, Zhizhong; Shao, Fengmin; Zhan, Feng; Lin, Jinying; Li, Li; Wei, Yanlin; Xu, Manlong; Liao, Zetao; Lin, Qu

    2009-01-01

    The objectives of this study were to evaluate the reliability of Bath ankylosing spondylitis functional index (BASFI) and Bath ankylosing spondylitis disease activity index (BASDAI) in Chinese ankylosing spondylitis (AS) and undifferentiated spondyloarthropathy (USpA) patients. 664 AS patients by the revised New York criteria for AS and 252 USpA patients by the European Spondyloarthropathy Study Group criteria were enrolled. BASDAI and BASFI questionnaires were translated into Chinese. Partic...

  13. The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations

    DEFF Research Database (Denmark)

    Exarchou, Sofia; Lindström, Ulf; Askling, Johan

    2015-01-01

    -economic factors, and according to subgroups with ankylosing spondylitis-related clinical manifestations and pharmacological treatment. METHODS: All individuals diagnosed with ankylosing spondylitis according to the World Health Organization International Classification of Disease codes, between 1967 and 2009......, were identified from the National Patient Register. Data regarding disease manifestations, patient demographics, level of education, pharmacological treatment, and geographical region were retrieved from the National Patient Register and other national registers. RESULTS: A total of 11,030 cases...... prevalence of ankylosing spondylitis (0.23% versus 0.14%, P uveitis (25.5% versus 20.0%, P 

  14. Coexistence of Ankylosing Spondylitis and Neurofibromatosis Type 1.

    Science.gov (United States)

    Gundogdu, Baris; Yolbas, Servet; Yildirim, Ahmet; Gonen, Murat; Koca, Suleyman Serdar

    2016-01-01

    Ankylosing spondylitis (AS) is a systemic disease primarily characterized by the inflammation of sacroiliac joints and axial skeleton. Neurofibromatosis type 1 (NF1) is a multisystem genetic disease which is characterized by cutaneous findings, most importantly café-au-lait spots and axillary freckling, by skeletal dysplasia, and by the growth of both benign and malignant nervous system neoplasms, most notably benign neurofibromas. In this case report, we present a 43-year-old male with AS and NF1.

  15. Magnetic resonance imaging for ankylosing spondylitis

    International Nuclear Information System (INIS)

    Bollow, M.

    2002-01-01

    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.) [de

  16. Symptom modifiers in therapy for ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Vladimir Vasilyevich Badokin

    2010-01-01

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

  17. Prevalence of fibromyalgia in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Aref Hosseinian Amiri

    2014-01-01

    Full Text Available Introduction: Ankylosing spondylitis (AS is a chronic inflammatory disease that affects the peripheral and axial skeletal system, causing pain, arthritis, low back pain and functional incapacity. Questionnaires are used to assess disease activity bath ankylosing spondylitis disease activity index (BASDAI to measure the effect of AS on patient′s life quality, functional incapacity bath ankylosing spondylitis functional index (BASFI; and Ankylosing Spondylitis quality of life (ASQoL. Fibromyalgia (FM is one of the most common causes of generalized pain and fatigability and can coexist with other diseases; it can be assessed by the FM impact questionnaire (FIQ. There are few studies that 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. Materials and Methods: A total of 36 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: Seven patients met the criteria for FM; thus a FM prevalence of 19.4% was observed among patients with AS. FM was more prevalent among women (2.5:1. Age at disease onset (AS was 24.3 years. The human leukocyte antigen-B27 antigen was positive in most of them (83.2%. When comparing BASDAI, BASFI and ASQoL test means, it was observed that values are significantly higher (P < 0.01 among patients with FM. We concluded that the coexistence of FM with AS is associated with disease activity aspects including pain, as well as functional disability and quality of life.

  18. Current treatment approaches in patients with ankylosing spondylitis

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    Bilal Elbey

    2015-03-01

    Full Text Available Ankylosing spondylitis (AS is a chronic, inflammatory, rheumatic disease that mainly affects sacroiliac joints and spine. AS predominantly occurs more often in males and typically begins in the second or third decade. The mainstay of therapy in AS are nonsteroidal anti-inflammatory drugs, which reduce inflammation and pain. Disease modifying antirheumatic drugs (DMARD did not have enough evidence to prove their effect in AS treatment. The use of DMARD may not sufficient to improve the treatment and symptoms. Currently, TNF-blockers such as, Golimumab Etanersept Adalimumab İnfliksimab have promising results in the treatment of AS. TNF-blockers improve the clinical signs and symptoms, and improve the patients’ physical function and quality of life. This manuscript is focused that Current pharmacological treatments in patients with ankylosing spondylitis.

  19. Ankylosing Spondylitis and Pregnancy: A Literature Review.

    Science.gov (United States)

    Giovannopoulou, Eirini; Gkasdaris, Grigorios; Kapetanakis, Stylianos; Kontomanolis, Emmanuel

    2017-01-01

    Ankylosing Spondylitis (AS) is the prototype of a group of systemic rheumatic diseases collectively referred to as Spondylarthitides (SpA). It has now become clear that AS is not as rare as previously thought and, although it has an early onset in life affecting patients in their reproductive years, it has not been proved to adversely affect fertility in females. The aim of this review is to summarize all the recent data on AS and pregnancy in terms of fertility, disease course and pregnancy outcome from a clinical perspective. A literature research was conducted based on the following medical databases: Pubmed/ Medline and the Cochrane Library. We searched for randomized controlled studies, casecontrol studies, cohort studies, patient and drug registers in relation to pregnancy and AS. The existing data do not support a causal relationship between AS and infertility. The state of pregnancy is not associated with reduced disease activity in patients with AS. Additionally, AS tends to adversely affect health-related quality of life during pregnancy, in comparison with normal population and patients with rheumatoid arthritis. As far as the obstetrical outcome is concerned, there is no consensus on the significant association between AS and specific pregnancy, delivery and fetal complications. Previous studies are highly heterogenous and mainly retrospective and thus, the existing data are controversial and inconclusive. Subsequent studies are required to enlighten our knowledge on the interaction between AS and pregnancy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  20. Coexisting ankylosing spondylitis and rheumatoid arthritis: a case report with literature review.

    Science.gov (United States)

    Guo, Ying-Ying; Yang, Li-Li; Cui, Hua-Dong; Zhao, Shuai; Zhang, Ning

    2011-10-01

    A 30-year-old female patient with coexisting ankylosing spondylitis and rheumatoid arthritis was diagnosed and treated. The human leukocyte antigen (HLA)-B27 is a predisposing factor of ankylosing spondylitis and HLA-DR4 is a predisposing factor of rheumatoid arthritis. This patient was HLA-B27 and HLA-DR4 positive, and ankylosing spondylitis manifested before rheumatoid arthritis. After disease modifying anti-rheumatic drugs successfully arrested ankylosing spondylitis activity the patient conceived and delivered a healthy baby. One year later, she developed peripheral polyarthritis and was diagnosed with rheumatoid arthritis. We hypothesized that pregnancy may be one of the environmental factors that can activate rheumatoid arthritis, and that disease modifying anti-rheumatic drugs play an important role in keeping the disease under control.

  1. Integrative Structural Biomechanical Concepts of Ankylosing Spondylitis

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    Alfonse T. Masi

    2011-01-01

    Full Text Available Ankylosing spondylitis (AS is not fully explained by inflammatory processes. Clinical, epidemiological, genetic, and course of disease features indicate additional host-related risk processes and predispositions. Collectively, the pattern of predisposition to onset in adolescent and young adult ages, male preponderance, and widely varied severity of AS is unique among rheumatic diseases. However, this pattern could reflect biomechanical and structural differences between the sexes, naturally occurring musculoskeletal changes over life cycles, and a population polymorphism. During juvenile development, the body is more flexible and weaker than during adolescent maturation and young adulthood, when strengthening and stiffening considerably increase. During middle and later ages, the musculoskeletal system again weakens. The novel concept of an innate axial myofascial hypertonicity reflects basic mechanobiological principles in human function, tissue reactivity, and pathology. However, these processes have been little studied and require critical testing. The proposed physical mechanisms likely interact with recognized immunobiological pathways. The structural biomechanical processes and tissue reactions might possibly precede initiation of other AS-related pathways. Research in the combined structural mechanobiology and immunobiology processes promises to improve understanding of the initiation and perpetuation of AS than prevailing concepts. The combined processes might better explain characteristic enthesopathic and inflammatory processes in AS.

  2. Ankylosing spondylitis in an athlete with chronic sacroiliac joint pain.

    Science.gov (United States)

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

    2014-02-01

    Ankylosing spondylitis is a disease in which inflammation of joints, most often in the axial skeleton, can lead to reactive fibrosis and eventual joint fusion with associated immobility and kyphosis. The disease often involves extra-articular features, such as uveitis and aortic regurgitation, as well as associated inflammatory conditions of the intestines. Its etiology is unknown. Ankylosing spondylitis most commonly presents in young males (15-30 years old) as persistent low back pain and stiffness that is worse in the morning and at night and improves with activity. The authors report the case of a young male athlete whose symptoms were initially incorrectly diagnosed as sacroiliac joint instability and dysfunction and later as a sacroiliac stress fracture before further workup revealed a seronegative spondyloarthropathy and the diagnosis of ankylosing spondylitis. The patient was prescribed oral indomethacin daily by the attending rheumatologist and started on a slow progression of return to running, jumping, and weight lifting. Within 4 weeks of beginning this treatment, the patient had complete cessation of pain with the medication. At follow-up 1 year after graduation from his university, the patient was nearly symptom free and working in a non-heavy labor job. The purpose of this case report is to remind sports medicine physicians of the prevalence of rheumatologic diseases in general and ankylosing spondylitis in particular and of the various ways in which spondyloarthropathies may present in athletes. Increased suspicion may lead to earlier diagnosis and treatment, potentially reducing illness severity and duration and improving the performance of athletes with this condition. Copyright 2014, SLACK Incorporated.

  3. Significance of Plain Radiography of the Pelvis for the Diagnosis of Ankylosing Spondylitis in Clinical Practice

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    А.V. Smirnov

    2015-08-01

    Full Text Available Diagnosis of ankylosing spondylitis is based on characteristic clinical picture of the disease and mandatory identification of sacroiliitis on pelvis X-ray. However, case reports of the radiographic stages of sacroiliac joint disorder available in literature are less informative and often lead to misinterpretation of radiographic changes. Based on many years of experience, the authors present the extended explanations of standard radiographic stages of sacroiliitis and other radiological signs that can facilitate diagnostic search in ankylosing spondylitis.

  4. Atlantoaxial Ankylosis Detected on Neck CT Scans in a Patient with Ankylosing Spondylitis: A Case Report

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    Lee, Jeong Ah; Lee, Seung Hun; Joo, Kyung Bin [Dept. of Radiology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of); Ryu, Jeong Ah [Dept. of Radiology, Guri Hospital, Hanyang University College of Medicine, Guri (Korea, Republic of); Kim, Tae Hwan [Dept. of Rheynmatology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2011-07-15

    Ankylosing spondylitis is a chronic inflammatory disorder of unknown cause that principally affects the axial skeleton. The cervical spine is also vulnerable to this disease process and the characteristic feature of cervical involvement is atlantoaxial subluxation. However, only a few cases of atlantoaxial ankylosis have been reported to date. We report a case of atlantoaxial ankylosis in a patient with ankylosing spondylitis with radiologic findings incidentally detected on neck CT scans.

  5. Atlantoaxial Ankylosis Detected on Neck CT Scans in a Patient with Ankylosing Spondylitis: A Case Report

    International Nuclear Information System (INIS)

    Lee, Jeong Ah; Lee, Seung Hun; Joo, Kyung Bin; Ryu, Jeong Ah; Kim, Tae Hwan

    2011-01-01

    Ankylosing spondylitis is a chronic inflammatory disorder of unknown cause that principally affects the axial skeleton. The cervical spine is also vulnerable to this disease process and the characteristic feature of cervical involvement is atlantoaxial subluxation. However, only a few cases of atlantoaxial ankylosis have been reported to date. We report a case of atlantoaxial ankylosis in a patient with ankylosing spondylitis with radiologic findings incidentally detected on neck CT scans.

  6. Atlantoaxial instability: An exceptional complication of ankylosing spondylitis

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    Zeineb Alaya

    2018-04-01

    Full Text Available Background: Atlantoaxial instability (AAI and more rarely odontoid pannus formation, similar to the one observed in Rheumatoid Arthritis, are seldom reported in ankylosing spondylitis (AS. We report a new case of a patient with AS with a pannus in the atlanto-axial region and cervical C1-C2 instability. Case presentation: The patient, now aged 41, was diagnosed with AS in 2010. She was put on different non steroidal anti inflammatory treatments with persistent spinal pain. She was referred to our department in 2015 with severe cervical pain and stiffness since 3 months. On examination, the patient had severely limited cervical spine movements. Lumbar spine movements were moderately affected. There was no neurological deficit. Her Bath Ankylosing Spondylitis Disease Activity Index (BASDAI was 4.9/10 and Bath Ankylosing Spondylitis Functional Index (BASFI was 5/10. Plain Radiographs of the pelvis showed bilateral grade 4 sacroilitis and bilateral coxitis. Dorsal and lumbar spine plain radiographs showed squaring of vertebral bodies. Cervical spine radiographs showed an increased atlanto-axial distance. Spinal MRI confirmed the atlantoaxial subluxation with an anterior distance of 8 mm, with marked intraspinal pannus formation and synovitis around the odontoid peg. Synovial thickening exerted an anterior mark on the bulbo-medullary junction with no evidence of oedema signs. Posterior zygapophysial ankylosis involving all cervical levels was also observed. The patient had a cervical collar with anti-tumor necrosis factor-α (cerolizumab-pegol prescription with favorable outcome. Conclusion: Odontoid pannus formation is rare in AS. Clinical and radiological follow-up are important to assess the impact on the cervical spine. Keywords: Ankylosing spondylitis, Atlantoaxial instability, MRI, Cerolizumab-pegol

  7. 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)

    Straube, F.; Sagner, K.; Mende, T.; Tutar, K.

    2002-01-01

    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 [ 224 Ra]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 [ 224 Ra]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 p rofile 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 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

  8. Idiopathic Hypoparathyroidism Mimicking Ankylosing Spondylitis: A Case Report

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    Ozge Illeez Memetoglu

    2016-01-01

    Full Text Available Idiopathic hypoparathyroidism, inadequate secretion of parathyroid hormone of unknown etiology, may mimic ankylosing spondylitis both clinically and radiologically. Spinal complaints may be the first sign of any endocrinological disorder.

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

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    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-α 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.

  10. TNF blockers inhibit spinal radiographic progression in ankylosing spondylitis by reducing disease activity: results from the Swiss Clinical Quality Management cohort.

    Science.gov (United States)

    Molnar, Christoph; Scherer, Almut; Baraliakos, Xenofon; de Hooge, Manouk; Micheroli, Raphael; Exer, Pascale; Kissling, Rudolf O; Tamborrini, Giorgio; Wildi, Lukas M; Nissen, Michael J; Zufferey, Pascal; Bernhard, Jürg; Weber, Ulrich; Landewé, Robert B M; van der Heijde, Désirée; Ciurea, Adrian

    2018-01-01

    To analyse the impact of tumour necrosis factor inhibitors (TNFis) on spinal radiographic progression in ankylosing spondylitis (AS). Patients with AS in the Swiss Clinical Quality Management cohort with up to 10 years of follow-up and radiographic assessments every 2 years were included. Radiographs were scored by two readers according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) with known chronology. The relationship between TNFi use before a 2-year radiographic interval and progression within the interval was investigated using binomial generalised estimating equation models with adjustment for potential confounding and multiple imputation of missing values. Ankylosing Spondylitis Disease Activity Score (ASDAS) was regarded as mediating the effect of TNFi on progression and added to the model in a sensitivity analysis. A total of 432 patients with AS contributed to data for 616 radiographic intervals. Radiographic progression was defined as an increase in ≥2 mSASSS units in 2 years. Mean (SD) mSASSS increase was 0.9 (2.6) units in 2 years. Prior use of TNFi reduced the odds of progression by 50% (OR 0.50, 95% CI 0.28 to 0.88) in the multivariable analysis. While no direct effect of TNFi on progression was present in an analysis including time-varying ASDAS (OR 0.61, 95% CI 0.34 to 1.08), the indirect effect, via a reduction in ASDAS, was statistically significant (OR 0.75, 95% CI 0.59 to 0.97). TNFis are associated with a reduction of spinal radiographic progression in patients with AS. This effect seems mediated through the inhibiting effect of TNFi on disease activity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Coexistence of Ankylosing Spondylitis and Neurofibromatosis Type 1

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    Baris Gundogdu

    2016-01-01

    Full Text Available Ankylosing spondylitis (AS is a systemic disease primarily characterized by the inflammation of sacroiliac joints and axial skeleton. Neurofibromatosis type 1 (NF1 is a multisystem genetic disease which is characterized by cutaneous findings, most importantly café-au-lait spots and axillary freckling, by skeletal dysplasia, and by the growth of both benign and malignant nervous system neoplasms, most notably benign neurofibromas. In this case report, we present a 43-year-old male with AS and NF1.

  12. [Acupuncture Therapy versus Disease-modifying Antirheumatic Drugs for the Treatment of Ankylosing Spondylitis--a Meta-analysis].

    Science.gov (United States)

    Lv, Zheng-tao; Zhou, Xiang; Chen, An-min

    2015-01-01

    We conducted a meta-analysis evaluating the efficacy and safety of acupuncture compared to disease-modifying antirheumatic drugs in patients with ankylosing spondylitis. Four databases including Pubmed, EMBASE, Cochrane library, and ISI Web of Science were searched in December 2014, taking also the reference section into account. Randomized controlled trials that aimed to assess the efficacy of acupuncture therapy were identified. The inclusion criteria for the outcome measurements were the clinical effect, ESR, occipital wall test, chest expansion, CRP and finger ground distance. Finally, six studies met these inclusion criteria. Two reviewers screened each article independently and were blinded to the findings of each other. We analyzed data from 6 RCTs involving 541 participants. Acupuncture therapy could further improve the clinical effect (OR = 3.01; 95% CI, 1.48-6.13; P = 0.002) and reduce ESR level (SMD = -0.77; 95% CI, -1.46 to -0.08; P = 0.03) compared to DMARDs; a combination of acupuncture and DMARDs could further improve clinical effect (OR = 3.20, 95% CI, 1.36-7.54; P = 0.008), occipital-wall distance (SMD = -0.84; 95% CI, -1.37 to -0.31; P = 0.002), chest expansion (SMD = 0.38; 95% CI, 0.16-0.60; P = 0.0009), and finger-ground distance (SMD = -0.48; 95% CI, -0.87 to -0.09; P = 0.02) as compared to DMARDs treatment alone. Our findings support that acupuncture therapy could be an option to relieve symptoms associated with AS. These results should be interpreted cautiously due to the generally poor methodological qualities of the included trials. © 2015 S. Karger GmbH, Freiburg.

  13. Socioeconomic impact of ankylosing spondylitis in Tunisia.

    Science.gov (United States)

    Younes, Mohamed; Jalled, Anis; Aydi, Zohra; Zrour, Saoussen; Korbaa, Wided; Ben Salah, Zohra; Letaief, Mondher; Bejia, Ismail; Touzi, Mongi; Bergaoui, Naceur

    2010-01-01

    Ankylosing spondylitis (AS) is the second most common chronic inflammatory joint disease after rheumatoid arthritis and causes substantial functional impairment, two features that generate a heavy socioeconomic burden. Here, our objective was to assess the socioeconomic impact of AS and to identify factors associated with higher costs. We retrospectively reviewed the medical charts of 50 patients with AS seen at the Monastir Public Health Service Hospital over the 6-month period from March to September 2006. The following were evaluated: direct costs of medical care; indirect costs related to work incapacity; and impact on marital life, offspring, social activities, and activities of daily living. There were 42 men and eight women (male-to-female ratio, 5.25) with a mean age of 38.9+/-10.8 years (range, 19-60 years). The median mean direct cost of medical care for AS was 426.072 Tunisian Dinars (TND) (266.295 euro) per year, and the interquartile range (IQR) was 270.468 TND. Of the 34 patients who had paid employment, 12 (35%) were on sick leave. The mean indirect cost was 447.4+/-294.3 TND (279.625+/-183.937 euro) per patient per year. The median mean total cost was 873.472 TND (545,92 euro) per patient per year with an IQR of 292,324 TND. Factors associated with higher costs were the use of nonsteroidal anti-inflammatory drugs and higher values of the BASDAI and BASRI. Among married patients, 44.4% reported sexual problems, which correlated with the BASMI; and 37% reported a negative reaction on the part of the healthy spouse. Adverse effects on schooling and quality of life of the children were noted in 29.6% of cases. Among single patients, 30.4% felt their disease was responsible for their unmarried status. The disease adversely affected the ability to carry out many activities of daily living (grooming in 38% of cases, housework in 76%, shopping in 92%, sporting activities in 96%, socializing in 68%, and traveling in 80%). The patients usually reported

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

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Madsen, Ole Rintek; Erlendsson, J.

    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...

  15. The Disease of the Italian Poet Giacomo Leopardi (1798-1837): A Case of Juvenile Ankylosing Spondylitis in the 19th Century?

    Science.gov (United States)

    Sganzerla, Erik Pietro; Riva, Michele Augusto

    2017-06-01

    Some authors sustained that the pessimistic thought of the Italian writer and philosopher Giacomo Leopardi (1798-1837) may be attributed to his unhappy life, characterized by several health problems. His philosophical theories appear as the result of depressive and melancholic state, related to his precarious health conditions, so limiting their intrinsic values. Several authors formulated various hypotheses on the diseases that Leopardi suffered from and postulated different theories on the cause of his early death. This article assumed that Leopardi may have been affected by juvenile ankylosing spondylitis, conditioning spinal deformities, relapsing-remitting uveitis, urinary tract and bowel tract problems, and acute arthritis. Chest deformity, as a complication of juvenile ankylosing spondylitis, may have caused progressive cardiorespiratory failure, worsened by recurrent bronchial and pulmonary complications, until his death caused by acute right ventricular heart failure. The acknowledgment of a physical cause of Leopardi's disease contributes to reevaluate his "cosmic pessimism" as an original expression of his thought, so leading a general revaluation of the figure of one of the most important European thinkers of the 19th century.

  16. Detection of Chlamydia pneumoniae in Ankylosing Spondylitis Patients

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    Dunya Fareed Salloom

    2018-03-01

    Full Text Available Ankylosing spondylitis is a complex debilitating disease because its pathogenesis is not clear. This study aims at detecting some pathogenesis factors that lead to induce the disease. Chlamydia pneumoniae is one of these pathogenesis factors which acts as a triggering factor for the disease. The study groups included forty Iraqi Ankylosing spondylitis patients and forty healthy persons as a control group. Immunological and molecular examinations were done to detect Chlamydia. pneumoniae in AS group. The immunological results were performed by Enzyme-Linked Immunosorbent Assay (ELISA to detect anti-IgG and anti-IgM antibodies of C. pneumoniae revealed that five of forty AS patients' samples (12.5% were positive for anti-IgG and IgM C. pneumoniae antibodies compared to controls which revealed seronegative. Molecular detection included 16srRNA and HSP-70 genes were to ensure the serological examination for detection of bacteria in the five blood samples which were positive; therefore, these results improved that C. pneumoniae played a role in the pathogenesis of the disease.

  17. Ankylosing spondylitis and cardiovascular risk – case report

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    Daniela Anghel

    2016-12-01

    Full Text Available Introduction: Ankylosing spondylitis (AS is a chronic progressive inflammatory disease of the axial skeleton and peripheral joints associated with HLA B27 antigen and with the predominance of the male gender (with an average between 20 and 30 years old. Case presentation A 48 years old male patient was admitted to our clinic, having a long history regarding this disease since he was 16. This patient has switched 3 therapies with anti TNF alpha agents until now, and we hope to obtain a good response for a long time. During the treatment with Etanercept he presented an acute anterior uveitis which had a good response to therapy. Conclusion: The ankylosing spondylitis management is complicated when we have the possibility to choose only three anti TNF alpha agents. If a patient does not respond to the first or second agent we are constrained to follow the last one. Therefore the principal problem regarding this special case is that the patient is non responder at the last agent. So the question that arises is witch will be the next therapy for this patient?

  18. A case of severe ankylosing spondylitis posted for hip replacement surgery

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    Nalini Kotekar

    2007-01-01

    Full Text Available A 50-year-old male patient with history of ankylosing spondylitis (AS for 30 years presented for hip replacement surgery. Airway management in ankylosing spondylitis patients presents the most serious array of intubation and airway hazards imagin-able, which is secondary to decrease in cervical spine mobility and possible temporo-mandibular joint disease. Literatures support definitive airway management and many authors consider regional anaesthesia to be contraindicated. The reasons cited include inability to gain neuraxial access and the need for urgent airway control in case of complication of regional anaesthesia.

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

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    Tschoeke Sven K

    2008-06-01

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

  20. Surgical orodental implications in ankylosing spondylitis

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    Mohammad Mehdizadeh

    2012-01-01

    Full Text Available Temporomandibular joint and the pelvic complex are bidirectionally related. Ankylosing spondylitis (AS is a seronegative arthropathy with the key feature of bony fusion of lumbar vertebrae. A 39 year old known case of AS was presented to private office for left lower impacted third molar surgical removal. Previously, he was rejected to receive oral care for pulpectomy and extraction due to limited mouth opening. Prior to the surgery, lateral neck radiography was obtained to exclude any subluxation of fracture of cervical vertebrae. Neck was supported to insure neck stability during surgical forces. In addition, considering consumption of immunosuppressive medications including corticosteroids, procedure was performed with a great care, with attention to higher possibility of infection and fracture. Access to the surgical site was not desirable, though surgery accomplished without any significant event and the patient discharged with routine analgesic and antibiotics recommendation. Sometimes, impaired access to the oral cavity in patients with AS leads to receive suboptimal or minimal orodental care. Long list of dental implications in these patients may be simplified by considering of careful neck and jaw support, applying at least possible forces and great attention to the infection control rules. It is wised to be performed under patient and skilled hands.

  1. Ankylosing Spondylitis Associated With Bilateral TMJ Ankylosis

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    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.

  2. The relationship between inflammation and new bone formation in patients with ankylosing spondylitis

    OpenAIRE

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

    2008-01-01

    Introduction Spinal inflammation as detected by magnetic resonance imaging and new bone formation as identified by conventional radiographs are characteristic of ankylosing spondylitis. Whether and how spondylitis and syndesmophyte formation are linked are unclear. Our objective was to investigate whether and how spinal inflammation are associated with new bone formation in ankylosing spondylitis. Methods Spinal magnetic resonance images and conventional radiographs from 39 ankylosing spondyl...

  3. Dependence of the sacroiliac indices of the X-ray stage of ankylosing spondylitis (Behterev's disease)

    International Nuclear Information System (INIS)

    Mlychkov, Kh.

    1983-01-01

    A total of 241 patients (482 sacroiliac indices) in different X-ray stage of the disease were studied and the data obtained were correlated with the sacroiliac indices in a control group of 104 normal subjects (208 sacroiliac indices). Sacroiliac indices were obtained by quantitative examination of the zones of interest of the sacroiliac joints and the sacrum, 3 hours after intravenous injection of 99 sup(m)Tc-pyrophosphate in indicator activities of 1.85 MBq/kg. The sacroiliac index levels increased with advancing X-ray stage of the disease within the I-III stage span; in the IV-th X-ray stage there was obvious decrease in these values. There appeared to exist statistically significant differences in the sacroiliac index values during all X-ray stages of the disease, as compared to the data obtained in the control group of healthy individuals (P<0.001). The significance level of the differences between neighbouring stages was low. Peak percentage of negative findings was observed in the zero stage (14.3) and in stage IV (11.7). The high percentage of positive findings in zero stage patients (15.7 per cent) is an evidence of the major sensitivity of quantitative scintigraphy in comparison with X-ray method of examination. (author)

  4. Oral Anaerobic Bacteria in the Etiology of Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Mesut Öğrendik

    2017-06-01

    Full Text Available Ankylosing spondylitis (AS is associated with periodontitis. Anti– Porphyromonas gingivalis and anti– Prevotella intermedia antibody titers were higher in patients with spondyloarthritis than in healthy people. Sulfasalazine is an effective antibiotic treatment for AS. Moxifloxacin and rifamycin were also found to be significantly effective. The etiology hypothesis suggests that oral anaerobic bacteria such as Porphyromonas spp and Prevotella spp contribute to the disease. These bacteria have been identified in AS, and we will discuss their pathogenic properties with respect to our knowledge of the disease. Periodontal pathogens are likely to be responsible for the development of AS in genetically susceptible individuals. This finding should guide the development of more comprehensive and efficacious treatment strategies for AS.

  5. Bamboo spine – X-ray findings of ankylosing spondylitis revisited ...

    African Journals Online (AJOL)

    Ankylosing spondylitis is a debilitating disease that is one of the seronegative spondylarthropathies, affecting more males than females in the proportion of about 6:1 in the age group 15 - 35 years of age. Early radiographic findings include bilateral sacro-iliitis and early axial (lower lumbar spine) ankylosis. Typical X-ray ...

  6. Social Role Participation in Patients With Ankylosing Spondylitis: A Cross-Sectional Comparison With Population Controls

    NARCIS (Netherlands)

    van Genderen, Simon; Plasqui, Guy; Landewe, Robert; Lacaille, Diane; Arends, Suzanne; van Gaalen, Floris; van der Heijde, Desiree; Heuft, Liesbeth; Luime, Jolanda; Spoorenberg, Anneke; Gignac, Monique; Boonen, Annelies

    2016-01-01

    Objective. Participation in social roles for persons with chronic disease is important for their quality of life, but interpretation of the data on participation is difficult in the absence of a benchmark. This study aimed to compare social role participation in patients with ankylosing spondylitis

  7. Social role participation in patients with ankylosing spondylitis. A cross-sectional comparison with population controls

    NARCIS (Netherlands)

    van Genderen, Simon; Plasqui, Guy; Landewé, Robert; Lacaille, Diane; Arends, Suzanne; van Gaalen, Floris; van der Heijde, Désirée; Heuft, Liesbeth; Luime, Jolanda; Spoorenberg, Anneke; Gignac, Monique A M; Boonen, Annelies

    2016-01-01

    OBJECTIVE: Social role participation of persons with a chronic disease is important for their lives, but interpretation of data on participation is difficult in the absence of a benchmark. This study aimed to compare social role participation in patients with ankylosing spondylitis (AS) to

  8. The image diagnosis of juvenile ankylosing spondylitis

    International Nuclear Information System (INIS)

    Xian Jianxing; Zhao Jihong

    2005-01-01

    Objective: To research the image change of JAS and improve the knowledge of this case. Method: 12 patients in this group, 11 males and 1 female. The morbidity age is between 9-16 years old and in average is 13 years old. All the cases use the pelvis platform and R F, HLA-B27 check. Four of them has made the CT and MRI level. Result: In this group, the case is extended over the sacroiliac joint. Among them, there are 5 samples that are referred to both of the coxa articution. The X-rays shows that under the sacroiliac joint, there has 2/3 sclerotin sclerotized and the side of sacroiliac shows this phenomenon especially. The sacroiliac joint is fuzziness and the size of articulation clearance is different, it shows as the sawtooth. When it refers to the coxa articulation, it shows as the acetabular and at the same time the articulation become abnormally. When it refers to the lumber, it shows as that the lumber articulation fuzziness while the articulation clearance disappear. CT level: when affected with this sickness it show that the size of the clearance is different. MRI level: T 1 WI shows that when affected with this case, it express that the size of the clearance is different and at the side of sacroiliac joint can see the low signal which can change into high signal when put it under the T 2 Wi, HLA-B27 is masculine. Conclusion: Because JAS is lack of the adjust ankylosing spondylitis special clinical in the early stage, so it is always be misdiagnosed as the Juvenile rheumatoid arthritis. In fact they are two different cases and treatment is also different. The authors should improve our knowledge about this case. In our opinion, checking of the image and HLA-B27 can diagnose this sickness earlier and correctly. (authors)

  9. Bioboosters in the treatment of rheumatic diseases: a comprehensive review of currently available biologics in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    Fabrizio Cantini

    2009-12-01

    Full Text Available Fabrizio Cantini, Carlotta Nannini, Laura NiccoliSecond Division of Medicine, Rheumatology Unit, Hospital of Prato, ItalyAbstract: Immunologic research has clarified many aspects of the pathogenesis of inflammatory rheumatic disorders. Biologic drugs acting on different steps of the immune response, including cytokines, B- and T-cell lymphocytes, have been marketed over the past 10 years for the treatment of rheumatoid arthritis (RA, ankylosing spondylitis (AS, and psoriatic arthritis (PsA. Randomized controlled trials (RCTs of anti-cytokine agents in RA (including the anti-tumor necrosis factor alpha (TNFα drugs infliximab, etanercept, adalimumab, golimumab, certolizumab, anti-interleukin (IL-1 anakinra, and anti-IL-6 tocilizumab demonstrated a significant efficacy compared to traditional therapies, if combined with methotrexate (MTX, as measured by ACR 20, 50 and 70 response criteria. The new therapies have also been demonstrated to be superior to MTX in slowing or halting articular damage. RCTs have shown the efficacy of anti-TNFα in AS patients through significant improvement of symptoms and function. Trials of anti-TNFα in PsA patients showed marked improvement of articular symptoms for psoriasis and radiological disease progression. More recent studies have demonstrated the efficacy of B-cell depletion with rituximab, and T-cell inactivation with abatacept. All these drugs have a satisfactory safety profile. This paper reviews the different aspects of efficacy and tolerability of biologics in the therapy of RA, AS, and PsA.Keywords: anti-TNF, anti-cytokine agents, rituximab, abatacept, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis

  10. Ankylosing spondylitis: a case report with review of literature ...

    African Journals Online (AJOL)

    Materials and Methods: A case report of a 60 year old Libyan male who has Ankylosing spondylitis and then review the available literature. Results: The patient has been having a chronic low back pain and stiffness for the last 26 years. His symptoms are most severe in morning and improve with movement. He developed ...

  11. Perinatal characteristics, older siblings, and risk of ankylosing spondylitis

    DEFF Research Database (Denmark)

    Lindström, Ulf; Forsblad-d'Elia, Helena; Askling, Johan

    2016-01-01

    BACKGROUND: The effect of circumstances and exposures early in life on the risk of developing ankylosing spondylitis (AS) is largely unknown. The purpose of this study was to determine whether perinatal characteristics predict development of AS. METHODS: AS cases (n = 1960; 59 % men) were defined...

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

    Directory of Open Access Journals (Sweden)

    Senabre-Gallego JM

    2013-09-01

    Full Text Available José Miguel Senabre-Gallego,1 Carlos Santos-Ramirez,2 Gregorio Santos-Soler,1 Esteban Salas-Heredia,1 Mabel Sánchez-Barrioluengo,3 Xavier Barber,4 José Rosas1 On behalf of the AIRE-MB group 1Rheumatology, Hospital Marina Baixa, Villajoyosa, 2Rheumatology, Hospital Marina Salud, Denia, 3INGENIO (Instituto de Gestión de la Inovación y del Conocimiento (CSIC [Consejo Superior de Investigaciones Científicas]-UPV [Universidad Politécnica de Valencia], Universitat Politècnica de València, Valencia, 4CIO (Centro de Investigación Operativa-UMH (Universidad Miguel Hernández, Universidad Miguel Henández, Elche, Spain Abstract: To date, anti-tumor necrosis factor alfa (anti-TNF-α therapy is the only alternative to nonsteroidal anti-inflammatory drugs for the treatment of ankylosing spondylitis. Etanercept is a soluble TNF receptor, with a mode of action and pharmacokinetics different to those of antibodies and distinctive efficacy and safety. Etanercept has demonstrated efficacy in the treatment of ankylosing spondylitis, with or without radiographic sacroiliitis, and other manifestations of the disease, including peripheral arthritis, enthesitis, and psoriasis. Etanercept is not efficacious in inflammatory bowel disease, and its efficacy in the treatment of uveitis appears to be lower than that of other anti-TNF drugs. Studies of etanercept confirmed regression of bone edema on magnetic resonance imaging of the spine and sacroiliac joint, but failed to reduce radiographic progression, as do the other anti-TNF drugs. It seems that a proportion of patients remain in disease remission when the etanercept dose is reduced or administration intervals are extended. Etanercept is generally well tolerated with an acceptable safety profile in the treatment of ankylosing spondylitis. The most common adverse effect of etanercept treatment is injection site reactions, which are generally self-limiting. Reactivation of tuberculosis, reactivation of

  13. The effect of balneotherapy on patients with ankylosing spondylitis.

    Science.gov (United States)

    Altan, L; Bingöl, U; Aslan, M; Yurtkuran, M

    2006-01-01

    To compare the effect of balneotherapy on physical activity and quality of life as well as the symptoms of pain and stiffness with exercise alone in ankylosing spondylitis (AS) patients. A total of 60 patients who had a diagnosis of AS according to the modified New York criteria were included in the study. The patients were randomly assigned to two groups. In Group I (n = 30) the patients received balneotherapy in a therapeutic pool for 30 min once a day for 3 weeks. All patients received instructions on the exercise programme, which they were requested to repeat once a day for 30 min during the study. The patients in this group continued the same exercise programme after the end of the balneotherapy protocol to complete a course of 6 months. In Group II the patients were given the same exercise protocol but did not receive balneotherapy. Patients were evaluated before the start of the study and at 3 weeks and 24 weeks. Evaluation parameters were daily and night pain, morning stiffness, the patient's global evaluation and the physician's global evaluation (according to a scoring system of 1 to 5), the Bath Ankylosing Spondilitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Dougados Functional Index (DFI), tragus-wall distance, chest expansion, modified Shober test (MST), fingertip-fibula head distance, and Nottingham Health Profile (NHP). Evaluations were completed in 54 patients in the two groups. Comparison of the groups showed significantly superior results for Group I for parameters of BASDAI, NHP total, pain, physical activity, tiredness and sleep score, patient's global evaluation and the physician's global evaluation at 3 weeks, but only for the parameters of patient's global evaluation and MST at 24 weeks. Balneotherapy has a supplementary effect on improvement in disease activity and functional parameters in AS patients immediately after the treatment period. However, in the light of our medium-term evaluation

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

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    Fernanda Genre

    2014-01-01

    Full Text Available 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-α antagonist infliximab therapy and if infliximab infusion modified TRAIL levels. Methods. We measured TRAIL serum levels in 30 nondiabetic AS patients without CV disease undergoing anti-TNF-α therapy, immediately before and after an infliximab infusion, and in 48 matched controls. Correlations of TRAIL levels with disease activity, systemic inflammation and MeS features, adipokines, and biomarkers of endothelial activation were evaluated. Changes in TRAIL levels following anti-TNF-α infusion were analyzed. Results. TRAIL levels were higher in AS patients than controls. TRAIL levels displayed an inverse correlation with total and LDL cholesterol. We observed an inverse correlation with QUICKI and a marginal association with HOMA-IR. We also found an inverse correlation with resistin and a marginal association with apelin and OPN. Anti-TNF-α infusion did not change TRAIL levels after 120′. Conclusion. Elevated TRAIL levels in AS patients may be the result of a compensatory mechanism to reduce CV risk in these patients.

  15. Lung findings on high resolution CT in early ankylosing spondylitis

    International Nuclear Information System (INIS)

    Kiris, Adem; Ozgocmen, Salih; Kocakoc, Ercan; Ardicoglu, Ozge; Ogur, Erkin

    2003-01-01

    Objective: Ankylosing spondylitis (AS) is a chronic inflammatory disease mainly affecting the axial skeleton and pulmonary involvement is a well known feature of the disease. The aim of this study was to investigate the pulmonary high resolution computed tomography (HRCT) findings of patients with early AS. The relationship between pulmonary function tests (PFT) and HRCT findings was also determined. Subjects and methods: Twenty-eight patients with AS (mean age 30.8±7.4 and disease duration 7.0±2.6) were included in the study. Patients with a disease duration of >10 years or had other pulmonary diseases were excluded. All patients underwent plain chest radiography (posteroanterior and lateral views), thoracic HRCT and PFT. Results: All chest radiographs were normal and HRCT revealed abnormalities in 18 patients. The most common abnormalities seen on HRCT were mosaic pattern (ten of 28), subpleural nodule (seven of 28) and parenchymal bands (five of 28). Seven of ten patients with mosaic pattern revealed air trapping areas on end expiratory scans. Twelve patients had abnormal PFT and all had restrictive type of involvement. Ten of these 12 patients had abnormal HRCT and the remaining two patients had normal HRCT. On the other hand, eight patients with normal PFT had abnormalities on HRCT. Conclusion: Patients with early AS frequently have abnormalities on HRCT, even though they have normal PFT and chest X-ray. Small airway involvement was found as frequent as interstitial lung disease in early AS

  16. Lung findings on high resolution CT in early ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Kiris, Adem E-mail: ademkiris@hotmail.com; Ozgocmen, Salih; Kocakoc, Ercan; Ardicoglu, Ozge; Ogur, Erkin

    2003-07-01

    Objective: Ankylosing spondylitis (AS) is a chronic inflammatory disease mainly affecting the axial skeleton and pulmonary involvement is a well known feature of the disease. The aim of this study was to investigate the pulmonary high resolution computed tomography (HRCT) findings of patients with early AS. The relationship between pulmonary function tests (PFT) and HRCT findings was also determined. Subjects and methods: Twenty-eight patients with AS (mean age 30.8{+-}7.4 and disease duration 7.0{+-}2.6) were included in the study. Patients with a disease duration of >10 years or had other pulmonary diseases were excluded. All patients underwent plain chest radiography (posteroanterior and lateral views), thoracic HRCT and PFT. Results: All chest radiographs were normal and HRCT revealed abnormalities in 18 patients. The most common abnormalities seen on HRCT were mosaic pattern (ten of 28), subpleural nodule (seven of 28) and parenchymal bands (five of 28). Seven of ten patients with mosaic pattern revealed air trapping areas on end expiratory scans. Twelve patients had abnormal PFT and all had restrictive type of involvement. Ten of these 12 patients had abnormal HRCT and the remaining two patients had normal HRCT. On the other hand, eight patients with normal PFT had abnormalities on HRCT. Conclusion: Patients with early AS frequently have abnormalities on HRCT, even though they have normal PFT and chest X-ray. Small airway involvement was found as frequent as interstitial lung disease in early AS.

  17. Coexistence of Ankylosing Spondylitis and Löfgren’s Syndrome

    Directory of Open Access Journals (Sweden)

    Senol Kobak

    2014-01-01

    Full Text Available A 46-year-old male patient diagnosed with ankylosing spondylitis presented to our polyclinic with complaints of pain, swelling, and limitation in joint mobility in both ankles and erythema nodosum skin lesions in both pretibial sites. The sacroiliac joint graphy and the MRI taken revealed active and chronic sacroiliitis. On the thorax CT, multiple mediastinal and hilar lymphadenopathies were reported. Mediastinoscopic excisional lymph node biopsy was taken and noncalcified granulomatous structures, lymphocytes, and histiocytes were determined on histopathological examination. The patients were diagnosed with ankylosing spondylitis, sarcoidosis, and Löfgren’s syndrome. NSAIDs, sulfasalazine, and low dose corticosteroid were started. Significant regression was seen in the patient’s subjective and laboratory assessments.

  18. Carbohydrate metabolism disorders in patients with rheumatoid arthritis and ankylosing spondylitis – impact of the severity of the inflammatory process and disease activity

    Directory of Open Access Journals (Sweden)

    Piotr Dąbrowski

    2014-03-01

    Full Text Available Carbohydrate metabolism disorders are much more common among rheumatoid arthritis (RA and ankylosing spondylitis (AS patients than in the general population. Chronic inflammation related to insulin resistance underlies the pathogenic mechanism of both rheumatoid disorders and diabetes. Interleukin-6 (IL-6 and tumour necrosis factor α (TNF-α as well as substances produced by adipose tissue, including free fatty acids, leptin, resistin, visfatin and adiponectin, play a crucial role in the development of insulin resistance. The data show that there is a strong relationship between high level of inflammatory markers and insulin resistance and higher risk of diabetes in patients with inflammatory rheumatic diseases. However, still other markers of disease activity are being sought, which could help to identify the patients with highest risk of impaired glucose tolerance. In the paper a literature overview has been presented concerning the assessment of risk of carbohydrate disorders among RA and AS patients and the disorders’ relationship with the intensity of non-specific inflammation and the disease activity.

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

    International Nuclear Information System (INIS)

    Windeyer, B.

    1976-01-01

    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) [de

  20. Ankylosing Spondylitis: Patterns of Spinal Injury and Treatment Outcomes

    OpenAIRE

    Altun, Idiris; Yuksel, Kas?m Zafer

    2016-01-01

    Study Design Retrospective review. Purpose We retrospectively reviewed our patients with ankylosing spondylitis (AS) to identify their patterns of spinal fractures to help clarify management strategies and the morbidity and mortality rates associated with this group of patients. Overview of Literature Because of the brittleness of bone and long autofused spinal segments in AS, spinal fractures are common even after minor trauma and often associated with overt instability. Methods Between Janu...

  1. 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 (TNFα 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.

  2. Coexistence of multiple sclerosis and ankylosing spondylitis: Report of four cases from Russia and review of the literature.

    Science.gov (United States)

    Fominykh, Vera; Shevtsova, Tatyana; Arzumanian, Narine; Brylev, Lev

    2017-10-01

    Multiple sclerosis is a chronic demyelinating disorder of the central nervous system. There are many cases of multiple sclerosis - like syndrome and demyelinating disorders in systemic lupus erythematosus, Sjogren disease, Behcet disease and other autoimmune conditions. Coexistence of ankylosing spondylitis and multiple sclerosis usually is rare but in this article we report 4 Russian patients with concomitant multiple sclerosis and ankylosing spondylitis diseases. None of these patients received anti-tumor necrosis factor alpha therapy prior to diagnosis of multiple sclerosis. Pathogenesis, diagnostic and treatment challenges are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. [Airway management in a man with ankylosing spondylitis].

    Science.gov (United States)

    Gil, S; Jamart, V; Borrás, R; Miranda, A

    2007-02-01

    We report a case of difficult airway management in a 41-year-old man with ankylosing spondylitis who was scheduled for total left hip replacement surgery. After several failed attempts to achieve regional anesthesia, we converted to general anesthesia with orotracheal intubation using a fiberoptic bronchoscope. Ankylosing spondylitis leads to fibrosis, ossification, and ankylosis along the spinal column and sacroiliac articulations. Cervical column and atlantooccipital articulation mobility are reduced and in severe cases the cervical vertebrae become fixed in a flexed position. This portion of the spine is also the most susceptible to fracture, particularly in hyperextension, an event that could lead to damage to the cervical spinal cord during maneuvers to manage the airway. Patients with this condition may also have temporomandibular joint involvement, further complicating airway management. We report the case of a patient with ankylosing spondylitis with fixation along the entire spine. The airway was managed by intubation with a fiberoptic bronchoscope. Spontaneous ventilation was maintained during the maneuver, and sedation was achieved with perfusion of remifentanil as the only anesthetic agent following failure of intradural anesthesia.

  4. Men's experiences of living with ankylosing spondylitis: a qualitative study.

    Science.gov (United States)

    Madsen, Mette; Jensen, Kim Vilbek; Esbensen, Bente Appel

    2015-03-01

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

  5. Carbohydrate metabolism disorders in patients with rheumatoid arthritis and ankylosing spondylitis – impact of treatment

    Directory of Open Access Journals (Sweden)

    Piotr Dąbrowski

    2014-06-01

    Full Text Available Chronic inflammation – the crucial pathogenic mechanism of rheumatoid arthritis and ankylosing spondylitis – is the main cause of accelerated atherosclerosis, insulin resistance and well-known consequences related to it. The conservative treatment of rheumatoid arthritis and ankylosing spondylitis may provide a significant influence on glucose metabolism. The paper is a literature overview concerning insulin resistance and impaired glucose metabolism during treatment with disease-modifying drugs including biologic DMARDs (disease-modifying antirheumatic drugs, corticosteroids and commonly used non-steroidal anti-inflammatory drugs (NSAID. It has been found that the risk of carbohydrate disorders among those patients is much lower after therapy with hydroxychloroquine, methotrexate and TNF blockers – particularly with infliximab. The NSAID may play an important protective role in reducing risk of diabetes. The recent data show, contrary to general opinion, the advantageous outcome for glucose metabolism after treatment with corticosteroids, especially in the early active stage of rheumatoid arthritis.

  6. Clinical feature and imaging findings of juvenile ankylosing spondylitis

    International Nuclear Information System (INIS)

    Zeng Hui; Liang Hongchang; Wang Weigang; Liu Hui; Huang Meiping; Zheng Junhui

    2003-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Alberto Daniel Rocha-Muñoz

    2015-01-01

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

  8. Enterobacterial involvement in the pathogenesis of secondary ankylosing spondylitis.

    Science.gov (United States)

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

    1988-01-01

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

  9. Odontoid pannus formation in a patient with ankylosing spondylitis causing atlanto-axial instability

    Science.gov (United States)

    Rajak, Rizwan; Wardle, Phil; Rhys-Dillon, Ceril; Martin, James C

    2012-01-01

    Ankylosing spondylitis is one of the commonest inflammatory diseases of the axial skeleton and can be complicated by atlanto-axial instability. This serious and likely underestimated complication can be easily overlooked. However, there are clear features which can help alert suspicion to initiate the appropriate investigations with imaging that is very effective at diagnosing and assessing this complication. The authors report an unusual case where odontoid pannus formation, akin to that seen in rheumatoid arthritis, was the underlying cause. PMID:22665557

  10. Serum Adipokines and Adipose Tissue Distribution in Rheumatoid Arthritis and Ankylosing Spondylitis. A Comparative Study

    OpenAIRE

    Toussirot, Éric; Grandclément, Émilie; Gaugler, Béatrice; Michel, Fabrice; Wendling, Daniel; Saas, Philippe; Dumoulin, Gilles

    2013-01-01

    Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are inflammatory rheumatic diseases that may modify body composition. Adipose tissue has the ability to release a wide range of products involved in physiologic functions, but also in various pathological processes, including the inflammatory/immune response. RA and AS are both associated with the development of cardiovascular complications. It is has been established that central/abdominal, and particularly intra-abdominal or visceral...

  11. Serum adipokines and adipose tissue distribution in rheumatoid arthritis and ankylosing spondylitis. A comparative study.

    OpenAIRE

    ERIC eTOUSSIROT; Emilie eGrandclement; Beatrice eGaugler; Fabrice eMichel; daniel eWendling; Philippe eSaas; Gilles eDumoulin; cic ebt

    2013-01-01

    Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are inflammatory rheumatic diseases that may modify body composition. Adipose tissue has the ability to release a wide range of products involved in physiologic functions, but also in various pathological processes, including the inflammatory/immune response. RA and AS are both associated with the development of cardiovascular complications. It is has been established that central/abdominal and particularly intra-abdominal or visceral ...

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

    International Nuclear Information System (INIS)

    Schmitt, E.; Wick, R.R.

    1983-01-01

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

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

    Science.gov (United States)

    Malinowski, Krzysztof Piotr; Kawalec, Paweł

    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.

  14. The role of biomechanical factors in ankylosing spondylitis: the patient’s perspective

    Directory of Open Access Journals (Sweden)

    R.C. Ansell

    2016-02-01

    Full Text Available Biomechanical factors including occupational joint physical stressing and joint injury have been linked to spondyloarthritis. We explored such factors in ankylosing spondylitis (AS. A retrospective, online survey was developed alongside the UK National Ankylosing Spondylitis Society (NASS. Questions on early entheseal symptoms, potential precipitating trauma, sporting activity, and physiotherapy were asked. A total of 1026 patients responded with 44% recalling an instance of injury or trauma as a potential trigger for their AS. After symptom onset, 55% modified sporting activities and 28% reported that the initial AS recommended exercises exacerbated symptoms. Patients report physical trauma, exercise and physiotherapy as potential triggers for AS symptoms. These findings further support the experimental evidence for the role of biomechanical factors in disease.

  15. THE RISK OF CORONARY ARTERY DISEASE DEVELOPMENT IN PATIENTS WITH ANKYLOSING SPONDYLITIS (BECHTEREW’S DISEASE AND PSORIATIC ARTHRITIS: A 10-YEAR PROSPECTIVE FOLLOW-UP STUDY

    Directory of Open Access Journals (Sweden)

    I. Z. Gaidukova

    2016-01-01

    Full Text Available Objective: assessment of coronary artery disease (CAD incidence among patients with ankylosing spondylitis (AS and psoriatic arthritis (PsA without manifestation of cardiovascular diseases.Materials and methods. We analyzed the data of 10-year prospective follow-up of the patient with AS (n = 278, psoriatic arthritis (n = 85 and healthy controls (n = 150 without any cardiovascular diseases. All groups were comparable in regard to cardiovascular risk factors. During these 10 years all new cases of CAD (verified by cardiologist in the study population were tracked.Results. New cases of CAD were fixed in 64 out of 278 patietns with AS and in 16 out of 150 controls (p = 0.0017. Using log-rank MantelCox test and logrank test for trend we demonstrated statistically significant differences in CAD incidence between patients without spondyloarthritis (SpA and patients with AS and PsA (p < 0,0001. The risk of CAD development was higher in PsA group than in the control group; relative risk was 4.16 (95 % confidence interval (CI 2.36–7.33, RR 6.1 (95 % CI 3.05–12.44 (p < 0.05. Increased risk of myocardial infarction was observed both in patients with AS (RR 4.98; 95 % CI 1.54–6.12 and patients with PsA (RR 5.2; 95 % CI 2.4–7.8 comparing to healthy controls. There was no significant difference between the AS-group and the control group in terms of risk of stenocardia development (p > 0.05.Conclusion. The risk of exertional stenocardia in patients with AS was not higher than that in individuals without SpA. However, patients with AS have higher risk of myocardial infarction than those without SpA. PsA patients have increased risk of CAD development comparing to healthy controls and individuals with AS.

  16. The abilities of golimumab in the therapy of ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Sh. F. Erdes

    2014-09-01

    Full Text Available The paper summarizes the data of the GO-RAISE trial evaluating the efficacy and tolerability of golimumab (GLM in patients with ankylosing spondylitis (AS. The trial was launched in 57 clinical centers of North America, Europe, and Asia in 2005. It enrolled 356 patients with high AS activity (BASDAI≥4 in whom previous and current therapies with nonsteroidal anti-inflammatory drugs (NSAIDs or disease-modifying anti-rheumatic drugs were ineffective. Group 1 patients received subcutaneous placebo; Group 2 had subcutaneous GLM 50 mg; Group 3 took GLM 100 mg every 4 weeks. Concomitant therapy with methotrexate, sulfasalazine, hydroxychloroquine, glucocorticoids, and NSAIDs was continued in previous doses. The investigators have concluded that GLM therapy in patients with AS gives rise to a rapid clinical and radiographic response that persists for a long time. Although no comparative trials of GLM versus other tumor necrosis factor-α (TNF-α inhibitors used to treat AS have conducted, the available data show that its efficacy and tolerability in these patients are similar to those of the TNF-α inhibitors already used in Russia. The GLM dose of 100 mg is noted to be worse tolerated than that of 50 mg with their practically equal clinical efficacy. The standard dose of GLM is 50 mg subcutaneously administered once monthly for all indications, including also for AS.

  17. The abilities of golimumab in the therapy of ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Sh. F. Erdes

    2014-01-01

    Full Text Available The paper summarizes the data of the GO-RAISE trial evaluating the efficacy and tolerability of golimumab (GLM in patients with ankylosing spondylitis (AS. The trial was launched in 57 clinical centers of North America, Europe, and Asia in 2005. It enrolled 356 patients with high AS activity (BASDAI≥4 in whom previous and current therapies with nonsteroidal anti-inflammatory drugs (NSAIDs or disease-modifying anti-rheumatic drugs were ineffective. Group 1 patients received subcutaneous placebo; Group 2 had subcutaneous GLM 50 mg; Group 3 took GLM 100 mg every 4 weeks. Concomitant therapy with methotrexate, sulfasalazine, hydroxychloroquine, glucocorticoids, and NSAIDs was continued in previous doses. The investigators have concluded that GLM therapy in patients with AS gives rise to a rapid clinical and radiographic response that persists for a long time. Although no comparative trials of GLM versus other tumor necrosis factor-α (TNF-α inhibitors used to treat AS have conducted, the available data show that its efficacy and tolerability in these patients are similar to those of the TNF-α inhibitors already used in Russia. The GLM dose of 100 mg is noted to be worse tolerated than that of 50 mg with their practically equal clinical efficacy. The standard dose of GLM is 50 mg subcutaneously administered once monthly for all indications, including also for AS.

  18. BONE METABOLISM AND ITS REGULATION IN PATIENTS WITH ANKYLOSING SPONDYLITIS

    Directory of Open Access Journals (Sweden)

    O. V. Bugrova

    2016-01-01

    Full Text Available Osteoporosis in ankylosing spondylitis (AS may exacerbate pain and functional disorders and increases the risk of fractures. The mechanisms  of its development in AS have not been adequately studied.Objective: to study bone mineral density (BMD  and its regulation in patients with AS.Subjects and methods. 70 patients (mean age, 43.2±9.2 years with a documented diagnosis of AS (mean disease duration, 17.1±7.8 years and a control group of 30 healthy individuals were examined. All the patients underwent estimation of BMD and the serum concentrations of osteocalcin,  CrossLaps, and key regulators of osteoclastogenesis, such as osteoprotegerin (OPG  and a receptor activator of nuclear factor kappa-B ligand (RANKL by an enzyme immunoassay. Results and discussion. In patients with AS, bone metabolism was characterized  by a decrease in bone formation and by some increase in bone tissue degradation especially in high AS activity. These patients showed the elevated levels of the major blocker of osteoclastogenesis OPG and the OPG/RANKL ratio, which can cause the process of ossification characteristic  of AS.

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

    Directory of Open Access Journals (Sweden)

    Nina Brodin

    2014-01-01

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

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

    International Nuclear Information System (INIS)

    Mlychkov, Kh.; Mlychkova, D.

    1989-01-01

    In 620 patients quantitative bone scintigraphy with 99m Tc 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 D 10 /sacrum, index L 4 /sacrum and index C 7 /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

  1. Foot Disability in Patients with Ankylosing Spondylitis: A Clinical and Ultrasonographic Assessment

    Directory of Open Access Journals (Sweden)

    Erkan Mesci

    2016-04-01

    Full Text Available Aim: The objective of this study was to perform a clinical and ultrasonographic assessment of foot disability and related factors among patients with ankylosing spondylitis. Material and Method: The study enrolled 40 patients diagnosed with ankylosing spondylitis (AS according to the modified New York criteria and 30 matched healthy controls. In addition to the assessments for Disease activity (BASDAI and functional status (BASFI, foot functioning was evaluated using the Foot Function Index (FFI and quality of life using the Ankylosing Spondylitis Quality of Life (ASQoL questionnaire. Thickness of plantar fascia (PF and Achilles tendon (AT, changes in echogenicity and presence of bone erosions, entesophytes and bursitis were examined using ultrasound. Results: The mean age of patients was 39.9 ± 10.4 years and median disease duration was 48 (1-288 months. Sixteen patients (40% had foot pain. Thirteen patients (32.5% had clinical evidence for enthesitis. Thirty patients (75% showed at least one pathological finding at ultrasonographic examination. Mean FFI score was higher in the AS group versus control group (p

  2. Overlap of Ankylosing Spondylitis and Systemic Lupus Erythematosus: A case report

    Directory of Open Access Journals (Sweden)

    Mahmood Akbaryan

    2016-04-01

    Full Text Available Ankylosing spondylitis is a typical, very heritable incendiary joint inflammation, influencing principally the spine and pelvis. Inflammatory arthritis in ankylosing spondylitis causes pain and stiffness and progressively leads to new bone formation and ankylosis (fusion of affected joints. Systemic lupus erythematosus (SLE, lupus is a highly complex and heterogeneous autoimmune disease that most often afflicts women in their child-bearing years. It is characterized by circulating self-reactive antibodies that deposit in tissues, including skin, kidneys, and brain, and the ensuing inflammatory response can lead to irreparable tissue damage. There are few reports of coexistence of Ankylosing spondylitis and Systemic lupus erythematosus which firmly emphasis on an overlap phenomenon between these two disorders. A 30 year old woman was admitted to our hospital due to signs of butterfly-shaped rash on her cheeks, which became prominent after exposure to sunlight and severe inflammatory low-back pain. About ten year earlier, AS had been diagnosed and treatment started with non-steroidal anti-inflammatory drug (NSAID. To the best of our knowledge, the present case is one of 10 reported cases of coexistence of these two disorders in English literature. The coexistence of these two diseases with different genetic backgrounds and clinical symptoms may implicate the importance of shared environmental factors.

  3. The role of MRI in early ankylosing spondylitis: emphasis on the sacroiliac and hip joints

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chul Min; Kang, Moo Song; Kim, Chang Soo; Chung, Chun Phil [Maryknoll Hospital, Busan (Korea, Republic of)

    1995-05-15

    In clinically suspected ankylosing spondylitis of sacroiliac (SIJ) and hip joints with normal or minimal secondary bone change in simple X-ray films, we evaluated the role of MRI in sacroiliac and hip joints. Authors evaluated 11 cases (36 joints; SIJ 14 hip 22) confirmed as ankylosing spondylitis by clinical, laboratory, and radiologic findings, and compared the detectability of involvement of joints by simple X-ray film and MRI. Authors analysed MR findings for the presence of pannus and its signal intensities (SI), change of articular cartilage, bony erosion and sclerosis, subchondral bone cysts, osteophytosis, bone marrow edema, joint effusion, adjacent soft tissue change, and contrast enhancement of pannus. MRI detected not only 20 joints (SIJ 11, hip 9) detected in simple X-ray, but also additional 7 joints (SIJ 3, hip 4). MRI depicted simultaneous involvement of SIJ and hip joints in 5 of 11 cases (SIJ 10 joints, hip 9 joints), and bilateral involvement of SIJ and hip joints in 4 among the 5 cases. MRI also demonstrated pannus, which were not detected in conventional films, as intermediate SI on T1WI and high SI on T2WI, in all 27 joints (SIJ 14, hip 13). Gd-DTPA enhanced T1WI revealed enhancement of pannus in 7 cases (17 joints). MRI was a valuable modality in evaluation of clinically suspected ankylosing spondylitis of SIJ or hip joints with normal or minimal secondary bone change in simple X-ray. Simultaneous evaluation of SIJ and hip joints is suggested in clinically suspected ankylosing spondylitis or other joint diseases.

  4. [Effects of balneotherapy on the reactants of acute inflammation phase in ankylosing spondylitis].

    Science.gov (United States)

    2009-01-01

    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. The aim of the research was to establish serum concentrations of C-reactive protein (CRP), alpha 1-acid glycoprotein (alpha 1-AGP), ceruloplasmine (CP) and erythrocyte sedimentation rate (SE) before and after the balneotherapy in ankylosing spondylitis. 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 "Niska Banja". All the patients received medications and balneotherapy (radioactive oligomineral baths, peloid, massage, kinesitherapy); the serum concentrations of CRP, al-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. After dosed balneotherapy, a significant decrease in the concentrations of CP (p balneotherapy efficiency in the treatment of ankylosing spondylitis.

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

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, E [Universitatsklinik Friedrichsheim, Frankfurt, West Germany; Ruckbeil, C; Wick, R R

    1983-01-01

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

  6. [Ankylosing spondylitis in Shantou: clinical experience in fifteen years].

    Science.gov (United States)

    Zeng, Q; Chen, S; Xu, J; Xiao, Z; Lin, L; Liu, Y; Huang, S; Xie, S

    1999-07-01

    To evaluate the clinical features of ankylosing spondylitis (AS) in Shantou area and improve the diagnostic level and therapeutic effect. Clinical and laboratory data, and the methods and effects of therapy were analyzed. Some patients were followed up. 94% of the cases had an insidious onset. Low back pain or discomfort, peripheral arthritis, positive "4" test and pressing tenderness over the sacroiliac joints and lumbar spine were the frequent symptoms and signs. The degree of sacroiliitis and involvement of hip and spine were related to the disease duration. However, hip joint involvement in juvenile onset AS did not relate to the disease duration. Some cases with disease duration as long as 16 years still remained at II of degree sacroiliitis. Clinical improvement was more obvious in the first two years of treatment. Although some patients came to a standstill condition after this period, yet the disease activity might still relapse with withdrawal of the treatment. The rate of adhering to the treatment for 1, 2, and over 5 years was 34.6%, 28.4%, and 10.3% respectively. The radiological changes frequently did not parallel with the clinical manifestations. Early diagnosis is of importance in improving the prognosis of AS and adherence to slow-acting anti-rheumatic drug therapy is beneficial in disease controlling. A follow up of more than 3 years is necessary to estimate the therapeutic efficacy, and the radiological change is the key indicator. AS is a heterogenic disease and the risk factors for prognosis should be further studied.

  7. Ankylosing Spondylitis and Posture Control: The Role of Visual Input

    OpenAIRE

    De Nunzio, Alessandro Marco; Iervolino, Salvatore; Zincarelli, Carmela; Di Gioia, Luisa; Rengo, Giuseppe; Multari, Vincenzo; Peluso, Rosario; Di Minno, Matteo Nicola Dario; Pappone, Nicola

    2015-01-01

    Objectives. To assess the motor control during quiet stance in patients with established ankylosing spondylitis (AS) and to evaluate the effect of visual input on the maintenance of a quiet posture. Methods. 12 male AS patients (mean age 50.1 ± 13.2 years) and 12 matched healthy subjects performed 2 sessions of 3 trials in quiet stance, with eyes open (EO) and with eyes closed (EC) on a baropodometric platform. The oscillation of the centre of feet pressure (CoP) was acquired. Indices of stab...

  8. Non-steroidal anti-inflammatory drugs (NSAIDs) for axial spondyloarthritis (ankylosing spondylitis and non-radiographic axial spondyloarthritis)

    NARCIS (Netherlands)

    Kroon, Feline P. B.; van der Burg, Lennart R. A.; Ramiro, Sofia; Landewé, Robert B. M.; Buchbinder, Rachelle; Falzon, Louise; van der Heijde, Désirée

    2015-01-01

    Axial spondyloarthritis (axSpA) comprises ankylosing spondylitis (radiographic axSpA) and non-radiographic (nr-)axSpA and is associated with psoriasis, uveitis and inflammatory bowel disease. Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as first-line drug treatment. To determine

  9. Correlation of serum MMP3 and other biomarkers with clinical outcomes in patients with ankylosing spondylitis: A pilot study

    Science.gov (United States)

    The studies aimed to assess a set of biomarkers for their correlations with disease activity/severity of patients with ankylosing spondylitis (AS). A total of 24 AS patients were treated with etanercept and prospectively followed for 12 weeks. Serum levels of TNF-alpha, IFN-gamma, TGF-beta, IL6, IL1...

  10. Efficacy and safety of adalimumab in ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Mounach A

    2014-08-01

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

  11. Ankylosing Spondylitis and Posture Control: The Role of Visual Input

    Directory of Open Access Journals (Sweden)

    Alessandro Marco De Nunzio

    2015-01-01

    Full Text Available Objectives. To assess the motor control during quiet stance in patients with established ankylosing spondylitis (AS and to evaluate the effect of visual input on the maintenance of a quiet posture. Methods. 12 male AS patients (mean age 50.1 ± 13.2 years and 12 matched healthy subjects performed 2 sessions of 3 trials in quiet stance, with eyes open (EO and with eyes closed (EC on a baropodometric platform. The oscillation of the centre of feet pressure (CoP was acquired. Indices of stability and balance control were assessed by the sway path (SP of the CoP, the frequency bandwidth (FB1 that includes the 80% of the area under the amplitude spectrum, the mean amplitude of the peaks (MP of the sway density curve (SDC, and the mean distance (MD between 2 peaks of the SDC. Results. In severe AS patients, the MD between two peaks of the SDC and the SP of the center of feet pressure were significantly higher than controls during both EO and EC conditions. The MP was significantly reduced just on EC. Conclusions. Ankylosing spondylitis exerts negative effect on postural stability, not compensable by visual inputs. Our findings may be useful in the rehabilitative management of the increased risk of falling in AS.

  12. Ankylosing Spondylitis and Posture Control: The Role of Visual Input

    Science.gov (United States)

    De Nunzio, Alessandro Marco; Iervolino, Salvatore; Zincarelli, Carmela; Di Gioia, Luisa; Rengo, Giuseppe; Multari, Vincenzo; Peluso, Rosario; Di Minno, Matteo Nicola Dario; Pappone, Nicola

    2015-01-01

    Objectives. To assess the motor control during quiet stance in patients with established ankylosing spondylitis (AS) and to evaluate the effect of visual input on the maintenance of a quiet posture. Methods. 12 male AS patients (mean age 50.1 ± 13.2 years) and 12 matched healthy subjects performed 2 sessions of 3 trials in quiet stance, with eyes open (EO) and with eyes closed (EC) on a baropodometric platform. The oscillation of the centre of feet pressure (CoP) was acquired. Indices of stability and balance control were assessed by the sway path (SP) of the CoP, the frequency bandwidth (FB1) that includes the 80% of the area under the amplitude spectrum, the mean amplitude of the peaks (MP) of the sway density curve (SDC), and the mean distance (MD) between 2 peaks of the SDC. Results. In severe AS patients, the MD between two peaks of the SDC and the SP of the center of feet pressure were significantly higher than controls during both EO and EC conditions. The MP was significantly reduced just on EC. Conclusions. Ankylosing spondylitis exerts negative effect on postural stability, not compensable by visual inputs. Our findings may be useful in the rehabilitative management of the increased risk of falling in AS. PMID:25821831

  13. Evaluating the reliability of Persian version of ankylosing spondylitis quality of life (ASQoL) questionnaire and related clinical and demographic parameters in patients with ankylosing spondylitis.

    Science.gov (United States)

    Fallahi, Sasan; Jamshidi, Ahmad Reza; Bidad, Katayoon; Qorbani, Mostafa; Mahmoudi, Mahdi

    2014-06-01

    Ankylosing spondylitis quality of life (ASQoL) is an instrument for assessing quality of life (QoL). The aims of this study were to assess the reliability of Persian version of ASQoL questionnaire and evaluation of QoL status and related factors in ankylosing spondylitis (AS). One hundred and sixty-three Iranian patients with AS who fulfilled modified New York criteria were enrolled. Patients were evaluated using questionnaires including demographic and clinical variables, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), fatigue, Bath AS Metrology Index, pain and ASQoL. Reliability and validity of Persian version of ASQoL were evaluated by test-re-test agreement, internal consistency and correlation with specific scales. Relationship of parameters with ASQoL was analyzed by multiple regression. Age, disease duration and ASQoL score (mean ± SD) were 37.74 ± 9.88, 14.49 ± 8.47 and 8.02 ± 5.28 years, respectively. Test-re-test reproducibility for ASQoL was good as assessed by intra-class correlation coefficient (ICC: 0.97, P educational level, r = -0.37). Persian version of ASQoL is a valid and reliable scale to assess QoL in AS. Function, fatigue, mood, hip mobility and education are the factors which should be noted to achieve the best QoL.

  14. Rosuvastatin-Induced Carotid Plaque Regression in Patients With Inflammatory Joint Diseases: The Rosuvastatin in Rheumatoid Arthritis, Ankylosing Spondylitis and Other Inflammatory Joint Diseases Study.

    Science.gov (United States)

    Rollefstad, S; Ikdahl, E; Hisdal, J; Olsen, I C; Holme, I; Hammer, H B; Smerud, K T; Kitas, G D; Pedersen, T R; Kvien, T K; Semb, A G

    2015-07-01

    Patients with rheumatoid arthritis (RA) and carotid artery plaques have an increased risk of acute coronary syndromes. Statin treatment with the goal of achieving a low-density lipoprotein (LDL) cholesterol level of ≤1.8 mmoles/liter (≤70 mg/dl) is recommended for individuals in the general population who have carotid plaques. The aim of the ROsuvastatin in Rheumatoid Arthritis, Ankylosing Spondylitis and other inflammatory joint diseases (RORA-AS) study was to evaluate the effect of 18 months of intensive lipid-lowering treatment with rosuvastatin with regard to change in carotid plaque height. Eighty-six patients (60.5% of whom were female) with carotid plaques and inflammatory joint disease (55 with RA, 21 with AS, and 10 with psoriatic arthritis) were treated with rosuvastatin to obtain the LDL cholesterol goal. Carotid plaque height was evaluated by B-mode ultrasonography. The mean ± SD age of the patients was 60.8 ± 8.5 years, and the median compliance with rosuvastatin treatment was 97.9% (interquartile range [IQR] 96.0-99.4). At baseline, the median number and height of the carotid plaques were 1.0 (range 1-8) and 1.80 mm (IQR 1.60-2.10), respectively. The mean ± SD change in carotid plaque height after 18 months of treatment with rosuvastatin was -0.19 ± 0.35 mm (P < 0.0001). The mean ± SD baseline LDL cholesterol level was 4.0 ± 0.9 mmoles/liter (154.7 ± 34.8 mg/dl), and the mean reduction in the LDL cholesterol level was -2.3 mmoles/liter (95% confidence interval [95% CI] -2.48, -2.15) (-88.9 mg/dl [95% CI -95.9, -83.1]). The mean ± SD LDL cholesterol level during the 18 months of rosuvastatin treatment was 1.7 ± 0.4 mmoles/liter (area under the curve). After adjustment for age/sex/blood pressure, no linear relationship between a reduction in carotid plaque height and the level of LDL cholesterol exposure during the study period was observed. Attainment of the LDL cholesterol goal of ≤1.8 mmoles/liter (≤70

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

    DEFF Research Database (Denmark)

    Pedersen, Susanne J; Sørensen, Inge J; Hermann, Kay-Geert A

    2010-01-01

    OBJECTIVES: To investigate construct validity and responsiveness of the novel ankylosing spondylitis disease activity score (ASDAS) in patients with spondyloarthritis (SpA). METHODS: In a 46 weeks prospective, longitudinal multi-center study of 60 SpA patients (80% men, median age 40 years (range...... 21-62)) treated with tumor-necrosis-factor-alpha (TNF-alpha) inhibitors (infliximab (n=41), etanercept (n=13), adalimumab (n=6)) responsiveness of ASDAS, conventional clinical measures of disease activity and treatment response, and the Berlin magnetic resonance imaging (MRI) sacroiliac joint (SIJ......) and lumbar spine inflammation scores were compared. RESULTS: After 22 weeks, 58.3% of the patients were clinical responders (50% or 20mm reduction in BASDAI). At baseline, clinical responders had significantly higher ASDAS (median 4.15 (range 1.98-6.04), p=0.008) compared with non-responders (2.99, 2...

  16. Disturbance of the muscoloskeletal system in juvenile ankylosing spondylitis and disease developed in the adulthood (involvement of spine and sacroiliac joints

    Directory of Open Access Journals (Sweden)

    Yehudina Ye.D.

    2018-03-01

    Full Text Available Background. Two forms of ankylosing spondylitis (AS are distinguished: juvenile and adult, depending on debut age of the disease. The diagnosis of juvenile AS (JAS is one of the most urgent problems in a pediatric rheumatology. The peculiarities of AS course that onsets in childhood and adulthood are manifested by differences in the nature of a spinal column disturbance. At the same time, the evolution of JAS in adulthood remains unexplored. The goals and objectives of research: to study clinical and X-ray symptoms of spondylopathy and sacroiliitis course, to assess their characteristics in the disease that onset in childhood and adulthood. Material and methods. 217 patients with AS (193 men and 24 women with an average age of 38 years were examined. The fast-progressing course of the disease was detected in 21% of cases, moderate and high degree of activity – in 79% of cases, the ІІ-ІІІ stage in 82%, and polyarthritis – in 65%. JAS was detected in 16% of cases (all boys, among them the third stage occurred twice more likely than among the other patients. Results. The clinical and radiologic signs of spondylopathy and sacroiliitis are observed in 95% and 97% of the total number of AS cases, respectively, among all patients with JAS lumbago was detected 4,3 times more frequently, sciatic muscles hypotrophy – 7,8 times, "the string symptom" - 2,9 times", the calcification of the spinal cord - 2,3 times, whereas the prevalence of spinal column injury, the severity of cervico-spondylopathy and sacroiliitis among patients with the disease debut in the adulthood is significantly greater, and the involvement in the process of the lumbar and thoracic spine are detected correspondingly twice as often and by 19%, occurrence of dorsalgia is 4 times as often, the limitation of body lateral bendover by 59%, while there are ambiguous dispersion-correlation links with extraarticular (systemic manifestations of the disease, and the high prevalence of

  17. Sacroiliitis in Ankylosing Spondylitis: Comparison with Multidetector Row CT and Plain Radiography

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Ji Youn; Joo, Kyung Bin; Choi, Byeong Kyoo; Ryu, Jeong Ah; Kim, Tae Hwan; Choi, Woo Jung [Hanyang University Hospital, Seoul (Korea, Republic of)

    2009-03-15

    The objective of our study was to compare multidetector row CT and the plain radiographs for making the diagnosis and grading the sacroiliitis that accompanies ankylosing spondylitis. We wanted to determine the role of multidetector row CT for the evaluation of the sacroilitis in patients with ankylosing spondylitis. One hundred ninety two patients with clinically suspected ankylosing spondylitis were evaluated by conventional radiography and multidetector row CT. Two musculoskeletal radiologists retrospectively analyzed the images, and they graded the sacroiliitis using the modified New York Criteria. Multidetector row CT demonstrated a significantly higher sensitivity (74.5%, 83.3%) than did plain radiography (59.9%, 66.7%) for detecting early sacroiliitis (p<0.05). Multidetector row CT showed a higher grade of sacroiliitis in 114 and 127 of 384 sacroiliac joints. Performing multidetector row CT rather than plain radiography for making the diagnoses of accompanying ankylosing spondylitis allows an early start of treatment with a subsequently improved prognosis

  18. Safety of Etoricoxib, Celecoxib, and Nonselective Nonsteroidal Antiinflammatory Drugs in Ankylosing Spondylitis and Other Spondyloarthritis Patients

    DEFF Research Database (Denmark)

    Kristensen, L E; Jakobsen, A K; Askling, J

    2015-01-01

    OBJECTIVE: Safety data regarding the use of etoricoxib and other nonsteroidal antiinflammatory drugs (NSAIDs) in ankylosing spondylitis (AS) and other spondyloarthritis (SpA) patients are rather limited. Our objective was to estimate and compare rates of gastrointestinal, renovascular, and cardio......OBJECTIVE: Safety data regarding the use of etoricoxib and other nonsteroidal antiinflammatory drugs (NSAIDs) in ankylosing spondylitis (AS) and other spondyloarthritis (SpA) patients are rather limited. Our objective was to estimate and compare rates of gastrointestinal, renovascular...

  19. Is magnetotherapy applied to bilateral hips effective in ankylosing spondylitis patients? A randomized, double-blind, controlled study.

    Science.gov (United States)

    Turan, Yasemin; Bayraktar, Kevser; Kahvecioglu, Fatih; Tastaban, Engin; Aydin, Elif; Kurt Omurlu, Imran; Berkit, Isil Karatas

    2014-03-01

    This double-blind, randomized controlled study was conducted with the aim to investigate the effect of magnetic field therapy applied to the hip region on clinical and functional status in ankylosing spondylitis (AS) patients. Patients with AS (n = 66) who were diagnosed according to modified New York criteria were enrolled in this study. Patients were randomly divided in two groups. Participants were randomly assigned to receive magnetic field therapy (2 Hz) (n = 35), or placebo magnetic field therapy (n = 31) each hip region for 20 min. Patients in each group were given heat pack and short-wave treatments applied to bilateral hip regions. Both groups had articular range of motion and stretching exercises and strengthening exercises for surrounding muscles for the hip region as well as breathing and postural exercises by the same physical therapist. These treatment protocols were continued for a total of 15 sessions (1 session per day), and patients were examined by the same physician at months 1, 3 and 6. Visual analogue scale (VAS) pain, VAS fatigue, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrologic Index (BASMI), DFI, Harris hip assessment index and Ankylosing Spondylitis Quality of Life scale (ASQOL) were obtained at the beginning of therapy and at month 1, month 3 and month 6 for each patient. There were no significant differences between groups in the VAS pain, VAS fatigue, morning stiffness, BASDAI, BASFI, BASMI, DFI, Harris hip assessment index and ASQoL at baseline, month 1, month 3 or month 6 (p > 0.05). Further randomized, double-blind controlled studies are needed in order to establish the evidence level for the efficacy of modalities with known analgesic and anti-inflammatory action such as magnetotherapy, particularly in rheumatic disorders associated with chronic pain.

  20. 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

  1. Risk of falls in patients with ankylosing spondylitis.

    Science.gov (United States)

    Dursun, Nigar; Sarkaya, Selda; Ozdolap, Senay; Dursun, Erbil; Zateri, Coskun; Altan, Lale; Birtane, Murat; Akgun, Kenan; Revzani, Aylin; Aktas, İlknur; Tastekin, Nurettin; Celiker, Reyhan

    2015-03-01

    Risk of vertebral fractures is increased in patients with ankylosing spondylitis (AS). The underlying mechanisms for the elevated fracture risk might be associated with bone and fall-related risks. The aims of this study were to evaluate the risk of falls and to determine the factors that increase the risk of falls in AS patients. Eighty-nine women, 217 men, a total of 306 AS patients with a mean age of 40.1 ± 11.5 years from 9 different centers in Turkey were included in the study. Patients were questioned regarding history of falls within the last 1 year. Their demographics, disease characteristics including Bath AS Disease Activity Index, Bath AS Metrology Index (BASMI), Bath AS Functional Index (BASFI), and risk factors for falls were recorded. The Short Physical Performance Battery (SPPB) test was used for evaluation of static and dynamic balance. Erythrocyte sedimentation rate, C-reactive protein, and 25-hydroxyvitamin D levels were measured. Forty of 306 patients reported at least 1 fall in the recent 1 year. The patients with history of falls had higher mean age and longer disease duration than did nonfallers (P = 0.001). In addition, these patients' BASMI and BASFI values were higher than those of nonfallers (P = 0.002; P = 0.000, respectively). We found that the patients with history of falls had lower SPPB scores (P = 0.000). We also found that the number of falls increased with longer disease duration and older age (R = 0.117 [P = 0.041] and R = 0.160 [P = 0.005]). Our results show that decreased SPPB scores were associated with increased number of falls (R = 0.183, P = 0.006). Statistically significant correlations were found between number of falls and AS-related lost job (R = 0.140, P = 0.014), fear of falling (R = 0.316, P = 0.000), hip involvement (R = 0.112, P = 0.05), BASMI (R =0.234, P = 0.000), and BASFI (R = 0.244, P = 0.000). Assessment of pain, stiffness, fatigue, and lower-extremity involvement as well as asking for a history of falls will

  2. Baseline factors that influence ASAS 20 response in patients with ankylosing spondylitis treated with etanercept.

    Science.gov (United States)

    Davis, John C; Van der Heijde, Désirée M F M; Dougados, Maxime; Braun, Jurgen; Cush, John J; Clegg, Daniel O; Inman, Robert D; de Vries, Todd; Tsuji, Wayne H

    2005-09-01

    To examine the baseline demographic and disease characteristics that might influence improvement as measured by the Assessment in Ankylosing Spondylitis Response Criteria (ASAS 20) in patients with ankylosing spondylitis (AS). A multicenter Phase 3 study was performed to compare the safety and efficacy of 24 weeks of etanercept 25 mg subcutaneous injection twice weekly (n = 138) and placebo (n = 139) in patients with AS. The ASAS 20 was measured at multiple time points. Using a significance level of 0.05, a repeated measures logistic regression model was used to determine which baseline factors influenced response in the etanercept-treated patients during the 24-week double blind portion of the trial. The following baseline factors were used in the model: demographic and disease severity variables, concomitant medications, extra-articular manifestations, and HLA-B27 status. The predictive capability of the model was then tested on the patients receiving placebo after they had received open-label etanercept treatment. Baseline factors that were significant predictors of an ASAS 20 response in etanercept-treated patients were C-reactive protein (CRP), back pain score, and Bath Ankylosing Spondylitis Functional Index (BASFI) score. Although clinical response to etanercept was seen at all levels of baseline disease activity, responses were consistently more likely with higher CRP levels or back pain scores and less likely with increased BASFI scores at baseline. Higher CRP values and back pain scores and lower BASFI scores at baseline were significant predictors of a higher ASAS 20 response in patients with AS receiving etanercept but predictive value was of insufficient magnitude to determine treatment in individual patients.

  3. Pregabalin for Opioid-Refractory Pain in a Patient with Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Konstantinos A. Kontoangelos

    2013-01-01

    Full Text Available Background. Ankylosing spondylitis (AS is a systemic inflammatory disease with chronic back pain as the most common presenting symptom. We present a case of a male patient with AS reporting symptoms of severe low back pain, buttock pain, and limited spinal mobility. After chronic treatment with opioids, we administered pregabalin at a dose of 300 mg as an analgesic agent while opioids were discontinued. Findings. Pain symptoms improved progressively, and opioids were gradually discontinued without any withdrawal symptoms reported. Conclusions. Pregabalin is potentially useful in the management of pain in patients with AS while effectively managing the discontinuation of opioid treatment.

  4. Virtual reality: towards a novel treatment environment for ankylosing spondylitis.

    Science.gov (United States)

    Li, Shijuan; Kay, Stephen; Hardicker, Nicholas R

    2007-01-01

    The objective of this paper is to outline the project that eventually seeks to visualize clinical knowledge found within the record; the immediate task being to create a model that can be deployed for therapeutic purposes. How therapies for a certain type of chronically ill patient can benefit from Virtual Reality (VR) tools is investigated. Ankylosing Spondylitis (AS) is selected as a test condition. VR is expected to provide a novel treatment environment for AS sufferers, in which they can relax, manage their pain and take part in the routine exercise more effectively and efficiently by using the VR tools. An integral part of this model's construction will be to elicit evaluative detail from the literature and the patients' perspective. The purpose is to understand the inevitable challenges facing this proposed intervention if the design prototype is to successfully move from the research domain and become an integral part of established therapeutic practice.

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

    Directory of Open Access Journals (Sweden)

    Stamenković 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, α 1-acid glycoprotein (α 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, α1-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, α1-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 α 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.

  6. 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.)

  7. THERAPEUTIC EXERCISE FOR PATIENTS WITH ANKYLOSING SPONDYLITIS: RECOMMENDATIONS AND REALITY

    Directory of Open Access Journals (Sweden)

    T. V. Dubinina

    2014-01-01

    Full Text Available Objective. To study how the patients with ankylosing spondylitis (AS follow recommendations for performing physi- cal exercises. Material and methods. To clarify the compliance of patients with AC to physical exercise, a special questionnaire was designed. The Exercise Benefits/Barriers Scale (EBBS was used to assess the perception of physical exercises. The study included 79 patients (the mean age of 34.5 ± 9.4 years with AS (diagnosed according to the New York criteria who have been treated at the clinic of V.A. Nasonova Research Institute of Rheumatology of the Russian Academy of Medical Sciences. Results. Of the 79 patients included in the study, 77.2% were doing therapeutic exercises; 41.0% of patients were doing them every day. 41.0% of the patients have received sets of exercises from the attending doctor, 41.0 % from the Internet, and 18.0% from other sources (brochures for patients or courses for patients with AS. The average total EEBS score was 114.2 ± 17.8 points; the benefits score was 87.1 ± 12.8; and the barriers score was 27.1 ± 5.0. The most frequent responses to question about the benefits of physical exercises were as follows: «They reduce the feeling of stress and tension» (90.6% and «They increase the muscle strength» (93.7%. «I am tired physically from doing exercises» (96.6% was the most common barrier to execution of physical exercises. Conclusion. Despite the positive perception of physical exercises, only 41.0% of the patients with AS have done them every day. The lack of information about exercises recommended for AS patients, the frequency of their use, the effect on the disease activity and functionality significantly limits the use of exercises by patients with AS. It remains unclear exactly, which sets of exercises are most effective and what regularity of exercises should be used to prevent impair- ment of the functions of the spine and joints. 

  8. Costs and quality of life of patients with ankylosing spondylitis in Hong Kong.

    Science.gov (United States)

    Zhu, T Y; Tam, L-S; Lee, V W-Y; Hwang, W W; Li, T K; Lee, K K; Li, E K

    2008-09-01

    To assess the annual direct, indirect and total societal costs, quality of life (QoL) of AS in a Chinese population in Hong Kong and determine the cost determinants. A retrospective, non-randomized, cross-sectional study was performed in a cohort of 145 patients with AS in Hong Kong. Participants completed questionnaires on sociodemographics, work status and out-of-pocket expenses. Health resources consumption was recorded by chart review. Functional impairment and disease activity were measured using the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), respectively. Patients' QoL was assessed using the Short Form-36 (SF-36). The mean age of the patients was 40 yrs with mean disease duration of 10 yrs. The mean BASDAI score was 4.7 and BASFI score was 3.3. Annual total costs averaged USD 9120. Direct costs accounted for 38% of the total costs while indirect costs accounted for 62%. Costs of technical examinations represented the largest proportion of total cost. Patients with AS reported significantly impaired QoL. Functional impairment became the major cost driver of direct costs and total costs. There is a substantial societal cost related to the treatment of AS in Hong Kong. Functional impairment is the most important cost driver. Treatments that reduce functional impairment may be effective to decrease the costs of AS and improve the patient's QoL, and ease the pressure on the healthcare system.

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

    DEFF Research Database (Denmark)

    Madsen, Ole Rintek; Egsmose, Charlotte

    2009-01-01

    Ankylosing spondylitis (AS) is an inflammatory disorder affecting the axial skeleton, peripheral joints, entheses and extra-articular sites. Patients with early disease, a higher level of erythrocyte sedimentation rate and/or peripheral arthritis might benefit from sulfasalazine. Otherwise...

  10. 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.

    Science.gov (United States)

    Schefte, David B; Hetland, Merete L

    2010-01-01

    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. 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. ICC ranged from 0.922 to 0.988 (P health when compared with the traditional paper form. Implementation of touch screens in clinical practice is feasible and patients need no instruction.

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

    Directory of Open Access Journals (Sweden)

    Hong-xia Xue

    2015-01-01

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

  12. [Muscular disorders associated with ankylosing spondylitis and their correction with the help of whole body cryotherapy].

    Science.gov (United States)

    Kulikov, A G; Tabiev, V I; Rassulova, M A

    2015-01-01

    The objective of the present study was to evaluate the possibilities for the correction of muscular disorders associated with ankylosing spondylitis and their correction with the help of whole body cryotherapy. The study included 55 patients randomly allocated to two groups. Group 1 was comprised of the patients treated with the use of the common mineral baths, physiotherapy, therapeutic physical exercises, spinal massage, and whole body air-cryotherapy. Group 2 contained the patients who were treated in a similar way with the exception of whole body cryotherapy; they served as controls. Muscular disorders were diagnosed by means of functional muscular testing. The study has demonstrated the high prevalence of muscular disorders in the patients suffering from ankylosing spondylitis. Moreover, it revealed the profile of such disorders associated with ankylosing spondylitis and showed significant correlation between the results of functional muscular testing, BASMI and BASFI indices as well as characteristics of chest excursions (pcryotherapy in comparison with the alternative therapeutic modalities employed in the present study. This therapeutic modality ensured the statistically more pronounced improvement of functional muscular testing parameters (pcryotherapy accounting for its corrective influence on the muscular disorders in the patients presenting with ankylosing spondylitis. It is concluded that the proposed approach can be recommended for the introduction in the combined therapeutic and rehabilitative treatment of muscular disorders associated with ankylosing spondylitis.

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

    Science.gov (United States)

    Xue, Hong-Xia; Fu, Wen-Yi; Cui, Hua-Dong; Yang, Li-Li; Zhang, Ning; Zhao, Li-Juan

    2015-05-01

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

  14. STEM CELL TRANSPLANTATION AS A POSSIBLE STRATEGY FOR TREATING STANDARD THERAPY-RESISTANT ANKYLOSING SPONDYLITIS

    Directory of Open Access Journals (Sweden)

    I. Z. Gaidukova

    2016-01-01

    Full Text Available The authors have analyzed the literature dealing with studies of the efficiency and safety of stem cell transplantation (SCT in patients with ankylosing spondylitis (AS through the electronic resources Pubmed and Medline by using the keywords «bone marrow transplantation», «hematopoietic stem cell transplantation», «ankylosing spondylitis», «autoimmune diseases», and «sacroiliac joint biopsy». The paper describes four cases of SCT in AS patients, including transplantation that was carried out in one patient with lymphoma concurrent with AS, in two AS patients without blood cancers, and in one patient with AS concurrent with myeloid leukemia. Drug-free remission was achieved in 3 cases: lymphoma concurrent with AS (n=1, AS concurrent with myeloid leukemia (n=1, and AS without comorbidities (n=1. In addition to an improvement in the course of AS, there were also two cases with clinical presentations of AS after SCT. The given cases show that SCT can be basically used to induce drug-free remission in patients with severe forms of standard therapy-resistant AS. However, the introduction of SCT in clinical practice needs to adjust the technique to the specific features of AS patients. 

  15. [Rehabilitation and outpatient physiotherapy in rheumatic disease patients. Results of cross-sectional studies of patients with rheumatoid arthritis or ankylosing spondylitis and rheumatologists].

    Science.gov (United States)

    Mau, W; Müller, A

    2008-11-01

    Rehabilitation and outpatient physiotherapy were investigated from the perspectives of patients suffering from rheumatoid arthritis (RA) or ankylosing spondylitis (AS) and of rheumatologists. In 2007, 204 outpatients with RA and 47 with AS at the Arthritis Center in Halle, Germany, and 117 rheumatologists from all over the country participated in two questionnaire surveys. Patients and rheumatologists gave predominantly positive judgements of physiotherapy, psychological interventions, and patient education programs. However, outpatient care including these interventions was judged to be mainly limited by fixed budgets and other formal restrictions. Even though these therapeutic options are part of (primarily inpatient) rehabilitation programs, the estimate of the need for multidisciplinary rehabilitation programs varied widely among the rheumatologists. Significant objections against rehabilitation include reluctance of the patients, administrative burden for the physicians, payers' rejections, and limited choice of rehabilitation clinic. Despite major functional limitations, a substantial portion of the patients received no multidisciplinary medical rehabilitation, outpatient physiotherapy, psychological interventions, or patient education. Recommendations for the improvement of care are derived from these data.

  16. MUSCLE RELAXANTS: ARE THEY NEEDED IN ANKYLOSING SPONDYLITIS?

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    T. V. Dubinina

    2016-01-01

    Full Text Available Guidelines for the treatment of ankylosing spondylitis (AS lack muscle relaxants. At the same time, the latter are used for combined therapy using nonsteroidal  anti-inflammatory drugs (NSAIDs  in 53.1% of patients in an outpatient  setting. No clear recommendations make the administration of these agents uncontrolled, on the one hand, and substantially restrict therapeutic  possibilities, on the other.Objective: to investigate the short-term effect and safety of using tolperisone hydrochloride  (THC,  Mydocalm®  in patients with AS during group therapeutic  exercise (TE.Subjects and methods. The investigation included 40 patients aged over 18 years with a valid diagnosis of AS who had been treated at the Clinic of the V.A. Nasonova Research Institute of Rheumatology and agreed to participate  in the study. All the patients were randomized  in a 1:1 ratio into two groups: 1 20 patients used NSAIDs in combination with TE; 2 20 patients received NSAIDs,  TE, and THC 450 mg/day. The groups were matched for age, gender, disease duration,  and functional impairments. Before and after completion  of the investigation, the investigators estimated BASDAI, BASFI, patient-rated numerical pain rating scale (NPRS, patient-rated TE performance  scores (NPRS, where 0 (very effective, 10 (ineffective, THC tolerance monitoring  (consideration of adverse events. Spinal motility was evaluated using BASMI and chest excursion measurement.Results and discussion. During TE, both groups showed a significant increase in the volume of movements (p < 0.03, when measuring chest excursion and carrying out modified Schober's test, a decrease in BASDAI (p < 0.01 and BASFI (p < 0.009, as well as a reduction  in patient-rated overall disease activity assessment (p < 0.02 as compared to the baseline values. At the same time the modified Schober test revealed that the increase in motility was significantly higher in Group 2 than in Group 1 (p < 0.05. During the

  17. Decreased Oxidative Stress in Male Patients with Active Phase Ankylosing Spondylitis Who Underwent Whole-Body Cryotherapy in Closed Cryochamber

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    Agata Stanek

    2018-01-01

    Full Text Available Objective. The aim of the study was to estimate the impact of whole body cryotherapy (WBC on oxidative stress when performed in a closed cryochamber on patients with ankylosing spondylitis (AS. Material and methods. The effect of ten WBC procedures lasting 3 minutes a day with a subsequent 60-minute session kinesiotherapy on oxidative stress in male AS patients (WBC group n=16 was investigated. To assess the disease activity, the Bath Ankylosing Spondylitis Diseases Activity Index (BASDAI and Bath Ankylosing Spondylitis Functional Index (BASFI were calculated. The WBC group was compared to the kinesiotherapy only (KT; n=16 group. The routine parameters of oxidative stress (antioxidant enzymatic and nonenzymatic antioxidant status, lipid peroxidation products, total oxidative status (TOS, and oxidative stress index (OSI were estimated one day before the beginning and one day after the completion of the research program. Results. After the completion of the treatment in the WBC group, a significant decrease of oxidative stress markers (TOS and OSI and a significant increase of total antioxidant status were observed. The erythrocyte activity of glutathione peroxidase, glutathione reductase decreased significantly in both groups, but the differences of activity of that enzymes prior to post treatment values (Δ in the KT group were significantly higher as compared to the WBC group. The activity of erythrocyte catalase and plasma ZnCu isoenzyme of superoxide dismutase showed a decreased tendency; erythrocyte total superoxide dismutase activity showed an increased tendency in the WBC group after the completion of the treatment. The BASDAI and BASFI decreased significantly in both groups, but the differences of value indexes prior to post treatment (Δ were significantly higher in the WBC than KT group. Conclusion. WBC performed in a closed cryochamber decreases oxidative stress and improves BASDAI and BASFI indexes in male patients during the active

  18. 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.)

  19. Leukocytoclastic Vasculitis in a Patient with Ankylosing Spondylitis

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    Senol Kobak

    2014-01-01

    Full Text Available A 26-year-old male patient presented to our rheumatology clinic with pain, swelling and limitation of movement in his right ankle, and also purpuric skin lesions in the lower extremity pretibial region. He was asked questions, and he said that he had been having chronic low back pain and morning stiffness for the last few years. His physical examination revealed that he had arthritis in his right ankle, purpuric skin lesions in pretibial regions of both legs, and bilateral FABERE/FADIR positivity. The sacroiliac joint imaging and MRI revealed bilateral sacroiliitis findings, and the lateral heel imaging revealed enthesitis. HLA-B27 was positive. Skin biopsy from lower skin lesions was reported to be consistent with leukocytoclastic vasculitis. Based on clinical, laboratory, radiological, and pathological examinations, the patient was diagnosed with ankylosing spondylitis and leukocytoclastic vasculitis. Administration of corticosteroid, salazopyrin, and nonsteroid anti-inflammatory medications was started. Notable clinical and laboratory regression was observed during his checks 3 months later.

  20. Improved CT imaging in diagnosis of ankylosing spondylitis

    International Nuclear Information System (INIS)

    Mai Yuanfeng; Sun Haixing; Ling Jian; Kuang Jianyi; Pan Ximin

    2006-01-01

    Objective: To evaluate the improved CT imaging of sacroiliac joint in diagnosis of ankylosing spondylitis (AS). Methods: 22 patients, diagnosed as AS by clinical and radiography, undertook both conventional and improved CT imaging. All images were comparatively studied. Results: With conventional CT imaging, in the 44 joints of 22 cases, unremarkable images were obtained in 3 cases; early stage AS was found in 15 joints of 9 cases; AS in progressive stage was revealed in 8 cases/16 joints, stabled AS was presented in 2 cases/4 joints. There were 23 joints in 12 cases diagnosed as early term by improved imaging, progressive staged AS was shown in 8 cases/16 joints as, stable AS was demonstrated in 2 cases/4 joints. Conclusion: The improved imaging is sensitive in the diagnosis of early staged AS, for the application of thin slice scan, which helps to reduce partial volume effect. Scanning along the longitudinal axis of the sacroiliac joint extends the observation of erosion of the joint surface. For progressive or stable staged AS, the alterations of bone and joint space are prominent, improved CT imaging is not superior to the conventional. (authors)

  1. Physical Activity and Exercise: Perspectives of Adults With Ankylosing Spondylitis.

    Science.gov (United States)

    O'Dwyer, Tom; McGowan, Emer; O'Shea, Finbar; Wilson, Fiona

    2016-05-01

    Exercise is a key component of the management of ankylosing spondylitis (AS). Despite numerous benefits, compliance with exercise programs is low. Little attention has been accorded to the experiences of individuals with AS toward physical activity (PA). This study aimed to explore the attitudes toward PA and exercise of adults with AS. A qualitative descriptive design using thematic analysis was used. Seventeen adults with AS participated in individual, semistructured interviews. Interviews were recorded, transcribed, coded and analyzed for themes and subthemes. Four themes emerged from the analysis: (1) benefits, (2) barriers, (3) motivation, and (4) strategies and enablers. Benefits included amelioration of symptoms, improvements in general health, and enhancement of quality of life. Subthemes of barriers to PA included lack of resources, negative attitudes to exercise, misinformation, and condition-related factors. Motivation to exercise was influenced by intrinsic and extrinsic factors. Participants proposed strategies to enhance PA participation and exercise engagement. Awareness of the benefits of PA appears insufficient to motivate individuals with AS to exercise; a number of factors influence individual motivation to exercise. Many perceived barriers to PA may be considered modifiable. Individually-tailored interventions, collaboratively developed by the individual and the healthcare professionals, were proposed as strategies for effective PA and exercise prescription.

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

    Energy Technology Data Exchange (ETDEWEB)

    Koivikko, M.P.; Kiuru, M.J.; Koskinen, S.K. [Helsinki Univ. Central Hospital, Toeoeloe Trauma Center (Finland). Dept. of Radiology

    2004-11-01

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

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

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    C. Campana

    2011-06-01

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

  4. Differences in clinical presentation of ankylosing spondylitis in men and women

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    Hossain Soleymani Salehabadi

    2016-10-01

    Full Text Available Background: Ankylosing spondylitis (AS is an inflammatory disease that mainly affects axial skeleton of the body and ankylosing spondylitis ligaments around the spine at the junction of the spine are inflamed, because the disease is progressive and can lead to significantly cause of disability and the studies could provide a mechanism for the early detection of the disease or help determine when to start treatment, the difference in clinical presentations of AS in men and women is indicative of potential effect of gender on severity of the disease. This study was conducted with the aim to investigate the effect of gender on severity of AS. Methods: In a cross-sectional study, one hundred and fifteen patients with ankylosing spondylitis who referred to Yazd Rheumatology Clinic between 2001 and 2013 were evaluated. Sampling was performed using non-random convenient method. The most important variables studied included demographic data, clinical presentation, radiographic stage of sacroiliac involvement, and laboratory data extracted from patients’ files and recorded in questionnaires. Results: Both groups according to age at diagnosis, presence of enteritis, peripheral joint involvement and laboratory data such as C-reactive protein (CRP, erythrocyte sedimentation rate (ESR and hemoglobin were matched. Inflammatory neck pain was more prevalent in men than in women (77.2% against 51.8%; P< 0.05. Sacroiliac radiographic study revealed stage 1 involvement in 11.3% of men and 37% of women (P= 0.009, and stage 4 in 27.2% of men and 3.7% of women (P< 0.001, with a significant difference. Conclusion: According to the results of the study, the time between age of onset and age at diagnosis, inflammatory pain in the neck and advanced stage in men than in women was higher. Although these findings suggest that gender may have an impact on the pattern and severity of AS but the time delay in diagnosis as a disease affecting the intensity and pattern should

  5. Construction and analysis of protein-protein interaction network correlated with ankylosing spondylitis.

    Science.gov (United States)

    Kanwal, Attiya; Fazal, Sahar

    2018-01-05

    Ankylosing spondylitis, a systemic illness is a foundation of progressing joint swelling that for the most part influences the spine. However, it frequently causes aggravation in different joints far from the spine, and in addition organs, for example, the eyes, heart, lungs, and kidneys. It's an immune system ailment that may be activated by specific sorts of bacterial or viral diseases that initiate an invulnerable reaction that don't close off after the contamination is recuperated. The particular reason for ankylosing spondylitis is obscure, yet hereditary qualities assume a huge part in this condition. The rising apparatuses of network medicine offer a stage to investigate an unpredictable illness at framework level. In this study, we meant to recognize the key proteins and the biological regulator pathways including in AS and further investigating the molecular connectivity between these pathways by the topological examination of the Protein-protein communication (PPI) system. The extended network including of 93 nodes and have 199 interactions respectively scanned from STRING database and some separated small networks. 24 proteins with high BC at the threshold of 0.01 and 55 proteins with large degree at the threshold of 1 have been identified. CD4 with highest BC and Closeness centrality located in the centre of the network. The backbone network derived from high BC proteins presents a clear and visual overview which shows all important regulatory pathways for AS and the crosstalk between them. The finding of this research suggests that AS variation is orchestrated by an integrated PPI network centered on CD4 out of 93 nodes. Ankylosing spondylitis, a systemic disease is an establishment of advancing joint swelling that generally impacts the spine. Be that as it may, it as often as possible causes disturbance in various joints a long way from the spine, and what's more organs. It's a resistant framework affliction that might be actuated by particular sorts

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

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    Han-qing HUANG

    2013-07-01

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

  7. Improvement of the clinical outcome in Ankylosing spondylitis by balneotherapy.

    Science.gov (United States)

    Yurtkuran, Merih; Ay, Alev; Karakoç, Yüksel

    2005-07-01

    This study is designed to show the efficacy of balneotherapy and balneotherapy (BT) + nonsteroid antiinflammatory drug (NSAID) use in Ankylosing spondylitis (AS) patients. In this prospective study, BT, BT+ NSAID and NSAID therapy in 61 patients with AS were evaluated by ASAS core set. BT group (21 patients) was treated only with BT for 20 min, once a day, 5 days a week, over a period of 3 weeks. BT+NSAID group (20 patients) was treated with 1000 mg naproxen as well as BT. NSAID group (20 patients) was treated with 1000 mg naproxen. All of the participants did respiratory and postural exercises for 20 min a day and for the whole study period. Each patient was evaluated on admission (before treatment), at the end of the therapy and 6 months after the treatment. At the end of the study, statistically significant improvement was observed in all the clinical parameters of the patients in BT (G1), BT+NSAID (G2) and NSAID (G3) groups. This significant symptomatic and clinical improvement was maintained even 6 months after the treatment. The changes from baseline to follow up were similar in G1 and G2 except duration of morning stiffness (DMS) and chest expansion (CE). Improvements in CE and DMS were better in G1 and G2, respectively. Improvements observed in G1 and G2 were superior to the improvements observed in G3 for the variables of morning pain, nocturnal pain, DMS, global well being of the patient, occiput-wall distance, CE, finger to floor distance and functional index. In Schober test, improvement observed in G1 was statistically superior to G3. We concluded that BT can be suggested as an effective symptomatic treatment modality in patients with AS. Furthermore, sufficient improvement in clinical parameters can be obtained by BT alone.

  8. The impact of ankylosing spondylitis on audiovestibular functions.

    Science.gov (United States)

    Kapusuz Gencer, Zeliha; Özkırış, Mahmut; Günaydın, Ilhan; Saydam, Levent

    2014-09-01

    In this study, we aimed to evaluate the audiovestibular functions in the patients with ankylosing spondylitis (AS). This prospective study was performed in collaboration by the Otolaryngology and Rheumatology Departments of Bozok University School of Medicine between May 1, 2012, and January 1, 2013. We studied 80 subjects consisting of 40 AS patients (37 men and 3 women) in whom the diagnosis confirmed by the criteria of New York and 40 healthy controls (35 men and 5 women). All participants were evaluated by routine audiologic (including tympanometric evaluation, pure-tone audiograms, speech tests) and vestibular studies (including spontaneous nystagmus, gaze, optokinetic, saccadic movements, smooth pursuit, caloric test and Dix-Hallpike tests). The tympanometric values did not show a statistically significant difference between the AS group and the healthy subjects (p > 0.05). At low frequencies (250, 500, 1,000, and 2,000 Hz) pure-tone audiologic evaluations also proved statistically non-significant results at mean air conduction thresholds (ACT) and bone conduction thresholds (BCT) between the AS and control groups (p > 0.05). At high frequencies (4,000, 6,000, and 8,000 Hz), the ACTs and BCTs in AS group were lower than control group which was statistically significant (p 0.05). The comparison of smooth pursuit and Dix-Hallpike tests reached statistical significance (p VNG) revealed central abnormalities in 7 patients (17.5 %), peripheral abnormalities in 16 patients (40 %), and mixed abnormalities in 3 patients (7.5 %). Our findings suggest a possible association between AS and audiovestibular system dysfunction. We assume that the hearing and vestibular disturbances in AS are more prevalent than previously recognized.

  9. 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...

  10. A Possible Role of Intestinal Microbiota in the Pathogenesis of Ankylosing Spondylitis

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    Lianjun Yang

    2016-12-01

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory disease primarily affecting the sacroiliac joints and the spine, for which the pathogenesis is thought to be a result of the combination of host genetic factors and environmental triggers. However, the precise factors that determine one’s susceptibility to AS remain to be unraveled. With 100 trillion bacteria residing in the mammalian gut having established a symbiotic relation with their host influencing many aspects of host metabolism, physiology, and immunity, a growing body of evidence suggests that intestinal microbiota may play an important role in AS. Several mechanisms have been suggested to explain the potential role of the microbiome in the etiology of AS, such as alterations of intestinal permeability, stimulation of immune responses, and molecular mimicry. In this review, the existing evidence for the involvement of the microbiome in AS pathogenesis was discussed and the potential of intestinal microbiome-targeting strategies in the prevention and treatment of AS was evaluated.

  11. Acute fulminant drug induced necrotizing pancreatitis in a patient with ankylosing spondylitis

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    Pablo Miramontes

    2015-03-01

    Full Text Available Drug-induced acute necrotizing pancreatitis is a rare adverse event, although it has been reported in association with different drugs, including non-steroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, and analgesic agents commonly used in rheumatology. In different reviews of the pancreotoxicity of drugs, infliximab and etanercept are mentioned among all medications implicated in drug-induced pancreatitis, but clinical cases of acute pancreatitis complicating treatment with these anti-TNF-α agents have been exceptionally reported. We describe a patient with ankylosing spondylitis treated with etanercept, who developed an acute fulminant necrotizing pancreatitis that resulted in death. Doctors should pay close attention to patients taking biologic drugs in which a complaint of abdominal pain lasting for several days with no apparent cause may require a prompt referral for medical consultation.

  12. MMP mediated type V collagen degradation (C5M) is elevated in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Veidal, S S; Larsen, D V; Chen, Xijuan

    2012-01-01

    Type V collagen has been demonstrated to control fibril formation. The aim of this study was to develop an ELISA capable of detecting a fragment of type V collagen generated by MMP-2/9 and to evaluate the assay as biomarker for ankylosing spondylitis (AS)....

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

    NARCIS (Netherlands)

    Boonen, A.; Chorus, A.; Miedema, H.; van der Heijde, D.; Landewé, R.; Schouten, H.; van der Tempel, H.; van der Linden, S.

    2001-01-01

    To investigate withdrawal from the labour force because of inability to work owing to ankylosing spondylitis (AS) and to determine the characteristics of patients with no job because of work disability attributable to AS. A postal questionnaire was sent to 709 patients with AS aged 16-60 years

  14. Effectiveness of preoperative planning in the restoration of balance and view in ankylosing spondylitis

    NARCIS (Netherlands)

    Pigge, R.R.; Scheerder, F.J.; Smit, T.H.; Mullender, M.G.; van Royen, B.J.

    2008-01-01

    Object. The object of this study was to assess the effectiveness of preoperative planning in the restoration of balance and view angle in patients treated with lumbar osteotomy in ankylosing spondylitis (AS). Methods. The authors prospectively analyzed 8 patients with a thoracolumbar kyphotic

  15. Why golimumab in the treatment of psoriatic arthritis, ankylosing spondylitis and rheumatoid arthritis?

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    M. Rossini

    2015-03-01

    Full Text Available Golimumab is an anti-TNF monoclonal antibody administred subcutaneously once a month and produced with an innovative technology that minimizes immunogenicity. This paper reviews and updates the main studies on the efficacy, safety and pharmacoeconomic aspects of treatment with golimumab of psoriatic arthritis, ankylosing spondylitis and rheumatoid arthritis.

  16. Validity of ankylosing spondylitis and undifferentiated spondyloarthritis diagnoses in the Swedish National Patient Register

    DEFF Research Database (Denmark)

    Lindström, U; Exarchou, S; Sigurdardottir, V

    2015-01-01

    OBJECTIVES: Epidemiological studies of spondyloarthritis (SpA), using ICD codes from the Swedish National Patient Register (NPR), offer unique possibilities but hinge upon an understanding of the validity of the codes. The aim of this study was to validate the ICD codes for ankylosing spondylitis...

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

    DEFF Research Database (Denmark)

    Pedersen, Susanne J; Chiowchanwisawakit, Praveena; Lambert, Robert G W

    2011-01-01

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

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

    DEFF Research Database (Denmark)

    Pedersen, Susanne J; Chiowchanwisawakit, Praveena; Lambert, Robert G W

    2011-01-01

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

  19. Spinal pseudo arthrosis in the ankylosing spondylitis: complications with infectious discytis simulation

    International Nuclear Information System (INIS)

    Galant, J.; Marti-Bonmarti, L.; Poyatos, C.; Martinez-Rodrigo, J.; Ferrer, M.D.

    1995-01-01

    A case is presented of radiological signs typical of spinal pseudo arthrosis in a patient with ankylosing spondylitis. The radiological signs (plain radiology, computerized tomography and magnetic resonance) are described, and the recognition of this disorder and its differentiation with respect to infectious spondilodiscitis is discussed. (Author) 11 refs

  20. Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial

    NARCIS (Netherlands)

    van Tubergen, A.; Landewé, R.; van der Heijde, D.; Hidding, A.; Wolter, N.; Asscher, M.; Falkenbach, A.; Genth, E.; Thè, H. G.; van der Linden, S.

    2001-01-01

    To determine the efficacy of combined spa-exercise therapy in addition to standard treatment with drugs and weekly group physical therapy in patients with ankylosing spondylitis (AS). A total of 120 Dutch outpatients with AS were randomly allocated into 3 groups of 40 patients each. Group 1 (mean

  1. Anxiety, Depression, Problem Solving and Stress Management in Patients with Ankylosing Spondylitis

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    Yasemin Özkan

    2018-04-01

    Full Text Available Objective: This study aims to determine anxiety, depression, self-esteem, stress management and problem solving skills in ankylosing spondylitis (AS patients compared to healthy subjects. Materials and Methods: The study involves 33 patients with AS according to the Modified New York Criteria and 31 healthy subjects as control group. A socio-demographic data form, the Hospital Anxiety and Depression Scale (HADS, the Rosenberg Self-Esteem Scale (RSES, the Problem Solving Inventory (PSI and the Coping Orientation to Problems Experienced (COPE scale were used to evaluate participants. Results: The mean ages of the patients and the control were 36.3±10.9 and 33.6±6.2 years respectively with no significant difference between the two groups (p>0.05. On the HADS scale, AS patients showed significantly higher anxiety and depression scores (p<0.05. AS patients had significantly lower self-esteem as determined by the RSES scores (p<0.05. When the study groups were compared using the PSI, a significant difference was observed only in the “approach-avoidance style” subscale. A positive correlation between Bath Ankylosing Spondylitis Disease Activity Index (BASDAI and RSES was reported and there was a very strong negative correlation between BASDAI and overall PSI scores. A negative correlation was found between humor, mental disengagement and behavioral disengagement and BASDAI scores (p<0.05. Conclusion: Being a chronic rheumatic disease, AS not only limits daily living activities due to its physical manifestations but also causes psychological problems such as depression ve anxiety. However, it does not seem to impair problem solving skills and the ability to cope with stress significantly. It might be helpful to evaluate AS patients using a holistic approach and to be aware of the factors that are associated with difficulties in their social interactions.

  2. MAGNETIC RESONANCE IMAGING DIAGNOSIS OF INFLAMMATORY CHANGES OF THE AXIAL SKELETON IN ANKYLOSING SPONDYLITIS

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    A. V. Smirnov

    2016-01-01

    Full Text Available As of now, magnetic resonance imaging (MRI ranks high in the early diagnosis of inflammatory changes in the musculoskeletal system. The uniqueness of MRI is that this diagnostic technique can detect the signs of active and inactive inflammation at the pre-radiological stage of the disease, i.e. before the onset of radiological symptoms of sacroiliitis and the formation of spinal syndesmophytes. At the same time there is evidence that there is a temporary association between active inflammation and the development of radiological changes in the joints.The detection of bone marrow edema in the subchondral portions of bone tissue is of great importance not only for diagnosing the disease and verifying inflammatory activity, but also for predicting the development of chronic arthritis, choosing a treatment option, and evaluating the efficiency of performed therapy.Based on their long-term experience, the authors provided explanations of the MRI pattern of active and inactive chronic sacroiliitis and spondylitis, which can considerably facilitate the early diagnosis of injury to the sacroiliac joints and vertebral column in patients with ankylosing spondylitis.

  3. Cancer mortality among patients with ankylosing spondylitis not given X-ray therapy

    International Nuclear Information System (INIS)

    Smith, P.G.; Doll, R.; Radford, E.P.

    1977-01-01

    The causes of death among 1021 patients with ankylosing spondylitis not treated with X-rays (the 'untreated' group) have been compared with (i) those expected in a population of similar age and sex subject to the national mortality rates for England and Wales over the same period and (ii) those observed in 14000 similar patients given deep X-ray therapy (the 'treated' group). The untreated patients with spondylitis were enrolled in Great Britain and Northern Ireland during the period 1935 to 57 and have been followed up to 1965. The men in both treatment groups appear to have had spondylitis of similar severity, as judged from their death rates from various causes, but the 'untreated' women appear to have had a milder form of the disease. The number of deaths from cancer in the untreated group was not greater than that expected from national death rates, and there was no death from leukaemia. In the treated series the number of deaths from leukaemia was significantly raised (P = 0.03) when compared with that among patients not treated with X-rays. Deaths from cancers of sites classified as 'heavily irradiated' were also higher in the treated group though this difference was not statistically significant. Thus the excess leukaemia mortality in the treated patients, and possibly also the excess from other cancers, is likely to be associated with the X-ray treatment rather than with the disease process itself. Death rates from causes other than cancer were similar among treated and untreated patients. It is likely that modern X-ray treatment with smaller fields and lower dosage will carry a smaller risk of induced malignancy. This risk must be balanced against the possible therapeutic advantages of radiation treatment, the extent of which can be determined only by controlled trials. (author)

  4. Radiographic measurement reliability of lumbar lordosis in ankylosing spondylitis.

    Science.gov (United States)

    Lee, Jung Sub; Goh, Tae Sik; Park, Shi Hwan; Lee, Hong Seok; Suh, Kuen Tak

    2013-04-01

    Intraobserver and interobserver reliabilities of the several different methods to measure lumbar lordosis have been reported. However, it has not been studied sofar in patients with ankylosing spondylitis (AS). We evaluated the inter and intraobserver reliabilities of six specific measures of global lumbar lordosis in patients with AS. Ninety-one consecutive patients with AS who met the most recently modified New York criteria were enrolled and underwent anteroposterior and lateral radiographs of whole spine. The radiographs were divided into non-ankylosis (no bony bridge in the lumbar spine), incomplete ankylosis (lumbar spines were partially connected by bony bridge) and complete ankylosis groups to evaluate the reliability of the Cobb L1-S1, Cobb L1-L5, centroid, posterior tangent L1-S1, posterior tangent L1-L5, and TRALL methods. The radiographs were composed of 39 non-ankylosis, 27 incomplete ankylosis and 25 complete ankylosis. Intra- and inter-class correlation coefficients (ICCs) of all six methods were generally high. The ICCs were all ≥0.77 (excellent) for the six radiographic methods in the combined group. However, a comparison of the ICCs, 95 % confidence intervals and mean absolute difference (MAD) between groups with varying degrees of ankylosis showed that the reliability of the lordosis measurements decreased in proportion to the severity of ankylosis. The Cobb L1-S1, Cobb L1-L5 and posterior tangent L1-S1 method demonstrated higher ICCs for both inter and intraobserver comparisons and the other methods showed lower ICCs in all groups. The intraobserver MAD was similar in the Cobb L1-S1 and Cobb L1-L5 (2.7°-4.3°), but the other methods showed higher intraobserver MAD. Interobserver MAD of Cobb L1-L5 only showed low in all group. These results are the first to provide a reliability analysis of different global lumbar lordosis measurement methods in AS. The findings in this study demonstrated that the Cobb L1-L5 method is reliable for measuring

  5. MR imaging features of foot involvement in ankylosing spondylitis

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

    2005-01-01

    Objective: To determine alterations of the soft tissue, tendon, cartilage, joint space, and bone of the foot using magnetic resonance (MR) imaging in ankylosing spondylitis (AS) patients. Materials and Method: Clinical and MR examination of the foot was performed in 23 AS patients (46 feet). Ten asymptomatic volunteers (20 feet) were studied on MR imaging, as a control group. MR imaging protocol included; T1-weighted spin-echo, T2-weighted fast-field echo (FFE) and fat-suppressed short tau inversion recovery (STIR) sequences in sagittal, sagittal oblique, and coronal planes using a head coil. Specifically, we examined: bone erosions, tendinitis (acute and chronic), para-articular enthesophyte, joint effusion, plantar fasciitis, joint space narrowing, soft tissue edema, bone marrow edema, enthesopathy in the Achilles tendon and plantar fascia attachment, subchondral signal intensity abnormalities (edema and sclerosis), tenosynovitis, retrocalcaneal bursitis, subchondral cysts, subchondral fissures, and bony ankylosis. Midfoot, hindfoot, and ankle were included in examined anatomic regions. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in 3 (13%) of the patients while frequency of involvement was 21 (91%) with MR imaging assessment. The MR imaging findings were bone erosions (65%), Achilles tendinitis (acute and chronic) (61%), para-articular enthesophyte (48%), joint effusion (43%), plantar fasciitis (40%), joint space narrowing (40%), subchondral sclerosis (35%), soft tissue edema (30%), bone marrow edema (30%), enthesopathy of the Achilles attachment (30%), subchondral edema (26%), enthesopathy in the plantar fascia attachment (22%), retrocalcaneal bursitis (22%), subchondral cysts (17%), subchondral fissures (17%), tendinitis and enthesopathy of the plantar ligament (13%), and bony ankylosis (9%). The most common involved anatomical region was the hindfoot (83%) following by midfoot (69% ) and ankle (22

  6. MR imaging features of foot involvement in ankylosing spondylitis

    International Nuclear Information System (INIS)

    Erdem, C. Zuhal; Sarikaya, Selda; Erdem, L. Oktay; Ozdolap, Senay; Gundogdu, Sadi

    2005-01-01

    Objective: To determine alterations of the soft tissue, tendon, cartilage, joint space, and bone of the foot using magnetic resonance (MR) imaging in ankylosing spondylitis (AS) patients. Materials and Method: Clinical and MR examination of the foot was performed in 23 AS patients (46 feet). Ten asymptomatic volunteers (20 feet) were studied on MR imaging, as a control group. MR imaging protocol included; T1-weighted spin-echo, T2-weighted fast-field echo (FFE) and fat-suppressed short tau inversion recovery (STIR) sequences in sagittal, sagittal oblique, and coronal planes using a head coil. Specifically, we examined: bone erosions, tendinitis (acute and chronic), para-articular enthesophyte, joint effusion, plantar fasciitis, joint space narrowing, soft tissue edema, bone marrow edema, enthesopathy in the Achilles tendon and plantar fascia attachment, subchondral signal intensity abnormalities (edema and sclerosis), tenosynovitis, retrocalcaneal bursitis, subchondral cysts, subchondral fissures, and bony ankylosis. Midfoot, hindfoot, and ankle were included in examined anatomic regions. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in 3 (13%) of the patients while frequency of involvement was 21 (91%) with MR imaging assessment. The MR imaging findings were bone erosions (65%), Achilles tendinitis (acute and chronic) (61%), para-articular enthesophyte (48%), joint effusion (43%), plantar fasciitis (40%), joint space narrowing (40%), subchondral sclerosis (35%), soft tissue edema (30%), bone marrow edema (30%), enthesopathy of the Achilles attachment (30%), subchondral edema (26%), enthesopathy in the plantar fascia attachment (22%), retrocalcaneal bursitis (22%), subchondral cysts (17%), subchondral fissures (17%), tendinitis and enthesopathy of the plantar ligament (13%), and bony ankylosis (9%). The most common involved anatomical region was the hindfoot (83%) following by midfoot (69% ) and ankle (22

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

    Science.gov (United States)

    Tran-Duy, An; Boonen, Annelies; van de Laar, Mart A F J; Franke, Angelinus C; Severens, Johan L

    2011-12-01

    To develop a modelling framework which can simulate long-term quality of life, societal costs and cost-effectiveness as affected by sequential drug treatment strategies for ankylosing spondylitis (AS). Discrete event simulation paradigm was selected for model development. Drug efficacy was modelled as changes in disease activity (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)) and functional status (Bath Ankylosing Spondylitis Functional Index (BASFI)), which were linked to costs and health utility using statistical models fitted based on an observational AS cohort. Published clinical data were used to estimate drug efficacy and time to events. Two strategies were compared: (1) five available non-steroidal anti-inflammatory drugs (strategy 1) and (2) same as strategy 1 plus two tumour necrosis factor α inhibitors (strategy 2). 13,000 patients were followed up individually until death. For probability sensitivity analysis, Monte Carlo simulations were performed with 1000 sets of parameters sampled from the appropriate probability distributions. The models successfully generated valid data on treatments, BASDAI, BASFI, utility, quality-adjusted life years (QALYs) and costs at time points with intervals of 1-3 months during the simulation length of 70 years. Incremental cost per QALY gained in strategy 2 compared with strategy 1 was €35,186. At a willingness-to-pay threshold of €80,000, it was 99.9% certain that strategy 2 was cost-effective. The modelling framework provides great flexibility to implement complex algorithms representing treatment selection, disease progression and changes in costs and utilities over time of patients with AS. Results obtained from the simulation are plausible.

  8. Multicenter validation of the value of BASFI and BASDAI in Chinese ankylosing spondylitis and undifferentiated spondyloarthropathy patients

    Science.gov (United States)

    Lin, Zhiming; He, Peigen; Gao, Jiesheng; Zuo, Xiaoxia; Ye, Zhizhong; Shao, Fengmin; Zhan, Feng; Lin, Jinying; Li, Li; Wei, Yanlin; Xu, Manlong; Liao, Zetao; Lin, Qu

    2009-01-01

    The objectives of this study were to evaluate the reliability of Bath ankylosing spondylitis functional index (BASFI) and Bath ankylosing spondylitis disease activity index (BASDAI) in Chinese ankylosing spondylitis (AS) and undifferentiated spondyloarthropathy (USpA) patients. 664 AS patients by the revised New York criteria for AS and 252 USpA patients by the European Spondyloarthropathy Study Group criteria were enrolled. BASDAI and BASFI questionnaires were translated into Chinese. Participants were required to fill in BASFI and BASDAI questionnaires again after 24 h. Moreover, BASDAI and BASFI were compared in AS patients receiving Enbrel or infliximab before and after treatment. For AS group, BASDAI ICC: 0.9502 (95% CI: 0.9330–0.9502, α = 0.9702), BASFI ICC: 0.9587 (95% CI: 0.9521–0.9645, α = 0.9789). For USpA group, BASDAI ICC: 0.9530 (95% CI: 0.9402–0.9632, α = 0.9760), BASFI ICC: 0.9900 (95% CI: 0.9871–0.9922, α = 0.9950). In the AS group, disease duration, occipital wall distance, modified Schober test, chest expansion, ESR, and CRP showed significant correlation with BASDAI and BASFI (all P < 0.01). In the USpA group, onset age, ESR, and CRP were significantly correlated with BASDAI (all P < 0.05), while modified Schober test, ESR, and CRP were significantly associated with BASFI (all P < 0.05). The change in BASDAI and BASFI via Enbrel or infliximab treatment showed a significant positive correlation (P < 0.01). The two instruments have good reliability and reference value regarding the evaluation of patient’s condition and anti-TNF-α treatment response. PMID:20012866

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

    DEFF Research Database (Denmark)

    Lukas, C; Braun, J; van der Heijde, D

    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...... the Ankylosing Spondylitis spine Magnetic Resonance Imaging-activity [ASspiMRI-a, grading activity (0-6) per vertebral unit in 23 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...

  10. The relationship between inflammation and new bone formation in patients with ankylosing spondylitis.

    Science.gov (United States)

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

    2008-01-01

    Spinal inflammation as detected by magnetic resonance imaging and new bone formation as identified by conventional radiographs are characteristic of ankylosing spondylitis. Whether and how spondylitis and syndesmophyte formation are linked are unclear. Our objective was to investigate whether and how spinal inflammation are associated with new bone formation in ankylosing spondylitis. Spinal magnetic resonance images and conventional radiographs from 39 ankylosing spondylitis patients treated with anti-tumour necrosis factor (anti-TNF) agents at baseline and after 2 years were analysed for syndesmophyte formation at vertebral edges with or without inflammatory lesions at baseline. Overall, 922 vertebral edges at the cervical and lumbar spine were analysed. At baseline, the proportion of vertebral edges with and without inflammation (magnetic resonance imaging) that showed structural changes (conventional radiographs) was similar (in total, 16.6% of all vertebral edges in 71.4% of patients). From the perspective of syndesmophyte formation (n = 26, 2.9%) after 2 years, there were more vertebral edges without (62%) than with (38%) inflammation at baseline (P = 0.03). From the perspective of spinal inflammation at baseline (n = 153 vertebral edges), more syndesmophytes developed at vertebral edges with (6.5%) than without (2.1%) inflammation (P = 0.002, odds ratio 3.3, 95% confidence interval 1.5 to 7.4). Inflammation persisted in 31% of the initially inflamed vertebral edges (n = 132), and new lesions developed in 8% of the vertebral edges without inflammation at baseline (n = 410). From the perspective of spinal inflammation after 2 years (n = 72 vertebral edges), 5.6% of the vertebral edges showed syndesmophyte development in contrast to 1.9% of the vertebral edges with new syndesmophytes without inflammation (P = 0.06). These findings obtained in patients treated with anti-TNF agents suggest linkage and some dissociation of inflammation and new bone formation in

  11. Work Productivity and Costs Related to Patients with Ankylosing Spondylitis, Rheumatoid Arthritis, and Psoriasis.

    Science.gov (United States)

    Kruntorádová, Klára; Klimeš, Jiří; Šedová, Liliana; Štolfa, Jiří; Doležal, Tomáš; Petříková, Alena

    2014-09-01

    To determine and compare the impact of rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriasis on work productivity, to calculate the productivity costs (PC), and to map out factors that influence (functional status and disease activity) work productivity. The Work Productivity and Activity Impairment questionnaire was used to evaluate productivity losses of patients with RA (n = 77), AS (n = 230), and psoriasis (n = 93). Demographic data, patient-reported outcomes (PROs) (Health Assessment Questionnaire [HAQ] and Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), and clinical parameters (Disease Activity Score in 28 joints [DAS28], body surface area [BSA], and Psoriasis Area and Severity Index [PASI]) were collected. The correlations among PROs, clinical parameters, and overall productivity loss were examined, and multiple regression models were used to examine relationships among parameters and productivity loss. PC were calculated using the friction cost approach. Mean patient age and disease duration were 47.1 and 15.7 years, respectively. The mean HAQ and DAS28 in patients with RA were 1.22 and 5.6, respectively. The mean BASDAI score in patients with AS was 4.43. The mean BSA and PASI score in patients with psoriasis were 21.1% and 12.9, respectively. The percentage of patients with psoriatic arthritis (in those with psoriasis) was 24.7%. We did not find significant differences in Work Productivity and Activity Impairment domains among various diagnoses. Patients with AS, RA, and psoriasis reported overall work productivity losses of 40.9%, 42.9%, and 42.8%, respectively. Daily activity impairments were approximately 50.0%. Overall work productivity loss strongly correlated with PROs, whereas correlations with clinical parameters were weak. The HAQ and BASDAI were identified as major predictors of productivity impairment. The greatest loss in productivity was in those with psoriatic arthritis; however, it was not significant. In

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

    Directory of Open Access Journals (Sweden)

    Nannini C

    2013-01-01

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

  13. [Efficacy and Safety Evaluation of Bushen Shuji Granule in Treating Ankylosing Spondylitis Patients: a Clinical Study].

    Science.gov (United States)

    Kong, Wei-ping; Tao, Qing-wen; Zhang, Ying-ze; Yang, Shu; Xu, Yuan; Zhu, Xiao-xia; Jin, Yue; Yang, Wen-xue; Yan, Xiao-ping

    2015-06-01

    To evaluate the short-term efficacy and safety of Bushen Shuji Granule (BSG) in treating ankylosing spondylitis (AS) patients. A prospective randomized controlled clinical trial was carried out in 62 active stage AS patients with Shen deficiency Du-channel cold syndrome (SDDCS), who were randomly assigned to the BSG group (treated with BSG) and the control group (treated with Celecoxib Capsule). Twelve weeks consisted of one therapeutic course. Therapeutic effects were evaluated by ASAS20 and ASAS40 (set by Assessments in Ankylosing Spondylitis working group) , BASDA150, Chinese medical (CM) syndrome efficacy evaluation standards. BASDAI, the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath AS Metrology Index (BASMI), scores for spine pain, scores for pain at night, patient global assessment (PGA) , erythrocyte sedimentation rate (ESR) , and C reactive protein (CRP) were observed before and after treatment. After three-month treatment by BSG, ASAS20 standard rate was 63. 33% (19/30 cases) in the BSG group and 66.67% (20/30 cases) in the control group with no significant difference between the two groups (χ2 = 0.073, P > 0.05). The efficacy for CM syndromes was 70.00% (21/30 cases) in the BSG group, higher than that in the control group [40.00% (12/30 cases), χ2 = 5.455, P channel strengthening, blood activating, and channels dredging method had good short-term clinical efficacy and safety in treating AS.

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

    International Nuclear Information System (INIS)

    Dale, K.; Vinje, O.

    1985-01-01

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

  15. Physical Activity in Ankylosing Spondylitis: evaluation and analysis of an eHealth tool

    Directory of Open Access Journals (Sweden)

    Jess Shelagh Tyrrell

    2016-07-01

    Full Text Available Background Ankylosing spondylitis (AS is a chronic inflammatory condition characterised by spinal arthritis and exercise is often recommended to reduce the symptoms and improve mobility. However, very little evidence exists for the value of exercise in AS. Objectives Firstly, this pilot study aimed to evaluate an eHealth tool, the AS Observer, specifically designed to monitor symptoms, quality of life and physical activity in AS, in terms of patient experience and suitability in generating data for epidemiological studies. Secondly, it also investigated the collected data to determine if physical activity benefited individuals with AS. Methods The AS Observer was designed to enable weekly monitoring of AS symptoms and exercise using a web based platform. Participants with AS (n = 223 were recruited to use the AS observer. They provided baseline data and completed online weekly data entry for 12 weeks (e.g. Bath Ankylosing Spondylitis Activity Index (BASDAI, howRu, International Physical Activity Questionnaire (IPAQ. Panel data analysis with fixed effects models investigated associations between variables. Activity type data and exit questionnaires were subjected to qualitative thematic analysis. Results In general, the AS Observer was well received and considered useful by participants, with 66% providing a positive response. The collected data suggested that IPAQ is inversely associated with total BASDAI, stiffness, tenderness and pain, but not fatigue. Stratified analysis demonstrated differential associations between BASDAI, IPAQ and howRU based on sex, HLA-B27 status and disease duration. Approximately half of the participants frequently did therapy and three-quarters undertook at least some vigorous activity ranging from formal exercise to recreation and (house work. Despite some technical challenges, tool evaluation suggested that the AS Observer was a useful self-monitoring tool for participants. Conclusions This pilot study demonstrated

  16. Inhibition of Klebsiella pneumoniae growth by selected Australian plants: natural approaches for the prevention and management of ankylosing spondylitis.

    Science.gov (United States)

    Winnett, V; Sirdaarta, J; White, A; Clarke, F M; Cock, I E

    2017-04-01

    A wide variety of herbal remedies are used in traditional Australian medicine to treat inflammatory disorders, including autoimmune inflammatory diseases. One hundred and six extracts from 40 native Australian plant species traditionally used for the treatment of inflammation and/or to inhibit bacterial growth were investigated for their ability to inhibit the growth of a microbial trigger for ankylosing spondylitis (K. pneumoniae). Eighty-six of the extracts (81.1%) inhibited the growth of K. pneumoniae. The D. leichardtii, Eucalyptus spp., K. flavescens, Leptospermum spp., M. quinquenervia, Petalostigma spp., P. angustifolium, S. spinescens, S. australe, S. forte and Tasmannia spp. extracts were effective K. pneumoniae growth inhibitors, with MIC values generally <1000 µg/mL. The T. lanceolata peppercorn extracts were the most potent growth inhibitors, with MIC values as low as 16 µg/mL. These extracts were examined by non-biased GC-MS headspace analysis and comparison with a compound database. A notable feature was the high relative abundance of the sesquiterpenoids polygodial, guaiol and caryophyllene oxide, and the monoterpenoids linalool, cineole and α-terpineol in the T. lanceolata peppercorn methanolic and aqueous extracts. The extracts with the most potent K. pneumoniae inhibitory activity (including the T. lanceolata peppercorn extracts) were nontoxic in the Artemia nauplii bioassay. The lack of toxicity and the growth inhibitory activity of these extracts against K. pneumoniae indicate their potential for both preventing the onset of ankylosing spondylitis and minimising its symptoms once the disease is established.

  17. Oral rehabilitation of a patient with temporomandibular joint ankylosis caused by ankylosing spondylitis: A case report

    Directory of Open Access Journals (Sweden)

    Brkić Zlata

    2017-01-01

    Full Text Available Introduction. Ankylosing spondylitis (AS/Morbus Bechterew is a chronic inflammatory rheumatoid disease. The temporomandibular joint (TMJ dysfunction is involved in 4–35% of AS cases, and is correlated to the severity and extension of AS. Even though AS-caused TMJ ankylosis is exceptional, one should have high index of suspicion of TMJ ankylosis in AS for an early detection, because it is an extremely serious and disabling condition that causes problems with mastication, swallowing, digestion, speech, appearance and poor oral hygiene with heavy caries. Case report. A 54-year-old male patient sought medical attention at the Department of Periodontology and Oral Medicine, Clinic for Dentistry at the Military Medical Academy, Belgrade, Serbia, with the chief complaint of pain in the area of the upper left canine in the presence of limited mouth opening. The treatment plan consisted of upper left canine management and rehabilitation of the remaining teeth in the frontal and the premolar region in both, the upper and lower jaw. Even though molar region needed to be treated, unfortunately it was not in the treatment plan because ankylosis of TMJ made the treatment impossible. Conclusions. The patients with AS-caused TMJ ankylosis are considered a diagnostic challenge to routine dentistry. Accent should be given to early diagnosis and multidisciplinary approach in the treatment of the AS patients towards the favorable disease course and outcome.

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

    Directory of Open Access Journals (Sweden)

    Serbulent Yigit

    2012-01-01

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

  19. [The relevance of ADC value, T₁intensive rate and the clinical activities in ankylosing spondylitis sacroiliitis].

    Science.gov (United States)

    Zhao, Yinghua; Han, Xinai; Hu, Shaoyong; Shi, Xingliang; Zhao, Jing; Sun, Erwei; Li, Shaolin

    2014-09-23

    To evaluate the value of judging for the activity in AS by diffusion-weighted sequences (DWI) and enhance sequences MRI(DCE-MRI), to explore the correlation of Apparent diffusion coefficient(ADC) values, intensive rate and the clinical activity index in sacroiliitis (SIJ) of ankylosing spondylitis (AS). 56 patients prospectively choiced and diagnosed were divided into two groupsas, active group (n = 32) and chronic group (n = 24) by rheumatologist according to BASDAI and laboratory parameters. Twenty healthy adults were as control group. The values of ADC and intensive rate of all sacroiliac joints (SIJs) were measured on MRI. BASDAI score were got by Bath ankylosing spondylitis disease activity index. ESR, CPR and were got by laboratory. Statisticaly to analysis whether the parameters were significantly different amang AS active, chronic, and the control group. To assess the correlation of the values of ADC, intensive rate and BASDAI score, ESR, CPR and in SIJ. the values of ADC and intensive rate were significantly different among AS active, chronic and the control group. There were the significant correlation between the values of ADC, intensive rate and BASDAI score. Diffusion-weighted sequences and Contrast-enhanced sequences is superior to other methods in judging the activity in AS.combined with clinical activity index, the accuracy can significantly be improved to explore whether the activities of AS are.

  20. Association between use of disease-modifying antirheumatic drugs and diabetes in patients with ankylosing spondylitis, rheumatoid arthritis, or psoriasis/psoriatic arthritis: a nationwide, population-based cohort study of 84,989 patients

    Directory of Open Access Journals (Sweden)

    Chen HH

    2017-05-01

    Full Text Available Hsin-Hua Chen,1–7 Der-Yuan Chen,1–6 Chi-Chen Lin,1,2 Yi-Ming Chen,1–4 Kuo-Lung Lai,3,4 Ching-Heng Lin1 1Department of Medical Research, Taichung Veterans General Hospital, 2Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, 3School of Medicine, National Yang-Ming University, Taipei, 4Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, 5School of Medicine, Chung-Shan Medical University, 6Department of Medical Education, Taichung Veterans General Hospital, Taichung, 7Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan Purpose: The aim of this study is to investigate the association between the use of disease-modifying antirheumatic drugs (DMARDs and diabetes mellitus (DM in patients with ankylosing spondylitis (AS, rheumatoid arthritis (RA, or psoriasis/psoriatic arthritis (PS/PSA.Patients and methods: This retrospective cohort study used a nationwide, population-based administrative database to enroll 84,989 cases with AS, RA, or PS/PSA who initiated treatment with anti-tumor necrosis factor (anti-TNF drugs or nonbiologic DMARDs. Multivariable analysis was used to estimate the effect of different therapies on the risk of DM.Results: The incidence rates of DM per 1,000 person-years were 8.3 for users of anti-TNF drugs, 13.3 for users of cyclosporine (CSA, 8.4 for users of hydroxychloroquine (HCQ, and 8.1 for users of other nonbiologic DMARDs. Compared with the users of nonbiologic DMARDs, the multivariate-adjusted hazard ratios (aHRs for DM were significantly lower for those who used anti-TNF drugs with HCQ (aHR: 0.49, 95% confidence interval [CI]: 0.36–0.66 and those who used HCQ alone (aHR: 0.70, 95% CI: 0.63–0.78, but not for those who used anti-TNFs without HCQ (aHR: 1.23, 95% CI: 0.94–1.60 or CSA (aHR: 1.14, 95% CI: 0.77–1

  1. Risk of malignancy in ankylosing spondylitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Deng, Chuiwen; Li, Wenli; Fei, Yunyun; Li, Yongzhe; Zhang, Fengchun

    2016-08-18

    Current knowledge about the overall and site-specific risk of malignancy associated with ankylosing spondylitis (AS) is inconsistent. We conducted a systematic review and meta-analysis to address this knowledge gap. Five databases (PubMed, EMBASE, Web of Science, the Cochrane library and the virtual health library) were systematically searched. A manual search of publications within the last 2 years in key journals in the field (Annals of the Rheumatic Diseases, Rheumatology and Arthritis &rheumatology) was also performed. STATA 11.2 software was used to conduct the meta-analysis. After screening, twenty-three studies, of different designs, were eligible for meta-analysis. AS is associated with a 14% (pooled RR 1.14; 95% CI 1.03-1.25) increase in the overall risk for malignancy. Compared to controls, patients with AS are at a specific increased risk for malignancy of the digestive system (pooled RR 1.20; 95% CI 1.01 to 1.42), multiple myelomas (pooled RR 1.92; 95% CI 1.37 to 3.69) and lymphomas (pooled RR 1.32; 95% CI 1.11 to 1.57). On subgroup analysis, evidence from high quality cohort studies indicated that AS patients from Asia are at highest risk for malignancy overall. Confirmation of findings from large-scale longitudinal studies is needed to identify specific risk factors and to evaluate treatment effects.

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

    International Nuclear Information System (INIS)

    Smith, P.G.; Doll, R.

    1982-01-01

    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)

  3. 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.

  4. Early diagnosis and treatment of ankylosing spondylitis in Africa and the Middle East.

    Science.gov (United States)

    Rachid, Bahiri; El Zorkany, Bassel; Youseif, Ehab; Tikly, Mohammed

    2012-11-01

    Ankylosing spondylitis (AS) is the prototype for spondyloarthritis primarily affecting young men. Geographic and ethnic variations exist in the prevalence and severity of AS and relate to the wide disparity in the frequency of human leukocyte antigen (HLA)-B27, a major genetic risk factor. The strength of the disease association with HLA-B27 is lower in most Arab populations (25-75 %) than in Western European populations (>90 %), and there is no association in sub-Saharan Africa, where the prevalence of HLA-B27 is Africa, and the high rate of spondyloarthropathies associated with human immunodeficiency virus infection. Diagnosis of AS is often delayed 8-10 years; potential reasons for the delay in Africa and the Middle East include low awareness among physicians and patients, the requirement for radiographic evidence of sacroiliitis for diagnosis, and limited access to magnetic resonance imaging in some countries. Treatment should be initiated early to prevent or reduce skeletal deformity and physical disability. Nonsteroidal anti-inflammatory drugs are effective first-line treatment and anti-tumor necrosis factor-α drugs are indicated for patients who have an inadequate response to first-line therapy. In Africa and the Middle East, such treatments may be precluded either by cost or contraindicated because of the high prevalence of latent tuberculosis infection. Research is sorely needed to develop cost-effective tools to diagnose AS early as well as effective, inexpensive, and safe treatments for these developing regions.

  5. Association of HLA-DP/DQ and STAT4 polymorphisms with ankylosing spondylitis in Southwest China.

    Science.gov (United States)

    Liu, Xinle; Yang, Bin; Li, Lixin; Cai, Bei; Liao, Yun; Li, Linhui; Wu, Zhiqiang; Wang, Lanlan

    2016-10-01

    Ankylosing spondylitis (AS) is a highly heritable complex inflammatory arthritis disease. Genetic factors are thought to be crucial in the pathogenesis of AS. However, few data are available on the relationship between HLA-DP/DQ and STAT4 polymorphisms and AS susceptibility in the Chinese population. Therefore, we examined HLA-DP/DQ and STAT4 polymorphisms (rs3077, rs9277535, rs7453920 and rs7574865) in a total of 779 subjects, including 400 AS and 379 age- and sex-matched healthy controls in Chinese. No significant difference was observed between AS patients and healthy controls in the allele frequency of rs3077, rs9277535 and rs7574865. However, there was a significant association between the HLA-DQ rs7453920 G/A variant and AS patients, with minor allele A correlated with a reduced risk of AS (allelic frequency, adjusted OR=0.66, 95% CI=0.55-0.78, p=4.0E-06; dominant model, adjusted OR=0.75, 95% CI=0.66-0.85, p=1.1E-05). Moreover, the haplotypes block AAA and GGA in the HLA gene significantly correlated with reduced risk of AS. This is the first study demonstrating the significant associations of SNP rs7453920 and the haplotypes in the HLA gene with the risk of AS in Southwest Chinese population. This research sheds new light on the significant relationship between HLA polymorphisms and AS. Copyright © 2016 Elsevier B.V. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-09-15

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

  7. 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.

  8. Tumour necrosis factor inhibitor treatment and occurrence of anterior uveitis in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Lie, Elisabeth; Lindström, Ulf; Zverkova-Sandström, Tatiana

    2017-01-01

    OBJECTIVES: Tumour necrosis factor-α inhibitor (TNFi) treatment has been shown to reduce the rates of anterior uveitis (AU) in patients with ankylosing spondylitis (AS). Our objective was to compare the effect of adalimumab (ADA), etanercept (ETN) and infliximab (IFX) on AU occurrence in AS, using...... obtained by linkage to the Swedish National Patient Register. For each TNFi, AU rates 2 years before TNFi start and for the first 2 years on TNFi treatment were compared. In the subgroup of patients who were AU-free during the 2 years before TNFi start, we also compared the risk of a first AU event...

  9. Efficacy of golimumab in treating uveitis in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    T. V. Dubinina

    2016-01-01

    Full Text Available The paper presents the results of recent studies of the efficacy of golimumab (GLM in the treatment of uveitis in patients with ankylosing spondylitis (AS. The data obtained in these studies suggest that GLM is highly effective in relieving and preventing uveitis attacks. However, all the given studies have a number of disadvantages; primarily they have included a limited number of patients. Further prospective randomized clinical trials with large sample sizes are required to evaluate the efficacy and safety of GLM for the treatment of uveitis in patients with spondyloarthritis.

  10. Temporomandibular joint ankylosis in ankylosing spondylitis: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Nishtha Gupta

    2016-01-01

    Full Text Available Ankylosing spondylitis (AS is a chronic systemic inflammatory disorder. It primarily affects the axial skeleton through involvement of the peripheral joint scan occurs. Temporomandibular joint (TMJ involvement in AS varies from 4% to 35%. Here, we present a case of a 35-year-old male, follow-up of AS from last 8 years on nonsteroidal anti-inflammatory drugs, presented with fresh complaints of painfully restricted movements of jaw during swallowing. Computer tomography of patient demonstrates articular cartilage changes with disc and joint abnormalities.

  11. Bone formation rather than inflammation reflects Ankylosing Spondylitis activity on PET-CT: a pilot study

    OpenAIRE

    Bruijnen, Stefan TG; van der Weijden, Mignon AC; Klein, Joannes P; Hoekstra, Otto S; Boellaard, Ronald; van Denderen, J Christiaan; Dijkmans, Ben AC; Voskuyl, Alexandre E; van der Horst-Bruinsma, Irene E; van der Laken, Conny J

    2012-01-01

    Introduction Positron Emission Tomography - Computer Tomography (PET-CT) is an interesting imaging technique to visualize Ankylosing Spondylitis (AS) activity using specific PET tracers. Previous studies have shown that the PET tracers [18F]FDG and [11C](R)PK11195 can target inflammation (synovitis) in rheumatoid arthritis (RA) and may therefore be useful in AS. Another interesting tracer for AS is [18F]Fluoride, which targets bone formation. In a pilot setting, the potential of PET-CT in ima...

  12. Anterior dural ectasia mimicking a lytic lesion in the posterior vertebral body in ankylosing spondylitis.

    Science.gov (United States)

    Bele, Keerthiraj; Pendharkar, Hima Shriniwas; Venkat, Easwer; Gupta, Arun Kumar

    2011-12-01

    Anterior dural ectasia is an extremely rare finding in ankylosing spondylitis (AS). The authors describe a unique case of AS in which the patient presented with cauda equina syndrome as well as an unusual imaging finding of erosion of the posterior aspect of the L-1 (predominantly) and L-2 vertebral bodies due to anterior dural ectasia. Symptomatic patients with long-standing AS should be monitored for the presence of dural ectasia, which can be anterior in location, as is demonstrated in the present case.

  13. Cauda equina syndrome complicating ankylosing spondylitis: use of electromyography and computerised tomography in diagnosis.

    Science.gov (United States)

    Young, A; Dixon, A; Getty, J; Renton, P; Vacher, H

    1981-06-01

    A case of the cauda equina syndrome complicating ankylosing spondylitis (AS) is described. An unusual feature of this case was the relapsing and remitting nature of the condition, but there is sufficient evidence to explain the clinical picture on the basis of a recurrent intraspinal inflammatory process. The clinical and radiological features are similar to those of a further 28 reported in the literature. An electromyogram (EMG) proved important in defining the extent of neurological involvement. Computerised tomography (CT) showed marked laminar erosion and no bony exit foramen encroachment. We believe that the clinical diagnosis of this condition can be adequately confirmed with plain radiology, EMG, and CT scan.

  14. A rare cause of dysphagia: compression of the esophagus by an anterior cervical osteophyte due to ankylosing spondylitis.

    Science.gov (United States)

    Albayrak, Ilknur; Bağcacı, Sinan; Sallı, Ali; Kucuksen, Sami; Uğurlu, Hatice

    2013-09-01

    Ankylosing spondylitis (AS) is a chronic inflammatory rheumatological disease affecting the axial skeleton with various extra-articular complications. Dysphagia due to a giant anterior osteophyte of the cervical spine in AS is extremely rare. We present a 48-year-old male with AS suffering from progressive dysphagia to soft foods and liquids. Esophagography showed an anterior osteophyte at C5-C6 resulting in esophageal compression. The patient refused surgical resection of the osteophyte and received conservative therapy. However, after 6 months there was no improvement in dysphagia. This case illustrates that a large cervical osteophyte may be the cause of dysphagia in patients with AS and should be included in the diagnostic workup in early stages of the disease.

  15. Serum Sclerostin as a Possible Biomarker in Ankylosing Spondylitis: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Fabio Massimo Perrotta

    2018-01-01

    Full Text Available Objective. Several molecules are involved in the pathogenesis of a new bone formation in ankylosing spondylitis (AS. The aim of this study was to evaluate the serum levels of sclerostin in patients with AS as a possible biomarker and to investigate any correlations with radiographic damage, disease activity, and function. Methods. AS patients fulfilled the modified New York criteria, and healthy controls were enrolled for this study. BASDAI, ASDAS-CRP, BASMI, BASFI, patient and physician VAS, and C-reactive protein were evaluated at baseline visit. Spinal damage was assessed using the mSASSS on radiographs performed within 3 months from baseline. Serum concentrations of sclerostin were assessed at baseline and after four months of therapy in patients who started an anti-TNF. Results. Twenty healthy subjects and 40 AS patients were enrolled in the study. In our group, serum sclerostin levels (median (25th–75th percentile were significantly higher in healthy controls (18.04 (13.6–24 pg/ml than in AS patients (6.46 (4.5–11.1 pg/ml; P value < 0.01. However, no significant correlations were found between serum sclerostin levels and radiographic damage, assessed by mSASSS, and between serum sclerostin levels and clinical indices of activity and disability or with laboratory parameters. Sclerostin levels did not show significant changes after 4 months of anti-TNF therapy. Conclusions. The results of our study suggest a possible role of sclerostin in the identification of AS patients. Further studies are needed to prove the role of sclerostin as a disease activity biomarker and progression of disease in AS.

  16. Clinical characteristics and frequency of TLR4 polymorphisms in Brazilian patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Natalia Pereira Machado

    Full Text Available ABSTRACT Objectives: Innate immunity is involved in the physiopathology of ankylosing spondylitis (AS, with the participation of Gram-negative bacteria, modulation of human leukocyte antigen (HLA B27 and the involvement of pattern recognition receptors, such as Toll-like receptors (TLRs. The aim of this study was to investigate the clinical characteristics and frequency of TLR4 polymorphisms (Asp299Gly and Thr 399Ile in a cohort of Brazilian patients with AS. Methods: A cross-sectional study was carried out involving 200 patients with a diagnosis of AS and a healthy control group of 200 individuals. Disease activity, severity and functional capacity were measured. The study of TLR4 polymorphisms was performed using the restriction fragment length polymorphism method. HLA-B27 was analyzed by conventional polymerase chain reaction. The IBM SPSS Statistics 20 program was used for the statistical analysis, with p-values less than 0.05 considered significant. Results: Mean age and disease duration were 43.1 ± 12.7 and 16.6 ± 9.2 years, respectively. The sample was predominantly male (71% and non-Caucasian (52%. A total of 66% of the group of patients were positive for HLA-B27. The sample of patients was characterized by moderate functional impairment and a high degree of disease activity. No significant association was found between the two TLR4 polymorphisms and susceptibility to AS. Conclusions: TLR4 polymorphisms 399 and 299 were not more frequent in patients with AS in comparison to the health controls and none of the clinical variables were associated with these polymorphisms.

  17. Association of IL1R polymorphism with HLA-B27 positive in Iranian patients with ankylosing spondylitis.

    Science.gov (United States)

    Mahmoudi, M; Amirzargar, A A; Jamshidi, A R; Farhadi, E; Noori, S; Avraee, M; Nazari, B; Nicknam, M H

    2011-12-01

    Ankylosing spondylitis (AS) is one of the most common causes of inflammatory arthritis, with an estimated prevalence of 0.1-0.9%. Genetic factors have been strongly implicated in its aetiology, and heritability as assessed by twin studies has been estimated to be >90%. HLA- B27 is almost essential for inheritance of AS; it is not merely sufficient for explaining the pattern of familial recurrence of the disease. This study's purpose is to investigate the association of ankylosing spondylitis with single-nucleotide polymorphisms (SNPs) in the IL-1 family: IL-1a (-889C/T) rs1800587, IL-1b (-511C/T) rs16944, IL-1b (+3962C/T) rs1143634, IL-1R (Pst-1 1970C/T) rs2234650 and IL-1RA (Mspa-1 11100C/T) rs315952. 99 unrelated Iranian AS patients and 217 healthy control subjects were selected. Cytokine typing was performed by the polymerase chain reaction with sequence-specific primers assay. The allele and genotype frequencies of the polymorphisms were determined: The IL1α rs1800587, IL1β rs16944 and IL1β rs1143634 were not significantly associated with AS. Genotype frequencies at IL1R rs2234650 differed between cases and controls (χ(2)=8.85; p=0.01); the IL1R rs2234650 C/T and T/T genotypes were less common in AS patients than controls. The IL1R rs2234650 C/T genotype was inversely associated with AS comparing with the IL1R rs2234650 C/C genotype (OR=0.48; p=0.005). IL1R rs2234650 C/T genotype was less common in patients than controls (OR=0.37; p=0.02).Furthermore IL1R rs2234650 T allele was strongly associated with HLA-B2702 patients rather than HLA-B2705 but was not associated with HLA-B27 negative patients (OR=0.33; p=0.01). Polymorphisms of IL1α rs1800587, IL1β rs16944 and IL1β rs1143634 were not significantly associated with ankylosing spondylitis but inversely in this study IL1R rs2234650 was significantly associated and carriage of T allele in IL1R rs2234650 seems to be protective, while carriage of C allele result in two fold higher risk of developing AS.

  18. TREATMENT IN PATIENTS WITH ANKYLOSING SPONDYLITIS IN THE REAL CLINICAL PRACTICE OF A RHEUMATOLOGIST IN RUSSIA

    Directory of Open Access Journals (Sweden)

    Sh F Erdes

    2013-01-01

    Full Text Available Objective: to analyze the treatment of ankylosing spondylitis (AS in the real practice of a rheumatologist in Russia. Subjects and methods. The cross-sectional study included 330 AS patients who had been actively seeking medical advice from rheumatologists during 4 months in 24 cities and towns of the Russian Federation. The therapy performed was studied using the medical history data recorded by physicians in the specially designed clinical chart. Drug intake, its regularity, reasons for discontinuation of medications, and their clinical effect were elucidated in all the patients. The need to intensify the therapy and to use genetically engineered biological agents was determined by disease activity at the time of examination. Results. The medical histories indicated that 62% of the patients received nonsteroidal anti-inflammatory drugs (NSAIDs regularly, 34% had them periodically, and 4% were not treated; two thirds of the patients took diclofenac, nimesulide, or meloxicam. 33, 14, and 9% of the patients used sulfasalazine, methotrexate, and oral glucocorticosteroids, respectively. Sixty (18% patients received tumor necrosis factor-α (TNF-α inhibitors. Different physiotherapeutic methods were used in 30% of cases; only 46% did exercises regularly; as high as 4% of the patients had sanatorium-and-spa treatment. In the physicians' opinion, 81% of the patients needed intensified therapy and 62% did therapy with TNF-α inhibitors. At the same time TNF-α inhibitors were indicated in 38% of the patients according to the ASAS recommendations. Conclusion. In real clinical practice, AS treatment does not always meet the current recommendations: only 62% of the patients received continuous NSAID therapy; disease-modifying antirheumatic drugs were frequently used without any indications. 18% of the patients took TNF-α inhibitors and 38% really needed them.

  19. Which aspects of functioning are relevant for patients with ankylosing spondylitis: results of focus group interviews.

    Science.gov (United States)

    Boonen, Annelies; van Berkel, Monique; Cieza, Alarcos; Stucki, Gerold; van der Heijde, Désirée

    2009-11-01

    To investigate whether concepts important to patients with ankylosing spondylitis (AS) are covered by disease-specific self-report health status instruments. A qualitative focus group study was conducted with AS patients on problems in daily functioning. Group sessions with 4 to 5 patients each were organized up to the point that no new information was brought forward. Group sessions were tape-recorded, transcribed, and divided into meaning units. Concepts contained in the meaning units were extracted. Self-report instruments on health status specific for AS were identified in a literature search. Using the International Classification of Functioning, Disability and Health (ICF) as a common reference, it was determined whether the concepts identified in the focus groups were covered by the instruments. Nineteen patients participated in 4 focus group interviews. In total, 332 unique meaning units were linked to 90 second-level ICF categories, of which 25 referred to body functions, 10 to body structures, 35 to activities and participation and 30 to environmental factors. In addition, several concepts relating to personal factors were identified. Only 47 categories were also covered by one of the self-report instruments in AS. Only a minority of concepts addressed by the AS-specific questionnaires were not revealed as relevant in the interviews. Relevant aspects of the influence of AS are not covered by the classic disease-specific instruments. In particular, the influence of AS on socializing and leisure and the relevance of environmental and personal factors are not adequately assessed by available instruments.

  20. Hypoparathyroidism in a patient with systemic lupus erythematosus coexisted with ankylosing spondylitis: a case report and review of literature.

    Science.gov (United States)

    Jiang, Lindi; Dai, Xiaomin; Liu, Jun; Ma, Lili; Yu, Fei

    2010-12-01

    Hypoparathyroidism is rare in patients with systemic lupus erythematosus (SLE). Here we describe a case of SLE coexisted with hypoparathyroidism and ankylosing spondylitis with definite diagnosis, and also give a review of past five cases of SLE with hypoparathyroidism. We find that hypoparathyroidism is easily ignored by subtle manifestations despite of its significant complications. More attention should be paid to clues to hypocalcemia, symptoms of central nervous system and prolonged QT interval on electrocardiogram. The three diseases may be coexistent of genetically determined markers. The cause of hypoparathyroidism in SLE patient is not clear. It may be independent of SLE. Copyright © 2010 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  1. Cardiovascular risk profiles in a hospital-based population of patients with psoriatic arthritis and ankylosing spondylitis

    DEFF Research Database (Denmark)

    Nissen, Christoffer B; Hørslev-Petersen, Kim; Primdahl, Jette

    2017-01-01

    The objective of the study was to investigate the frequency of traditional risk factors for the cardiovascular (CV) disease, to calculate the Systematic COronary Risk Evaluation (SCORE) for CV-related mortality in Danish patients with psoriatic arthritis (PsA) and ankylosing spondylitis (AS......), and to compare with results from patients with rheumatoid arthritis (RA) from the same settlement. All PsA and AS patients aged 18-85 years from one outpatient clinic were invited. A rheumatology nurse conducted 30-min screening consultation, preceded by a lipid and glucose profile. High SCORE risk led...... to recommendation of follow-up by general practitioners. Multiple and logistic regression analyses, adjusted for age and gender, were performed, to compare risk factors and risk SCOREs. Participants were 116 AS (29.3% female) and 170 PsA (54.7% female). AS had opposed PsA patients' lower 10-year risk SCOREs of CV...

  2. Quantitative scintigraphy of the sacroiliac joints and spinal column in patients with probable form of ankylosing spondylitis

    International Nuclear Information System (INIS)

    Mlychkov, Kh.; Andreev, T.

    1983-01-01

    Quantitative scintigraphy with sup(99m)Tc-pyrophos--phate was performed in 103 patients with probable form of ankylosing spondylitis and in a control group of 104 healthy individuals. Sacroiliac and spino-sacral indexes were determined in the patients by comparing small zones of interest of the spinal column, sacroiliac joints and the sacrum. A total of 634 indexes were determined: 293 in patients with probable form of ankylosing spondylitis and 341 in the control group of normal individuals. Comparison of the sacroiliac and spino-sacral indexes in the two groups showed that these indexes were raised in patients with probable form of ankylosing spondylitis, in contrast to the control group. The difference was statistically significant with a high level of significance (p 10 /sacrum and L 4 /sacrum. The difference between the C 7 /sacrum indexes in both groups of individuals had low significance level P=0.04. Repeated check up of patients with probable form of ankylosing spondylitis over a period of 2 to 5 years revealed that in the course of time the obligatory criteria for making a reliable diagnosis had been fulfilled in 15 patients. This is a proof of the high diagnostic value of quantitative scintigraphy of the sacroiliac joints and the spinal column. (authors)

  3. The effect of bisphosphonates on bone mineral density in patients with ankylosing spondylitis in daily clinical practice

    NARCIS (Netherlands)

    Arends, S.; Veneberg, J.G.; Wink, F.R.; Bos, R.; Brouwer, E.; Van Der Veer, E.; Bootsma, H.; Van Roon, E.N.; Maas, F.; Spoorenberg, A.

    2016-01-01

    Background: Ankylosing spondylitis (AS) is not only characterized by excessive bone formation, but also by excessive bone loss which may lead to low bone mineral density (BMD). So far, little is known about the effect of treatment with bisphosphonates on BMD in patients with AS. Objectives: To

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

    NARCIS (Netherlands)

    A. Tran-Duy (An); A. Boonen (Annelies); M.A.F.J. van de Laar (Mart); A. Franke (Andre); J.L. Severens (Hans)

    2011-01-01

    textabstractObjective: To develop a modelling framework which can simulate long-term quality of life, societal costs and cost-effectiveness as affected by sequential drug treatment strategies for ankylosing spondylitis (AS). Methods: Discrete event simulation paradigm was selected for model

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

    NARCIS (Netherlands)

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

    2011-01-01

    Objective To develop a modelling framework which can simulate long-term quality of life, societal costs and cost-effectiveness as affected by sequential drug treatment strategies for ankylosing spondylitis (AS). Methods Discrete event simulation paradigm was selected for model development. Drug

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

    NARCIS (Netherlands)

    van der Heijde, Désirée; Landewé, Robert; Hermann, Kay-Geert; Rudwaleit, Martin; Østergaard, Mikkel; Oostveen, Ans; O'Connor, Phil; Maksymowych, Walter P.; Lambert, Robert G.; Lukas, Cédric; Jurik, Anne Grethe; Boers, Maarten; Baraliakos, Xenofon; Braun, Jürgen

    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

  7. Diffusion-weighted Imaging Is a Sensitive and Specific Magnetic Resonance Sequence in the Diagnosis of Ankylosing Spondylitis.

    Science.gov (United States)

    Bradbury, Linda A; Hollis, Kelly A; Gautier, Benoît; Shankaranarayana, Sateesh; Robinson, Philip C; Saad, Nivene; Lê Cao, Kim-Anh; Brown, Matthew A

    2018-06-01

    We tested the discriminatory capacity of diffusion-weighted magnetic resonance imaging (DWI) and its potential as an objective measure of treatment response to tumor necrosis factor inhibition in ankylosing spondylitis (AS). Three cohorts were studied prospectively: (1) 18 AS patients with Bath Ankylosing Spondylitis Disease Activity Index > 4, and erythrocyte sedimentation rate > 25 and/or C-reactive protein > 10 meeting the modified New York criteria for AS; (2) 20 cases of nonradiographic axial spondyloarthritis (nr-axSpA) as defined by the Assessment of Spondyloarthritis international Society (ASAS) criteria; and (3) 20 non-AS patients with chronic low back pain, aged between 18 and 45 years, who did not meet the imaging arm of the ASAS criteria for axSpA. Group 1 patients were studied prior to and following adalimumab treatment. Patients were assessed by DWI and conventional magnetic resonance imaging (MRI), and standard nonimaging measures. At baseline, in contrast to standard nonimaging measures, DWI apparent diffusion coefficient (ADC) values showed good discriminatory performance [area under the curve (AUC) > 80% for Group 1 or 2 compared with Group 3]. DWI ADC values were significantly lower posttreatment (0.45 ± 0.433 before, 0.154 ± 0.23 after, p = 0.0017), but had modest discriminating capacity comparing pre- and posttreatment measures (AUC = 68%). This performance was similar to the manual Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system. DWI is informative for diagnosis of AS and nr-axSpA, and has moderate utility in assessment of disease activity or treatment response, with performance similar to that of the SPARCC MRI score.

  8. Clinical course and signs in patients with uveitis associated with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Refik Oltulu

    2013-09-01

    Full Text Available Aim: To evaluate clinical course and signs in patients withuveitis associated ankylosing spondylitis (AS.Methods: In this retrospective study we evaluated thepatients who were diagnosed as uveitis related to AS andfollowed up at the Ophthalmology Department of NecmettinErbakan University Hospital between May 2009 andJune 2012. Demographical features and clinical courseswere assessed.Results: Seventeen eyes of 13 patients were includedin the study. Nine patients (69.2% were male and four(30.8% were female. The mean age at presentation was38.54±9.61 years (range 28-63. Bilateral involvementwas observed in four (30.8% patients. The mean followuptime was 17.46±11.86 months (range 3-36. The meannumber of attacks was 1.15±0.37 (range 1-2. Posteriorsegment manifestation accompanied anterior uveitis inthree eyes (17.6%. Posterior synechia developed in one(7.7% and cataract in one patient (7.7%, cystoid macularedema in two patients (15.4%, and epiretinal membranein one patient (%7.7. The mean final visual acuitywas 0.975±0.07 (range 0.2-1.0.Conclusion: The prognosis of anterior uveitis associatedwith AS is good if the treatment is administered at theappropriate time. However, the posterior segment complicationsmay develop in these patients, treatment andfollow-up should be done in co-operation with the departmentof rheumatology.Key words: Ankylosing spondylitis, uveitis, rheumatology,clinical course

  9. {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.)

  10. Social Role Participation in Patients With Ankylosing Spondylitis: A Cross-Sectional Comparison With Population Controls.

    Science.gov (United States)

    van Genderen, Simon; Plasqui, Guy; Landewé, Robert; Lacaille, Diane; Arends, Suzanne; van Gaalen, Floris; van der Heijde, Désirée; Heuft, Liesbeth; Luime, Jolanda; Spoorenberg, Anneke; Gignac, Monique; Boonen, Annelies

    2016-12-01

    Participation in social roles for persons with chronic disease is important for their quality of life, but interpretation of the data on participation is difficult in the absence of a benchmark. This study aimed to compare social role participation in patients with ankylosing spondylitis (AS) to population controls using the Social Role Participation Questionnaire (SRPQ). There were 246 AS patients and 510 population controls who completed the SRPQ, which assesses participation in 11 roles (with scores ranging 1-5) across 4 dimensions (importance, satisfaction with performance, satisfaction with time, and physical difficulty), and additionally ranked their 3 most important roles. The ranking of role importance, the SRPQ dimension scores, and the gap between importance and satisfaction with performance of roles were compared between patients and controls. Patients (62% male; mean ± SD age 51 ± 12 years) and controls (70% male; mean ± SD 42 ± 15 years) ranked intimate relationships, relationships with children/stepchildren/grandchildren, and employment as the most important roles. Compared to controls, patients gave higher scores on the SRPQ to importance (3.75 versus 3.43), but reported lower satisfaction with performance (3.19 versus 3.58) and greater physical difficulty (3.87 versus 4.67) (P ≤ 0.05 for all). The largest differences in gaps between importance and satisfaction with performance for patients compared to controls were seen in the physical leisure, hobbies, and traveling and vacation categories, in which patients assigned higher importance but reported especially low satisfaction. As society places increasing emphasis on individual responsibility to participate fully in social roles, the current data suggest that health care providers should pay more attention to participation restrictions experienced by patients with AS. © 2016, American College of Rheumatology.

  11. Predicting pathway cross-talks in ankylosing spondylitis through investigating the interactions among pathways.

    Science.gov (United States)

    Gu, Xiang; Liu, Cong-Jian; Wei, Jian-Jie

    2017-11-13

    Given that the pathogenesis of ankylosing spondylitis (AS) remains unclear, the aim of this study was to detect the potentially functional pathway cross-talk in AS to further reveal the pathogenesis of this disease. Using microarray profile of AS and biological pathways as study objects, Monte Carlo cross-validation method was used to identify the significant pathway cross-talks. In the process of Monte Carlo cross-validation, all steps were iterated 50 times. For each run, detection of differentially expressed genes (DEGs) between two groups was conducted. The extraction of the potential disrupted pathways enriched by DEGs was then implemented. Subsequently, we established a discriminating score (DS) for each pathway pair according to the distribution of gene expression levels. After that, we utilized random forest (RF) classification model to screen out the top 10 paired pathways with the highest area under the curve (AUCs), which was computed using 10-fold cross-validation approach. After 50 bootstrap, the best pairs of pathways were identified. According to their AUC values, the pair of pathways, antigen presentation pathway and fMLP signaling in neutrophils, achieved the best AUC value of 1.000, which indicated that this pathway cross-talk could distinguish AS patients from normal subjects. Moreover, the paired pathways of SAPK/JNK signaling and mitochondrial dysfunction were involved in 5 bootstraps. Two paired pathways (antigen presentation pathway and fMLP signaling in neutrophil, as well as SAPK/JNK signaling and mitochondrial dysfunction) can accurately distinguish AS and control samples. These paired pathways may be helpful to identify patients with AS for early intervention.

  12. Ankylosing Spondylitis Increases Perioperative and Postoperative Complications After Total Hip Arthroplasty.

    Science.gov (United States)

    Blizzard, Daniel J; Penrose, Colin T; Sheets, Charles Z; Seyler, Thorsten M; Bolognesi, Michael P; Brown, Christopher R

    2017-08-01

    Ankylosing spondylitis (AS) is a chronic autoimmune spondyloarthropathy that primarily affects the axial spine and hips. Progressive disease leads to pronounced spinal kyphosis, positive sagittal balance, and altered biomechanics. The purpose of this study is to determine the complication profile of patients with AS undergoing total hip arthroplasty (THA). The Medicare sample was searched from 2005 to 2012 yielding 1006 patients with AS who subsequently underwent THA. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for 90-day, 2-year, and the final postoperative follow-up for complications including hip dislocation, periprosthetic fracture, wound complication, revision THA, and postoperative infection. Compared to controls, AS patients had an RR of 2.50 (CI, 1.04-5.99) of THA component breakage at 90-days post-operatively and 1.99 (CI, 1.10-3.59) at 2-years. The RR of periprosthetic hip dislocation was elevated at 90 days (1.44; CI, 0.93-2.22) and significantly increased at 2-years (1.67; CI, 1.25-2.23) and overall follow-up (1.49; CI, 1.14-1.93). Similarly, the RR for THA revision was elevated at 90-days (1.46; CI, 0.97-2.18) and significantly increased at 2-years (1.69; CI, 1.33-2.14) and overall follow-up (1.51; CI, 1.23-1.85). Patients with AS are at increased risk for complications after THA. Altered biomechanics from a rigid, kyphotic spine place increased demand on the hip joints. The elevated perioperative and postoperative risks should be discussed preoperatively, and these patients may require increased preoperative medical optimization as well as possible changes in component selection and position to compensate for altered spinopelvic biomechanics. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Serum adipokines and adipose tissue distribution in rheumatoid arthritis and ankylosing spondylitis. A comparative study.

    Directory of Open Access Journals (Sweden)

    ERIC eTOUSSIROT

    2013-12-01

    Full Text Available Rheumatoid arthritis (RA and ankylosing spondylitis (AS are inflammatory rheumatic diseases that may modify body composition. Adipose tissue has the ability to release a wide range of products involved in physiologic functions, but also in various pathological processes, including the inflammatory/immune response. RA and AS are both associated with the development of cardiovascular complications. It is has been established that central/abdominal and particularly intra-abdominal or visceral adiposity is closely linked to cardiovascular events. Thus, in this study, we aimed to evaluate the body composition of patients with RA or AS compared to healthy controls (HC with a special emphasis on the visceral region. In parallel, we measured adipose products or adipokines, namely leptin, adiponectin and its high molecular weight (HMW isoform, resistin, and ghrelin, a gastric peptide that plays a role in energetic balance. The homeostasis model assessment for insulin resistance (HOMA-IR and atherogenic index were used to evaluate cardiovascular risk. One hundred and twelve subjects were enrolled (30 patients with RA, 31 with AS and 51 HC. Body composition was measured using dual-energy X-ray absorptiometry (DXA to determine total fat mass and lean mass, adiposity, fat in the android and gynoid regions, and visceral fat. Patients and HC did not differ in terms of body mass index. On the contrary, adiposity was increased in RA (p= 0.01 while visceral fat was also increased, but only in women (p=0.01. Patients with AS tended to have lower total fat mass (p=0.07 and higher lean mass compared to HC (p = 0.07. Leptin and leptin/fat mass were decreased in male patients with AS (p

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

    Directory of Open Access Journals (Sweden)

    Helliwell Philip

    2009-06-01

    Full Text Available Abstract Background The Work Instability Scale for Rheumatoid Arthritis (RA-WIS is established and is used by physicians to identify patients at risk of job loss for rapid intervention. The study objective was to explore the concept of Work Instability (a mismatch between an individual's abilities and job demands in Ankylosing Spondylitis (AS and develop a Work Instability Scale specific to this population. Methods New items generated from qualitative interviews were combined with items from the RA-WIS to form a draft AS-WIS. Rasch analysis was used to examine the scaling properties of the AS-WIS using data generated through a postal survey. The scale was validated against a gold standard of expert assessment, a test-retest survey examined reliability. Results Fifty-seven participants who were in work returned the postal survey. Of the original 55 items 38 were shown to fit the Rasch model (χ2 37.5; df 38; p 0.494 and free of bias for gender and disease duration. Following analysis for discrimination against the gold standard assessments 20 items remained with good fit to the model (χ2 24.8; df 20; p 0.21. Test-retest reliability was 0.94. Conclusion The AS-WIS is a self-administered scale which meets the stringent requirements of modern measurement. Used as a screening tool it can identify those experiencing a mismatch at work who are at risk of job retention problems and work disability. Work instability is emerging as an important indication for the use of biologics, thus the AS-WIS has the potential to become an important outcome measure.

  15. The application of MR imaging in the detection of hip involvement in patients with ankylosing spondylitis

    International Nuclear Information System (INIS)

    Huang, Zhen-Guo; Zhang, Xue-Zhe; Hong, Wen; Wang, Guo-Chun; Zhou, Hui-Qiong; Lu, Xin; Wang, Wu

    2013-01-01

    Objective: To investigate the changes in hip MR imaging, evaluate the frequency of hip involvement and compare the value of clinical symptoms, radiographs, and MR imaging in the detection of hip involvement in patients with ankylosing spondylitis (AS). Methods: Anteroposterior radiographs of the pelvis, MR imaging of the hip and clinical evaluation were undertaken in 58 patients with definite AS. All patients were followed up 3 years. Annual radiographs and clinical evaluation were carried out. The imaging data were independently assessed by two experienced radiologists who were blinded to patient identity and clinical characteristics. Based on the Bath Ankylosing Spondylitis Radiology Hip Index (BASRI-hip) scoring system, BASRI-hip scores ≥2 were defined as radiological hip involvement. On MR imaging, both acute and chronic inflammatory changes were considered positive signs for hip involvement. Symptomatic hip involvement was defined as current or past pain or limitation of the hip movement. The statistical analysis was performed using the χ 2 test for comparison of sensitivity among clinical symptoms, radiographs, and MR imaging in the detection of hip involvement and the Student's t-test for comparison of disease duration between with and without hip involvement. A P value <0.05 was considered to be statistically significant. For interpreting MRI and radiographs, the percentage of agreement between the two assessors and the kappa coefficients were calculated. Results: On MR imaging, positive changes were detected in 86 (74.1%) hips among 116 hips in all 58 patients. Joint effusion was observed in 73 (62.9%) hips; 23 out of 27 patients who underwent fat-saturated contrast-enhanced T 1 -weighted sequences had abnormal synovial enhancement in bilateral hips. The other abnormal MR findings included subchondral bone marrow edema in 35 (30.2%) hips, enthesitis in 22 (19.0%) hips, fatty accumulation of the bone marrow in 28 (24.1%) hips, bone erosive

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

    International Nuclear Information System (INIS)

    Darby, S.C.; Doll, R.; Gill, S.K.; Smith, P.G.

    1987-01-01

    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)

  17. DIFFICULTIeS OF TOTAL HIP REPLACEMENT IN PATIENTS WITH ANKYLOSING SPONDYLITIS (case report

    Directory of Open Access Journals (Sweden)

    R. M. Tikhilov

    2016-01-01

    Full Text Available A distinctive feature of patients with ankylosing spondylitis is the formation of hip ankylosis in an extremely unfavorable functional position combined with upset of sagittal balance of the body along with a thoracolumbar kyphosis. Treatment of these patients poses considerable technical difficulties and is often associated with complications. The authors report a clinical case of a female 40 years old patient with confirmed rhizomelic spondylitis. The patient mainly complained of fixed malposition of the right lower extremity (hip ankylosis in extreme 1450 flexion and 1500 abduction combined with a severe fixed spine deformity (thoracic kyphosis 920, lumbar lordosis 170. Considering significant sagittal balance disorder it was decided to go for a two-stage procedure. Total hip arthroplasty of the right joint was performed at the first stage. At the second stage the authors corrected thoracolumbar spinal deformity by Th12 (type PSO 4 and L2 (type PSO 3 wedge resections and converging resected vertebral bodies by a multilevel fixation system with transpedicular support elements. The interval between the stages was 11 months. Two-stage treatment of this patient al-lowed to avoid adverse postoperative complications and to achieve a significant functional improvement in one year after treatment started. The sum of points before and after the treat-ment amounted respectively to 46 and 79 on Harris Hip Score, 17 and 38 points on Oxford Hip Score (OHS. To summarize, comprehensive treatment with planning of all subsequent steps prior to hip replacement is the method of choice for avoidance of postoperative complications in patients with ankylosing spondylitis accompanied by a significant upset of sagittal balance.

  18. Improvement of Lipid Profile Is Accompanied by Atheroprotective Alterations in High-Density Lipoprotein Composition Upon Tumor Necrosis Factor Blockade A Prospective Cohort Study in Ankylosing Spondylitis

    NARCIS (Netherlands)

    Eijk, van I.C.; Vries, de M.K.; Levels, J.H.M.; Peters, M.J.L.; Huizer, E.E.; Dijkmans, B.A.C.; Horst - Bruinsma, van der I.E.; Hazenberg, B.P.C.; Stadt, van de R.J.; Wolbink, G.; Nurmohamed, M.T.

    2009-01-01

    Objective. Cardiovascular mortality is increased in ankylosing spondylitis (AS), and inflammation plays an important role. Inflammation deteriorates the lipid profile and alters high-density lipoprotein cholesterol (HDL-c) composition, reflected by increased concentrations of serum amyloid A (SAA)

  19. Surgical anesthesia with a combination of T12 paravertebral block and lumbar plexus, sacral plexus block for hip replacement in ankylosing spondylitis: CARE-compliant 4 case reports.

    Science.gov (United States)

    Ke, Xijian; Li, Ji; Liu, Yong; Wu, Xi; Mei, Wei

    2017-06-26

    Anesthesia management for patients with severe ankylosing spondylitis scheduled for total hip arthroplasty is challenging due to a potential difficult airway and difficult neuraxial block. We report 4 cases with ankylosing spondylitis successfully managed with a combination of lumbar plexus, sacral plexus and T12 paravertebral block. Four patients were scheduled for total hip arthroplasty. All of them were diagnosed as severe ankylosing spondylitis with rigidity and immobilization of cervical and lumbar spine and hip joints. A combination of T12 paravertebral block, lumbar plexus and sacral plexus block was successfully used for the surgery without any additional intravenous anesthetic or local anesthetics infiltration to the incision, and none of the patients complained of discomfort during the operations. The combination of T12 paravertebral block, lumbar plexus and sacral plexus block, which may block all nerves innervating the articular capsule, surrounding muscles and the skin involved in total hip arthroplasty, might be a promising alternative for total hip arthroplasty in ankylosing spondylitis.

  20. Physical functioning in patients with ankylosing spondylitis: comparing approaches of experienced ability with self-reported and objectively measured physical activity.

    Science.gov (United States)

    van Genderen, Simon; van den Borne, Carlie; Geusens, Piet; van der Linden, Sjef; Boonen, Annelies; Plasqui, Guy

    2014-04-01

    Physical functioning can be assessed by different approaches that are characterized by increasing levels of individual appraisal. There is insufficient insight into which approach is the most informative in patients with ankylosing spondylitis (AS) compared with control subjects. The objective of this study was to compare patients with AS and control subjects regarding 3 approaches of functioning: experienced ability to perform activities (Bath Ankylosing Spondylitis Functional Index [BASFI]), self-reported amount of physical activity (PA) (Baecke questionnaire), and the objectively measured amount of PA (triaxial accelerometer). This case-control study included 24 AS patients and 24 control subjects (matched for age, gender, and body mass index). Subjects completed the BASFI and Baecke questionnaire and wore a triaxial accelerometer. Subjects also completed other self-reported measures on disease activity (Bath AS Disease Activity Index), fatigue (Multidimensional Fatigue Inventory), and overall health (EuroQol visual analog scale). Both groups included 14 men (58%), and the mean age was 48 years. Patients scored significantly worse on the BASFI (3.9 vs 0.2) than their healthy peers, whereas PA assessed by Baecke and the accelerometer did not differ between groups. Correlations between approaches of physical functioning were low to moderate. Bath Ankylosing Spondylitis Functional Index was associated with disease activity (r = 0.49) and physical fatigue (0.73) and Baecke with physical and activity related fatigue (r = 0.54 and r = 0.54), but total PA assessed by accelerometer was not associated with any of these experience-based health outcomes. Different approaches of the concept physical functioning in patients with AS provide different information. Compared with matched control subjects, patients with AS report more difficulties but report and objectively perform the same amount of PA.

  1. The effect of comedication with conventional synthetic disease modifying antirheumatic drugs on TNF inhibitor drug survival in patients with ankylosing spondylitis and undifferentiated spondyloarthritis

    DEFF Research Database (Denmark)

    Lie, Elisabeth; Kristensen, Lars Erik; Forsblad-d'Elia, Helena

    2015-01-01

    on patients with a clinical diagnosis of AS or uSpA starting treatment with adalimumab, etanercept or infliximab as their first TNFi during 2003-2010 were retrieved from the Swedish national biologics register and linked to national population based registers. Five-year drug survival was analysed by Cox......, and the associations were retained when adjusting for erythrocyte sedimentation rate, C-reactive protein, patient global, swollen joints, uveitis, psoriasis and inflammatory bowel disease. CONCLUSIONS: In this large register study of patients with AS and uSpA, use of csDMARD comedication was associated with better 5...

  2. Investigation of two novel biochemical markers of inflammation, matrix metalloproteinase and cathepsin generated fragments of C-reactive protein, in patients with ankylosing spondylitis

    DEFF Research Database (Denmark)

    Skjøt-Arkil, Helene; Schett, Georg; Zhang, Chen

    2012-01-01

    Ankylosing spondylitis (AS) is a chronic inflammation of the spine and the sacroiliac joints. Current markers of inflammation, such as C-reactive protein (CRP), are reflecting the production of an acute phase reactant rather than tissue specific inflammation, but the use of CRP as a diagnostic...... and prognostic marker for AS has not provided the sought accuracy and specificity. We hypothesized that local enzymatic activity in the disease-affected tissue, which is associated with extensive tissue turnover may, by cleavage, modify the CRP produced in the liver. These cleavage products may provide...

  3. Chronic low backache and stiffness may not be due ankylosing spondylitis.

    Science.gov (United States)

    Ahmed, Shahid; Shah, Zahir; Ali, Nadir

    2010-08-01

    A 38 years old man presented with 2 years history of low backache and progressively increasing stiffness of the spine. Movements were restricted at lumbar spine due to stiffness especially forward flexion was markedly reduced. He was suspected to be suffering from ankylosing spondylitis. There was no tenderness over sacroiliac joints or lumbar spine. Yellowish green Ochronotic pigmentation of cartilage of ears was noted. Radiographs of lumbar and thoracic spine revealed narrowing of inter-vertebral spaces with calcification of intervertebral discs. Homogentisic acid was present in the patient's urine sample, suggesting him to be suffering from Alkaptonuria. Patient is being managed with non steroidal anti-inflammatory drugs and vitamin C, 1g daily.

  4. THE POSSIBILITIES AND RESULTS OF INDIRECT COMPARISON OF BIOLOGICAL AGENTS IN ANKYLOSING SPONDYLITIS

    Directory of Open Access Journals (Sweden)

    Sh. F. Erdes

    2016-01-01

    Full Text Available The paper analyzes two matching-adjusted indirect comparison-based investigations of the efficacy of adalimumab (ADA and secukinumab (SCM in active ankylosing spondylitis, which have been recently reported at the EULAR Congress (London, 2016. One study sponsored by AbbVie was conducted to determine the short-term (16-week comparative clinical and economic efficacy of the test drugs and the other was supported by Novartis to reveal long-term (52-week, only clinical efficacy. Both studies have shown that the short-term efficacy ofADAand SCM is practically similar; however, the latter has a better long-term clinical efficacy. A pharmacoeconomic analysis of both drugs used during the first 12 weeks has demonstrated some advantage ofADA. 

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

    DEFF Research Database (Denmark)

    Lukas, Cédric; Braun, Jürgen; van der Heijde, Désirée

    2007-01-01

    = 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 in 23 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......) 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...

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

    DEFF Research Database (Denmark)

    Lukas, Cédric; Braun, Jürgen; van der Heijde, Désirée

    2007-01-01

    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...... 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...... the Ankylosing Spondylitis spine Magnetic Resonance Imaging-activity [ASspiMRI-a, grading activity (0-6) per vertebral unit in 23 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...

  7. Adverse events of anti-tumor necrosis factor α therapy in ankylosing spondylitis.

    Directory of Open Access Journals (Sweden)

    Qiang Tong

    Full Text Available This study aims to investigate the prevalence of short-term and long-term adverse events associated with tumor necrosis factor-α (TNF-α blocker treatment in Chinese Han patients suffering from ankylosing spondylitis (AS.The study included 402 Chinese Han AS patients treated with TNF-α 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-α blockers.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%; 1/402, [corrected] 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 are (3.5%; 6/172 [corrected], 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.This study reports on the prevalence of adverse events in short-term and long-term treatment with TNF-α 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-α therapy. Long

  8. Bone formation rather than inflammation reflects ankylosing spondylitis activity on PET-CT: a pilot study.

    Science.gov (United States)

    Bruijnen, Stefan T G; van der Weijden, Mignon A C; Klein, Joannes P; Hoekstra, Otto S; Boellaard, Ronald; van Denderen, J Christiaan; Dijkmans, Ben A C; Voskuyl, Alexandre E; van der Horst-Bruinsma, Irene E; van der Laken, Conny J

    2012-04-02

    Positron Emission Tomography - Computer Tomography (PET-CT) is an interesting imaging technique to visualize Ankylosing Spondylitis (AS) activity using specific PET tracers. Previous studies have shown that the PET tracers [18F]FDG and [11C](R)PK11195 can target inflammation (synovitis) in rheumatoid arthritis (RA) and may therefore be useful in AS. Another interesting tracer for AS is [18F]Fluoride, which targets bone formation. In a pilot setting, the potential of PET-CT in imaging AS activity was tested using different tracers, with Magnetic Resonance Imaging (MRI) and conventional radiographs as reference. In a stepwise approach different PET tracers were investigated. First, whole body [18F]FDG and [11C](R)PK11195 PET-CT scans were obtained of ten AS patients fulfilling the modified New York criteria. According to the BASDAI five of these patients had low and five had high disease activity. Secondly, an extra PET-CT scan using [18F]Fluoride was made of two additional AS patients with high disease activity. MRI scans of the total spine and sacroiliac joints were performed, and conventional radiographs of the total spine and sacroiliac joints were available for all patients. Scans and radiographs were visually scored by two observers blinded for clinical data. No increased [18F]FDG and [11C](R)PK11195 uptake was noticed on PET-CT scans of the first 10 patients. In contrast, MRI demonstrated a total of five bone edema lesions in three out of 10 patients. In the two additional AS patients scanned with [18F]Fluoride PET-CT, [18F]Fluoride depicted 17 regions with increased uptake in both vertebral column and sacroiliac joints. In contrast, [18F]FDG depicted only three lesions, with an uptake of five times lower compared to [18F]Fluoride, and again no [11C](R)PK11195 positive lesions were found. In these two patients, MRI detected nine lesions and six out of nine matched with the anatomical position of [18F]Fluoride uptake. Conventional radiographs showed structural

  9. Serum adipokines and adipose tissue distribution in rheumatoid arthritis and ankylosing spondylitis. A comparative study.

    Science.gov (United States)

    Toussirot, Eric; Grandclément, Emilie; Gaugler, Béatrice; Michel, Fabrice; Wendling, Daniel; Saas, Philippe; Dumoulin, Gilles

    2013-01-01

    Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are inflammatory rheumatic diseases that may modify body composition. Adipose tissue has the ability to release a wide range of products involved in physiologic functions, but also in various pathological processes, including the inflammatory/immune response. RA and AS are both associated with the development of cardiovascular complications. It is has been established that central/abdominal, and particularly intra-abdominal or visceral adiposity is closely linked to cardiovascular events. Thus, in this study, we aimed to evaluate the body composition of patients with RA or AS compared to healthy controls (HC), with a special emphasis on the visceral region. In parallel, we measured adipose products or adipokines, namely leptin, adiponectin and its high molecular weight (HMW) isoform, resistin, and ghrelin, a gastric peptide that plays a role in energetic balance. The homeostasis model assessment for insulin resistance (HOMA-IR) and atherogenic index were used to evaluate cardiovascular risk. One hundred and twelve subjects were enrolled (30 patients with RA, 31 with AS, and 51 HC). Body composition was measured using dual-energy X-ray absorptiometry to determine total fat mass and lean mass, adiposity, fat in the android and gynoid regions, and visceral fat. Patients and HC did not differ in terms of body mass index. On the contrary, adiposity was increased in RA (p = 0.01) while visceral fat was also increased, but only in women (p = 0.01). Patients with AS tended to have lower total fat mass (p = 0.07) and higher lean mass compared to HC (p = 0.07). Leptin and leptin/fat mass were decreased in male patients with AS (p ghrelin in any group of patients. HOMA-IR and the atherogenic index were not modified in RA and AS. These results confirm that body composition was altered in RA and AS, affecting distinct soft tissue compartments. The effect of the increased visceral adipose tissue on

  10. [Effects of comprehensive therapy on serum SPARC levels in ankylosing spondylitis patients accompanied with osteoporosis].

    Science.gov (United States)

    Xu, Jing-ren; Lin, Yan; Zhang, Chun-Yan; Li, Wei-Min; Guo, Chen-Jun; Ye, Lei

    2013-04-01

    To observe the effects of comprehensive therapy on serum secreted protein acidic and rich in cysteine (SPARC) levels in ankylosing spondylitis (AS) patients accompanied with osteoporosis (OP), and to explore the possible mechanisms for SPARC in AS patients accompanied with osteoporosis. Totally 48 AS patients accompanied with OP (Group A) were treated with massage, intravenous infusion of Cervus and Cucumis Polypeptide Injection, and Bushen Quhan Zhiwang Decoction (BQZD) for 3 months. At the same time, 45 normal healthy subjects were recruited as the normal control group (Group B). Serum SPARC levels were measured by ELISA in Group A before and after comprehensive therapy and in those of Group B. The levels of bone mineral density of femoral neck (FN BMD), bone mineral density of 2 -4 lumbar spine (L2-4 BMD), bone specific alkaline phosphatase (BSAP), tumor necrosis factor alpha (TNF-alpha), and transforming growth factor beta-1 (TGF-beta1) were detected. Meanwhile, Bath AS disease activity index (BASDAI) and Bath AS functional index (BASFI) were detected in Group A before and after treatment. The correlations between the aforesaid indices and serum SPARC levels were analyzed. Serum SPARC levels were significantly lower in those of Group A than in those of Group B (175. 30 +/- 72.04 micro/L vs 190. 52 +/- 86. 13 microg/ L, P <0. 01). Serum SPARC levels in those of Group A were negatively correlated with TNF-alpha (r = -0.261, P <0.01), positively with L2-4 BMD, TGF-beta1, and BSAP (r =0.437,0.256, 0.385, P <0.05, P <0.01). L2-4BMD and BSAP were independently predictors of serum SPARC in patients of Group A. After comprehensive therapy, the levels of TNF-alpha, BASDAI, and BASFI obviously decreased, TGF-beta1, BSAP, L2-4 BMD, and FN BMD obviously increased (P <0. 05, P <0. 01). The serum SPARC levels also significantly increased (188.32 +/- 87.50 microg/L, P <0. 05). Comprehensive therapy could effectively improve the bone metabolism, clinical symptoms and the

  11. How should clinicians manage osteoporosis in ankylosing spondylitis?

    Science.gov (United States)

    Bessant, Rupa; Keat, Andrew

    2002-07-01

    Osteoporosis is a common complication of AS, with an incidence between 18.7% and 62%. The prevalence of osteoporosis is greater in males, and increases with increasing patient age and disease duration. Osteoporosis is also more common in patients with syndesmophytes, cervical fusion, and peripheral joint involvement. These variables are not all independent, as they may be indicators of disease duration. Osteoporosis in patients with AS is largely confined to the axial skeleton, in contrast to the pattern of osteoporosis seen in rheumatoid arthritis. BMD at the lumbar spine and femoral neck may be severely reduced, while most studies indicate that carpal and radial BMD remain within normal limits. The development of syndesmophytes in late AS can lead to difficulties in the use of DEXA scanning to determine lumbar BMD, as the extraspinal bone may obscure osteoporotic vertebrae. Under these circumstances more accurate assessment of lumbar BMD, and one that correlates better with femoral neck BMD, may be obtained by quantitative CT scanning or DEXA scanning of the lateral aspect of the L3 vertebra. Osteoporosis in AS significantly increases the risk of vertebral compression fractures within 5 years of the diagnosis of AS. The risk of a vertebral compression fracture occurring over a 30 year period following the diagnosis of AS is 14%, compared to 3.4% for population controls. In patients with vertebral osteoporosis relatively minor trauma, such as slipping, can lead to spinal fracture and dislocatior with subsequent damage to the spinal cord. There is a higher incidence of spinal cord injury following spinal fracture dislocations in patients with AS, and the resulting neurological deficit can range from mild sensory loss to complete paraplegia. Cytokines such as TNF-alpha and IL-6 may play an important part in the pathogenesis of osteoporosis in early AS, and IL-6 levels have been correlated with markers of disease activity and severity. In late AS, mechanical factors

  12. Fracture-dislocation at C6-C7 level with Quadriplegia after Traditional Massage in a Patient with Ankylosing Spondylitis: A Case Report.

    Science.gov (United States)

    Abilash, Kak; Mohd, Qmq; Ahmad, Zah; Towil, Basir

    2017-07-01

    Ankylosing spinal disorders (ASD) tend to result in fractures and/or dislocations after minor trauma because of the altered biomechanical properties. The relative risk of traumatic vertebral fractures in patients with ankylosing spondylitis has been estimated as three times higher than in the general population. These spine traumas, which are located at cervical level in 81% of patients with ankylosing spondylitis, are complicated by neurological lesions in 65% of patients, due to the high inherent instability of these fractures. Traditional massage is an ancient practice in many parts of Asia. It has many benefits that are currently recognized world-wide. However, it can be dangerous and even lethal if practised without adequate knowledge and skill. We report a case of C6-C7 fracture-dislocation with complete neurology and neurogenic shock in a middle aged man with undiagnosed ankylosing spondylitis.

  13. Fracture-dislocation at C6-C7 level with Quadriplegia after Traditional Massage in a Patient with Ankylosing Spondylitis: A Case Report

    Directory of Open Access Journals (Sweden)

    Abilash KAK

    2017-07-01

    Full Text Available Ankylosing spinal disorders (ASD tend to result in fractures and/or dislocations after minor trauma because of the altered biomechanical properties. The relative risk of traumatic vertebral fractures in patients with ankylosing spondylitis has been estimated as three times higher than in the general population. These spine traumas, which are located at cervical level in 81% of patients with ankylosing spondylitis, are complicated by neurological lesions in 65% of patients, due to the high inherent instability of these fractures. Traditional massage is an ancient practice in many parts of Asia. It has many benefits that are currently recognized world-wide. However, it can be dangerous and even lethal if practised without adequate knowledge and skill. We report a case of C6-C7 fracture-dislocation with complete neurology and neurogenic shock in a middle aged man with undiagnosed ankylosing spondylitis.

  14. Marginal erosive discovertebral ''Romanus'' lesions in ankylosing spondylitis demonstrated by contrast enhanced Gd-DTPA magnetic resonance imaging

    International Nuclear Information System (INIS)

    Jevtic, V.; Kos-Golja, M.; Rozman, B.; McCall, I.

    2000-01-01

    Objective. To assess the value of Gd-DTPA magnetic resonance (MR) imaging in the demonstration of marginal destructive discovertebral Romanus lesions in ankylosing spondylitis.Design and patients. A prospective study of Gd-DTPA MR imaging was performed in 39 patients with a clinical diagnosis of ankylosing spondylitis and typical Romanus lesions seen on radiographs of the thoracolumbar spine. MR morphological appearances and signal intensity changes at the discovertebral junctions were analysed and compared with the radiographic findings.Results. Ninety-nine discovertebral junctions with Romanus lesions showed low signal intensity on T1-weighted and high signal on T2-weighted and T1-weighted postcontrast images at the vertebral corners consistent with oedematous hyperaemic inflammatory tissue. There were nine discovertebral junctions with similar MR findings but normal radiographs. Fifty-three discovertebral junctions showed syndesmophyte formation with increased signal intensity on both T1- and T2-weighted images with no contrast enhancement. Sixty-five discovertebral junctions showed a mixture of radiographic features and varied high and low signal changes at the vertebral rim on MR imaging with rims of enhancement in the vertebral body following contrast administration.Conclusion. Gd-DTPA MR imaging demonstrates a variable signal pattern and degree of contrast enhancement which may reflect the evolutionary stages of discovertebral enthesitis in ankylosing spondylitis. MR imaging may identify early erosive changes in radiographically normal vertebra. The role of MR imaging needs further investigation. (orig.)

  15. Lack of association of the G22A polymorphism of the ADA gene in patients with ankylosing spondylitis.

    Science.gov (United States)

    Camargo, U; Toledo, R A; Cintra, J R; Nunes, D P T; Acayaba de Toledo, R; Brandão de Mattos, C C; Mattos, L C

    2012-05-07

    Genes located outside the HLA region (6p21) have been considered as candidates for susceptibility to ankylosing spondylitis. We tested the hypothesis that the G22A polymorphism of the adenosine deaminase gene (ADA; 20q13.11) is associated with ankylosing spondylitis in 166 Brazilian subjects genotyped for the HLA*27 gene (47 patients and 119 controls matched for gender, age and geographic origin). The HLA-B*27 gene and the G22A ADA polymorphism were identified by PCR with sequence-specific oligonucleotide probes and PCR-RFLP, respectively. There were no significant differences in frequencies of ADA genotypes [odds ratio (OR) = 1.200, 95% confidence interval (CI) = 0.3102-4.643, P > 0.8] and ADA*01 and ADA*02 alleles (OR = 1.192, 95%CI = 0.3155-4.505, P > 0.8) in patients versus controls. We conclude that the G22A polymorphism is not associated with ankylosing spondylitis.

  16. Translation to Brazilian Portuguese, cultural adaptation and reproducibility of the questionnaire "Ankylosing Spondylitis: What do you know?"

    Science.gov (United States)

    Orlandi, Aline; Brumini, Christine; Jones, Anamaria; Natour, Jamil

    2016-09-26

    Ankylosing spondylitis (AS) generates inflammation and pain in entheses, peripheral joints and the spine. Education regarding AS can improve patients' disability. Thus, it is important to assess patients' knowledge. There is no instrument in the literature for assessing knowledge of AS in Portuguese. The aim here was to translate to the Brazilian Portuguese language, culturally adapt and test the reliability of the questionnaire "Ankylosing Spondylitis: What do you know?" and to correlate the findings with other factors. Original article regarding validation of questionnaire, produced at the Federal University of Sao Paulo (Unifesp). For translation and cultural adaptation, Guilleman methodology was used. After the first phase, the reliability was tested on 30 patients. Correlations between these scores and other factors were examined. In the interobserver assessment, the Pearson correlation coefficient and Cronbach's alpha were 0.831 and 0.895, respectively. In the intraobserver evaluation, the intraclass correlation coefficient and Cronbach's alpha were 0.79 and 0.883, respectively. At this stage, the score for area of knowledge A showed correlations with ethnicity and education; the score for area D, with age; the total score and scores for areas A and B with "social aspects" of SF-36; and the score for area D with "pain", "vitality" and "emotional aspects" of SF-36. The Brazilian version of the questionnaire "Ankylosing Spondylitis: What do you know?" was created. It is reproducible and correlates with education level, ethnicity and the SF-36 domains "social aspects" and "emotional aspects".

  17. Ankylosing Spondylitis

    Science.gov (United States)

    ... they will comfortably go. Diet: A healthy diet is good for everyone and may be very helpful if you have AS. Keeping a healthy weight reduces stress on painful joints. Omega-3 fatty acids, found ...

  18. Frequency of the use of biological treatment of patients with rheumatoid arthritis and ankylosing spondylitis in Lower Silesia

    Directory of Open Access Journals (Sweden)

    Wojciech Tański

    2016-09-01

    Full Text Available Background: Rheumatoid arthritis (RA and ankylosing spondylitis (AS are chronic connective tissue diseases. Inadequate treatment of RA and AS results in health failure, disability and premature death. In recent years, development of immunology and genetic engineering techniques has started a new generation of drugs in the treatment of RA and AS, called biologic response modifiers or biologics. It is a very effective therapy of serious RA and AS. In many cases, they represent the only way to improve the quality of life, slowing or even arresting the development of these diseases. According to national statistics, the percentage of patients with rheumatic diseases treated with biologic treatment in Poland is less than 1.5%, and it is much lower than in Western European countries (20%.Purpose: The aim of the study was to evaluate the use of biological treatment in Lower Silesia in patients with RA and AS in the years 2006-2015, based on data obtained from the Lower Silesian Branch of the Polish National Health Fund.Results and conclusions: In the last 10 years the frequency of biological treatment of RA or AS in Lower Silesia was estimated as 2.06% of patients (in 2011 to 6.03% of patients (during the first 8 months of 2015. Biological treatment is more often used in Lower Silesia in comparison to national statistics and ranks at a similar level as in other countries of Central and Eastern Europe.

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

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    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.

  20. Is there a relation between pre-sarcopenia, sarcopenia, cachexia and osteoporosis in patients with ankylosing spondylitis?

    Science.gov (United States)

    El Maghraoui, Abdellah; Ebo'o, François Bertin; Sadni, Siham; Majjad, Abderrahim; Hamza, Toufik; Mounach, Aziza

    2016-07-11

    Osteoporosis is a well-known complication of ankylosing spondylitis (AS). However, data about body composition modifications and muscle performance showed conflicting results. The aim of the study was to determine the prevalence and risk factors of pre-sarcopenia, sarcopenia and cachexia in patients with AS and analyze its relationship with bone loss and symptomatic and severity parameters of the disease. Sixty-seven consecutive male patients with AS (mean age of 40.9 ± 11.0 years) and 67 healthy controls were studied. Body composition and bone mineral density (BMD) scans were obtained using DXA. The fat-free mass index (FFMI; fat-free mass divided by height squared) and the percent of fat mass (%FM) were calculated. Pre-sarcopenia was defined by low skeletal muscle mass (SMI 10 s) and cachexia by a BMI 5 mg/l, SMI cachexia, and osteoporosis prevalences were (50.4, 34.3, 11.9, and 16.0) respectively. Patients had a mean 3 kg significant decrease in FFM and a 1 kg/m(2) decrease in appendicular mass vs. healthy controls. Pre-sarcopenia, sarcopenia and cachexia were significantly associated to higher BASDAI levels and low BMD. Our study showed that men with AS had a statistically significant reduction in total and appendicular lean mass that is related to higher disease activity and significantly associated to bone loss.

  1. Effect of ankylosing spondylitis on health-related quality of life and different aspects of social life in young patients.

    Science.gov (United States)

    Ozgül, Ahmet; Peker, Fatma; Taskaynatan, M Ali; Tan, A Kenan; Dinçer, Kemal; Kalyon, Tunç Alp

    2006-03-01

    The aim of this study was to determine the emotional and sociodemographic characteristics of patients with ankylosing spondylitis (AS) and to investigate the impact of the disease on their social life and quality of life (QOL). This study included 101 patients with the diagnosis of AS. All patients filled in a questionnaire comprising their sociodemographic and emotional status and their self-rating on the disease and completed the 36-item Short Form Health Survey (SF-36). The impact of the disease on work status, sexuality, and family relations was measured on a Likert scale. The impact of the disease on employment, family and sexual relations, work life as well as SF-36 was investigated. Therefore, the effect of educational level, employment, social security, and sexual relations with spouse, etc. on QOL were assessed. More than half of the patients had no knowledge about the disease and half of them were not under a physician's control. Thirty-two percent of the previously working patients quit their jobs because of the disease. Quitting a job due to the disease was more frequent in the first 10 years of the disease. The most affected domains of the SF-36 were physical role power, general health, and pain. Patients unemployed due to the disease had lower SF-36 scores compared with employed ones. Unemployed patients without social insurance had lower values on SF-36 subscales (prelations (pwork and social life. Work disability affects QOL. Educating the patients about the disease may play an important role in improving his/her life quality and coping with the disease. Thus, the socioeconomic burden of the disease on the person and on society can be diminished.

  2. Are Indian patients with juvenile-onset ankylosing spondylitis taller than reference population ?

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    Pulukool Sandhya

    2015-01-01

    Full Text Available Background & objectives: Paucity of growth retardation has been observed by us in patients with juvenile-onset ankylosing spondylitis (JAS in a tertiary care health centre in south India. We, therefore, undertook this pilot study to assess and compare anthropometry of patients with JAS who were 15 yr and older with that of adult onset ankylosing spondylitis (AAS and matching Indian reference population. Methods: Consecutive male patients (December 2009- October 2012 with JAS and AAS fulfilling Modified New York Criteria were selected after applying inclusion and exclusion criteria. Demography and anthropometry were noted. Height of both patient groups as well as their parents and siblings were compared with that of the reference population. Mid-parental height and delta height were derived. Those with delta height of >8.5 cm were compared with the remaining. Multivariate logistic regression was done for variables that were found to be significant by chi-square in bivariate analysis. Similar analysis was done for BMI also. Results: There was no significant difference in anthropometric variables between JAS and AAS groups. Twenty eight of the 30 (93.33% JAS patients were taller as compared to the reference population. Twenty six (86.67% AAS patients were taller than the reference population. The mean heights of JAS (170.67 ± 6.94 cm and AAS (168.2 ± 5.94 cm patients were significantly higher than the reference value of 163.11 cm; both p0 <0.001. Logistic regression revealed that tallness in JAS was associated positively with hypermobility (OR=23.46,95%CI 1.2-447.2, p0 =0.036. No significant association was detected for height in AAS and for BMI in both JAS and AAS groups. Interpretation & conclusions: No growth retardation was seen in patients with JAS in our study. Majority of patients with JAS and AAS were taller than reference population. The difference between mean height of JAS and AAS was not significant. Larger studies involving different

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

    International Nuclear Information System (INIS)

    Darby, S.C.; Doll, R.; Smith, P.G.

    1985-01-01

    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. Detailed results of this further follow-up will be presented

  4. Improved precision of syndesmophyte measurement for the evaluation of ankylosing spondylitis using CT: a phantom and patient study

    Science.gov (United States)

    Tan, Sovira; Yao, Jianhua; Yao, Lawrence; Ward, Michael M.

    2012-07-01

    Ankylosing spondylitis is a disease characterized by abnormal bone formation (syndesmophyte) at the margins of inter-vertebral disc spaces. Syndesmophyte growth is currently typically monitored by the visual inspection of radiographs. The limitations inherent to the modality (2D projection of a 3D object) and rater (qualitative human judgment) may compromise sensitivity. With newly available treatments, more precise measures of syndesmophytes are needed to determine whether treatment can slow rates of syndesmophyte growth. We previously presented a computer algorithm measuring syndesmophyte volumes and heights in the 3D space of CT scans. In this study, we present improvements to the original algorithm and evaluate the gain in precision as applied to an anthropomorphic vertebral phantom and patients. Each patient was scanned twice in one day, thus providing two syndesmophyte volume and height measures. The difference between those two measures (ideally zero) determines our algorithm's precision. The technical improvements to the algorithm decreased the mean volume difference (standard deviation) between scans from 3.01% (2.83%) to 1.31% (0.95%) and the mean height difference between scans from 3.16% (2.99%) to 1.56% (1.13%). The high precision of the improved algorithm holds promise for application to longitudinal clinical studies.

  5. Improved precision of syndesmophyte measurement for the evaluation of ankylosing spondylitis using CT: a phantom and patient study

    International Nuclear Information System (INIS)

    Tan, Sovira; Ward, Michael M; Yao Jianhua; Yao, Lawrence

    2012-01-01

    Ankylosing spondylitis is a disease characterized by abnormal bone formation (syndesmophyte) at the margins of inter-vertebral disc spaces. Syndesmophyte growth is currently typically monitored by the visual inspection of radiographs. The limitations inherent to the modality (2D projection of a 3D object) and rater (qualitative human judgment) may compromise sensitivity. With newly available treatments, more precise measures of syndesmophytes are needed to determine whether treatment can slow rates of syndesmophyte growth. We previously presented a computer algorithm measuring syndesmophyte volumes and heights in the 3D space of CT scans. In this study, we present improvements to the original algorithm and evaluate the gain in precision as applied to an anthropomorphic vertebral phantom and patients. Each patient was scanned twice in one day, thus providing two syndesmophyte volume and height measures. The difference between those two measures (ideally zero) determines our algorithm's precision. The technical improvements to the algorithm decreased the mean volume difference (standard deviation) between scans from 3.01% (2.83%) to 1.31% (0.95%) and the mean height difference between scans from 3.16% (2.99%) to 1.56% (1.13%). The high precision of the improved algorithm holds promise for application to longitudinal clinical studies. (paper)

  6. Impact of peer-led group education on the quality of life in patients with ankylosing spondylitis.

    Science.gov (United States)

    Kaya, Taciser; Goksel Karatepe, Altinay; Atici Ozturk, Pinar; Gunaydin, Rezzan

    2016-02-01

    To determine the effect of peer-led group education on the quality of life and depression in patients with ankylosing spondylitis (AS). Eighty patients with definite AS were allocated randomly to either the education or control group. The education group (n = 40) was subjected to a peer-led group education program about disease and was given an educational booklet, while the control group (n = 40) was given the educational booklet only. Levels of quality of life and depression were measured at baseline, immediately after education (fourth week) and at 6 months in both groups. The results are based on 56 (n = 27, education group; n = 29, control group) patients. The level of quality of life and depressive symptoms were not changed except for a deterioration in the social functioning subgroup of Short From (SF)-36 in both groups. When the groups were compared, there were no significant differences between changes in social functioning scores. Peer-led education did not alter quality of life levels and depression scores. However, because of the maintainance of quality of life levels, this type of intervention may be considered as a supplementary intervention to the standard medical care for management of AS. © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

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

    International Nuclear Information System (INIS)

    Darby, S.C.; Doll, R.; Gill, S.K.; Smith, P.G.

    1989-01-01

    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)

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

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    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

  9. The importance of quality of life for work outcomes in patients with ankylosing spondylitis - a cross-sectional study

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    Burcu Taser

    2017-10-01

    Full Text Available Aims: Work impairment is one of the most important exploration and one of the aims of rheumatologists. We aimed to determine the risk factors for employment state and predictive factors of work outcomes using multi-dimensional measures in patients with ankylosing spondylitis (AS in this comprehensive study. Methods: One hundred patients with AS (31 females and 69 males were included into this study. Demographic properties, local factors, disease activity (BASDAI, functionality (BASFI, spinal mobility (BASMI, radiologic stage (BASRI, quality of life (AS-QoL, cardiopulmonary involvement, exercise stress test and work outcomes were investigated and compared in employed and un-employed patients. The work instability scale (AS-WIS and work productivity activity impairment scale (WPAI:SpA were selected as work outcomes. The predictive factors were analyzed using multiple stepwise linear regressions. Major results: Thirty-two patients (mean age: 42,6±11.7 were unemployed and the risk factors for unemployment state were female sex, lower annual income level, and older age. Work disability was detected only in 5% of patients. Decreased chest mobility (beta: -0.398, p:

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

    Science.gov (United States)

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

    1987-04-01

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

  11. Baseline extent of damage predicts spinal radiographic progression in Korean patients with ankylosing spondylitis treated with golimumab.

    Science.gov (United States)

    Lee, Jeong Seok; Song, Yeong Wook; Kim, Tae Hwan; Chung, Won Tae; Lee, Seung Geun; Park, Sung Hwan; Song, Gwan Gyu; Yu, Dae Young; Xu, Stephen; Lee, Eun Young

    2018-05-01

    For patients with ankylosing spondylitis (AS), golimumab has consistent efficacy in controlling disease activity over 5 years but its benefit in preventing radiographic progression was less clear at 4 years. To predict radiographic progression, we analyzed the baseline characteristics of AS patients in a Korean population. Sixty-eight Korean patients with AS participated in the phase 3, multicenter, randomized, placebo-controlled, double-blind trial (GO-RAISE) which has previously been described. Baseline modified stoke AS spine score (mSASSS) and change in mSASSS from baseline (ΔmSASSS) until week 208 were analyzed in the Korean patients enrolled in the GO-RAISE study. Although Korean patients had lower baseline mSASSS compared to non-Korean patients and received active management, radiographic progression was not prevented. Korean patients who did not undergo radiographic progression of spinal lesions of AS were younger and had shorter symptomatic duration, lower Bath AS functional and metrology indices, better chest expansion, and lower baseline mSASSS. The baseline mSASSS and ΔmSASSS were positively correlated in Korean AS patients ( p baseline mSASSS > 10 and less common (13.0%) with baseline mSASSS = 0. In Korean AS patients, radiographic progression of the spine after 4 years was predicted effectively by the initial severity of the spinal lesion(s) in patients treated with golimumab.

  12. Application value of curved planar reconstruction in sacroiliac joint of ankylosing spondylitis

    International Nuclear Information System (INIS)

    Wang Tuxing; Huan Xiao; Zhu Xiang; Fang Chun

    2008-01-01

    Objective: To determine the application value of curved planar reconstruction (CPR) of multislice spiral computed tomography(MSCT) in changes of sacroiliac joint of ankylosing spondylitis(AS). Methods: 33 patients with AS diagnosed clinically were chosen to take MSCT scanning of bilateral sacroiliac joints with the slice thick of 5mm and the slice interval of 5 mm. The primary images were transported to General Electric AW4.0 workstation, and the multiplanar reformatted sagittal images of sacrum were obtained by the reformat software, and further the coronary images of bilateral sacroiliac joints by CPR with the construction curves coincident with sacrums. Results: All coronary images of bilateral sacroiliac joints by CPR were excellent in density and space resolution, and showed complete sacroiliac joints and their changes clearly and directly. Of all 33 cases, 2 were graded as grade 0, 5 grade I, 11 grade II, 10 grade III, 5 glade IV, according to grading standard. Conclusion: The coronary images of sacroiliac joint by CPR are enough clear and eligible for clinical diagnosis, and, in combination with transversal images, are helpful to complete assessment about the grade and scope of changes of sacroiliac joint in AS patients. (authors)

  13. The diagnostic value of sacroiliac CT for detecting early changes of ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ju Hyun; Park, Ji Seon; Ryu, Kyung Nam [Kyunghee University Medical Center, Seoul (Korea, Republic of); Jin, Wook [East-West Neo Medical Center, Seoul (Korea, Republic of)

    2007-02-15

    We wanted to evaluate the diagnostic value of the various findings on sacroiliac CT for detecting the early changes of ankylosing spondylitis (AS). Between April 2005 and March 2006, 51 sacroiliac CT images with the clinical suspicion of AS, but no definite evidence of AS on the plain radiograph only, were retrospectively reviewed. Finally, 36 patients (mean age: 28.6 years; 34 males and 2 females), who were clinically diagnosed as AS (AS group, n = 26) or they had no evidence of AS (non-AS group, n = 10), were evaluated. Two musculoskeletal radiologists analyzed the presence of marginal irregularity, bony erosion and subchondral sclerosis. A statistical analysis was performed to evaluate the incidence, sensitivity and specificity of each finding. Marginal irregularity was seen in 21 of 26 AS subjects, and in 8 of 10 non-AS subjects. Bony erosion was only seen in 13 of 26 AS subjects. Subchondral sclerosis was observed in 19 of 26 AS subjects and in 8 of 10 non-AS subjects. The sensitivity/specificity for each findings were 72.4%/28.6%, 100%/43.5% and 70.4%/22.2%, respectively. Except for bony erosions, these results showed no statistical significance ({rho} = .006). Bony erosion on CT is a very sensitive finding for the early changes of AS, whereas marginal irregularity or subchondral sclerosis is not so helpful in differentiating AS from non-AS. Attention to these results may further enhance the accurate diagnosis of the early changes in AS.

  14. Hip morphometry of femoroacetabular impingement pattern in patients with ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Yoon; Lee, Eu Gene; Choi, Jung Ah [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2015-06-15

    To analyze hip morphometry of femoroacetabular impingement (FAI) pattern in patients with ankylosing spondylitis (AS) and correlate them with sacroiliitis grades. 384 patients with AS were analyzed regarding demographics, radiologic signs of FAI for hip involvement, and sacroiliitis grades. FAI was classified into 3 types according to alpha angle, lateral center-edge angle and pistol grip deformity. Sacroiliitis was graded according to the New York criteria. Prevalence of FAI morphometry types was determined and evaluated for association with sacroiliitis grades. Statistical analysis regarding numerical variables, including age, sacroiliitis score using t-test, sacroiliitis score in three groups using Kruskal-Wallis test and Mann-Whitney U-test, corrected by Bonferroni methods for post hoc analysis was done. Among 384 patients, 141 (36.7%) had FAI morphometry. Male predominance was found in group with FAI pattern involvement (87.2%) (p = 0.000). Pincer type (20.6%) was the most common. Hip involvement group also showed greater sacroiliitis score (2.49 vs. 1.75, p = 0.000). Combined-type had greater sacroiliitis score compared with others (p = 0.002, 0.003). FAI morphometry was frequent in hips of AS patients (36.7%), especially pincer type, more frequent in male, and associated with significantly greater grade of sacroiliitis; combined type FAI pattern had greater sacroiliitis score.

  15. Non-pharmacological treatment of ankylosing spondylitis: Barriers to effective implementation of recommendations in Morocco

    Directory of Open Access Journals (Sweden)

    Abderrazak Hajjioui

    2014-01-01

    Full Text Available This cross-sectional study aimed to describe non-pharmacological treatment modalities in Moroccan patients with ankylosing spondylitis (AS, and to approach physical therapy implementation barriers. 61 patients with AS according to New York classification criteria were included in the study. Socio-demographic data and clinical characteristics were collected and different therapeutic modalities, including physical therapy were investigated. The mean age of the patients was 38.20 (SD 12.36 years with a male/female ratio of 1.5. 55 (90% patients received pharmacological therapy, 37 (60.7% received physical therapy, 5(8.2% underwent surgery and 36 (59% tried at least one type of complementary medicine (medicine plants, sand baths, acupuncture, fire needles, and cupping. Patients’ major expectations from physical therapy were improving their functional status (86.5%, and reducing their pain (59.5%. Most patients (86.49% were satisfied of their physical therapy and 56.8% practiced home exercises. Reasons for nonattendance to physical therapy for the remaining 24 patients were nonprescription (58.3%, lack of financial resources (20.8%, geographical remoteness from rehabilitation centers (4% and lack of motivation (17%. Non-pharmacological treatment, especially based on exercise and education, is an integral part of the comprehensive management of AS. However, it is not efficiently implemented in Morocco and more effort should be made to develop this both efficient and relatively inexpensive component of AS treatment.

  16. Incidence of tumours of the skeleton in 224Ra-treated ankylosing spondylitis patients

    International Nuclear Information System (INIS)

    Wick, R.R.; Goessner, W.

    1983-01-01

    We are following 1426 ankylosing spondylitis (a.sp.) patients treated with 224 Ra and 1556 control patients with a.sp. not treated with any form of ionizing radiation. The average follow-up time of the exposure group is 16 years and the average α-dose to the skeleton is 65 rad, resulting from intravenous injection of 4.8μCi/kg 224 Ra on average within a medium injection span of 12 weeks. Injections normally have been performed once a week, and in some cases also half-weekly with a correspondingly shorter injection span. Since 1970 three cases of malignant tumours in the skeleton have been observed in the exposure group in patients with skeletal α-doses below 90 rad compared with 0.6 expected. (No bone tumour has occurred in the control group.) Two of the three cases observed were tumours of the bone marrow. The incidence of leukaemias in both exposure and control groups is discussed with respect to phenylbutazone treatment and α-radiation from 224 Ra. An effect of 224 Ra on the bone marrow not yet detected in the Spiess series of patients treated with higher amounts of 224 Ra cannot be excluded. (author)

  17. Intravitreal Triamcinolone Acetonide for Macular Edema in HLA-B27 Negative Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    M.M. Moschos

    2010-12-01

    Full Text Available We report a case of a human leukocyte antigen B27 (HLA-B27-negative patient with cystoid macular edema (CME and ankylosing spondylitis (AS after treatment with triamcinolone acetonide. The patient complained of deterioration of visual acuity of the right eye during the last 10 days. At presentation visual acuity of the right eye was 0.2, and the ophthalmic examination did not reveal any sign of active uveitis. Fluorescein angiography (FA and ocular coherent tomography (OCT showed CME. The left eye was normal with a visual acuity of 0.9. Eight weeks after intravitreal injection of triamcinolone acetonide, visual acuity improved to 0.8 and OCT revealed regression of macular edema. Six months later no recurrence was observed. Our case report indicates for the first time that CME may occur in AS independently of the presence of HLA-B27 and intraocular inflammation. Intravitreal use of triamcinolone acetonide can reduce macular edema and restore visual acuity.

  18. Assessment of the value of joint imaging in patients with ankylosing spondylitis

    International Nuclear Information System (INIS)

    Miao Weibing; Wu Jing; Lin Haoxue; Ye Defu

    2002-01-01

    Objective: To assess the value of 99 Tc m -human immunoglobulin G(HIgG) and 99 Tc m -methylene diphosphonic acid (MDP) joint imaging in patients with ankylosing spondylitis (AS). Methods: Whole body imaging with 99 Tc m -HIgG was performed on 21 patients with AS and 18 with rheumatoid arthritis (RA). Among them, 12 cases of AS were studied in comparison with 99 Tc m -MDP. Results: 1) 20 of 21 cases of AS showed increased uptake of 99 Tc m -HIgG in Art. sacro-iliac were negative. 3) The comparison between 99 Tc m -HIgG and 99 Tc m -MDP imaging demonstrated: abnormal sacro-iliac, and there were 32 surrounding joints with abnormal images in 44 clinically positive joints. The rate of coincidence was 75%. The image of the hand was normal in every patient. 2) All images of the hand were abnormal in RA, while images of Art. sacro-iliac images were found in 11 cases with 99 Tc m -HIgG, while in 7 with 99 Tc m -MDP. Among 31 clinically involved surrounding joints, 24 showed increased uptake of 99 Tc m -HIgG, but only 16 were 99 Tc m -MDP positive. Significant difference was found between the two modalities (P 99 Tc m -HIgG joint imaging can more objectively detect inflammatory lesions of AS than 99 Tc m -MDP. It can also be helpful to the early diagnosis of AS

  19. Hip morphometry of femoroacetabular impingement pattern in patients with ankylosing spondylitis

    International Nuclear Information System (INIS)

    Lee, Jong Yoon; Lee, Eu Gene; Choi, Jung Ah

    2015-01-01

    To analyze hip morphometry of femoroacetabular impingement (FAI) pattern in patients with ankylosing spondylitis (AS) and correlate them with sacroiliitis grades. 384 patients with AS were analyzed regarding demographics, radiologic signs of FAI for hip involvement, and sacroiliitis grades. FAI was classified into 3 types according to alpha angle, lateral center-edge angle and pistol grip deformity. Sacroiliitis was graded according to the New York criteria. Prevalence of FAI morphometry types was determined and evaluated for association with sacroiliitis grades. Statistical analysis regarding numerical variables, including age, sacroiliitis score using t-test, sacroiliitis score in three groups using Kruskal-Wallis test and Mann-Whitney U-test, corrected by Bonferroni methods for post hoc analysis was done. Among 384 patients, 141 (36.7%) had FAI morphometry. Male predominance was found in group with FAI pattern involvement (87.2%) (p = 0.000). Pincer type (20.6%) was the most common. Hip involvement group also showed greater sacroiliitis score (2.49 vs. 1.75, p = 0.000). Combined-type had greater sacroiliitis score compared with others (p = 0.002, 0.003). FAI morphometry was frequent in hips of AS patients (36.7%), especially pincer type, more frequent in male, and associated with significantly greater grade of sacroiliitis; combined type FAI pattern had greater sacroiliitis score

  20. 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

  1. Chronic Periodontitis Is Associated With Spinal Dysmobility in Patients With Ankylosing Spondylitis.

    Science.gov (United States)

    Kang, Eun Ha; Lee, Jung Tae; Lee, Hyo-Jung; Lee, Joo Youn; Chang, Sung Hae; Cho, Hyon Joung; Choi, Byoong Yong; Ha, You-Jung; Park, Kyoung Un; Song, Yeong Wook; Van Dyke, Thomas E; Lee, Yun Jong

    2015-12-01

    Although microbes have been suggested to play a role in the pathogenesis of ankylosing spondylitis (AS), several studies present contradictory results regarding the association between AS and chronic periodontitis (CP). Clinical, laboratory, and medication data were collected from 84 patients with AS and 84 age- and sex-matched controls. Periodontal measurements, including probing depths (PDs), clinical attachment loss (AL), serum anti-Porphyromonas gingivalis titers, and the detection of P. gingivalis DNA in gingival crevicular fluid, were recorded. All participants with periodontitis with PD ≥4 to periodontitis with PD of ≥4 to periodontal treatment, PD and AL levels were improved in both groups, but the change was significantly greater in patients with AS than in controls. Patients with AS receiving anti-TNF-α agents exhibited a greater improvement in PD and AL than those who did not. Although AS was not associated with the presence of CP, CP was associated positively with the severity of spinal dysmobility in Korean patients with AS. These results suggest that periodontitis can have a negative effect on axial movement in AS.

  2. Translation to Brazilian Portuguese, cultural adaptation and reproducibility of the questionnaire "Ankylosing Spondylitis: What do you know?"

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    Aline Orlandi

    Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: Ankylosing spondylitis (AS generates inflammation and pain in entheses, peripheral joints and the spine. Education regarding AS can improve patients' disability. Thus, it is important to assess patients' knowledge. There is no instrument in the literature for assessing knowledge of AS in Portuguese. The aim here was to translate to the Brazilian Portuguese language, culturally adapt and test the reliability of the questionnaire "Ankylosing Spondylitis: What do you know?" and to correlate the findings with other factors. DESIGN AND SETTING: Original article regarding validation of questionnaire, produced at the Federal University of Sao Paulo (Unifesp. METHODS: For translation and cultural adaptation, Guilleman methodology was used. After the first phase, the reliability was tested on 30 patients. Correlations between these scores and other factors were examined. RESULTS: In the interobserver assessment, the Pearson correlation coefficient and Cronbach's alpha were 0.831 and 0.895, respectively. In the intraobserver evaluation, the intraclass correlation coefficient and Cronbach's alpha were 0.79 and 0.883, respectively. At this stage, the score for area of knowledge A showed correlations with ethnicity and education; the score for area D, with age; the total score and scores for areas A and B with "social aspects" of SF-36; and the score for area D with "pain", "vitality" and "emotional aspects" of SF-36. CONCLUSION: The Brazilian version of the questionnaire "Ankylosing Spondylitis: What do you know?" was created. It is reproducible and correlates with education level, ethnicity and the SF-36 domains "social aspects" and "emotional aspects".

  3. Genetic variants of STAT4 are associated with ankylosing spondylitis susceptibility and severity in a Chinese Han population

    OpenAIRE

    Liu, Zhixiang; Zhang, Peisen; Dong, Jie

    2014-01-01

    Objective: Genetic factors play an important role in ankylosing spondylitis (AS) etiology and signal transducer and activator of transcription 4 (STAT4) gene polymorphisms may be involved. The aim of this study was to test whether STAT4 variants were associated with susceptibility to AS in a Chinese population. Methods: A total of 175 subjects who were diagnosed as AS and 249 healthy age-matched controls were enrolled in the present study. The rs7574865 G/T SNP in STAT4 gene was genotyped in ...

  4. HLA alleles and HLA-B27 haplotypes associated with susceptibility and severity of ankylosing spondylitis in a Portuguese population.

    Science.gov (United States)

    Pimentel-Santos, F M; Matos, M; Ligeiro, D; Mourão, A F; Ribeiro, C; Costa, J; Santos, H; Barcelos, A; Pinto, P; Cruz, M; Sousa, E; Santos, R A; Fonseca, J E; Trindade, H; Guedes-Pinto, H; Branco, J C

    2013-12-01

    Human leukocyte antigen (HLA)-B27 is the mostly known major histocompatibility complex (MHC) gene associated with ankylosing spondylitis (AS). Nonetheless, there is substantial evidence that other MHC genes appear to be associated with the disease, although it has not yet been established whether these associations are driven by direct associations or by linkage disequilibrium (LD) mechanisms. We aimed to investigate the contributions of HLA class I and II alleles and B27-haplotypes for AS in a case-control study. A total of 188 HLA-B27 AS cases and 189 HLA-B27 healthy controls were selected and typed for HLA class I and II by the Luminex polymerase chain reaction-sequence specific oligonucleotide probe (PCR-SSOP) method. Allelic and haplotypic distributions were estimated by maximum likelihood method using Arlequin v3.11 and statistical analysis were performed by Stata10.1. No associations were found between non-HLA-B27 loci and AS susceptibility, but several associations were observed for phenotypic features of the disease. DRB1*08 was identified as a risk factor for uveitis and DQB1*04 seems to provide protection for AS severity (functional, metrological and radiological indexes). A*02/B27/C*02/DRB1*01/DQB1*05 [P<0.0001; odds ratio (OR) = 39.06; 95% confidence interval (CI) (2.34-651)] is the only haplotype that seems to confer susceptibility to AS. Moreover, the haplotype A*02/B27/C*01/DRB1*08/DQB1*04 seems to provide protection for disease functional and radiological repercussions. Our findings are compatible with the hypothesis that other genes within the HLA region besides HLA-B27 might play some role in AS susceptibility and severity. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Total hip arthroplasty in patients with ankylosing spondylitis: Midterm radiologic and functional results

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    Yavuz Saglam

    2016-08-01

    Conclusion: Revision incidence was similar in between ankylosed and non-ankylosed hips. While complication rates are high, significant functional improvement can be achieved after THA in patients with AS.

  6. Macrophage Migration Inhibitory Factor Induces Inflammation and Predicts Spinal Progression in Ankylosing Spondylitis.

    Science.gov (United States)

    Ranganathan, Vidya; Ciccia, Francesco; Zeng, Fanxing; Sari, Ismail; Guggino, Guiliana; Muralitharan, Janogini; Gracey, Eric; Haroon, Nigil

    2017-09-01

    To investigate the role of macrophage migration inhibitory factor (MIF) in the pathogenesis of ankylosing spondylitis (AS). Patients who met the modified New York criteria for AS were recruited for the study. Healthy volunteers, rheumatoid arthritis patients, and osteoarthritis patients were included as controls. Based on the annual rate of increase in modified Stoke AS Spine Score (mSASSS), AS patients were classified as progressors or nonprogressors. MIF levels in serum and synovial fluid were quantitated by enzyme-linked immunosorbent assay. Predictors of AS progression were evaluated using logistic regression analysis. Immunohistochemical analysis of ileal tissue was performed to identify MIF-producing cells. Flow cytometry was used to identify MIF-producing subsets, expression patterns of the MIF receptor (CD74), and MIF-induced tumor necrosis factor (TNF) production in the peripheral blood. MIF-induced mineralization of osteoblast cells (SaOS-2) was analyzed by alizarin red S staining, and Western blotting was used to quantify active β-catenin levels. Baseline serum MIF levels were significantly elevated in AS patients compared to healthy controls and were found to independently predict AS progression. MIF levels were higher in the synovial fluid of AS patients, and MIF-producing macrophages and Paneth cells were enriched in their gut. MIF induced TNF production in monocytes, activated β-catenin in osteoblasts, and promoted the mineralization of osteoblasts. Our findings indicate an unexplored pathogenic role of MIF in AS and a link between inflammation and new bone formation. © 2017, American College of Rheumatology.

  7. 224Ra: Risk to bone and haematopoietic tissue in ankylosing spondylitis patients

    International Nuclear Information System (INIS)

    Wick, R.R.; Goessner, W.; Chmelevsky, D.

    1986-01-01

    This follow-up study includes 1501 adult patients, who received repeated intraveneous injections of 224 Ra as a treatment for ankylosing spondylitis (a.sp), and a control group of 1557 a.sp. patients not treated with radioactive drugs or X-rays. The average total injected activity for the patients of the exposure group was 4.8 μCi of 224 Ra per kg body weight; the resulting average skeletal dose of α-rays has been 0.65 Gy. The mean duration of the 224 Ra treatment was 12 weeks with the mode at 10 weeks. At present, the mean follow-up time in the group of exposed patients is 16 years, and three cases of malignant skeletal tumours have been observed in patients with α-doses to the skeleton below 0.9 Gy (the lowest skeletal dose found to be associated with a bone tumour in the high dose group followed by Spiess and Mays). Based on general population statistics the expected number of bone tumours (ICD 170) was 0.4-0.7 . A recent risk estimate from data of Spiess and Mays suggests 5.8 radiation induced bone tumours for the present follow-up time. It is, furthermore, notable that 2 of the 3 observed skeletal tumours are tumours of the bone marrow; in the high dose group of Spiess and Mays there has been only 1 bone marrow tumour among 55 bone tumours. No malignant bone tumours have occurred, until now, in the control group. In the 224 Ra-group and the control group there have been 6 and 5 leukaemias, respectively,. Among the 6 leukaemias in the 224 R group 3 were chronic myeloid leukaemias while among the 5 leukaemias in the control group there was no chronic myeloid leukaemia. (orig.)

  8. Anti-TNFα Treatment for HLA-B27-Positive Ankylosing Spondylitis-Related Uveitis.

    Science.gov (United States)

    Kim, Mirinae; Won, Jae-Yon; Choi, Seung Yong; Ju, Ji Hyeon; Park, Young-Hoon

    2016-10-01

    To assess the long-term efficacy of the most widely used anti-tumor necrosis factor alpha (TNFα) agents for treatment of HLA-B27-positive ankylosing spondylitis (AS)-related uveitis. Retrospective cohort study. The medical records of 143 patients with HLA-B27-positive AS who visited Seoul St. Mary's Hospital and were taking an anti-TNFα agent for at least 1 year were studied. Subjects were divided into 3 groups according to anti-TNFα treatment: Group 1 (infliximab, 66), Group 2 (adalimumab, 45), and Group 3 (etanercept, 32). Mean age was 41.0 ± 13.0 years, and 97 patients (67.8%) were male. Mean follow-up period was 70.6 ± 37.9 months. In cases of active ocular inflammation at the onset of anti-TNFα treatment, patients showed improved activity of uveitis after 24.0 ± 15.0 days (Group 1), 17.9 ± 6.0 days (Group 2), and 25.9 ± 18.0 days (Group 3). After the anti-TNFα treatment, 71 of 94 patients (32 [76.2%] in Group 1, 26 [78.8%] in Group 2, and 13 [68.4%] in Group 3) remained without uveitis relapse. A reduction in the number of systemic medications was achieved in 129 patients (90.2%). Twenty-eight cases of minor side effects were observed, and 4 cases were tuberculosis leading to discontinuation of anti-TNFα treatment. Infliximab, adalimumab, and etanercept were effective for treating and reducing the number of uveitis relapses in HLA-B27-positive AS. However, the risk of serious infections was noted, so ophthalmologists should consider the possibility that prolonged use of biologic agents may result in systemic side effects. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Valuing Treatment With Infliximab for Ankylosing Spondylitis Using a Willingness-to-Pay Approach.

    Science.gov (United States)

    Webers, Casper; Essers, Ivette; van Tubergen, Astrid; Braun, Jürgen; Heldmann, Frank; Baraliakos, Xenofon; Boonen, Annelies

    2018-04-01

    To investigate willingness to pay (WTP) for treatment with infliximab by patients with ankylosing spondylitis (AS) and explore factors associated with WTP. Data from 85 patients participating in the European AS Infliximab Cohort (EASIC) open-label extension of the AS Study for the Evaluation of Recombinant Infliximab Therapy (ASSERT) were used. WTP was included at baseline in EASIC and comprised a hypothetical scenario exploring whether the patient would be willing to pay for beneficial effects of infliximab and, if so, what amount they would be willing to pay per administration. Factors associated with WTP were explored using zero-inflated negative binomial (ZINB) regressions. Of the 85 patients, 63 (74.1%) were willing to pay, and among these, the mean amount they were willing to pay per administration was €275 (median €100 [interquartile range €50-200]). Multivariable ZINB analysis showed that Assessment of SpondyloArthritis international Society criteria for 20% improvement (ASAS20) response was associated with a 7-fold lower likelihood to pay 0 euros (odds ratio [OR] 0.14 [95% confidence interval (95% CI) 0.03-0.71]) and a 3-fold increase in the amount willing to pay (exp(β) = 3.32 [95% CI 1.44-7.69]). In addition, the country of residence was associated with a lower likelihood to pay 0 euros (OR 0.07 [95% CI 0.02-0.36]), while increased age was associated with the amount willing to pay (exp(β) = 1.05 [95% CI 1.01-1.09]). In a hypothetical scenario, three-quarters of patients with AS receiving long-term infliximab stated that they were willing to pay an out-of-pocket contribution for this treatment. Treatment response contributed to the willingness as well as to the amount patients were willing to pay. © 2017, The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.

  10. Retrospective analysis of spinal trauma in patients with ankylosing spondylitis: a descriptive study in Indian population.

    Science.gov (United States)

    Mahajan, R; Chhabra, H S; Srivastava, A; Venkatesh, R; Kanagaraju, V; Kaul, R; Tandon, V; Nanda, A; Sangondimath, G; Patel, N

    2015-05-01

    This study aims to understand the demographics, mode of trauma, hospital stay, complications, neurological improvement, mortality and expenditure incurred by Indian patients with spinal trauma and ankylosing spondylitis (AS). Retrospective analysis of the patient data admitted to a tertiary referral hospital from 2008 to 2013 with the diagnosis of AS and spinal trauma was carried out. The variables studied were demographics, mode of trauma, neurological status, neurological improvement, involved vertebral level, duration of hospital stay, comorbid factors, expenditure and complications during the stay. Forty-six patients with diagnosis of AS with spine trauma were admitted over the last 5 years with a total of 52 fractures. All were male patients; 58.6% had injury because of trivial trauma and 78.2% patients presented with neurological injury. C5 C6, C6 C7, C7 D1 and D12 were the most common injured level. Fractures through intervertebral disc were most common in cervical spine. Of the patients, 52.7% had shown neurological improvement of at least grade 1(AIS). Mean expenditure of patient admitted with spinal cord injury (SCI) with AS is 7957 USD (United States dollar), which is around five times the per capita income in India (as per year 2013). Males with AS are much more prone to spinal fractures than females and its incidence may be higher than previously reported. Domestic falls are the most common mechanism of spinal trauma in this population. High velocity injuries are associated with complete SCI. The study reinforces the need for development of subsidized spinal care services for SCI management.

  11. The Cost of Ankylosing Spondylitis in the UK Using Linked Routine and Patient-Reported Survey Data.

    Directory of Open Access Journals (Sweden)

    Roxanne Cooksey

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory arthritis which typically begins in early adulthood and impacts on healthcare resource utilisation and the ability to work. Previous studies examining the cost of AS have relied on patient-reported questionnaires based on recall. This study uses a combination of patient-reported and linked-routine data to examine the cost of AS in Wales, UK.Participants in an existing AS cohort study (n = 570 completed questionnaires regarding work status, out-of-pocket expenses, visits to health professionals and disease severity. Participants gave consent for their data to be linked to routine primary and secondary care clinical datasets. Health resource costs were calculated using a bottom-up micro-costing approach. Human capital costs methods were used to estimate work productivity loss costs, particularly relating to work and early retirement. Regression analyses were used to account for age, gender, disease activity.The total cost of AS in the UK is estimated at £19016 per patient per year, calculated to include GP attendance, administration costs and hospital costs derived from routine data records, plus patient-reported non-NHS costs, out-of-pocket AS-related expenses, early retirement, absenteeism, presenteeism and unpaid assistance costs. The majority of the cost (>80% was as a result of work-related costs.The major cost of AS is as a result of loss of working hours, early retirement and unpaid carer's time. Therefore, much of AS costs are hidden and not easy to quantify. Functional impairment is the main factor associated with increased cost of AS. Interventions which keep people in work to retirement age and reduce functional impairment would have the greatest impact on reducing costs of AS. The combination of patient-reported and linked routine data significantly enhanced the health economic analysis and this methodology that can be applied to other chronic conditions.

  12. Importance of Contextual Factors When Measuring Work Outcome in Ankylosing Spondylitis: A Systematic Review by the OMERACT Worker Productivity Group.

    Science.gov (United States)

    Stolwijk, Carmen; Castillo-Ortiz, José-Dionisio; Gignac, Monique; Luime, Jolanda; Boonen, A

    2015-09-01

    To review the literature on contextual factors (CoFas) and their relationship to work outcomes in individuals with ankylosing spondylitis (AS). Articles that quantified the relationship between CoFas and employment status, sick leave, or presenteeism in individuals with AS were systematically identified. CoFas were classified into 5 domains for personal factors and 8 domains for environmental factors. We defined criteria for best-evidence synthesis for each CoFa domain based on the number of studies exploring that domain, and the quality of evidence of individual studies based on the risk of bias, adjustment of multivariable analyses for disease activity and physical function, and sample size. Twenty-five studies met our inclusion criteria: 20 addressed employment status, 6 examined sick leave, and 3 presenteeism. For employment, there was strong evidence for the role of age, moderate evidence for related skills/abilities, the absence of work accommodations, the nature of work and absence of workplace support, and poor evidence for the role of marital status. Evidence was insufficient for sex, education, and physical environment. For sick leave and presenteeism there were too few studies to perform a best-evidence synthesis for the role of CoFas. Using a newly proposed set of criteria for determining the best-evidence of the association between CoFa domains and work outcome, the following factors emerged: age, related skills/abilities, work accommodations, nature of work, and workplace support. In addition to disease-related variables, these CoFa domains seem important to include when designing and interpreting studies on work outcomes. © 2015, American College of Rheumatology.

  13. The Cost of Ankylosing Spondylitis in the UK Using Linked Routine and Patient-Reported Survey Data.

    Science.gov (United States)

    Cooksey, Roxanne; Husain, Muhammad J; Brophy, Sinead; Davies, Helen; Rahman, Muhammad A; Atkinson, Mark D; Phillips, Ceri J; Siebert, Stefan

    2015-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory arthritis which typically begins in early adulthood and impacts on healthcare resource utilisation and the ability to work. Previous studies examining the cost of AS have relied on patient-reported questionnaires based on recall. This study uses a combination of patient-reported and linked-routine data to examine the cost of AS in Wales, UK. Participants in an existing AS cohort study (n = 570) completed questionnaires regarding work status, out-of-pocket expenses, visits to health professionals and disease severity. Participants gave consent for their data to be linked to routine primary and secondary care clinical datasets. Health resource costs were calculated using a bottom-up micro-costing approach. Human capital costs methods were used to estimate work productivity loss costs, particularly relating to work and early retirement. Regression analyses were used to account for age, gender, disease activity. The total cost of AS in the UK is estimated at £19016 per patient per year, calculated to include GP attendance, administration costs and hospital costs derived from routine data records, plus patient-reported non-NHS costs, out-of-pocket AS-related expenses, early retirement, absenteeism, presenteeism and unpaid assistance costs. The majority of the cost (>80%) was as a result of work-related costs. The major cost of AS is as a result of loss of working hours, early retirement and unpaid carer's time. Therefore, much of AS costs are hidden and not easy to quantify. Functional impairment is the main factor associated with increased cost of AS. Interventions which keep people in work to retirement age and reduce functional impairment would have the greatest impact on reducing costs of AS. The combination of patient-reported and linked routine data significantly enhanced the health economic analysis and this methodology that can be applied to other chronic conditions.

  14. Can erosions on MRI of the sacroiliac joints be reliably detected in patients with ankylosing spondylitis? - A cross-sectional study

    DEFF Research Database (Denmark)

    Weber, Ulrich; Pedersen, Susanne J; Østergaard, Mikkel

    2012-01-01

    Erosions of the sacroiliac joints (SIJ) on pelvic radiographs of patients with ankylosing spondylitis (AS) are an important feature of the modified New York classification criteria. However, radiographic SIJ erosions are often difficult to identify. Recent studies have shown that erosions can...

  15. Willingness of patients with ankylosing spondylitis to pay for inpatient treatment is influenced by the treatment environment and expectations of improvement

    NARCIS (Netherlands)

    Boonen, A.; Severens, J. L.; van Tubergen, A.; Landewé, R.; Bonsel, G.; van der Heijde, D.; van der Linden, Sj

    2005-01-01

    Objective: To assess the willingness to pay (WTP) for treatment in a spa resort of patients with ankylosing spondylitis ( AS) and to assess if the experience of a spa influences the WTP. Methods: 120 patients participating in a randomised trial comparing 3 weeks' treatment in a spa resort in Austria

  16. Rheumatic patients at work : a study of labour force participations and its determinants in rheumatoid arthritis, ankylosing spondylitis, and juvenile chronic arthritis

    NARCIS (Netherlands)

    Chorus, A.M.J.

    2004-01-01

    This thesis at the University of Maastricht, defended at May 7, 2004, yields several important and new findings with regard to work related quality of life, participation in the labour force and its determinants of patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and juvenile

  17. A relationship between spinal new bone formation in ankylosing spondylitis and the sonographically determined Achilles tendon enthesophytes.

    Science.gov (United States)

    Aydin, Sibel Zehra; Can, Meryem; Alibaz-Oner, Fatma; Keser, Gokhan; Kurum, Esra; Inal, Vedat; Yazisiz, Veli; Birlik, Merih; Emmungil, Hakan; Atagunduz, Pamir; Direskeneli, Haner; McGonagle, Dennis; Pay, Salih

    2016-03-01

    Spinal new bone formation is a major but incompletely understood manifestation of ankylosing spondylitis (AS). We explored the relationship between spinal new bone formation and ultrasound (US)-determined Achilles enthesophytes to test the hypothesis that spinal new bone formation is part of a generalized enthesis bone-forming phenotype. A multicenter, case control study of 225 consecutive AS patients and 95 age/body mass index (BMI) matched healthy controls (HC) was performed. US scans of Achilles tendons and cervical and lumbar spine radiographs were obtained. All images were centrally scored by one investigator for US and one for radiographs, blinded to medical data. The relation between syndesmophytes (by modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) and the number of syndesmophytes) and enthesophytes (with a semi-quantitative scoring of the US findings) was investigated. AS patients had significantly higher US enthesophyte scores than HCs (2.1(1.6) vs. 1.6(1.6); p = 0.004). The difference was significant in males (p = 0.001) but not in females (p = 0.5). The enthesophyte scores significantly correlated with mSASSS scores (ρ = 0.274, p gender-specific phenotype that could be a useful marker predicting of new bone formation.

  18. Paroxysmal supraventricular tachycardia and Wolff-Parkinson-White syndrome in ankylosing spondylitis: a large cohort observation study and literature review.

    Science.gov (United States)

    Ho, Huei-Huang; Yeh, San-Jou; Tsai, Wen-Pin; Wang, Chin-Man; Chen, Ji Yih

    2012-12-01

    To investigate the associations of paroxysmal supraventricular tachycardia (PSVT) and Wolff-Parkinson-White (WPW) syndrome with ankylosing spondylitis (AS). We conducted a retrospective cohort study by reviewing the medical records of 1503 consecutive AS patients diagnosed at a tertiary medical center. The clinical and electrocardiographic (ECG) characteristics of 641 AS patients having 12-lead ECG available were further analyzed in a precise manner. Among the 641 AS patients with 12-lead ECG available for detecting cardiac abnormalities, 14 were identified as having PSVT, including 3 with WPW syndrome and 1 having a WPW (ventricular preexcitation) ECG pattern. A higher proportion of AS patients presented with PSVT (21.8/1000) compared with a general population-based study (2.25/1000). Also, AS patients demonstrated a higher prevalence of WPW syndrome or WPW pattern (6.24/1000) than found in general population-based studies (0.9 to 1.5/1000). Ankylosing spondylitis patients with PSVT or WPW syndrome had significantly higher rates of peripheral arthritis (78.6%; P = 0.002), acute anterior uveitis (64.3%; P = 0.003), bamboo spine (64.3%; P = 0.001), and other cardiovascular disorders (85.7%; P syndrome. Detailed ECG and electrophysiological examinations are required for early detection of PSVT and WPW syndrome for prompt resolution of potentially life-threatening complications in all AS patients, especially those presenting with the symptoms of palpitation, dizziness, dyspnea, or syncope. Copyright © 2012 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Jeroen P. Jansen

    2011-01-01

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

  20. Tofacitinib in patients with ankylosing spondylitis: a phase II, 16-week, randomised, placebo-controlled, dose-ranging study.

    Science.gov (United States)

    van der Heijde, Désirée; Deodhar, Atul; Wei, James C; Drescher, Edit; Fleishaker, Dona; Hendrikx, Thijs; Li, David; Menon, Sujatha; Kanik, Keith S

    2017-08-01

    To compare efficacy and safety of various doses of tofacitinib, an oral Janus kinase inhibitor, with placebo in patients with active ankylosing spondylitis (AS, radiographic axial spondyloarthritis). In this 16-week (12-week treatment, 4-week washout), phase II, multicentre, dose-ranging trial, adult patients with active AS were randomised (N=51, 52, 52, 52, respectively) to placebo or tofacitinib 2, 5 or 10 mg twice daily. The primary efficacy endpoint was Assessment of SpondyloArthritis International Society 20% improvement (ASAS20) response rate at week 12. Secondary endpoints included objective measures of disease activity, patient-reported outcomes and MRI of sacroiliac joints and spine. Safety was monitored. Emax model analysis of the primary endpoint predicted a tofacitinib 10 mg twice daily ASAS20 response rate of 67.4%, 27.3% higher than placebo. Supportive normal approximation analysis demonstrated tofacitinib 5 mg twice daily ASAS20 response rate significantly higher than placebo (80.8% vs 41.2%; ptofacitinib 2 and 10 mg twice daily demonstrated greater response rate than placebo (51.9% and 55.8%, respectively; not significant). Secondary endpoints generally demonstrated greater improvements with tofacitinib 5 and 10 mg twice daily than placebo. Objective (including MRI) endpoints demonstrated clear dose response. Adverse events were similar across treatment groups with no unexpected safety findings. Dose-dependent laboratory outcome changes returned close to baseline by week 16. Tofacitinib 5 and 10 mg twice daily demonstrated greater clinical efficacy versus placebo in reducing signs, symptoms and objective endpoints of active AS in adult patients with a similar 12-week safety profile as reported in other indications. NCT01786668. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. IL23R gene confers susceptibility to ankylosing spondylitis concomitant with uveitis in a Han Chinese population.

    Directory of Open Access Journals (Sweden)

    Hongtao Dong

    Full Text Available PURPOSE: The interleukin-23 receptor (IL-23R has been shown to be associated with ankylosing spondylitis (AS in many different populations. This study examined whether IL-23R polymorphisms were associated with susceptibility to this disease in a Chinese Han population. METHODS: Three single-nucleotide polymorphisms (SNP, rs7517847, rs11209032, and rs17375018, were genotyped in 291 AS patients and 312 age-, sex-, and ethnically matched healthy controls using a polymerase chain reaction (PCR restriction fragment length polymorphism (RFLP assay. RESULTS: The genotype and allele frequencies of rs17375018, rs7517847, and rs11209032 were not different between the patients with AS and the healthy controls. On the one hand, stratification analysis indicated that the rs17375018 GG genotype and the G allele were increased in AS patients who were HLA-B27 positive (corrected p = 0.024, odds ratio [OR] 2.35, 95% CI 1.30-4.24; p c = 0.006, OR 1.98, 95% CI 1.28-3.07, respectively. On the other hand, the analysis according to clinical characteristics showed a significantly increased prevalence of the homozygous rs17375018 GG genotype and the G allele in patients with AS and uveitis compared with the controls (p c = 0.024 and p c = 0.024, respectively. In addition, haplotype analysis performed with the SHEsis platform revealed no significant difference concerning the haplotypes between AS patients and healthy controls. CONCLUSIONS: In this study, the results suggested that the rs17375018 of IL23R was positively associated with HLA-B27-positive AS and that the rs17375018 GG of IL-23R was associated with AS concomitant with uveitis. We found no evidence for an association between the other two SNPs of IL-23R and AS.

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

    Science.gov (United States)

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

    2014-01-01

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

  3. Understanding limitations in at-work productivity in patients with active ankylosing spondylitis: the role of work-related contextual factors.

    Science.gov (United States)

    Boonen, Annelies; Boone, Caroline; Albert, Adelin; Mielants, Herman

    2015-01-01

    To explore the effect of health-related and contextual factors on presenteeism, absenteeism, and overall work productivity loss in patients with active ankylosing spondylitis (AS). Consecutive patients with AS starting their first tumor necrosis factor inhibitor and in paid employment were eligible. Patients completed the Work Productivity and Activity Impairment (WPAI) questionnaire for AS to assess presenteeism, absenteeism, and overall work productivity loss in the previous 7 days. In addition, they answered questions about work characteristics (type, characteristics of workplace, satisfaction of contacts with colleagues, and importance of work in life) and health status [Bath AS Functional Index (BASFI), AS Disease Activity Score-C-reactive protein (ASDAS-CRP)]. Physicians assessed the Bath Ankylosing Spondylitis Metrology Index, presence of articular and extraarticular manifestations, comorbidities, and laboratory indicators of inflammation. Stepwise regression models were computed to determine which work-related and health-related factors contributed to WPAI outcomes. The study included 80 patients. The WPAI presenteeism, absenteeism, and overall work productivity loss scores were 49.1%, 30.2%, and 53.1%, respectively. Presenteeism was associated with higher BASFI, female sex, and poor quality of contact with colleagues. Absenteeism was associated with increasing age, current smoking status, higher ASDAS-CRP, and low importance of work for life. Overall work productivity loss was associated with female sex, higher BASFI, past adaptation of job because of illness, number of working hours, and manual profession. Both health-related and contextual factors contribute to work limitations in patients with AS and suggest additional opportunities for improvement by addressing the working environment.

  4. Computer simulation of two-level pedicle subtraction osteotomy for severe thoracolumbar kyphosis in ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Ning Zhang

    2017-01-01

    Full Text Available Background: Advanced ankylosing spondylitis is often associated with thoracolumbar kyphosis, resulting in an abnormal spinopelvic balance and pelvic morphology. Different osteotomy techniques have been used to correct AS deformities, unfortunnaly, not all AS patients can gain spinal sagittal balance and good horizontal vision after osteotomy. Materials and Methods: Fourteen consecutive AS patients with severe thoracolumbar kyphosis who were treated with two-level PSO were studied retrospectively. All were male with a mean age of 34.9 ± 9.6 years. The followup ranged from 1–5 years. Preoperative computer simulations using the Surgimap Spinal software were performed for all patients, and the osteotomy level and angle determined from the computer simulation were used surgically. Spinal sagittal parameters were measured preoperatively, after the computer simulation, and postoperatively and included thoracic kyphosis (TK, lumbar lordosis (LL, sagittal vertical axis (SVA, pelvic incidence, pelvic tilt (PT, and sacral slope (SS. The level of correlation between the computer simulation and postoperative parameters was evaluated, and the differences between preoperative and postoperative parameters were compared. The visual analog scale (VAS for back pain and clinical outcome was also assessed. Results: Six cases underwent PSO at L1 and L3, five cases at L2 and T12, and three cases at L3 and T12. TK was corrected from 57.8 ± 15.2° preoperatively to 45.3 ± 7.7° postoperatively (P < 0.05, LL from 9.3 ± 17.5° to −52.3 ± 3.9° (P < 0.001, SVA from 154.5 ± 36.7 to 37.8 ± 8.4 mm (P < 0.001, PT from 43.3 ± 6.1° to 18.0 ± 0.9° (P < 0.001, and SS from 0.8 ± 7.0° to 26.5 ± 10.6° (P < 0.001. The LL, VAS, and PT of the simulated two-level PSO were highly consistent with, or almost the same as, the postoperative parameters. The correlations between the computer simulations and postoperative parameters were significant. The VAS decreased

  5. [APPLICATION OF PHOTOSHOP CS16.0 SOFTWARE IN PREOPERATIVE OSTEOTOMY DESIGN OF ANKYLOSING SPONDYLITIS KYPHOSIS].

    Science.gov (United States)

    Wang, Fei; Tao, Huiren; Liu, Zhibin; Zhang, Jianhua; Han, Fangmin

    2015-02-01

    To introduce the application of Photoshop CS16.0 (PS) software in preoperative osteotomy design of ankylosing spondylitis kyphosis (ASK), and to investigate applied values of the preoperative design. Between March 2009 and March 2013, 21 cases of ASK were treated through preoperative osteotomy design by using PS software. There were 16 males and 5 females, aged from 23 to 50 years (mean, 34.2 years). The deformity included thoracolumbar kyphosis in 14 cases, thoracic kyphosis in 2 cases, and lumbar kyphosis in 5 cases. The ultimate osteotomy angle of preoperative plans and the location and extent of osteotomy were determined by the osteotomy design, which guided operation procedures of the surgeon. The actual osteotomy angle was obtained by measuring Cobb angle of osteotomy segment before and after operation. The sagittal parameters of spine and pelvis including global kyphosis (GK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), and chin brow-vertical angle (CBVA) were measured at preoperation, at 1 week after operation, and last follow-up. The clinical outcomes were assessed by simplified Chinese Scoliosis Research Society-22 (SRS-22) questionnaire and Oswestry disability index (ODI). No complications occurred in the other cases except 1 case of dural tear during operation and 1 case of nerve injury after operation, and primary healing of incision was obtained. All patients were followed up 14 to 45 months (mean, 26.3 months). The SRS-22 and ODI scores at 1 week after operation and last follow-up were significantly improved when compared with preoperative scores (P 0.05). The preoperative planned osteotomy angle and the postoperative actual osteotomy angle were (34.2 ± 10.5) degrees and (33.7 ± 9.7) degrees respectively, showing no significant difference (t = 0.84, P = 0.42). The CBVA, GK, SVA, PT, and LL were significantly improved when compared with the preoperative values (P 0.05). At last follow-up, no failures

  6. Dysbiosis and zonulin upregulation alter gut epithelial and vascular barriers in patients with ankylosing spondylitis.

    Science.gov (United States)

    Ciccia, Francesco; Guggino, Giuliana; Rizzo, Aroldo; Alessandro, Riccardo; Luchetti, Michele Maria; Milling, Simon; Saieva, Laura; Cypers, Heleen; Stampone, Tommaso; Di Benedetto, Paola; Gabrielli, Armando; Fasano, Alessio; Elewaut, Dirk; Triolo, Giovanni

    2017-06-01

    Dysbiosis has been recently demonstrated in patients with ankylosing spondylitis (AS) but its implications in the modulation of intestinal immune responses have never been studied. The aim of this study was to investigate the role of ileal bacteria in modulating local and systemic immune responses in AS. Ileal biopsies were obtained from 50 HLA-B27 + patients with AS and 20 normal subjects. Silver stain was used to visualise bacteria. Ileal expression of tight and adherens junction proteins was investigated by TaqMan real-time (RT)-PCR and immunohistochemistry. Serum levels of lipopolysaccharide (LPS), LPS-binding protein (LPS-BP), intestinal fatty acid-BP (iFABP) and zonulin were assayed by ELISA. Monocyte immunological functions were studied in in vitro experiments. In addition the effects of antibiotics on tight junctions in human leukocyte antigen (HLA)-B27 transgenic (TG) rats were assessed. Adherent and invasive bacteria were observed in the gut of patients with AS with the bacterial scores significantly correlated with gut inflammation. Impairment of the gut vascular barrier (GVB) was also present in AS, accompanied by significant upregulation of zonulin, and associated with high serum levels of LPS, LPS-BP, iFABP and zonulin. In in vitro studies zonulin altered endothelial tight junctions while its epithelial release was modulated by isolated AS ileal bacteria. AS circulating monocytes displayed an anergic phenotype partially restored by ex vivo stimulation with LPS+sCD14 and their stimulation with recombinant zonulin induced a clear M2 phenotype. Antibiotics restored tight junction function in HLA-B27 TG rats. Bacterial ileitis, increased zonulin expression and damaged intestinal mucosal barrier and GVB, characterises the gut of patients with AS and are associated with increased blood levels of zonulin, and bacterial products. Bacterial products and zonulin influence monocyte behaviour. Published by the BMJ Publishing Group Limited. For permission to use

  7. Estimated radiation doses to different organs among patients treated for ankylosing spondylitis with a single course of X rays

    International Nuclear Information System (INIS)

    Lewis, C.A.; Smith, P.G.; Stratton, I.M.; Darby, S.C.; Doll, R.

    1988-01-01

    A follow-up study of over 14000 patients treated with a single course of X rays for ankylosing spondylitis demonstrated substantial excess risk of developing cancer. Previously the excess risk of leukaemia has been related to the estimated mean radiation dose to active bone marrow but detailed estimates were not made of the radiation doses to other organs. Data extracted from the original treatment records of a random sample of one in 15 patients have been used to make dose estimates, using Monte Carlo methods, for 30 specific organs or body regions and 12 bone marrow sites. Estimates of mean and median organ doses, standard deviations and ranges have been tabulated. Detailed distributions are presented for six organs (lung, bronchi, stomach, oesophagus, active bone marrow and total body). Comparison with the earlier bone marrow estimates and more recent theoretical estimates shows good agreement. (author)

  8. ATTEMPT OF OVERCOMING SECONDARY INEFFECTIVENESS OF INFLIXIMAB IN A PATIENT WITH ANKYLOSING SPONDYLITIS USING PLASMAPHERESIS (A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Oksana Alekseyevna Rumyantseva

    2013-01-01

    Full Text Available The article focuses on the problem of secondary ineffectiveness of tumor necrosis factor α infliximab (INF and describes an attempt of using plasmapheresis (PF to eliminate this problem in a patient with ankylosing spondylitis who had received INF treatment at a dose of 5 mg/kg for a long time (over 4 years. After PF, the IFF therapy ensured a long-term clinical and laboratory improvement of patient's condition. One can assume that PF made it possible to overcome secondary ineffectiveness of INF and can be used in some patients in cases when INF cannot be replaced with another TNFα inhibitor.

  9. 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; Hermann, Kay-Geert

    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...

  10. The risk of depression, suicidal ideation and suicide attempt in patients with psoriasis, psoriatic arthritis or ankylosing spondylitis

    DEFF Research Database (Denmark)

    Wu, J J; Penfold, R B; Primatesta, P

    2017-01-01

    BACKGROUND: Sparse information is available concerning mental health issues in psoriasis, psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients. OBJECTIVE: To estimate risk of depression, suicidal ideation and suicide attempt in patients with psoriasis, PsA and AS, respectively......, compared with the general population. METHODS: This population-based cohort study analysed 36 214 psoriasis patients, 5138 PsA patients and 1878 AS patients who were frequency-matched with a general population cohort. Annual incidence rate of depression, suicidal ideation and suicide attempt was calculated...... separately for psoriasis, PsA and AS. RESULTS: There was an increased risk of depression in the three cohorts; adjusted IRR: psoriasis, 1.14 (95% CI, 1.11, 1.17); PsA, 1.22 (95% CI, 1.16, 1.29); AS, 1.34 (95% CI, 1.23, 1.47). There was no significantly increased risk for suicidal ideations or suicide attempt...

  11. Genetic variants of STAT4 are associated with ankylosing spondylitis susceptibility and severity in a Chinese Han population.

    Science.gov (United States)

    Liu, Zhixiang; Zhang, Peisen; Dong, Jie

    2014-01-01

    Genetic factors play an important role in ankylosing spondylitis (AS) etiology and signal transducer and activator of transcription 4 (STAT4) gene polymorphisms may be involved. The aim of this study was to test whether STAT4 variants were associated with susceptibility to AS in a Chinese population. A total of 175 subjects who were diagnosed as AS and 249 healthy age-matched controls were enrolled in the present study. The rs7574865 G/T SNP in STAT4 gene was genotyped in all the subjects. The SPSS software was used to investigate the association between the rs7574865 genotypes and AS susceptibility or severity. Rs7574865 G/T was found to be significantly associated with increased risk and severity of AS. Our data demonstrated the STAT4 rs7574865 G/T SNP was significantly associated with increased AS susceptibility and severity in Chinese Han Population.

  12. Inflammation Intensity-dependent Expression of Osteoinductive Wnt Proteins is Critical for Ectopic New Bone Formation in Ankylosing Spondylitis.

    Science.gov (United States)

    Li, Xiang; Wang, Jianru; Zhan, Zhongping; Li, Sibei; Zheng, Zhaomin; Wang, Taiping; Zhang, Kuibo; Pan, Hehai; Li, Zemin; Zhang, Nu; Liu, Hui

    2018-02-26

    To investigate the molecular mechanism underlying the inflammation- related ectopic new bone formation in ankylosing spondylitis (AS). Spinal tissues and sera were collected from patients or normal volunteers to detect the expression of Wnt proteins. An in vitro cell culture system mimicking the local inflammatory microenvironment of bone-forming sites was established to study the relationship between inflammation and Wnt expression, the regulatory mechanism of inflammation-induced Wnt expression and the role of Wnt signaling in new bone formation. A modified collagen-induced arthritis (mCIA) and a proteoglycan -induced spondylitis (PGIS) animal model were used to confirm the key findings in vivo. The levels of osteoinductive Wnt proteins were obviously increased in the sera and spinal ligament tissues of patients with AS. Only constitutive low-intensity TNF-α stimulation, but not short-term or high-intensity TNF-α stimulation, induced persistent expression of osteoinductive Wnt proteins and subsequent bone formation through NF-κB (p65) and JNK/AP-1 (c-Jun) signaling pathways. Furthermore, inhibition of either Wnt/β-catenin or Wnt/PKCδ pathway significantly suppressed new bone formation. The increased expression of Wnt proteins was confirmed in both mCIA and PGIS models. A kyphotic and ankylosing phenotype of the spine was observed during long-term observation in mCIA model. Inhibition of either Wnt/β-catenin or Wnt/PKCδ signaling pathway significantly reduced the incidence and severity of this phenotype. Inflammation intensity-dependent expression of osteoinductive Wnt proteins is a key link between inflammation and ectopic new bone formation in AS. Activation of both canonical Wnt/β-catenin and noncanonical Wnt/PKCδ pathways is required for inflammation-induced new bone formation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  13. Bone edema on magnetic resonance imaging is highly associated with low bone mineral density in patients with ankylosing spondylitis.

    Directory of Open Access Journals (Sweden)

    Danmin Wang

    Full Text Available This study aimed to assess the relationship between bone marrow edema (BME on magnetic resonance imaging (MRI and bone mineral density (BMD in patients with ankylosing spondylitis (AS.The study included 333 patients with AS who underwent BMD measurements and axial MRI. Additionally, 106 normal controls were included. The modified New York criteria were used as the classification criteria of AS. Clinical, laboratory, and imaging data were collected and analyzed. Lumbar spine and proximal femur BMD were assessed using dual-energy X-ray absorptiometry. Low BMD was defined by a Z-score ≤-2. The Spondyloarthritis Research Consortium of Canada (SPARCC MRI index was used to assess inflammation at the sacroiliac joint (SIJ and spine.Among the 333 patients, the male:female ratio was 4.6:1, mean patient age was 28.5±10.6 years, and mean disease duration was 7.3±6.8 years. The prevalences of low BMD, osteopenia, and osteoporosis were significantly higher among AS patients than among controls (19.8%, 62.8%, and 5.7% vs. 4.7%, 33.0%, and 0%, respectively, P = 0.000. The BMD values were significantly lower and prevalences of low BMD at both the spine and femur were significantly higher among patients with BME on MRI than among those without BME. Multivariate logistic regression analysis showed that male sex (OR 3.87, 95% CI 1.21-7.36, P = 0.023, high ASDAS-CRP score (OR 2.83, 95% CI 1.36-4.76, P = 0.015, the presence of BME on sacroiliac MRI (OR 2.83, 95% CI 1.77-6.23, P = 0.000 and spinal MRI (OR 4.06, 95% CI 1.96-8.46, P = 0.000, and high grade of sacroiliitis (OR 2.93, 95% CI 1.82-4.45, P = 0.002 were risk factors for low BMD (any site. The SPARCC scores of the SIJ were negatively correlated with femoral BMD (r = -0.22, 95% CI -0.33 to -0.10, P = 0.000. Additionally, the SPARCC scores of the spine were negatively correlated with BMD values (r = -0.23, 95% CI -0.36 to -0.09, P = 0.003 and Z-scores (r = -0.24, 95% CI -0.36 to -0.12, P = 0.001 at the

  14. INVESTIGATION OF A ROLE OF THE IMMUNOGENICITY OF INFLIXIMAB IN THE THERAPY OF ANKYLOSING SPONDYLITIS

    Directory of Open Access Journals (Sweden)

    O. A. Rumyantseva

    2016-01-01

    Full Text Available At present, there are a number of unsolved problems associated with unawareness of the causes and ways to prevent the inefficacy of tumor necrosis factor-α  inhibitors.Objective: to study the causes of secondary inefficacy of infliximab (INF, by analyzing its concentrations and antidrug antibody levels in the serum of ankylosing spondylitis (AS patients receiving long INF,  as well as a possibility to overcome its secondary inefficacy through plasmapheresis.Subjects and methods. 54 patients with active AS (BASDAI > 4 underwent regular long-term  (1-to-10-year treatment with INF 5 mg/kg according to the standard scheme. During the therapy blood samples were taken before a regular INF infusion to quantify the levels of antibodies to the drug and its concentration. According to the efficiency of the drug, two groups were formed: 1 27 (50% patients with INF inefficacy (an exacerbation occurred 2–4 weeks after infusion; 2 27 patients with drug efficacy. The levels of anti-double stranded DNA antibodies and antinuclear factor were estimated in 27 patients to investigate a relationship between the immunogenicity of INF and the presence of autoantibodies in its secondary inefficacy. A plasmapheresis session was carried out in 5 patients before a regular IFN infusion.Results and discussion. Anti-INF antibodies were found in 28 (52% patients, these being more common  in the patients with drug inefficacy than in the others (67 and 37%, respectively; p < 0.05. In the patients with INF inefficacy, anti-INF antibody levels were significantly higher than in those with preserved drug effect (18.33 and 4.67 U/ml, respectively; р < 0.05. Moreover, the serum concentration of INF was not significantly different in these groups (1.6 and 2.96 μg/ml. There was an inverse correlation  between INF concentrations and anti-INF antibodies (r = -0.7; p < 0.05. The level of autoantibodies  did not correlate with that of anti-INF antibodies. Following

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

    DEFF Research Database (Denmark)

    Madsen, Ole Rintek; Lindhardsen, Jesper

    2011-01-01

    Ankylosing spondylitis is an inflammatory disorder primarily affecting the axial skeleton. The disease is associated with increased cardiovascular morbidity and mortality. Structural changes in the heart, and arteriosclerosis secondary to inflammation may be of importance. The role of traditional...

  16. Golimumab for the treatment of ankylosing spondylitis : a NICE single technology appraisal

    NARCIS (Netherlands)

    Armstrong, Nigel; Joore, Manuela; van Asselt, Thea; Misso, Kate; Manning, Nathan; Tomini, Florian; Kleijnen, Jos; Riemsma, Rob

    As part of the National Institute for Health and Clinical Excellence (NICE) single technology appraisal (STA) process, the Evidence Review Group (ERG) produced a report to comment on the clinical and cost effectiveness of golimumab (Simponi(®), Merck Sharp & Dohme) for the treatment of ankylosing

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

    Directory of Open Access Journals (Sweden)

    Valderilio Feijó Azevedo

    2010-12-01

    Full Text Available INTRODUÇÃO: A Espondilite Anquilosante (EA é uma doença inflamatória crônica que acomete o esqueleto axial. Cursa com dor e incapacidade funcional. Para medir o impacto da EA na vida dos pacientes são utilizados questionários que avaliam a atividade da doença (BASDAI; a incapacidade funcional (BASFI; e a qualidade de vida (ASQoL. A Fibromialgia (FM é uma das causas mais comuns de dor generalizada e pode coexistir com outras doenças; pode ser avaliada por meio do questionário de impacto da Fibromialgia (FIQ. Há poucos estudos demonstrando correlações entre FM e EA. O presente estudo obteve dados referentes ao perfil epidemiológico de pacientes com EA e FM e avaliou a prevalência de FM em portadores de EA. Avaliou-se a interferência da FM nos escores dos testes BASDAI, BASFI e ASQoL. PACIENTES E MÉTODO: Foram incluídos 71 pacientes portadores de EA diagnosticados de acordo com os critérios modificados de Nova York. Avaliação clínica, funcional e aplicação dos testes BASDAI, BASFI e ASQoL foram realizados. Os pacientes com diagnóstico de FM foram avaliados com o FIQ. RESULTADOS: Onze pacientes preencheram os critérios para FM, observando-se assim uma prevalência de 15% de FM entre os pacientes com EA, sendo mais frequente entre as mulheres (3,8:1. A idade de início da doença (EA foi de 27,5 anos. O antígeno HLA-B27 foi positivo na grande maioria (80,4%. Comparando-se as médias dos testes BASDAI, BASFI e ASQoL, verificou-se que os valores são significativamente superiores (P INTRODUCTION: Ankylosing spondylitis (AS is a chronic inflammatory disease that affects the axial skeletal system, causing pain and functional incapacity. To measure the impact of AS on patient's life, questionnaires are used to assess disease activity (BASDAI; functional incapacity (BASFI; and quality of life (ASQoL. Fibromyalgia (FM is one of the most common causes of generalized pain and can coexist with other diseases; it can be assessed by

  18. 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.

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    Eric Toussirot

    Full Text Available 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.

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

    Directory of Open Access Journals (Sweden)

    Xiugao Feng

    2015-01-01

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

  20. Increased body mass index in ankylosing spondylitis is associated with greater burden of symptoms and poor perceptions of the benefits of exercise.

    Science.gov (United States)

    Durcan, Laura; Wilson, Fiona; Conway, Richard; Cunnane, Gaye; O'Shea, Finbar D

    2012-12-01

    Increased body mass index (BMI) in patients with ankylosing spondylitis (AS) is associated with a greater burden of symptoms and poor perceptions of the benefits of exercise. In AS, the effect of obesity on disease characteristics and exercise perceptions is unknown. We evaluated the prevalence of obesity in AS, to assess the attitudes of patients toward exercise and to evaluate the effect of obesity on symptoms and disease activity. Demographic data and disease characteristics were collected from 46 patients with AS. Disease activity, symptomatology, and functional disability were examined using standard AS questionnaires. BMI was calculated. Comorbidity was analyzed using the Charlson Comorbidity Index. Patients' attitudes toward exercise were assessed using the Exercise Benefits and Barriers Scale (EBBS). We compared the disease characteristics, perceptions regarding exercise, and functional limitations in those who were overweight to those who had a normal BMI. The mean BMI in the group was 27.4; 67.5% of subjects were overweight or obese. There was a statistically significant difference between those who were overweight and those with a normal BMI regarding their perceptions of exercise (EBBS 124.7 vs 136.6, respectively), functional limitation (Bath AS Functional Index 4.7 vs 2.5, Health Assessment Questionnaire 0.88 vs 0.26), and disease activity (Bath AS Disease Activity Index 4.8 vs 2.9). There was no difference between the groups in terms of their comorbid conditions or other demographic variables. The majority of patients in this AS cohort were overweight. They had a greater burden of symptoms, worse perceptions regarding the benefits of exercise, and enhanced awareness of their barriers to exercising. This is of particular concern in a disease where exercise plays a crucial role.

  1. The effects of balance and postural stability exercises on spa based rehabilitation programme in patients with ankylosing spondylitis.

    Science.gov (United States)

    Gunay, Selim M; Keser, Ilke; Bicer, Zemzem T

    2018-01-01

    Ankylosing spondylitis (AS) can cause severe functional disorders that lead to loss of balance. The aim of this study was to investigate the effects of balance and postural stability exercises on spa based rehabilitation programme in AS subjects. Twenty-one participants were randomized to the study (n= 11) and control groups (n= 10). Patients balance and stability were assessed with the Berg Balance Scale (BBS), Timed Up and Go (TUG) Test, Single Leg Stance Test (SLST) and Functional Reach Test (FRT). AS spesicied measures were used for assessing to other parameters. The treatment plan for both groups consisted of conventional transcutaneous electrical nerve stimulation (TENS), spa and land-based exercises 5 days per week for 3 weeks. The study group performed exercises based on postural stability and balance with routine physiotherapy practice in thermal water and in exercise room. The TUG, SLST and FUT scores were significantly increased in the study group. In both groups, the BASMI, BASFI, BASDAI and ASQoL scores decreased significantly by the end of the treatment period (pbalance and stability exercises in addition to spa based routine approaches can increase the duration of maintaining balance and can improve the benefits of physiotherapy.

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

    International Nuclear Information System (INIS)

    Darby, S.C.; Doll, Richard; Smith, P.G.

    1987-01-01

    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. Comparison of radiography, computed tomography and magnetic resonance imaging in the detection of sacroiliitis accompanying ankylosing spondylitis

    International Nuclear Information System (INIS)

    Yu, Wei; Feng Feng; Yang Hongzen; Jiang Ming; Dion, E.; Genant, H.K.

    1998-01-01

    Objective. To compare magnetic resonance (MR) imaging, computed tomography (CT), and radiography in the detection of sacroiliitis accompanying ankylosing spondylitis (AS). Design and subjects. Nine volunteers and 24 patients were recruited. Radiography, CT, and MR imaging were completed within a 1-week period in 24 patients with AS. In precontrast MR examination, spin-echo T1, fast spin-echo T2, and gradient echo with rephasing T2* images were obtained without fat saturation using a 0.3-T imager for all volunteers and patients. Postcontrast MR examination was performed using the same precontrast SE T1 sequence for patients with AS. Results and conclusions. MR imaging directly showed the normal cartilage in all 16 sacroiliac joints of the 8 volunteers. In the 24 patients with AS, cartilage abnormalities were observed in 42 sacroiliac joints. More diagnoses of sacroiliitis were made using MR and CT imaging than using radiography (P<0.001). Therefore, low-field-strength MR can be useful in detecting early sacroiliitis in patients with AS. MR imaging was able to reveal early cartilage changes and bone marrow edema, which could not be found by either CT or radiography. (orig.)

  4. Evaluation of the internal oblique, external oblique, and transversus abdominalis muscles in patients with ankylosing spondylitis: an ultrasonographic study.

    Science.gov (United States)

    Üşen, Ahmet; Kuran, Banu; Yılmaz, Figen; Aksu, Neşe; Erçalık, Cem

    2017-11-01

    The objectives of the study are to compare abdominal muscle thickness in ankylosing spondylitis (AS) patients with healthy subjects and determine the factors affecting these muscle thickness. Thirty-five male patients with a previous diagnosis of AS according to the Modified New York criteria and a control group consisting of 35 healthy male individuals were included in this cross-sectional and case-control study. Thicknesses of the internal oblique (IO), external oblique (EO), and transversus abdominalis (TrA) muscles were measured with ultrasound (US). AS patients were classified according to the International Physical Activity Questionnaire (IPAQ). There were 35 AS patients with a mean age of 35.17 ± 8.05 years and 35 healthy subjects with a mean age 32.57 ± 7.05 years. No significant difference was observed between the groups in terms of abdominal muscle thicknesses (p > 0.005). When the AS patients were classified according to the IPAQ scores, thicknesses of the IO and TrA muscles were significantly lower in patients who had the low level of IPAQ scores (p < 0.05). In the light of our first and preliminary results, muscle thickness of the IO, EO, and TrA muscles were similar in AS patients to healthy subjects. However, AS patients who had lower level of physical activity have also reduced thickness of IO and TrA muscles.

  5. Towards an ICF-based clinical measure of functioning in people with ankylosing spondylitis: a methodological exploration.

    Science.gov (United States)

    Cieza, A; Hilfiker, R; Boonen, A; van der Heijde, D; Braun, J; Stucki, G

    2009-01-01

    To explore whether it is possible to construct clinical measures of functioning for patients with ankylosing spondylitis (AS) by integrating information obtained across categories of the International Classification of Functioning, Disability and Health (ICF). Sixty-eight ICF categories that were identified as relevant by patients with AS and that covered body functions, structures, and activity and participation were analysed based on the Rasch model for ordered response options. The following properties were studied: unidimensionality, reliability, fit of the ICF categories to the Rasch model, the appropriateness of the order of the response options of the ICF qualifier, and the targeting between the ICF categories and the person's abilities. After accounting for disordered thresholds and misfitting ICF categories, a clinical measure of functioning for AS was proposed that contained 64 ICF categories. On the basis of a transformation table, the raw scores obtained by adding the answers to the 64 ICF categories can be transformed to the Rasch logit scale and to a meaningful interval scale ranging from zero to 100. For the first time, it has been shown that clinical measures of functioning, in principle, can be constructed based on the comprehensive ICF framework covering body functions and structures and activities and participation domains. The results of this investigation are preliminary and must be validated, but they are promising and can contribute to the acceptance and usefulness of the ICF in clinical practice.

  6. Non-­‐pharmacological treatment of ankylosing spondylitis: Barriers to effective implementation of recommendations in Morocco

    Directory of Open Access Journals (Sweden)

    Abderrazak Hajjioui

    2014-05-01

    Full Text Available This cross-sectional study aimed to describe non--‐pharmacological treatment modalities in Moroccan patients with ankylosing spondylitis (AS, and to approach physical therapy implementation barriers. 61 patients with AS according to New York classification criteria were included in the study. Socio-demographic data and clinical characteristics were collected and different therapeutic modalities, including physical therapy were investigated. The mean age of the patients was 38.20 (SD 12.36 years with a male/female ratio of 1.5. 55 (90% patients received pharmacological therapy, 37 (60.7% received physical therapy, 5(8.2% underwent surgery and 36 (59% tried at least one type of complementary medicine (medicine plants, sand baths, acupuncture, fire needles, and cupping. Patients’ major expectations from physical therapy were improving their functional status (86.5%, and reducing their pain (59.5%. Most patients (86.49% were satisfied of their physical therapy and 56.8% practiced home exercises. Reasons for nonattendance to physical therapy for the remaining 24 patients were nonprescription (58.3%, lack of financial resources (20.8%, geographical remoteness from rehabilitation centers (4% and lack of motivation (17%. Non-pharmacological treatment, especially based on exercise and education, is an integral part of the comprehensive management of AS. However, it is not efficiently implemented in Morocco and more effort should be made to develop this both efficient and relatively inexpensive component of AS treatment.

  7. PICTORIAL ESSAY Bamboo spine – X-ray findings of ankylosing ...

    African Journals Online (AJOL)

    Pathology and imaging characteris- tics. In this pictorial essay, we focus on the characteristic axial skeleton imaging findings of AS, as it presents on conventional X-ray:1. • florid anterior spondylitis (Romanus lesions). • florid diskitis (Andersson lesions). Ankylosing spondylitis is a debilitating disease that is one of the sero-.

  8. The potent suppressive effect of β-d-mannuronic acid (M2000) on molecular expression of the TLR/NF-kB Signaling Pathway in ankylosing spondylitis patients.

    Science.gov (United States)

    Roozbehkia, Maryam; Mahmoudi, Mahdi; Aletaha, Somaye; Rezaei, Nima; Fattahi, Mohammad Javad; Jafarnezhad-Ansariha, Fahimeh; Barati, Anis; Mirshafiey, Abbas

    2017-11-01

    Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease characterized by the inflammation of sacroiliac joints and axial skeleton. A combination of genetic, environmental and immunological factors are involved in AS's pathogenesis. TLRs are type I transmembrane glycoproteins that play a crucial role in the innate immune responses against invading pathogens. Observational studies have demonstrated a possible association between TLR dysregulation and AS. The β-d-mannuronic acid (M2000), as a novel NSAID with immunosuppressive property, has shown an inhibitory effect on Toll-like receptor (TLR) 2, 4 signaling in HEK293 cells. In the present study, we investigated the gene expression of Myd88, IKB-alpha, NF-kB and MAPK14 (genes of the TLR/NF-kB Signaling Pathway) in AS patients in comparison to healthy subjects and also the effect of β-d-mannuronic acid on disease activity and mRNA expression of these molecules in affected patients. We showed for the first time that the gene expression level of Myd88, IKB-alpha, NF-kB and MAPK14 was higher in AS patients in comparison to healthy subjects. Moreover we confirmed that the β-d-mannuronic acid not just reduced significantly the disease activity of AS individuals compared to placebo, but also it could significantly decrease the expression level of genes associated with TLR/NF-kB Signaling Pathway in treated patients with M2000. These results may provide a new therapeutic approach to attenuate inflammatory responses in AS patients, (Identified; IRCT 2013062213739N1). Copyright © 2017. Published by Elsevier B.V.

  9. Comparable long-term efficacy, as assessed by patient-reported outcomes, safety and pharmacokinetics, of CT-P13 and reference infliximab in patients with ankylosing spondylitis: 54-week results from the randomized, parallel-group PLANETAS study.

    Science.gov (United States)

    Park, Won; Yoo, Dae Hyun; Jaworski, Janusz; Brzezicki, Jan; Gnylorybov, Andriy; Kadinov, Vladimir; Sariego, Irmgadt Goecke; Abud-Mendoza, Carlos; Escalante, William Jose Otero; Kang, Seong Wook; Andersone, Daina; Blanco, Francisco; Hong, Seung Suh; Lee, Sun Hee; Braun, Jürgen

    2016-01-20

    CT-P13 (Remsima®, Inflectra®) is a biosimilar of the infliximab reference product (RP; Remicade®) and is approved in Europe and elsewhere, mostly for the same indications as RP. The aim of this study was to compare the 54-week efficacy, immunogenicity, pharmacokinetics (PK) and safety of CT-P13 with RP in patients with ankylosing spondylitis (AS), with a focus on patient-reported outcomes (PROs). This was a multinational, double-blind, parallel-group study in patients with active AS. Participants were randomized (1:1) to receive CT-P13 (5 mg/kg) or RP (5 mg/kg) at weeks 0, 2, 6 and then every 8 weeks up to week 54. To assess responses, standardized assessment tools were used with an intention-to-treat analysis of observed data. Anti-drug antibodies (ADAs), PK parameters, and safety outcomes were also assessed. Of 250 randomized patients (n = 125 per group), 210 (84.0 %) completed 54 weeks of treatment, with similar completion rates between groups. At week 54, Assessment of Spondylo Arthritis international Society (ASAS)20 response, ASAS40 response and ASAS partial remission were comparable between treatment groups. Changes from baseline in PROs such as mean Bath Ankylosing Spondylitis Disease Activity Index (BASDAI; CT-P13 -3.1 versus RP -2.8), Bath Ankylosing Spondylitis Functional Index (BASFI; -2.9 versus -2.7), and Short Form Health Survey (SF-36) scores (9.26 versus 10.13 for physical component summary; 7.30 versus 6.54 for mental component summary) were similar between treatment groups. At 54 weeks, 19.5 % and 23.0 % of patients receiving CT-P13 and RP, respectively, had ADAs. All observed PK parameters of CT-P13 and RP, including maximum and minimum serum concentrations, were similar through 54 weeks. The influence of ADAs on PK was similar in the two treatment groups. Most adverse events were mild or moderate in severity. There was no notable difference between treatment groups in the incidence of adverse events, serious adverse events

  10. Being a parent or grandparent with back pain, ankylosing spondylitis or rheumatoid arthritis: a descriptive postal survey.

    Science.gov (United States)

    Grant, M I; Foster, N E; Wright, C C; Barlow, J H; Cullen, L A

    2004-01-01

    Research that explores being a parent or grandparent with musculoskeletal problems has been fairly limited to date. The aim of this study was to describe the experience of parenting in the context of back pain (BP), ankylosing spondylitis (AS) and rheumatoid arthritis (RA), with a particular focus on the extent and nature of childcare experiences and to compare these experiences across the three groups. In addition, the possible reasons for these reported experiences, the availability of advice and support and the development of strategies for coping were explored using a cross-sectional descriptive survey. A total of 448 participants was recruited from relevant charitable organizations and the National Health Service (280 with BP, 106 with AS and 62 with RA). A combination of opportunistic and random sampling was used. Quantitative data were analysed with appropriate descriptive and inferential statistics using Statistical Package for the Social Sciences (SPSS version 10). Qualitative data were analysed using content analysis. Results indicate that a high proportion of all groups experienced a wide range of difficulties with parenting (81% BP, 77% AS, 97% RA). The most prevalent problems were similar for all three groups: lifting baby/child from the floor or cot, encouraging children/grandchildren to help with domestic chores and keeping up (in terms of energy) with children/grandchildren. However, the RA group reported having greater difficulties than the other two groups. Very little advice was offered to participants with parenting difficulties which may indicate a gap in service provision. However, a wide range of strategies for coping were described by respondents. The study highlighted a need for healthcare professionals to develop a greater awareness of parenting issues and to provide opportunities for these issues to be addressed. Copyright (c) 2004 Whurr Publishers Ltd.

  11. Evaluation of Tp-e interval and Tp-e/QT ratio in patients with ankylosing spondylitis.

    Science.gov (United States)

    Acar, Gurkan; Yorgun, Hikmet; Inci, Mehmet Fatih; Akkoyun, Murat; Bakan, Betul; Nacar, Alper Bugra; Dirnak, Imran; Cetin, Gozde Yildirim; Bozoglan, Orhan

    2014-03-01

    Ankylosing spondylitis (AS) is a chronic multi-systemic inflammatory rheumatic disorder. Several studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarization and that increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. The aim of this study was to evaluate ventricular repolarization by using Tp-e interval and Tp-e/QT ratio in patients with AS, and to assess the relation with inflammation. Sixty-two patients with AS and 50 controls were included. Tp-e interval and Tp-e/QT ratio were measured from a 12-lead electrocardiogram, and the Tp-e interval corrected for heart rate. The plasma level of high sensitive C-reactive protein (hsCRP) was measured. These parameters were compared between groups. In electrocardiographic parameters analysis, QT dispersion (QTd) and corrected QTd were significantly increased in AS patients compared to the controls (31.7 ± 9.6 vs 28.2 ± 7.4 and 35.8 ± 11.5 vs 30.6 ± 7.9 ms, P = 0.03 and P = 0.007, respectively). cTp-e interval and Tp-e/QT ratio were also significantly higher in AS patients (92.1 ± 10.2 vs 75.8 ± 8.4 and 0.22 ± 0.02 vs 0.19 ± 0.02 ms, all P values ratio were significantly correlated with hsCRP (r = 0.63, P ratio were increased in AS patients. These electrocardiographic ventricular repolarization indexes were significantly correlated with the plasma level of hsCRP.

  12. Impact of gender, work, and clinical presentation on diagnostic delay in Italian patients with primary ankylosing spondylitis.

    Science.gov (United States)

    Bandinelli, F; Salvadorini, G; Delle Sedie, A; Riente, L; Bombardieri, S; Matucci-Cerinic, M

    2016-02-01

    The variability of demographic, social, genetic, and clinical factors might influence the time between the onset of symptoms and the diagnosis [diagnostic delay (DD)] of ankylosing spondylitis (AS) in different geographic areas. Different clinical manifestations in men and women affected by AS might indicate a possible role of gender in DD. The aim of the present study was to investigate the influence of demographic, social, genetic, and clinical factors on DD and the differences of DD between men and women related to the presence of different demographic, social, clinical, and genetic parameters in an Italian cohort of primary AS patients. A total of 135 Italian primary AS patients (45 female and 90 male, 27.9 ± 0.89 years old at onset) were studied. The DD, gender, education and work (manual or non-manual) levels, and type of first clinical presentation (inflammatory back pain, arthritis, enthesitis) at onset, family history of AS, and HLA B27 presence were analyzed. The DD (8.744 mean ±0.6869) was significantly higher in men (p = 0.0023), in axial presentation (p = 0.0021), and in manual work (even if with low significance, p = 0.047). The lower DD in women in comparison to that in men was likely related to higher education (p = 0.0045) and work (p = 0.0186) levels, peripheral involvement (p = 0.0009), and HLA B27 positivity (p = 0.0231). DD was higher in AS patients: male, employed in manual jobs, and with axial symptoms at onset. In men, DD seemed to be negatively influenced by lower level of education and work, axial clinical presentation, and HLA B27.

  13. MRI findings of sacroiliitis in ankylosing spondylitis: roles of MPGR and delayed post-contrast T1-weighted images

    International Nuclear Information System (INIS)

    Jeon, Eui Yong; Joo, Kyung Bin; Koo, Ja Hong; Moon, Won Jin; Hahm, Chang Kok; Kim, Tae Hwan; Kim, Seong Yoon

    1997-01-01

    For early diagnosis of sacroiliitis in spondyloarthropathy, the MRI findings of sacroiliitis, roles of MPGR(multiplanar Gradient Recalled Acquisition in Steady State), and delayed post-contrast T1-weighted images were evaluated. Twenty six patients with seronegative spondyloarthropathy(Probable clinical diagnosis of ankylosing spondylitis) were grouped as either less than radiographic grade 1(group A) or more than grade 2(group B). The MRI findings of both sacroiliac joints were evaluated in every patient, and predominant sites were determined. The two groups were then compared. In 17 patients, the number of enhancing panni seen on early and delayed post-contrast T1-weighted images was counted and compared between the two groups. Panni were found in all cases, and in both groups, predominant patterns of involvement were the lower and iliac aspects of the sacroiliac joints in both groups; in group A, the synovial joints and punctate pannus were predominantly involved, and in group B, the ligamentous joints as well as the synovial joints and linear pannus. In group B, More periarticular fat accumulation than periarticular osteitis was found. For the evaluation of changes in joint space, MPGR images were superior to spin echo images. For the delineation of enhancing pannus less than radiographic grade I, delayed post-contrast images were statistically superior to those which were early post-contrast. MRI can detect early sacroiliitic change according to the predominant sites of involvement, and deslyed post-contrast images play a role in the diagnosis of early sacroiliitis. MPGR imaging is good for the evaluation of joint space change

  14. MRI findings of sacroiliitis in ankylosing spondylitis: roles of MPGR and delayed post-contrast T1-weighted images

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Eui Yong; Joo, Kyung Bin; Koo, Ja Hong; Moon, Won Jin; Hahm, Chang Kok; Kim, Tae Hwan; Kim, Seong Yoon [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-10-01

    For early diagnosis of sacroiliitis in spondyloarthropathy, the MRI findings of sacroiliitis, roles of MPGR(multiplanar Gradient Recalled Acquisition in Steady State), and delayed post-contrast T1-weighted images were evaluated. Twenty six patients with seronegative spondyloarthropathy(Probable clinical diagnosis of ankylosing spondylitis) were grouped as either less than radiographic grade 1(group A) or more than grade 2(group B). The MRI findings of both sacroiliac joints were evaluated in every patient, and predominant sites were determined. The two groups were then compared. In 17 patients, the number of enhancing panni seen on early and delayed post-contrast T1-weighted images was counted and compared between the two groups. Panni were found in all cases, and in both groups, predominant patterns of involvement were the lower and iliac aspects of the sacroiliac joints in both groups; in group A, the synovial joints and punctate pannus were predominantly involved, and in group B, the ligamentous joints as well as the synovial joints and linear pannus. In group B, More periarticular fat accumulation than periarticular osteitis was found. For the evaluation of changes in joint space, MPGR images were superior to spin echo images. For the delineation of enhancing pannus less than radiographic grade I, delayed post-contrast images were statistically superior to those which were early post-contrast. MRI can detect early sacroiliitic change according to the predominant sites of involvement, and deslyed post-contrast images play a role in the diagnosis of early sacroiliitis. MPGR imaging is good for the evaluation of joint space change.

  15. Comparative Efficacy and Acceptability of Anti-TNF-Alpha Therapy in Ankylosing Spondylitis: A Mixed-Treatments Comparison

    Directory of Open Access Journals (Sweden)

    Yehua Wang

    2016-09-01

    Full Text Available Background: Tumor necrosis factor α (TNFα antagonists, namely, golimumab, adalimumab, infliximab, etanercept and certolizumab have been prescribed to alleviate and treat ankylosing spondylitis (AS. However, the lack of comparative evidence does not enable us to make constructive recommendations particularly for AS patient populations. Methods: Eligible controlled trials regarding the above 5 anti-TNFα therapies were searched electronically through PubMed, Embase and Cochrane until April 1, 2015. Odds ratios (ORs were estimated and compared for efficacy (ASAS20, ASAS40, ASAS5/6 responses and ASAS partial remission and acceptability (serious adverse effects (SAE among the anti-TNFα reagents. Results: Totally, 25 trials with 2989 participants were incorporated in this mixed treatment comparison. All the 5 TNFα blockers achieved better ASAS20, ASAS40, ASAS5/6 and ASAS-PR responses than the placebo. Furthermore, there was no significant distinction existed among inter-drug comparisons, except that unfavorable effects induced by certolizumab seemed to be less severe than those by etanercept (OR = 0.22, 95% CI: 0.05-0.93. Apart from that, etanercept was estimated to arrive at the most favorable ASAS20 response (90.6% and SAE (83.6%, while infliximab seemed to accomplish the best ASAS40 (83.6% and ASAS-PR responses (77.3%. In addition, adalimumab was estimated to rank the highest ASAS5/6 response (75.0%. Conclusions: Etanercept, infliximab and adalimumab might be prioritized among the commonly recognized 5 anti-TNFα therapies specific for AS patients, though existing evidence did not suffice to confirm significant superiority among the above 5 anti-TNFα reagent.

  16. Increased risk of ischemic stroke in young patients with ankylosing spondylitis: a population-based longitudinal follow-up study.

    Directory of Open Access Journals (Sweden)

    Chia-Wei Lin

    Full Text Available BACKGROUND: Prospective data on the association between ischemic stroke and ankylosing spondylitis (AS in the young are sparse. The purpose of this population-based, age- and sex-matched longitudinal follow-up study was to investigate the risk of developing ischemic stroke in young patients with AS. METHODS: A total of 4562 patients aged 18- to 45-year-old with at least two ambulatory visits in 2001 with a principal diagnosis of AS were enrolled in the AS group. The non-AS group consisted of 22810 age- and sex-matched, randomly sampled subjects without AS. The two-year ischemic stroke-free survival rate for each group were calculated using the Kaplan-Meier method. Cox proportional hazards regression analysis was used to estimate the hazard ratio of ischemic stroke after adjusting for demographic and clinical covariates. RESULTS: During follow-up, 21 patients in the AS group and 53 in the non-AS group developed ischemic stroke. The ischemic stroke-free survival rate over the 2 year follow-up was lower in the AS group than the non-AS group (p = 0.0021. The crude hazard ratio of ischemic stroke for the AS group was 1.98 (95% CI, 1.20-3.29; p = 0.0079 and the adjusted hazard ratio after controlling for demographic and comorbid medical disorders was 1.93 (95% CI, 1.16-3.20; p = 0.0110. CONCLUSION: Our study showed an increased risk of developing ischemic stroke in young patients with AS.

  17. Increased risk of ischemic stroke in young patients with ankylosing spondylitis: a population-based longitudinal follow-up study.

    Science.gov (United States)

    Lin, Chia-Wei; Huang, Ya-Ping; Chiu, Yueh-Hsia; Ho, Yu-Tsun; Pan, Shin-Liang

    2014-01-01

    Prospective data on the association between ischemic stroke and ankylosing spondylitis (AS) in the young are sparse. The purpose of this population-based, age- and sex-matched longitudinal follow-up study was to investigate the risk of developing ischemic stroke in young patients with AS. A total of 4562 patients aged 18- to 45-year-old with at least two ambulatory visits in 2001 with a principal diagnosis of AS were enrolled in the AS group. The non-AS group consisted of 22810 age- and sex-matched, randomly sampled subjects without AS. The two-year ischemic stroke-free survival rate for each group were calculated using the Kaplan-Meier method. Cox proportional hazards regression analysis was used to estimate the hazard ratio of ischemic stroke after adjusting for demographic and clinical covariates. During follow-up, 21 patients in the AS group and 53 in the non-AS group developed ischemic stroke. The ischemic stroke-free survival rate over the 2 year follow-up was lower in the AS group than the non-AS group (p = 0.0021). The crude hazard ratio of ischemic stroke for the AS group was 1.98 (95% CI, 1.20-3.29; p = 0.0079) and the adjusted hazard ratio after controlling for demographic and comorbid medical disorders was 1.93 (95% CI, 1.16-3.20; p = 0.0110). Our study showed an increased risk of developing ischemic stroke in young patients with AS.

  18. 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

  19. Adaptation of Chinese and English versions of the Ankylosing Spondylitis quality of life (ASQoL) scale for use in Singapore.

    Science.gov (United States)

    Leung, Ying Ying; Lee, Weixian; Lui, Nai Lee; Rouse, Matthew; McKenna, Stephen P; Thumboo, Julian

    2017-08-17

    To cross-culturally adapt and validate the Singapore Chinese and Singapore English versions of the Ankylosing Spondylitis Quality of Life (ASQoL) scales. Translation of the ASQoL into Singapore Chinese and English was performed by professional and lay translation panels. Field-testing for face and content validity was performed by interviewing ten Chinese speaking and ten English speaking axial spondyloarthritis (AxSpA) patients. AxSpA patients (either Chinese or English speaking) were invited to take part in validation surveys. The Health Assessment Questionnaire (HAQ), Short Form Health Survey (SF-36), Bath Indices, and other measures of disease activity were used as comparator scales for convergent validity. A separate sample of AxSpA patients were invited to participate in a test-retest postal study, with 2 weeks between administrations. The cross-sectional study included 183 patients (77% males, 82% English speaking), with a mean (SD) age of 39.4 (13.7) years. The ASQoL had excellent internal consistency (Cronbach's alpha = 0.88), and correlated moderately with all the comparator scales. The ASQoL was able to distinguish between patients grouped by disease activity and perceived general health. The ASQoL fulfilled the Rasch model analysis for fit, reliability and unidimensionality requirements. No significant differential item functioning was noted for gender, age below or above 50 years, and language of administration. Test-retest reliability was good (r = 0.81). The ASQoL was adapted into Singapore Chinese and English language versions, and shown to be culturally relevant, valid and reliable when used with combined samples of AxSpA patients who speak either Chinese or English.

  20. Infrared sauna in patients with rheumathoid arthritis and ankylosing spondylitis. A piolot study showing good tolerance, short-term improvement of pain and stiffness and a trend towards long-term beneficial effects

    NARCIS (Netherlands)

    Oosterveld, Frederikus G.J.; Rasker, Johannes J.; Floors, Mark; Landkroon, Robert; van Rennes, Bob; Zwijnenberg, Jan; van de Laar, Mart A F J; Koel, Gerard J.

    2009-01-01

    To study the effects of infrared (IR) Sauna, a form of total-body hyperthermia in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) patients were treated for a 4-week period with a series of eight IR treatments. Seventeen RA patients and 17 AS patients were studied. IR was well

  1. Genetics and Rheumatic Disease

    Science.gov (United States)

    ... Well with Rheumatic Disease Genetics and Rheumatic Disease Genetics and Rheumatic Disease Fast Facts Studying twins has ... 70%, and for non-identical pairs, even lower. Genetics and ankylosing spondylitis Each rheumatic disease has its ...

  2. 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)

    Wick, R.R.; Chmelevsky, D.; Goessner, W.

    1993-01-01

    In an epidemiological study of the somatic late effects risk following incorporation of a short lived α-emitter, 1473 ankylosing spondylitis patients treated with repeated intravenous injections of 224 Ra 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 μCi) of 224 Ra each, given at weekly intervals; this would result in an cumulative α-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 239 Pu, an α-emitter which like 224 Ra deposits preferentially on the bone surface. (orig.) [de

  3. High 3-year golimumab survival in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis: real world data from 328 patients.

    Science.gov (United States)

    Thomas, Konstantinos; Flouri, Irini; Repa, Argiro; Fragiadaki, Kalliopi; Sfikakis, Petros P; Koutsianas, Christos; Kaltsonoudis, Evripidis; Voulgari, Paraskevi V; Drosos, Alexandros A; Petrikkou, Evangelia; Sidiropoulos, Prodromos; Vassilopoulos, Dimitrios

    2018-01-01

    Our primary objective was to study the long-term survival on drug (SOD) of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) treated with golimumab (GLM) in real life settings. This was a retrospective, observational study of all patients treated with GLM in 4 Academic Centres in Greece during a 4-year period (09/2010-06/2014). SOD was analysed using Kaplan-Meier survival analysis, while Cox regression analysis estimating hazard ratios (HRs) for different baseline variables associated with drug discontinuation was performed for each disease. 328 patients (RA: 166, PsA: 82, AS: 80) were included. The estimated SOD at 2 and 3 years was 68% and 62% overall and was better for AS (79% and 76%) compared to RA (69% and 60%, p=0.067) and PsA (58% and 53%, p=0.001) patients; no difference was noted between RA and PsA patients (p=0.204). There was no difference in SOD between biologic-naïve and experienced nor between non-biologic co-treated or GLM monotherapy treated patients. Seropositivity (rheumatoid factor and/or anti-cyclic citrullinated peptide antibodies) was associated with a lower risk for GLM discontinuation by multivariate analysis (HR=0.5, 95% CI=0.0.25-1.1, p=0.05) in RA patients. During 606 patient-years of follow-up, 11 (3.3%) patients discontinued GLM due to adverse events (AE), accounting for 11% of treatment discontinuations. The rates of serious AEs and serious infections were 2.3 and 1.0/100-patient-years, respectively. In this real-life study, GLM showed a high 3-year SOD in patients with inflammatory arthritides with a low rate of discontinuation due to AEs.

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

    International Nuclear Information System (INIS)

    Schoerner, W.; Savaser, A.; Krueger, H.H.; Botsch, H.

    1982-01-01

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

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

    Science.gov (United States)

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

    2014-12-01

    Loss of productivity at work, as a result of health problems, is becoming an issue of interest due to the high burden it represents in society. The measurement of such phenomenon can be made using generic and specific scales for certain diseases such as the Stanford Presenteeism Scale (SPS-6) and the Work Instability Scale for Ankylosing Spondylitis (AS-WIS), specific for patients with ankylosing spondylitis (AS). The aim of this study was to translate and perform a cross-cultural adaptation of SPS-6 and AS-WIS into Portuguese and check their psychometric properties. The study also aimed to evaluate the relationship between the general scores of the scales and the main sociodemographic and clinical data, lifestyles, and absenteeism in patients with AS and correlate these variables with SPS-6 and AS-WIS scales. A sample of 120 patients with AS and 80 workers at a university hospital was evaluated. The processes for the translation and cross-cultural adaptation of the instruments followed preestablished steps and rules presented in the literature. For the evaluation of measurement properties and correlations between scales, intra-class correlation coefficient (reproducibility analysis), Cronbach alpha (internal consistency), and Pearson correlation coefficient (validity) were employed. The inter-observer (0.986) and intra-observer (0.992) reproducibilities of the AS-WIS were shown to be high as well as the internal consistency (0.995). Similarly, the inter-observer reliability of SPS-6 was considered good (0.890), although it showed a poorer performance when considering the same observer (Pearson correlation coefficient = 0.675 and intra-class correlation = 0.656). Internal consistency, for the total number of items, as measured by Cronbach alpha, was 0.889. The validity of the scales was evaluated thru the comparison of the achieved scores with the results of the WLQ, SF-36, ASQoL, BASFI, BASDAI, HAQ-S, and SRQ-20 instruments. Correlations between loss of

  6. Comparative study of radiography, CT and MRI in the identification of hip involvement in patients with ankylosing spondylitis

    International Nuclear Information System (INIS)

    Huang Zhenguo; Zhang Xuezhe; Hu Libin; Wang Guochun; Zhou Huiqiong; Lu Xin; Wang Wu

    2012-01-01

    Objective: To study the imaging findings of hip involvement and to compare the sensitivity of radiography, CT, and MRI in the identification of hip involvement in patients with ankylosing spondylitis (AS). Methods: Anteroposterior radiography of the pelvis and MRI of hip were performed in 55 patients with AS. CT scan of hip was performed in 29 of 55 patients. T 1 -weighted, T 2 -weighted, short tau inversion recovery (STIR) and three dimensional balanced turbo field echo with water selective excitation (3D-BTFE-WATS) coronal sequences of hips were obtained in all patients, of which fat-saturated contrast-enhanced T 1 -weighted sequence was performed in 24 patients. The imaging data of 55 patients were analyzed. The chi-square test was used to analyze the sensitivity in the identification of hip involvement among radiography, CT, and MRI. Results: Among 110 hips in all 55 patients, abnormal changes were detected in 13 hips by radiography, 85 hips by MRI. The findings of radiography included bone erosions in 13 hips, joint space narrowing in 4 hips,syndesmophytes in 5 hips. MRI revealed bone erosive destruction in 31 hips, joint space narrowing in 4 hips, joint effusion in 80 hips, subchondral bone marrow edema in 32 hips, fat accumulation of bone marrow in 28 hips, enthesitis in 21 hips. Bilateral synovial enhancement was showed in 19 of 24 patients who underwent fat-saturated contrast-enhanced T 1 -weighted sequence. Of the 58 hip joints in 29 patients who underwent CT examination, not only did CT show all bone erosions detected by radiography and MRI, but CT revealed bone erosive destruction that were not identified by radiography in 10 hips and by MRI in 1 hip as well. Abnormal changes were detected in 10.3% (6/58)by radiography, 27.6% (16/58) by CT, and 77.6% (45/58) by MRI. The sensitivity of MRI in the identification of hip involvement is higher than that of radiography and CT (χ 2 =53.22 and 29.08, P<0.05). In addition to chronic bone structural changes, MRI

  7. Comparison of Outcomes of Total Hip Arthroplasty between Patients with Ankylosing Spondylitis and Avascular Necrosis of the Femoral Head.

    Science.gov (United States)

    Lee, Sun-Ho; Lee, Gun-Woo; Seol, Young-Jun; Park, Kyung-Soon; Yoon, Taek-Rim

    2017-09-01

    The objective of this study was to compare clinical and radiological outcomes of total hip arthroplasty (THA) between ankylosing spondylitis (AS) of the hip joint and avascular necrosis (AVN) of the femoral head. Thirty patients (30 hips) underwent cementless THA for AS between 2003 and 2012. They were compared to 30 patients (30 hips) who underwent the same procedure for AVN of the femoral head. Each group was matched for age and gender, and both groups had similar preoperative demographic characteristics. All cases were followed for minimum 4 postoperative years. Clinical evaluation was based on operation time, intraoperative blood loss, quantity of postoperative drainage, Harris Hip Score (HHS), and range of motion (ROM). Radiological results were evaluated by acetabular cup anteversion and inclination, femoral stem orientation, pre- and postoperative leg length discrepancy, and postoperative complications. The operation time was significantly longer in the AS group (120.2 ± 26.2 min) than in the AVN group (79.5 ± 11.1 min). The volume of postoperative drainage was significantly greater in the AS group (764.5 ± 355.4 mL vs. 510.5 ± 195.6 mL). Preoperative HHS was lower in the AS group (55.6 ± 13.8 vs. 59.2 ± 2.8). Similarly, postoperative HHS was significantly lower in the AS group (92.8 ± 2.7 vs. 97.4 ± 2.6). The arc of ROM was improved from 146.5° ± 13.2° preoperatively to 254.7° ± 17.2° postoperatively in the AS group and from 182.6° ± 15.5° to 260.4° ± 13.7° in the AVN group. Implant position and postoperative leg length discrepancy were not different between the groups. However, three cases of heterotopic ossification was observed in the AS group, whereas only 1 case was found in the AVN group. One deep infection and one aseptic stem loosening were found in the AS group, whereas none was observed in the AVN group. Cementless THA showed satisfactory clinical and radiological results in both groups, despite the longer operation time

  8. Characterization of changes in IgG associated oligosaccharide profiles in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis using fluorophore linked carbohydrate electrophoresis.

    Science.gov (United States)

    Martin, K; Talukder, R; Hay, F C; Axford, J S

    2001-07-01

    To investigate fluorophore linked carbohydrate electrophoresis (FCE) as a method of analyzing serum immunoglobulin G (IgG) oligosaccharides in healthy individuals and those with rheumatic disease and compare with lectin binding assays of carbohydrate composition. IgG was isolated from patients with rheumatoid arthritis (RA) (n = 21), ankylosing spondylitis (AS) (n = 20), psoriatic arthritis (PsA) (n = 20), and healthy adults (n = 36). IgG oligosaccharides were released enzymatically, fluorescently labelled using 8 aminonaphthalene-136 trisulfonic acid; and identification of the oligosaccharide bands was by stepwise enzymatic degradation. Comparison of FCE was made with lectin binding analysis in which the lectins Ricinus communis (RCA1) and Bandeiraea simplicifolia (BSII) were used to detect galactose (Gal) and N-acetylglucosamine (GlcNAc), respectively. Each disease could be differentiated from healthy adults on the basis of Band 1 asialodigalacto core fucosylated oligosaccharide (gf2) intensity (p = 0.001), but not from each other. Reduced levels of different sugars were associated with specific diseases: reduced gf2 with RA (p < 0.001), PsA (p < 0.001) and AS (p < 0.02), reduced Band 5 disialo-digalacto core fucosylated (a2f) oligosaccharide with AS (p < 0.001), reduced Band 6 disialo-digalacto (a2) oligosaccharide with AS (p < 0.001) and PsA (p = 0.021). All diseases were associated with a significant increase in Band 4 asialo-agalacto core fucosylated oligosaccharide (g0f) (p < 0.001). In RA, FCE band intensities correlated with sugar quantity when identified using lectin binding analysis (p < 0.003). In contrast, there was no correlation between the same bands in healthy individuals. FCE is an accurate method of analyzing IgG associated oligosaccharides and reveals unique band patterns or sugar prints associated with healthy adults and patients with RA, PsA, and AS, and comparison with lectin binding analysis suggests undetected RA glycoprotein structural

  9. Low-dose CT detects more progression of bone formation in comparison to conventional radiography in patients with ankylosing spondylitis: results from the SIAS cohort.

    Science.gov (United States)

    de Koning, Anoek; de Bruin, Freek; van den Berg, Rosaline; Ramiro, Sofia; Baraliakos, Xenofon; Braun, Juergen; van Gaalen, Floris A; Reijnierse, Monique; van der Heijde, Désirée

    2018-02-01

    To compare the CT Syndesmophyte Score (CTSS) for low-dose CT (ldCT) with the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) for conventional radiographs (CR) in patients with ankylosing spondylitis (AS). Patients with AS in the Sensitive Imaging in Ankylosing Spondylitis cohort had lateral cervical and lumbar spine CR and whole spine ldCT at baseline and 2 years. CR and ldCT images were scored by two readers, paired by patient, blinded to time order, per imaging modality. For the total score analysis, we used average scores of readers per corner on CR or quadrant on ldCT. For the syndesmophyte analysis we used individual reader and consensus scores, regarding new or growing syndesmophyte at the same corner/quadrant. 50 patients were included in the syndesmophyte analysis and 37 in the total score analysis. Mean (SD) status scores for mSASSS (range 0-72) and CTSS (range 0-552) at baseline were 17.9 (13.8) and 161.6 (126.6), and mean progression was 2.4 (3.8) and 17.9 (22.1). Three times as many patients showed new or growing syndesmophytes at ≥3 quadrants on ldCT compared with ≥3 corners on CR for individual readers; for consensus this increased to five times. In 50 patients, 36 new or growing syndesmophytes are seen on CR compared with 151 on ldCT, most being found in the thoracic spine. ldCT, covering the whole spine, detects more progression in the form of new and growing syndesmophytes in patients with AS compared with CR, which is limited to the cervical and lumbar spine. Most progression occurred in the thoracic spine. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. CLINICAL CHARACTERISTICS OF ANKYLOSING SPONDYLITIS IN REAL PRACTICE IN RUSSIA: RESULTS OF THE CROSS-SECTIONAL NON-INTERVENTIONAL TRIAL EPICA2

    Directory of Open Access Journals (Sweden)

    Sh. F. Erdes

    2016-01-01

    Full Text Available The literature virtually lacks the results of investigations aimed to study the clinical picture of ankylosing spondylitis (AS in the real practice of rheumatologists  in Russia. At the same time, these investigations may give information  on not only the epidemiological aspects of the disease, but also a variety of its clinical presentation, its social importance, allow evaluation of the efficiency of therapy, and plan a system of further health care costs.Subjects and methods. In early 2015, the cross-sectional multicenter  non-interventional trial EPICA2 was conducted to refine the clinical picture of AS in the real practice of a rheumatologist. The trial involved 402 patients with AS from 10 centers of Russia. The patients were examined using the international standards accepted for this disease. Results and discussion. 180 out of the 402 patients were treated in hospital; the others were examined during outpatient visits. The patients' mean age was 40.8±11.5 years; there were 292 (72.6% men; 82.6% were HLA-B27 positive. The average age of onset was 27.6 years; the interval between symptom onset and diagnosis was 85.2 months. The rheumatologists  established the diagnosis in 87.3% of the cases. BASDAI and BASFI averaged 4.3±2.1 and 4.1±1.8, respectively. At the trial, there was peripheral arthritis in 33.1% of the patients, enthesitis in 37.1%, and dactylitis in 1.2%. Joint endoprosthesis was carried out in 4.7% of the patients. The most common  comorbidities were hypertension (25.1%, gastric ulcer (9.7%, coronary heart disease (4.0%, and diabetes mellitus (3.0%.Conclusion. AS is diagnosed in real practice more than 7 years after its onset mainly by rheumatologists.The delay of the diagnosis is mostly associated with the fact that specialists of other medical specialties are unaware of the clinical presentation  of the disease. The examined group of patients with AS shows a relatively high activity and obvious functional impairments

  11. Willingness of patients with ankylosing spondylitis to pay for inpatient treatment is influenced by the treatment environment and expectations of improvement.

    Science.gov (United States)

    Boonen, A; Severens, J L; van Tubergen, A; Landewé, R; Bonsel, G; van der Heijde, D; van der Linden, Sj

    2005-11-01

    To assess the willingness to pay (WTP) for treatment in a spa resort of patients with ankylosing spondylitis (AS) and to assess if the experience of a spa influences the WTP. 120 patients participating in a randomised trial comparing 3 weeks' treatment in a spa resort in Austria or in the Netherlands with a control group completed a WTP questionnaire before and after spa treatment. Patients indicated on a payment card the maximal co-payment they wanted to contribute for three scenarios that included (a) two levels of improvement in pain and stiffness and (b) two treatment environments: a rehabilitation hospital and a spa resort. At baseline, patients wanted to contribute more for the same improvement after treatment in a spa resort compared with a rehabilitation hospital (ppay more when expected effects were higher (pexpected improvement. Experiencing treatment in a spa resort does not influence the co-payment.

  12. Diagnostic value of diffusion weighted magnetic resonance image in early ankylosing spondylitis

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    Khaled Dewan

    2014-12-01

    Conclusion: Subchondral bone marrow ADC values of sacroiliac joints allow differentiation between inflammatory and mechanical LBP. Furthermore, it may be helpful in evaluating the efficacy of the treatment and determine disease prognosis.

  13. Is nephrolithiasis an unrecognized extra-articular manifestation in ankylosing spondylitis?

    DEFF Research Database (Denmark)

    Jakobsen, Ane Krag; Jacobsson, Lennart T H; Patschan, Oliver

    2014-01-01

    confounding and inability to study the chemical nature of NL were considered the main limitations of the study. CONCLUSIONS: Patients with AS are at increased risk of NL, which may be considered a novel extra-articular manifestation. Previous history of NL, IBD, AS disease severity and male sex were...

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

    International Nuclear Information System (INIS)

    Koch, W.

    1976-01-01

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

  15. 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

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

    Directory of Open Access Journals (Sweden)

    Aleksandr Viktorovich Smirnov

    2013-01-01

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

  17. Diagnosis of Ankylosing Spondylitis

    Science.gov (United States)

    ... pain and tenderness along the back, pelvic bones, sacroiliac joints, chest, and heels. During the exam, your ... The hallmark of AS is involvement of the sacroiliac (SI) joints. Some physicians still rely on X- ...

  18. Blocking p38 signalling inhibits chondrogenesis in vitro but not ankylosis in a model of ankylosing spondylitis in vivo.

    Science.gov (United States)

    Braem, Kirsten; Luyten, Frank P; Lories, Rik J U

    2012-05-01

    To investigate p38 mitogen activated protein kinase (MAPK) signalling in an in vitro model of bone morphogenetic protein (BMP) and transforming growth factor β (TGFβ)-induced chondrogenesis and in vivo, with specific attention to its potential role in ankylosing enthesitis. Human periosteum-derived cells (hPDCs) were cultured in pellets and stimulated with BMP2 or TGFβ1 in the presence or absence of a p38 inhibitor SB203580 or proinflammatory cytokines. Chondrogenic differentiation was evaluated using quantitative PCR. Male DBA/1 mice from different litters were caged together at the age of 8 weeks and treated with SB203580 in both a preventive and therapeutic strategy. The mice were evaluated for prospective signs of arthritis and the toe joints were analysed histologically to assess disease severity. p38 inhibition by SB203580 and proinflammatory cytokines downregulated chondrogenic markers in pellet cultures stimulated by BMP2 or TGFβ1. In contrast, the in vivo experiments resulted in an increased clinical incidence of arthritis and pathology severity score, reflecting progression towards ankylosis in mice given SB203580. Inhibition of p38 inhibited chondrogenic differentiation of progenitor cells, showing that not only the SMAD signalling pathways and also alternative activation of MAPKs including p38 contribute to chondrogenesis. Such an inhibitory effect is not found in an in vivo model of joint ankylosis and spondyloarthritis. Increased incidence and severity of disease in preventive experiments and shifts in disease stages in a therapeutic experimental set-up suggest that specific inhibition of p38 may have deleterious rather than beneficial effects.

  19. Impact of ankylosing spondylitis on sick leave, presenteeism and unpaid productivity, and estimation of the societal cost.

    Science.gov (United States)

    Boonen, Annelies; Brinkhuizen, Tjinta; Landewé, Robert; van der Heijde, Désirée; Severens, Johan L

    2010-06-01

    To describe the influence of ankylosing apondylitis (AS) on sick leave, presenteeism and unpaid work restrictions and to estimate related productivity costs. 142 consecutive and unselected patients with AS under the care of rheumatologists participated in a longitudinal observational study and completed the Health and Labour Questionnaire (HLQ) assessing disease-related sick leave, presenteeism and restrictions in unpaid work over the previous 2 weeks. Logistic regressions explored which explanatory variables were associated with work outcome. Productivity loss was valued in monetary terms. Among 72 patients in paid employment, 12% had sick leave over a period of 2 weeks and 53% experienced an adverse influence of AS on work productivity while at work. Over this period they reported on average of 5.8 h sick leave and 2.4 inefficient working hours, for which they estimated an extra 1.9 h were needed to complete unfinished work. Among all patients (n=137), 71% had experienced restrictions in unpaid work during the previous 2 weeks with 42% needing help for these tasks for an average of 8 h. The annual production costs for the total group were euro1451 (95% CI 425 to 2742) per patient for sick leave, euro967 (95% CI 503 to 1496) to compensate for hours worked inefficiently while at work and euro1930 (95% CI 1404 to 2471) to substitute loss of unpaid work production. Patients with AS not only have substantial sick leave but also experience restrictions while being at work and when performing unpaid tasks. Limitations in physical functioning are strongly associated with work restrictions. Societal costs of formal and informal care are comparable with the costs of sick leave and presenteeism combined.

  20. Impact of ankylosing spondylitis on sick leave, presenteeism and unpaid productivity, and estimation of the societal cost

    NARCIS (Netherlands)

    Boonen, Annelies; Brinkhuizen, Tjinta; Landewé, Robert; van der Heijde, Désirée; Severens, Johan L.

    2010-01-01

    To describe the influence of ankylosing apondylitis (AS) on sick leave, presenteeism and unpaid work restrictions and to estimate related productivity costs. 142 consecutive and unselected patients with AS under the care of rheumatologists participated in a longitudinal observational study and

  1. Whole-Body Cryotherapy Decreases the Levels of Inflammatory, Oxidative Stress, and Atherosclerosis Plaque Markers in Male Patients with Active-Phase Ankylosing Spondylitis in the Absence of Classical Cardiovascular Risk Factors

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    Agata Stanek

    2018-01-01

    Full Text Available Objective. The aim of the study was to estimate the impact of whole-body cryotherapy (WBC on cardiovascular risk factors in patients with ankylosing spondylitis (AS. Material and Methods. We investigated the effect of WBC with subsequent kinesiotherapy on markers of inflammation, oxidative stress, lipid profile, and atherosclerosis plaque in male AS patients (WBC group. To assess the disease activity, the BASDAI and BASFI were also calculated. The results from the WBC group were compared with results from the kinesiotherapy (KT group. Results. The results showed that in the WBC group, the plasma hsCRP level decreased without change to the IL-6 level. The ICAM-1 level showed a decreasing tendency. The CER concentration, as well as the BASDAI and BASFI, decreased in both groups, but the index changes of disease activity were higher in the WBC than KT patients. Additionally, in the WBC group, we observed a decrease in oxidative stress markers, changes in the activity of some antioxidant enzymes and nonenzymatic antioxidant parameters. In both groups, the total cholesterol and LDL cholesterol, triglycerides, sCD40L, PAPP-A, and PLGF levels decreased, but the parameter changes were higher in the WBC group. Conclusion. WBC appears to be a useful method of atherosclerosis prevention in AS patients.

  2. Assessment of clinical efficacy and safety in a randomized double-blind study of etanercept and sulfasalazine in patients with ankylosing spondylitis from Eastern/Central Europe, Latin America, and Asia.

    Science.gov (United States)

    Damjanov, Nemanja; Shehhi, Waleed Al; Huang, Feng; Kotak, Sameer; Burgos-Vargas, Ruben; Shirazy, Khalid; Bananis, Eustratios; Szumski, Annette; Llamado, Lyndon J Q; Mahgoub, Ehab

    2016-05-01

    Despite the demonstrated efficacy of etanercept for the treatment of ankylosing spondylitis (AS), sulfasalazine is often prescribed, especially in countries with limited access to biologic agents. The objective of this subset analysis of the ASCEND trial was to compare the efficacy of etanercept and sulfasalazine in treating patients with AS from Asia, Eastern/Central Europe, and Latin America. A total of 287 patients, 190 receiving etanercept 50 mg once weekly and 97 receiving sulfasalazine 3 g daily, from eight countries were included in this subset analysis. Differences in disease activity and patient-reported outcomes assessing health-related quality-of-life (HRQoL) parameters in response to treatment were analyzed using the Cochran-Mantel-Haenszel test for categorical efficacy endpoints and analysis of covariance model for continuous variables. At week 16, a significantly greater proportion of patients receiving etanercept achieved ASAS20 (79.0 %) compared with patients receiving sulfasalazine (61.9 %; p = 0.002). At week 16, treatment with etanercept also resulted in significantly better responses than sulfasalazine for ASAS40 (64.7 vs. 35.1 %; p Disease Activity Index (65.8 vs. 42.3 %; p Asia, Central/Eastern Europe, and Latin America.

  3. MR imaging - guided corticosteroid-infiltration of the sacroiliac joints: pain therapy of sacroiliitis in patients with ankylosing spondylitis; Magnetresonanzgesteuerte Kortikosteroid-Infiltration der Sakroiliakalgelenke: Schmerztherapie der Sakroiliitis bei Patienten mit Spondylitis ankylosans

    Energy Technology Data Exchange (ETDEWEB)

    Fritz, J.; Koenig, C.W.; Clasen, S.; Claussen, C.D.; Pereira, P.L. [Radiologische Klinik, Abt. fuer Radiologische Diagnostik, Eberhard-Karls-Univ. Tuebingen (Germany); Guenaydin, I.; Koetter, I. [Medizinische Klinik und Poliklinik II, Rheumaambulanz, Eberhard-Karls-Univ. Tuebingen (Germany); Kastler, B. [Univ. de Franche Comte, CHU Minjoz, Besancon (France)

    2005-04-01

    Purpose: To evaluate the efficacy and specific properties of MR imaging-guided corticosteroid infiltration of the sacroiliac (SI) joints in the treatment of therapy-refractory sacroiliitis in patients with ankylosing spondylitis. Materials and Methods: In this study, 26 patients were prospectively included. Inclusion criteria were AS with therapy refractory acute sacroiliitis and inflammatory back pain {>=} 6 months. The intervention was performed using an open low-field MR-scanner. Inflammatory back pain was assessed on a visual analog scale (VAS). Success of the therapy was defined as an absolute reduction of the VAS score {<=} 5, a relative reduction of the VAS score {>=} 35% and persisting improvement {>=} 2 months. The grade of sacroiliitis was documented using high-field MR imaging. Variables were compared using McNemar test and Wilcoxon test. The mean remission time was calculated using a Kaplan-Meier analysis. A p-value < 0.05 was considered statistically significant. Results: The intervention was technically successfully performed in all patients. Following MR imaging-guided corticosteroid infiltration of the SI joints, the VAS score improved from 8 (5-10) points to 4.5 (0-8) points(-44%) in all patients (n=26), which was statistically significant (p<0.001). Of 26 patients, 22 (85%) fulfilled the predefined criteria for successful therapy. This group had a statistically significant (p<0.01) improvement of the VAS score from 8 (6-10) to 3 (0-5) (-63%). Improvement was seen after 7 (1-30) days. There was a marked reduction of the subchondral bone marrow edema (-38%). The mean remission time was 12 (4-18) months. Conclusion: MR imaging-guided corticosteroid infiltration of the SI joints proved to be an effective therapy of inflammatory back pain in patients with therapy refractory AS. With the ability of multiplanar imaging, precise localization of the bone marrow edema and the lack of ionizing radiation, interventional MR imaging currently represents the

  4. Hypophosphatemic osteomalacia: a case simulating anklylosing spondylitis treated with anti-TNF therapy.

    Science.gov (United States)

    Sivas, F; Yurdakul, F G; Durak, M; Hatipoğlu, G; Önal, E D; Bodur, H

    2016-12-01

    In this case, a young male patient diagnosed as hypophosphatemic osteomalacia and ankylosing spondylitis (AS) will be assessed by literature. A 32-year-old male patient who had been previously diagnosed as ankylosing spondylitis and hypophosphatemic osteomalacia was admitted to our clinic. In the beginning of the disease, he complained of pain on the first metatarsal bone and low back. Sacroiliac magnetic resonance (MR) images were interpreted as sacroiliitis. He was diagnosed as AS, and referred to many hospitals and received several therapies. He did not benefit from the treatment and his complaints worsened. The human leukocyte antigen (HLA) B-27 test was negative and alkaline phosphatase level was high. Old femur fractures were reported in the whole body bone scintigraphy. In addition, the patient was diagnosed with osteomalacia. While the patient was receiving vitamin D, oral phosphate, anti-tumor necrosis factor therapy was added. Patient's diagnosis was reevaluated. His final diagnosis was hypophosphatemic osteomalacia instead of ankylosing spondylitis.

  5. Analysis of five chronic inflammatory diseases identifies 27 new associations and highlights disease-specific patterns at shared loci

    DEFF Research Database (Denmark)

    Ellinghaus, David; Jostins, Luke; Spain, Sarah L

    2016-01-01

    We simultaneously investigated the genetic landscape of ankylosing spondylitis, Crohn's disease, psoriasis, primary sclerosing cholangitis and ulcerative colitis to investigate pleiotropy and the relationship between these clinically related diseases. Using high-density genotype data from more th...

  6. Impact of anti-tumour necrosis factor alpha treatment on admissions to hospital and days of sick leave in patients with ankylosing spondylitis.

    Science.gov (United States)

    Listing, J; Brandt, J; Rudwaleit, M; Zink, A; Sieper, J; Braun, J

    2004-12-01

    To analyse the impact of infliximab treatment on the number of hospital inpatient days and days of sick leave in patients with active ankylosing spondylitis (AS). The data of a 2 year open extension study of a 12 week, double blind, randomised, placebo controlled trial, in which all patients with AS were treated with 5 mg/kg infliximab, were used to investigate the effect of anti-TNF treatment on admissions to hospital and days of sick leave. All patients were interviewed at baseline and at regular intervals during the study to collect this information by questionnaires. Patients who completed 2 years of treatment (n = 49) and those who did not (n = 20) were analysed separately. Sick leave analysis was restricted to currently employed patients (n = 38). During the 12 months before the screening visit, 20/49 (41%) completers had been admitted to hospital. After 1 and 2 years of treatment this percentage was reduced to 5/49 (10%; ppatients with active AS reduces some important costs of AS, but additional studies with detailed cost calculations are needed.

  7. Infliximab Dose Reduction Sustains the Clinical Treatment Effect in Active HLAB27 Positive Ankylosing Spondylitis: A Two-Year Pilot Study

    Directory of Open Access Journals (Sweden)

    Boel Mörck

    2013-01-01

    Full Text Available The rationale of the study was to evaluate the efficacy of infliximab (IFX treatment in patients with ankylosing spondylitis (AS and to determine whether IFX dose reduction and interval extension sustains the treatment effect. Nineteen patients were included and treated with IFX 5 mg/kg every 6 weeks for 56 weeks. All patients concomitantly received MTX with median dose 7.5 mg/weekly. During the second year, the IFX dose was reduced to 3 mg/kg every 8 weeks. Eighteen patients completed the 1-year and 15 patients the 2-year trial. The ≥50% improvement at week 16 from baseline of BASDAI was achieved in 16/19 (84% patients. Significant reductions in BASDAI, BASFI, and BASMI scores, decrease in ESR and CRP, and improvement in SF-36 were observed at weeks 16 and 56. The MRI-defined inflammatory changes in the sacroiliac joints disappeared in 10/15 patients (67% already at 16 weeks. IFX treatment effect was sustained throughout the second year after IFX dose reduction and interval extension. We conclude that IFX treatment is effective in well-established active AS and a dose reduction sustains the treatment effect. These observations are of clinical importance and open the opportunity to reduce the drug costs. This trial is registered with ClinicalTrials.gov NCT01850121.

  8. Serum C-reactive Protein Levels Demonstrate Predictive Value for Radiographic and Magnetic Resonance Imaging Outcomes in Patients with Active Ankylosing Spondylitis Treated with Golimumab.

    Science.gov (United States)

    Braun, Jürgen; Baraliakos, Xenofon; Hermann, Kay-Geert A; Xu, Stephen; Hsu, Benjamin

    2016-09-01

    Serum C-reactive protein (CRP) associates with radiographic progression in patients with ankylosing spondylitis (AS) untreated with tumor necrosis factor (TNF) antagonists. We assessed correlations between serum CRP and radiographic progression/magnetic resonance imaging (MRI)-detected inflammation after 2 years of anti-TNF therapy. Patients with active AS receiving golimumab (GOL)/placebo through Week 16 (early escape) or Week 24 (crossover by design), followed by GOL through 4 years, had sera/images obtained through Week 208. Lateral spinal radiographs and spinal MRI were scored with the modified Stoke AS Spine Score (mSASSS) and the AS spine MRI activity (ASspiMRI-a) score, respectively. ANOVA assessed differences based on CRP levels and mSASSS progression. The relationships between CRP levels and mSASSS/ASspiMRI-a were assessed by Spearman correlation and logistic regression. Of the randomized GO-RAISE patients, 299 (84.0%) had pre- and posttreatment spinal radiographs. Larger proportions of patients with Week 104 CRP ≥ 0.5 mg/dl (n = 47) versus formation risk. Elevated CRP after 2 years of anti-TNF treatment correlated with greater radiographic progression risk at 4 years. Elevated CRP at baseline or Week 14/Week 24 of anti-TNF treatment weakly predicted subsequent radiographic progression and modestly predicted residual spinal inflammation in patients with AS treated with anti-TNF. Findings are useful regarding new treatment options in patients treated with anti-TNF. ClinicalTrials.gov: NCT00265083.

  9. Ankylosing Spondylitis Patients with HLA-B*2704 have More Uveitis than Patients with HLA-B*2705 in a North Chinese Population.

    Science.gov (United States)

    Li, Haibo; Li, Qiuxia; Ji, Chen; Gu, Jieruo

    2018-01-01

    To investigate the correlation between clinical features of ankylosing spondylitis (AS) and different human leukocyte antigen (HLA)-B27 subtypes. We conducted a cross-sectional study of 216 patients with AS. HLA-B27 and its subtypes were detected by polymerase chain reaction with sequence specific primer (PCR-SSP). Clinical features were compared between the different HLA-B27 subtypes. A meta-analysis on uveitis frequencies in AS patients with HLA-B*2705 vs 2704 was performed. The most prevalent subtypes of HLA-B27 were HLA-B*2704 (66.1%) and HLA-B*2705 (32.2%). There were 57 HLA-B27-positive AS patients with the history of uveitis; 45 were B*2704 and 12 were B*2705. Patients with B*2704 had more uveitis than B*2705 (p = 0.021). After meta-analysis, there was no significant difference in the presence of uveitis between HLA-B*2704 and HLA-B*2705. AS patients with B*2704 have a higher risk of uveitis than AS with B*2705 in a north Chinese people.

  10. Comparison of bi-exponential and mono-exponential models of diffusion-weighted imaging for detecting active sacroiliitis in ankylosing spondylitis.

    Science.gov (United States)

    Sun, Haitao; Liu, Kai; Liu, Hao; Ji, Zongfei; Yan, Yan; Jiang, Lindi; Zhou, Jianjun

    2018-04-01

    Background There has been a growing need for a sensitive and effective imaging method for the differentiation of the activity of ankylosing spondylitis (AS). Purpose To compare the performances of intravoxel incoherent motion (IVIM)-derived parameters and the apparent diffusion coefficient (ADC) for distinguishing AS-activity. Material and Methods One hundred patients with AS were divided into active (n = 51) and non-active groups (n = 49) and 21 healthy volunteers were included as control. The ADC, diffusion coefficient ( D), pseudodiffusion coefficient ( D*), and perfusion fraction ( f) were calculated for all groups. Kruskal-Wallis tests and receiver operator characteristic (ROC) curve analysis were performed for all parameters. Results There was good reproducibility of ADC /D and relatively poor reproducibility of D*/f. ADC, D, and f were significantly higher in the active group than in the non-active and control groups (all P  0.050). In the ROC analysis, ADC had the largest AUC for distinguishing between the active group and the non-active group (0.988) and between the active and control groups (0.990). Multivariate logistic regression analysis models showed no diagnostic improvement. Conclusion ADC provided better diagnostic performance than IVIM-derived parameters in differentiating AS activity. Therefore, a straightforward and effective mono-exponential model of diffusion-weighted imaging may be sufficient for differentiating AS activity in the clinic.

  11. 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

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    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

  12. Myeloid leukaemia frequency after protracted exposure to ionizing radiation: experimental confirmation of the flat dose-response found in ankylosing spondylitis after a single treatment course with x-rays

    Energy Technology Data Exchange (ETDEWEB)

    Mole, R H; Major, I R [Medical Research Council, Harwell (UK). Radiobiological Research Unit

    1983-01-01

    The dose-response for leukaemia induction by exposure to ionizing radiation protracted over several weeks was largely independent of dose not only in X-rayed patients with ankylosing spondylitis but also in experimentally ..gamma..-rayed CBA/H mice. In the experiment the induced leukaemia frequency of acute myeloid leukaemia was independent of a several thousand-fold variation in physical dose rate. Any difference in leukaemia induction between brief and protracted exposures must therefore depend on specifically biological consequences of protracted exposures. Experimental analysis is required to provide the guides for inference about risks of low level exposure from observations on relatively heavily irradiated populations.

  13. Tuberculous spondylitis in Haji Adam Malik hospital, Medan

    Science.gov (United States)

    Dharmajaya, R.

    2018-03-01

    Ankylosing tuberculosis is an infection caused by Mycobacterium tuberculosis in one or more components of the vertebrae; it is Pott disease or tuberculous spondylitis. It might become a potential cause of morbidity, including neurological deficits and permanent deformity of the spine. Management of TB Spondylitis, in general, is chemotherapy with antituberculosis drugs (ATG), immobilization, and spine surgical interventions. A retrospective study was conducted to analyze the patients of TB Spondylitis who had undergone surgery at Haji Adam Malik hospital from June 2015 to June 2017. The most common location is thoracal (10%), lumbal (3%), and thoracolumbal junction (3%). Decompression laminectomy with fusion (18%) is the most suitable option for surgical management. The majority, pre- operation ASIA scale is D (8%), and post operation is E (8%). It means that surgical plays an important role in themanagement of tuberculous spondylitis.

  14. 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)

    Huang Zhenguo; Zhang Xuezhe; Hong Wen; Wang Guochun; Zhou Huiqiong; Lu Xin; Wang Wu

    2011-01-01

    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 T 1 -weighted, T 2 -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 T 1 -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 (χ 2 =0.16, P>0.05) and there was significant difference between CT and X-ray or MRI and X-ray (χ 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)

  15. IMPACT OF THE THERAPY WITH TUMOR NECROSIS FACTOR α INHIBITORS ON THE FREQUENCY OF UVEITIS EXACERBATIONS IN PATIENTS WITH ANKYLOSING SPONDYLITIS

    Directory of Open Access Journals (Sweden)

    Alla A Godzenko

    2014-01-01

    Full Text Available The course of uveitis in patients with ankylosing spondylitis (AS does not always correlate with inflammation in the axial skeleton and peripheral joints. Effect of tumor necrosis factor α (TNFα inhibitors on uveitis has been insufficiently studied yet, unlike their effect on the peripheral joints and spine.Objective. To compare the frequency of uveitis attacks in patients with AS during treatment with TNFα inhibitors and the conventional anti-inflammatory therapy.Materials and Methods. The study included 48 patients with AS and recurrent uveitis treated with TNFα inhibitors: 25 – infliximab, 15 – adalimumab, 9 – etanercept; 7 patients received two or more drugs sequentially. Median [25th, 75th percentiles] of the treatment duration was 3 [3.5; 5] years. The duration of treatment since the first attack of uveitis until administration of TNFα inhibitors was 5 [5; 9.7] years. Eighteen patients received only nonsteroidal anti-inflammatory drugs (NSAIDs, 30 patients received NSAIDs and basic anti-inflammatory drugs (DMARDs, including sulfasalazine (n = 23, methotrexate (n = 4, and cyclosporine (n = 4.Results. The median number of uveitis exacerbations during the standard anti-inflammatory therapy was 1 [0.4; 3] per year; during treatment with TNFα inhibitors – 0 [0; 0.5] per year (p = 0.0007. In 19 of 48 patients (40%, no exacerbations of uveitis were registered during therapy with these drugs. The frequency of uveitis attacks in patients treated with infliximab decreased from 1 [0.2; 2.75] to 0.1 [0; 0.8] episodes per year (p = 0.002, adalimumab – from 1.75 [1; 4.5] to 0 [0; 0.07] (p = 0.04, etanercept – from 0.95 [0.5; 1.75] to 0 [0; 0.07] (p = 0.001.Conclusion. Administration of TNFα inhibitors significantly reduces the frequency of uveitis attacks in patients with AS.

  16. 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.

    Science.gov (United States)

    Maksymowych, Walter P; Chiowchanwisawakit, Praveena; Clare, Tracey; Pedersen, Susanne J; Østergaard, Mikkel; Lambert, Robert G W

    2009-01-01

    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. 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. New syndesmophytes developed significantly more frequently in vertebral corners with inflammation (20%) than in those without inflammation (5.1%) seen on baseline MRI (P

  17. Increased Levels of Oxidative Stress Markers, Soluble CD40 Ligand, and Carotid Intima-Media Thickness Reflect Acceleration of Atherosclerosis in Male Patients with Ankylosing Spondylitis in Active Phase and without the Classical Cardiovascular Risk Factors

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    Agata Stanek

    2017-01-01

    Full Text Available Objective. The primary aim of the study was to assess levels of oxidative stress markers, soluble CD40 ligand (sCD40L, serum pregnancy-associated plasma protein-A (PAPP-A, and placental growth factor (PlGF as well as carotid intima-media thickness (IMT in patients with ankylosing spondylitis (AS with active phase without concomitant classical cardiovascular risk factors. Material and methods. The observational study involved 96 male subjects: 48 AS patients and 48 healthy ones, who did not differ significantly regarding age, BMI, comorbid disorders, and distribution of classical cardiovascular risk factors. In both groups, we estimated levels of oxidative stress markers, lipid profile, and inflammation parameters as well as sCD40L, serum PAPP-A, and PlGF. In addition, we estimated carotid IMT in each subject. Results. The study showed that markers of oxidative stress, lipid profile, and inflammation, as well as sCD40L, PlGF, and IMT, were significantly higher in the AS group compared to the healthy group. Conclusion. Our results demonstrate that ankylosing spondylitis may be associated with increased risk for atherosclerosis.

  18. Safety of Resuming Tumor Necrosis Factor Inhibitors in Ankylosing Spondylitis Patients Concomitant with the Treatment of Active Tuberculosis: A Retrospective Nationwide Registry of the Korean Society of Spondyloarthritis Research

    Science.gov (United States)

    Kim, Hye Won; Kwon, Seong Ryul; Jung, Kyong-Hee; Kim, Seong-Kyu; Baek, Han Joo; Seo, Mi Ryung; Bang, So-Young; Lee, Hye-Soon; Suh, Chang-Hee; Jung, Ju Yang; Son, Chang-Nam; Shim, Seung Cheol; Lee, Sang-Hoon; Lee, Seung-Geun; Lee, Yeon-Ah; Lee, Eun Young; Kim, Tae-Hwan

    2016-01-01

    Backgrounds Patients who develop an active tuberculosis infection during tumor necrosis factor (TNF) inhibitor treatment typically discontinue TNF inhibitor and receive standard anti-tuberculosis treatment. However, there is currently insufficient information on patient outcomes following resumption of TNF inhibitor treatment during ongoing anti- tuberculosis treatment. Our study was designed to investigate the safety of resuming TNF inhibitors in ankylosing spondylitis (AS) patients who developed tuberculosis as a complication of the use of TNF inhibitors. Methods Through the nationwide registry of the Korean Society of Spondyloarthritis Research, 3929 AS patients who were prescribed TNF inhibitors were recruited between June 2003 and June 2014 at fourteen referral hospitals. Clinical information was analyzed about the patients who experienced tuberculosis after exposure to TNF inhibitors. The clinical features of resumers and non-resumers of TNF inhibitors were compared and the outcomes of tuberculosis were surveyed individually. Findings Fifty-six AS patients were treated for tuberculosis associated with TNF inhibitors. Among them, 23 patients resumed TNF inhibitors, and these patients were found to be exposed to TNF inhibitors for a longer period of time and experienced more frequent disease flare-up after discontinuation of TNF inhibitors compared with those who did not resume. Fifteen patients resumed TNF inhibitors during anti-tuberculosis treatment (early resumers) and 8 after completion of anti-tuberculosis treatment (late resumers). Median time to resuming TNF inhibitor from tuberculosis was 3.3 and 9.0 months in the early and late resumers, respectively. Tuberculosis was treated successfully in all resumers and did not relapse in any of them during follow-up (median 33.8 [IQR; 20.8–66.7] months). Conclusions Instances of tuberculosis were treated successfully in our AS patients, even when given concomitantly with TNF inhibitors. We suggest that early

  19. Age- and time-dependent changes in the rates of radiation-induced cancers in patients with ankylosing spondylitis following a single course of X-ray treatment

    International Nuclear Information System (INIS)

    Smith, P.G.; Doll, R.

    1978-01-01

    The causes of death have been analysed in 14111 patients with ankylosing spondylitis following a single course of X-ray treatment. Patients who were re-treated with X-rays were followed until the end of the year following their second course of treatment and deaths subsequent to this time were ignored. An attempt was made to follow the remaining patients to 1 January 1970, or their date of death or emigration, whichever was the earlier. A total of 7455 (52.8%) patients were re-treated before 1 January 1970, 1759 (12.5%) patients had died and 269 (1.9%) had emigrated. A total of 208 (1.5%) patients were lost to follow-up and the remaining 4420 (31.3%), who had all received one course of treatment, were alive. The number of deaths from all causes was 66% greater than the expected number computed from national age and sex specific mortality rates. There were 31 deaths from leukaemia (6.5 expected), 259 from cancers of ''heavily irradiated'' sites (167.5 expected) and 79 from cancers of ''lightly irradiated'' sites, which was not significantly higher than the 65.6 expected. The ratio of observed to expected deaths and the excess death rate from leukaemia was greatest in the period three to five years after first treatment and subsequently declined. The ratio of observed to expected deaths from cancers of heavily irradiated sites was high in the two years following treatment, fell to a minimum six to eight years after treatment and then rose. Data for individual heavily irradiated sites showed little variation in the ratio of observed to expected numbers of deaths, apart from those due to tumours of the spinal cord. The ratio of observed to expected deaths for both leukaemia and cancers of the heavily irradiated sites showed no apparent change according to the age of the patients at their first treatment but the excess death rate showed a highly significant increase with increasing age at first treatment

  20. Anti-mutated citrullinated vimentin (anti-MCV) and anti-65 kDa heat shock protein (anti-hsp65): new biomarkers in ankylosing spondylitis.

    Science.gov (United States)

    Bodnár, Nóra; Szekanecz, Zoltán; Prohászka, Zoltán; Kemény-Beke, Adám; Némethné-Gyurcsik, Zsuzsanna; Gulyás, Katalin; Lakos, Gabriella; Sipka, Sándor; Szántó, Sándor

    2012-01-01

    Citrullination as well as anti-citrullinated protein/peptide antibodies (ACPA) have been implicated in the pathogenesis of rheumatoid arthritis (RA). While ACPAs are specific and sensitive markers for RA, there have been hardly any reports regarding ACPAs in ankylosing spondylitis (AS). The possible role of antibodies to Mycobacterial 65 kDa heat shock protein (hsp65) has not been characterized in AS. As new laboratory biomarkers of AS are needed, we investigated the prevalence of anti-mutated citrullinated vimentin (MCV) and anti-hsp65 antibodies in AS. Altogether 43 AS and 44 healthy controls were included in the study. Anti-MCV and anti-hsp65 were determined in sera by commercial and in-house ELISA, respectively. Serum autoantibody levels were correlated with ESR, CRP, HLA-B27 status, smoking habits, pain intensity, BASDAI, BASFI and BASMI indices. Patients with AS had significantly higher serum anti-MCV levels (17.3 U/mL, range: 8.3-31.5 U/mL) in comparison to healthy subjects (8.9 U/mL, range: 5.4-13.3 U/mL) (p20 U/mL). The mean anti-hsp65 concentration in AS sera was 124.8 AU/mL (range: 27.2-1000 AU/mL), while controls exerted significantly lower anti-hsp65 levels (mean: 51.8 AU/mL; range: 22.5-88.5 AU/mL) (p<0.001). Correlation analysis revealed that both anti-MCV positivity (r=0.613; p=0.012) and absolute serum anti-MCV levels (r=0.553; p=0.021) correlated with anti-hsp65 levels. Anti-MCV positivity also correlated with ESR (r=0.437; p=0.03). Anti-MCV and anti-hsp65 may be novel biomarkers in AS. Copyright © 2011. Published by Elsevier SAS.

  1. Social Role Participation and Satisfaction With Life : A Study Among Patients With Ankylosing Spondylitis and Population Controls

    NARCIS (Netherlands)

    van Genderen, Simon; Plasqui, Guy; van der Heijde, Désirée; van Gaalen, Floris; Heuft, Liesbeth; Luime, Jolanda; Spoorenberg, Anneke; Arends, Suzanne; Lacaille, Diane; Gignac, Monique; Landewé, Robert; Boonen, Annelies

    OBJECTIVE: Participation in society of persons with chronic diseases receives increasing attention. However, little is known which components of participation are most relevant to life satisfaction. This study examines the association between several aspects of social role participation and

  2. Genetics Home Reference: ankylosing spondylitis

    Science.gov (United States)

    ... Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, Liang MH, Kremers HM, Mayes MD, Merkel PA, Pillemer SR, Reveille JD, Stone JH; National Arthritis Data Workgroup. Estimates of the ...

  3. Efficacy of golimumab in the treatment of patients with ankylosing spondylitis (according to the data of a long-term follow-up

    Directory of Open Access Journals (Sweden)

    A. V. Smirnov

    2015-01-01

    Full Text Available The paper summarizes the data of a randomized placebo-controlled phase 3 GO-RAISE trial of spondylitis (AS patients receiving two different doses (50 and 100 mg of golimumab (GLM, which evaluates its efficiency and safety and X-ray progression of changes in the axial skeleton. In AS patients, GLM therapy leads to a rapid long-lasting clinical and radiological response. The tolerability of long-term therapy with GLM generally complies with the safety profile of the entire class of tumor necrosis factor-р (TNF-р inhibitors.The data of the GO-RAISE trial has substantiated once again the established fact that the high baseline level of C-reactive protein (CRP and the presence of syndesmophytes are predictors for a rapider X-ray progression. At the same time, the results of the trial may question the recent assumptions that TNF-р suppression can exert a stimulating effect on the formation of new bone tissue with time. Further studies are to determine whether there is an association between the presence of syndesmophytes and elevated CRP levels and whether they have a combined effect on X-ray progression, and if so, whether the development of structural changes may be prevented with TNF-р inhibitors to be used at the earlier stages of the disease.

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

    Directory of Open Access Journals (Sweden)

    Nedović Jovan

    2009-01-01

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

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

    Science.gov (United States)

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

    2013-10-01

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

  6. Adaptation of the Bath measures on disease activity and function in ankylosing spondylitis into Danish

    DEFF Research Database (Denmark)

    Pedersen, Ole Birger; Hansen, G O; Svendsen, Anders Jørgen

    2007-01-01

    . RESULTS: Test-retest reliability was high (>0.90) and the random measurement error was within+/-2.0 for the BASG and within approximately+/-1.5 for BASDAI and BASFI, which is acceptable for most clinical settings. The measures have good internal consistency and are able to discriminate between functional...

  7. Can Whole-Body Cryotherapy with Subsequent Kinesiotherapy Procedures in Closed Type Cryogenic Chamber Improve BASDAI, BASFI, and Some Spine Mobility Parameters and Decrease Pain Intensity in Patients with Ankylosing Spondylitis?

    Science.gov (United States)

    Stanek, Agata; Cholewka, Armand; Gadula, Jolanta; Drzazga, Zofia; Sieron, Aleksander; Sieron-Stoltny, Karolina

    2015-01-01

    The present study investigated whether whole-body cryotherapy (WBC) procedures could potentially have more beneficial effects on index of BASDAI and BASFI, pain intensity, and spine mobility parameters: Ott test, modified Schober test, chest expansion in ankylosing spondylitis (AS) patients, than kinesiotherapy procedures used separately. AS patients were exposed to a cycle of WBC procedures lasting 3 minutes a day, with a subsequent 60 minutes of kinesiotherapy or 60 minutes of kinesiotherapy only, for 10 consecutive days excluding weekend. After the completion of the cycle of WBC procedures with subsequent kinesiotherapy in the AS patients, BASDAI index decreased about 40% in comparison with the input value, whereas in the group of patients who received only kinesiotherapy it decreased only about 15% in comparison with the input value. After the completion of the treatment in the WBC group, BASFI index decreased about 30% in comparison with the input value, whereas in the kinesiotherapy group it only decreased about 16% in comparison with the input value. The important conclusion was that, in WBC group with subsequent kinesiotherapy, we observed on average about twice better results than in the group treated only by kinesiotherapy. PMID:26273618

  8. Risk of leukaemia following intravenous treatment with {sup 224}Ra - results of a long term follow-up study of ankylosing spondylitis patients; Leukaemierisiko nach intravenoeser {sup 224}Ra-Behandlung - Ergebnisse einer Langzeitstudie an Bechterew-Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Wick, R.R. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Strahlenbiologie; Chmelevsky, D. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Strahlenschutz; Goessner, W. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Pathologie

    1993-12-31

    In an epidemiological study of the somatic late effects risk following incorporation of a short lived {alpha}-emitter, 1473 ankylosing spondylitis patients treated with repeated intravenous injections of {sup 224}Ra 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 {mu}Ci) of {sup 224}Ra each, given at weekly intervals; this would result in an cumulative {alpha}-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 < 0.001) and 6 cases of leukaemia in the control group (vs. 3.3 - 3.5 exp., p = 0.14). Subclassification of the leukaemias shows a clear preference for chronic myeloid leukaemia (CML) in the exposure group (4 cases obs. vs. 0.8 cases exp., p = 0.009), whereas in the control group the observed cases of CML are within the range of expectancy. Similar observations have not been made in another group of patients, now observed by Spiess and co-workers, who have been treated at a higher dose/dose rate range. This increased incidence of leukaemias in our exposure group is in one line with results from animal experiments with bone seeking {alpha}-emitters given at low dose rates. The induction of myeloid leukaemia has been demonstrated in mice down to dose rates of only a few mGy/day also for {sup 239}Pu, an {alpha}-emitter which like {sup 224}Ra deposits preferentially on the bone surface. (orig.) [Deutsch] Im Rahmen einer epidemiologischen Studie zum somatischen Strahlenspaetschadenrisiko nach

  9. Rheumatic diseases and pregnancy | Gcelu | South African Medical ...

    African Journals Online (AJOL)

    The aim of this article is to discuss the optimal management of pregnant women with SLE and other rheumatic diseases, including antiphospholipid antibody syndrome, Sjögren's syndrome, systemic sclerosis, rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. The effects of pregnancy on underlying diseases ...

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

    Directory of Open Access Journals (Sweden)

    Karin M. Goya

    2009-04-01

    to postural dysfunction and thoracic ciphosis. OBJECTIVE: The objective of this study was to evaluate the lung function in patients with ankylosing spondylitis and to associate this parameter with physical activity. METHODS:104 patients were selected and only 15 fulfilled inclusion and exclusion criteria. They were divided in two groups: group I composed by sedentary patients, and group II with patients that has a regular physical activity. Demographic features, parameters of cervical, dorsal and lumbar column mobility were collected. Measurements of minute volume, respiratory rate, maximum inspiratory and expiratory pressures and quality of life (HAQ-S were also evaluated. RESULTS: Both groups were similar regarding mean age (49.6 ± 1.6 vs. 43.3 ± 13.2 years, p = 0.19, weight (70.9 ± 9.7 vs. 74.1 ± 12.1 kg, p = 0.30 and height (164.6 ± 3.5 vs. 167.6 ± 6.9 cm, p = 0.16. However, the mean disease duration was significantly higher in the group I compared to the active group (20.1 ± 6.9 vs. 9.6 ± 3.4 years, p = 0.004. Interestingly, a significantly higher minute volume was observed in the active group than inactive one (4.83 ± 1.07 vs. 6.1 ± 1.25 L/min, p = 0.035. On the other hand, no differences were found regarding respiratory rate (14.57 ± 1.76 vs. 16.25 ± 3.53 ipm, p = 0.15, tidal volume (0.402 ± 0.07 vs. 0.342 ± 0.10 L, p = 0.13, as well as maximum inspiratory pressure (84.29 ± 24.99 vs. 93.13 ± 16.76 cmH2O, p = 0.24 and maximum expiratory pressure (102.2 ± 29.26 vs. 105 ± 17.32 cmH2O, p = 0.42. , CONCLUSION: This study seems to show that respiratory volumes are maintained stable in patients with ankylosing spondylitis that are under regular physical activity.

  11. Experimental colitis does not increase the prevalence of ANKENT, a spontaneous joint disease in mice

    Czech Academy of Sciences Publication Activity Database

    Čapková, Jana; Štěpánková, Renata; Hudcovic, Tomáš; Šinkora, Jiří; Řeháková, Zuzana

    2004-01-01

    Roč. 49, č. 6 (2004), s. 745-750 ISSN 0015-5632 R&D Projects: GA ČR(CZ) GA310/00/1371; GA ČR(CZ) GA305/03/0287 Institutional research plan: CEZ:AV0Z5052915 Keywords : ankylosing spondylitis * ankylosing enthesopathy * inflammatory bowel disease Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 1.034, year: 2004

  12. Supra-acetabular line is better than supra-iliac line for coronal balance referencing-a study of perioperative whole spine X-rays in degenerative lumbar scoliosis and ankylosing spondylitis patients.

    Science.gov (United States)

    Hey, Hwee Weng Dennis; Kim, Cheung-Kue; Lee, Won-Gyu; Juh, Hyung-Suk; Kim, Ki-Tack

    2017-12-01

    The aim of spinal deformity correction is to restore the spine's functional alignment by balancing it in both the sagittal and coronal planes. Regardless of posture, the ideal coronal profile is straight, and therefore readily assessable. This study compares two radiological methods to determine which better predicts postoperative standing coronal balance. We conducted a single-center, radiographic comparative study between 2011 and 2015. A total of 199 patients with a mean age of 55.1 years were studied. Ninety patients with degenerative lumbar scoliosis (DLS) and 109 ankylosing spondylitis (AS) were treated with posterior surgery during this period. Baseline clinical and radiographic parameters (sagittal and coronal) were recorded. Comparison was performed between the new supra-acetabular line (central sacral vertical line [CSVL1]) and conventional supra-iliac line (CSVL2) perpendicular methods of coronal balance assessment. These methods were also compared with the gold standard standing C7 plumb line. Each patient underwent standardized operative procedures and had perioperative spine X-rays obtained for assessment of spinal balance. Adjusted multivariate analysis was used to determine predictors of coronal balance. Significant differences in baseline characteristics (age, gender, and radiographic parameters) were found between patients with DLS and AS. CSVL1, CSVL2, and C7 plumb line differed in all the perioperative measurements. These three radiological methods showed a mean right coronal imbalance for both diagnoses in all pre-, intra-, and postoperative radiographs. The magnitude of imbalance was the greatest for CSVL2 followed by CSVL1 and subsequently the C7 plumb line. A larger discrepancy between CSVL and C7 plumb line measurements intraoperatively than those postoperatively suggests a postural effect on these parameters, which is greater for CSVL2. Multivariate analysis identified that in DLS, the preoperative C7 plumb line was predictive of its

  13. Which spinal lesions are associated with new bone formation in patients with ankylosing spondylitis treated with anti-TNF agents? A long-term observational study using MRI and conventional radiography.

    Science.gov (United States)

    Baraliakos, X; Heldmann, F; Callhoff, J; Listing, J; Appelboom, T; Brandt, J; Van den Bosch, F; Breban, M; Burmester, Gr; Dougados, M; Emery, P; Gaston, H; Grunke, M; Van Der Horst-Bruinsma, I E; Landewé, R; Leirisalo-Repo, M; Sieper, J; De Vlam, K; Pappas, D; Kiltz, U; Van Der Heijde, D; Braun, J

    2014-10-01

    To study the relationship of spinal inflammation and fatty degeneration (FD) as detected by MRI and new bone formation seen on conventional radiographs (CRs) in ankylosing spondylitis (AS). CRs at baseline, 2 years and 5 years and spinal MRIs at baseline and 2 years of 73 AS patients treated with infliximab in European AS Infliximab Cohort were available. Relative risks (RR) were calculated with a general linear model after adjustment for within-patient variation. In a total of 1466 vertebral edges (VEs) without baseline syndesmophytes, 61 syndesmophytes developed at 5 years, the majority of which (57.4%) had no corresponding detectable MRI lesions at baseline. VEs with both inflammation and FD at baseline had the highest risk (RR 3.3, p=0.009) for syndesmophyte formation at 5 years, followed by VEs that developed new FD or did not resolve FD at 2 years (RR=2.3, p=0.034), while inflammation at baseline with no FD at 2 years had the lowest risk for syndesmophyte formation at 5 years (RR=0.8). Of the VEs with inflammation at baseline, >70% resolved completely, 28.8% turned into FD after 2 years, but only 1 syndesmophyte developed within 5 years. Parallel occurrence of inflammation and FD at baseline and development of FD without prior inflammation after 2 years were significantly associated with syndesmophyte formation after 5 years of anti-tumour necrosis factor (TNF) therapy. However, the sequence 'inflammation-FD-new bone formation' was rarely observed, an argument against the TNF-brake hypothesis. Whether an early suppression of inflammation leads to a decrease of the risk for new bone formation remains to be demonstrated. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Efficacy and safety of switching from reference infliximab to CT-P13 compared with maintenance of CT-P13 in ankylosing spondylitis: 102-week data from the PLANETAS extension study.

    Science.gov (United States)

    Park, Won; Yoo, Dae Hyun; Miranda, Pedro; Brzosko, Marek; Wiland, Piotr; Gutierrez-Ureña, Sergio; Mikazane, Helena; Lee, Yeon-Ah; Smiyan, Svitlana; Lim, Mie-Jin; Kadinov, Vladimir; Abud-Mendoza, Carlos; Kim, HoUng; Lee, Sang Joon; Bae, YunJu; Kim, SuYeon; Braun, Jürgen

    2017-02-01

    To investigate the efficacy and safety of switching from infliximab reference product (RP) to its biosimilar or maintaining biosimilar treatment in patients with ankylosing spondylitis (AS). This open-label extension study recruited patients with AS who completed a 54-week, randomised controlled study comparing CT-P13 with RP (PLANETAS). CT-P13 (5 mg/kg) was administered intravenously every 8 weeks from week 62 to week 102. Efficacy end points included the proportion of patients achieving Assessment of SpondyloArthritis international Society (ASAS)20. Antidrug antibodies (ADAs) were measured using an electrochemiluminescent method. Data were analysed for patients treated with CT-P13 in the main PLANETAS study and the extension (maintenance group) and those who were switched to CT-P13 during the extension study (switch group). Overall, 174 (82.9%) of 210 patients who completed the first 54 weeks of PLANETAS and agreed to participate in the extension were enrolled. Among these, 88 were maintained on CT-P13 and 86 were switched to CT-P13 from RP. In these maintenance and switch groups, respectively, ASAS20 response rates at week 102 were 80.7% and 76.9%. ASAS40 and ASAS partial remission were also similar between groups. ADA positivity rates were comparable (week 102: 23.3% vs 27.4%). Adverse events led to treatment discontinuation during the extension study in 3 (3.3%) and 4 (4.8%) patients, respectively. This is the first study to show that switching from RP to its biosimilar CT-P13 is possible without negative effects on safety or efficacy in patients with AS. In the maintenance group, CT-P13 was effective and well tolerated over 2 years of treatment. NCT01571206; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Osteoporosis in rheumatic diseases | Basma | African Journal of ...

    African Journals Online (AJOL)

    Background: Inflammatory joint disease such as rheumatoid arthritis, as well as other rheumatic conditions, such as Systemic Lupus Erythematosus (SLE) and ankylosing spondylitis comprise a heterogeneous group of joint disorders that are all associated with extra-articular manifestations, including bone loss and fractures ...

  16. Clinical response, drug survival and predictors thereof in 432 patients with ankylosing spondylitis switching anti tumor necrosis factor α therapy: Results from the Danish nationwide Danbio registry

    DEFF Research Database (Denmark)

    Glintborg, Bente; Østergaard, Mikkel; Krogh, N.

    2012-01-01

    , 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...

  17. CD8+ T cells with characteristic T cell receptor beta motif are detected in blood and expanded in synovial fluid of ankylosing spondylitis patients.

    Science.gov (United States)

    Komech, Ekaterina A; Pogorelyy, Mikhail V; Egorov, Evgeniy S; Britanova, Olga V; Rebrikov, Denis V; Bochkova, Anna G; Shmidt, Evgeniya I; Shostak, Nadejda A; Shugay, Mikhail; Lukyanov, Sergey; Mamedov, Ilgar Z; Lebedev, Yuriy B; Chudakov, Dmitriy M; Zvyagin, Ivan V

    2018-02-22

    The risk of AS is associated with genomic variants related to antigen presentation and specific cytokine signalling pathways, suggesting the involvement of cellular immunity in disease initiation/progression. The aim of the present study was to explore the repertoire of TCR sequences in healthy donors and AS patients to uncover AS-linked TCR variants. Using quantitative molecular-barcoded 5'-RACE, we performed deep TCR β repertoire profiling of peripheral blood (PB) and SF samples for 25 AS patients and 108 healthy donors. AS-linked TCR variants were identified using a new computational approach that relies on a probabilistic model of the VDJ rearrangement process. Using the donor-agnostic probabilistic model, we reveal a TCR β motif characteristic for PB of AS patients, represented by eight highly homologous amino acid sequence variants. Some of these variants were previously reported in SF and PB of patients with ReA and in PB of AS patients. We demonstrate that identified AS-linked clones have a CD8+ phenotype, present at relatively low frequencies in PB, and are significantly enriched in matched SF samples of AS patients. Our results suggest the involvement of a particular antigen-specific subset of CD8+ T cells in AS pathogenesis, confirming and expanding earlier findings. The high similarity of the clonotypes with the ones found in ReA implies common mechanisms for the initiation of the diseases.

  18. Spondylitis/spondylodiscitis; Spondylitis/Spondylodiszitis

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-06-15

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

  19. Comparison of MRI-defined back muscles volume between patients with ankylosing spondylitis and control patients with chronic back pain: age and spinopelvic alignment matched study.

    Science.gov (United States)

    Bok, Doo Hee; Kim, Jihye; Kim, Tae-Hwan

    2017-02-01

    To compare MRI-defined back muscle volume between AS patients and age, and spinopelvic alignment matched control patients with chronic back pain. 51 male patients with AS were enrolled. Age and spinopelvic alignment matched controls (male) were found among non-AS patients with chronic back pain. After matching procedure, fully matched controls were found in 31 of 51 AS patients (60.8%), who represent AS patients without deformity. However, matched controls were not found in 20 of 51 AS patients (39.2%), who represent AS patients with deformity. MRI parameters of back muscle (paraspinal muscle and psoas muscle) at L4/5 disc level including cross-sectional area (CSA) and fat-free cross-sectional area (FCSA) were compared between AS patients and matched controls. Covariates, including BMI, self-reported physical activity, and the presence of chronic disease, which can influence back muscle volume, were also investigated. There were no statistical differences in age, body mass index, score of back pain (NRS), and spinopelvic alignment, and physical activity between matched AS patients and control patients except for duration of back pain. All MRI parameters for paraspinal muscle volume in matched AS patients (without deformity) were significantly less than those of control patients, and significantly larger than those of non-matched AS patients (with deformity). Body size adjusted MRI parameters (relative CSA and relative FCSA) of paraspinal muscle showed strong correlations with lumbar lordosis and sacral slope. Such relationship between paraspinal muscle and spinopelvic parameters remained significant even after multivariate adjustment. AS patients without deformity already have decreased paraspinal muscle volume compared with age and spinopelvic alignment matched non-AS patients with chronic back pain. Such decrease in paraspinal muscle volume was significantly associated with kyphotic deformity of AS patients even after multivariate adjustment. Although the result

  20. Men's Experiences of Living with Ankylosing Spondylitis

    DEFF Research Database (Denmark)

    Madsen, Mette; Jensen, Kim Vilbek; Esbensen, Bente Appel

    2015-01-01

    was 12 years (range 0.3-28 years), and the median time from the first symptom to final diagnosis was seven years (range 2-20 years). Semi-structured interviews were conducted using an interview guide, and the interviews were analysed using content analysis inspired by Graneheim qualitative methodology....... RESULTS: The analysis revealed four categories: (1) 'Approaching a diagnosis'; (2) 'Ill in a social context'; (3) 'Challenged as a man'; and (4) 'The importance of remaining physically well'. Based on these categories, the overall category of 'An invisible companion for life' emerged, which captures...

  1. Intestinal bacteria as triggering agents in murine ankylosing enthesopathy

    Czech Academy of Sciences Publication Activity Database

    Řeháková, Z.; Čapková, Jana; Šinkora, J.; Osterreicher, J.; Ivanyi, P.

    2004-01-01

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

  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. MRI Findings of Brucellar Spondylitis: A Case Report

    International Nuclear Information System (INIS)

    Kim, Jin Woo; Kim, Myung Soon; Kim, Young Ju

    2013-01-01

    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.

  4. 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; Ejstrup, L

    2008-01-01

    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...

  5. Ankylosing spondylitis disease activity score is related to NSAID use, especially in patients treated with TNF-α inhibitors

    NARCIS (Netherlands)

    Carbo, Marlies J G; Spoorenberg, Anneke; Maas, Fiona; Brouwer, Elisabeth; Bos, Reinhard; Bootsma, Hendrika; van der Veer, Eveline; Wink, Freke; Arends, Suzanne

    2018-01-01

    BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are regarded as the cornerstone of conventional treatment for AS. However little is known about concomitant NSAID use during treatment (with TNF-α inhibitors) in daily clinical practice. METHODS AND FINDINGS: Consecutive patients from the

  6. Human leukocyte Antigen-B*27 allele subtype prevalence and disease association of ankylosing spondylitis among south indian population

    Directory of Open Access Journals (Sweden)

    Vikram Haridas

    2018-01-01

    Conclusion: The current study indicates that a majority of South Indian AS patients are associated with HLA-B*27 alleles. In addtion we found that HLA-B*27 associated AS patients presented with more severe axial manifestations.

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

    International Nuclear Information System (INIS)

    Andronikou, Savvas; Jadwat, Saaleha; Douis, Hassan

    2002-01-01

    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 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

  8. Male fertility potential alteration in rheumatic diseases: a systematic review.

    Science.gov (United States)

    Tiseo, Bruno Camargo; Cocuzza, Marcello; Bonfa, Eloisa; Srougi, Miguel; Silva, Clovis A

    2016-01-01

    Improved targeted therapies for rheumatic diseases were developed recently resulting in a better prognosis for affected patients. Nowadays, patients are living longer and with improved quality of life, including fertility potential. These patients are affected by impaired reproductive function and the causes are often multifactorial related to particularities of each disease. This review highlights how rheumatic diseases and their management affect testicular function and male fertility. A systematic review of literature of all published data after 1970 was conducted. Data was collected about fertility abnormalities in male patients with systemic lupus erythematosus, rheumatoid arthritis, dermatomyositis, ankylosing spondylitis, Behçet disease and gout. Two independent researchers carried out the search in online databases. A total of 19 articles were included addressing the following diseases: 7 systemic lupus erythematosus, 6 Behçet disease, 4 ankylosing spondylitis, 2 rheumatoid arthritis, 2 dermatomyositis and one gout. Systemic lupus erythematosus clearly affects gonadal function impairing spermatogenesis mainly due to antisperm antibodies and cyclophosphamide therapy. Behçet disease, gout and ankylosing spondylitis patients, including those under anti-TNF therapy in the latter disease, do not seem to have reduced fertility whereas in dermatomyositis, the fertility potential is hampered by disease activity and by alkylating agents. Data regarding rheumatoid arthritis is scarce, gonadal dysfunction observed as consequence of disease activity and antisperm antibodies. Reduced fertility potential is not uncommon. Its frequency and severity vary among the different rheumatic diseases. Permanent infertility is rare and often associated with alkylating agent therapy.

  9. 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

    Čapková, Jana; Ivanyi, P.; Řeháková, Z.

    2006-01-01

    Roč. 65, č. 1 (2006), s. 130-132 ISSN 0003-4967 R&D Projects: GA ČR(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

  10. 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.)

  11. MRI characteristics of tuberculous spondylitis

    International Nuclear Information System (INIS)

    Currie, S.; Galea-Soler, S.; Barron, D.; Chandramohan, M.; Groves, C.

    2011-01-01

    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.

  12. Noncontiguous multifocal brucellar spondylitis involving the cervical, thoracic, and lumbar spine: A case report

    Directory of Open Access Journals (Sweden)

    Rong Wang

    2017-06-01

    Full Text Available Brucellosis is a zoonosis infectious disease, brucellar spondylitis primarily infects the lumbar, the cervical is uncommon. Multiple-level involvement is extremely rare. This report describes a 46-year-old man with noncontiguous multifocal brucellar spondylitis involving the cervical, thoracic, and lumbar spine. Brucellar spondylitis is difficult to diagnose. Routine laboratory findings for the disease have little diagnostic value. Manifestations and radiological features are usually nonspecific. Radiological features of brucellar spondylitis are similar to tuberculous spondylitis and pyogenic spondylitis. MRI findings have diagnostic value. Suspicious patients with unexplained fever, musculoskeletal complaints at risk of infection should be considered.

  13. Infectious spondylitis and its differential diagnosis

    International Nuclear Information System (INIS)

    Erlemann, Rainer

    2012-01-01

    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.)

  14. Scintigraphic evaluation of the sacroiliac joints in anklylosing spondylitis

    International Nuclear Information System (INIS)

    Schoerner, W.

    1980-01-01

    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) [de

  15. Addison's disease secondary to connective tissue diseases: a report of six cases.

    Science.gov (United States)

    Zhang, Zhuo-li; Wang, Yu; Zhou, Wei; Hao, Yan-jie

    2009-04-01

    Addison's disease is an autoimmune process. However, Addison's disease associated with connective tissue diseases (CTD) is only occasionally reported. Here, we report six cases of Addison's disease secondary to a variety of CTD, which include systemic lupus erythematosus, Takayasu arteritis, systemic sclerosis, ankylosing spondylitis (AS) and antiphospholipid antibody syndrome. The association of Addison's disease with Takayasu arteritis and AS is reported for the first time. We also found high prevalence of hypothyroidism as concomitant autoimmune disorder. Our case series highlight the autoimmune features of Addison's disease. Therefore, we suggest considering adrenal dysfunction in patients with CTD.

  16. Musculoskeletal ultrasonographic evaluation of lower limb enthesopathy in ankylosing spondylitis and Behçet’s disease: Relation to clinical status and disease activity

    Directory of Open Access Journals (Sweden)

    E A Baraka

    2016-01-01

    Conclusion Ultrasonographic changes at the entheseal sites of the lower limbs are prevalent in both AS and BD. These changes are more frequently related to functional and articular involvement. MSUS is more sensitive than clinical examination in detecting enthesopathies of the lower limbs in both AS and BD patients.

  17. Radiologically- detectable sacroiliac involvement in behcet's disease

    International Nuclear Information System (INIS)

    Nadji, A.; Shabani, M.; Jamshidi, A.; Shahram, F.; Davatchi, F.

    2003-01-01

    Background: The association of Behcet's disease and ankylosing spondylitis is still a matter of debate. Objective: As the presence of sacroiliac joint involvement is an essential criterion in diagnosis of ankylosing spondylitis . We decided to determined the prevalence of sacroiliac joint involvement in Behcet's disease and compare it with that of a control group. Patients and Methods: We randomly selected two groups of 199 Behcet's disease patients and 168 non- Behcet's disease cases (the controls). All cases were over 20 years of ages. Standard anteroposterior radiographs of the sacroiliac joint were obtained and interpreted by two rheumatologists and a radiologists blinded to the diagnosis. To determined the severity of the condition, the following 5-point scale was employed: Normal (O), pseudo-widening (1), sclerosis (2), erosion (3), and bony fusion (4). The eliminate any doubt, only grades 3 and 4 were considered as sacroiliitis. Both group were separately evaluated for age (≤ 30, and ≥ 30), and gender. Results were compared using Chi square test. Results: The groups were matched for age and sex: There were 98 (49.2%) females in Behcet's disease vs. 91 (54.2%) in the control group (p=O.35). The mean ±SD age was 35±8.3 years in Behcet's disease and 35 ±10 in control group (p=1). The sacroiliac joint was involved in 9 (4.6%) patients in Behcet's disease and 7 (4.2%) patients in control group (p=O.93). Comparisons between the results of the unisexual cohorts revealed to significance either (p=O.68 for males, and p=O.64 for females). The age subdivisions (under- and over-30) again showed no significant difference (p=O.96 and p=O.69 for under- and over -30 patients, respectively). Conclusion: The presence of radiographic signs of sacroiliac joint involvement is not mandatory for the diagnosis of ankylosing spondylitis

  18. Male fertility potential alteration in rheumatic diseases: a systematic review

    Directory of Open Access Journals (Sweden)

    Bruno Camargo Tiseo

    2016-02-01

    Full Text Available ABSTRACT Background Improved targeted therapies for rheumatic diseases were developed recently resulting in a better prognosis for affected patients. Nowadays, patients are living longer and with improved quality of life, including fertility potential. These patients are affected by impaired reproductive function and the causes are often multifactorial related to particularities of each disease. This review highlights how rheumatic diseases and their management affect testicular function and male fertility. Materials and Methods A systematic review of literature of all published data after 1970 was conducted. Data was collected about fertility abnormalities in male patients with systemic lupus erythematosus, rheumatoid arthritis, dermatomyositis, ankylosing spondylitis, Behçet disease and gout. Two independent researchers carried out the search in online databases. Results A total of 19 articles were included addressing the following diseases: 7 systemic lupus erythematosus, 6 Behçet disease, 4 ankylosing spondylitis, 2 rheumatoid arthritis, 2 dermatomyositis and one gout. Systemic lupus erythematosus clearly affects gonadal function impairing spermatogenesis mainly due to antisperm antibodies and cyclophosphamide therapy. Behçet disease, gout and ankylosing spondylitis patients, including those under anti-TNF therapy in the latter disease, do not seem to have reduced fertility whereas in dermatomyositis, the fertility potential is hampered by disease activity and by alkylating agents. Data regarding rheumatoid arthritis is scarce, gonadal dysfunction observed as consequence of disease activity and antisperm antibodies. Conclusions Reduced fertility potential is not uncommon. Its frequency and severity vary among the different rheumatic diseases. Permanent infertility is rare and often associated with alkylating agent therapy.

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

    DEFF Research Database (Denmark)

    Sidiropoulos, P.I.; Hatemi, G.; Song, I.H.

    2008-01-01

    OBJECTIVE: Recommendations and/or guidelines represent a popular way of integrating evidence-based medicine into clinical practice. The 3E Initiatives is a multi-national effort to develop recommendations for the management of rheumatic diseases, which involves a large number of experts combined ...... of rheumatologists may improve their dissemination and implementation in daily clinical practice....

  20. Quantitative scintigraphy of the sacroiliac joints and spinal column in Bechterev's disease (spondylitis ankylopoetica)

    International Nuclear Information System (INIS)

    Mlychkov, Kh.

    1982-01-01

    Quantitative scintigraphy of the sacroiliac joints and the spinal column was performed in 138 patients with verified Bechterev's disease and in a control group of 104 healthy subjects, who had no clinical, roentgenographic and laboratory evidence of illness of the sacroiliac joints and the spinal column. By comparing skeletal ''zones of interest'' the author studied the following quantitative parameters: sacroiliac index (separately fop the right and left sacpoiliac joint); C 7 /sacrum jndex; D 10 /sacrum and L 4 /sacrum indices. The main values of these indices in the control group were accordingly 114.5 and 113.7 (for the right and left sacroiliac joints); 59; 95; 90. In patients with Bechterev's disease these indices were raised: 154 and 149 (for right and left sacroiliac joints); 75; 123; 113. Peak diagnostic value have the sacroiliac indices and the D 10 /sacrum, index, which appeared to be elevated in more than 95 per cent of the tested patients with verified Bechterev's disease. (author)

  1. Increased frequency of circulating CD19+CD24hiCD38hi B cells with regulatory capacity in patients with Ankylosing spondylitis (AS naïve for biological agents.

    Directory of Open Access Journals (Sweden)

    María-Belén Bautista-Caro

    Full Text Available Our objective was to study the frequency of circulating CD19+CD24hiCD38hi B cells (Breg in AS patients. To this end, peripheral blood was drawn from AS patients naïve for TNF blockers (AS/nb (n = 42 and healthy controls (HC (n = 42. Six patients donated blood for a second time, 6 months after initiating treatment with anti-TNFα drugs. After isolation by Ficoll-Hypaque, PBMCs were stained with antibodies to CD3, CD4, CD19, CD24, and CD38, and examined by cytometry. For functional studies, total CD19+ B cells were isolated from PBMCs of 3 HC by magnetical sorting. Breg-depleted CD19+ B cells were obtained after CD19+CD24hiCD38hi B cells were removed from total CD19+ cells by cytometry. Total CD19+ B cells or Breg-depleted CD19+ B cells were established in culture and stimulated through their BCR. Secretion of IFNγ was determined by ELISA in culture supernatants. When compared with HC, AS/nb patients demonstrated a significantly increased frequency of Breg cells, which was independent of disease activity. Anti-TNFα drugs induced a significant reduction of circulating Breg numbers, which were no longer elevated after six months of treatment. Functional in vitro studies showed that the secretion of IFNγ was significantly higher in Breg-depleted as compared with total CD19+ B cells, indicating that Breg can downmodulate B cell pro-inflammatory cytokine secretion. In summary, an increased frequency of circulating CD19+CD24hiCD38hi B cells is observed in AS/nb patients, that is not related with disease activity; anti-TNFα drugs are able to downmodulate circulating Breg numbers in AS.

  2. Sulfasalazine efficacy and tolerability in rheumatic diseases

    Directory of Open Access Journals (Sweden)

    V. V. Badokin

    2005-01-01

    Full Text Available Sulfasalazine is one of the main disease modifying drugs for the treatment of chronic inflammatory joint and spine diseases. The article describes mechanism of action of sulfasalazine and its main metabolites. Detailed information about anti-inflammatory and immunosuppressive action of the drug is presented. Results of many studies of sulfasalazine efficacy in rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and reactive arthritis are discussed from the evidence based medicine point of view. Data on sulfasalazine tolerability and safety are presented with separate discussion of hypersensitivity and dose-dependent adverse reactions so as their treatment and prophylaxis.

  3. Teriparatide and vertebral fracture healing in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Izolda Biro

    2017-12-01

    This case is unique as complete healing was achieved without preceding surgical intervention. Further exploration of the use of Teriparatide in spinal fractures in patients with AS is recommended to support the theories generated by this and other existing cases in the literature.

  4. Treatment of rheumatic diseases with X-rays

    International Nuclear Information System (INIS)

    Dihlmann, W.

    1977-01-01

    Treatment of rheumatic diseases with X-rays today still has some certain indications such as activated arthrosis, inflammatory insertion tendopathies, so-called periarthritis, ankylosing spondilytis, and - with reserve - cervical and lumbar syndromes. For X-radiation of rheumatic diseases, the rules and methods of the so-called inflammation radiation in low dosages are valid. Despite contradictory statements in the relevant literature, it is not proved that irradiation of the spinal column of patients with ankylosing spondylitis involves the danger of radiogenic leukaemia. Certain irradiations of joints, however, (e.g. hip joint, sacro-iliac joints) lead to a gonadal exposure (esp. in the case of women of reproductive age) which cannot be tolerated by any physician. (orig.) [de

  5. 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 pacientů s ankylozující spondylitidou

    Directory of Open Access Journals (Sweden)

    Petr Uhlíř

    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: Časové zapojování (aktivace svalů je závislé na mnoha faktorech. Povrchová polyelektromyografie zachycuje vzorce zapojování svalů u probandů rozdílného věku a zdravotního stavu v různých podmínkách. CÍLE: Cílem studie byla registrace a hodnocení pořadí zapojování svalů v průběhu sedání u t

  6. Joint diseases

    International Nuclear Information System (INIS)

    Weissman, S.D.

    1989-01-01

    The authors discuss how x-ray examination is essential in the diagnosis and evaluation of the arthritides. Most arthritides are first suspected by the clinician, and x-ray evaluation of these entities along with laboratory testing is important for confirmation of the clinical diagnosis and in staging of the disease process. Several arthritides are often diagnosed first by the podiatrist on x-ray evaluation, including pseudogout, ankylosing spondylitis, early rheumatoid arthritis, degenerative joint disease, and tuberculosis of bone. The joint responds to insult in only a limited number of ways that become apparent on x-ray. The soft tissues surrounding the joint, the articulating bones, and alignment of the joint space may all be involved by the arthritic process. On roentgenographic examination, the soft tissues must be examined for edema, masses, calcifications, and atrophy. The articulating bones must be examined for demineralization, erosions, osteophytes, periosteal reaction, cysts and sclerosis

  7. Aortic rupture complicating a fracture of an ankylosed thoracic spine. A case report.

    Science.gov (United States)

    Savolaine, E R; Ebraheim, N A; Stitgen, S; Jackson, W T

    1991-11-01

    A 34-year-old man was injured in a motorcycle accident and suffered both aortic rupture and thoracic spinal fracture, complicated by an underlying undetected ankylosing spondylitis. The latter disease can affect the integrity of vascular and spinal structure. Aortography is recommended as a high priority for the patient in an unstable cardiovascular condition requiring a definitive diagnosis. Aortic rupture and thoracic spine fracture may occur from high energy deceleration trauma. Motor vehicle passenger and pedestrian injuries are most commonly involved, although airline accidents and high falls also generate some cases. Mediastinal widening, displacement of esophagus and trachea, apical dissection of blood, and, especially, paravertebral pleural space widening are common to both injuries. Whereas most mediastinal hematomas are nonaortic in origin, a combined injury must be considered because clinical features may also overlap. These include hypotension (hypovolemic or spinal shock), paraplegia, and severe back pain. In light of the high mortality and time constraints associated with aortic rupture, immediate diagnostic resolution is necessary for appropriate management and priority of investigation.

  8. Description of spinal findings and determining the MR positive spondylitis

    International Nuclear Information System (INIS)

    Penkov, M.

    2015-01-01

    Full text: Spondyloarthritis (SpA) is an umbrella term applied to a family of rheumatic diseases that have both features in common with, as well as being distinct from, other inflammatory arthritides, particularly rheumatoid arthritis (RA). Recently, the ASAS working group established classification criteria to distinguish 2 broad categories of SpA: peripheral SpA and axSpA (Rudwaleit, 2011; Rudwaleit, 2010; Rudwaleit, 2009c). This division is based on the body part predominantly involved in the inflammatory process and those areas of the body that may respond similarly well to medication. Therefore, peripheral SpA includes diseases affecting mainly peripheral joints, such as reactive arthritis and psoriatic arthritis (PsA), whereas axSpA comprises those diseases with mainly axial involvement (sacroiliac joints and spine), including ankylosing spondylitis (AS) and nonradiographic axSpA (nr-axSpA). Patients with AS have definitive evidence of structural changes in the sacroiliac joint (sacroiliitis) on x-ray, fulfilling the Modified New York classification criteria (mNY-positive) (van der linden, 1984), whereas in those with nr-axSpA structural changes on conventional radiographs do not meet the mNy criteria (mNY-negative) (Rudwaleit, 2005; Dougados, 1991). Axial SpA is a chronic inflammatory disease that impacts a substantial proportion of the population. Limited evidence exists regarding the exact prevalence of axSpA. In the US, however, recent data suggest that the prevalence is similar to that of RA (axSpA: 0.7% to 1.4%; RA: 0.5% to 1.0%) (Reveille; 2012; Myasoedova, 2010; Helmick, 2008). In patients with axSpA, the disease typically originates in the sacroiliac joints, then progresses to the spine. In the sacroiliac joints and the spine, active inflammation results in erosions, sclerosis, and fatty lesions. However, the most characteristic feature is new bone formation leading to ankylosis of the sacroiliac joints and syndesmophytes attached to the vertebral

  9. Cervical Spondylitis and Epidural Abscess Caused by Brucellosis: a Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Reşorlu Hatice

    2016-12-01

    Full Text Available Brucellosis is a zoonotic disease widely seen in endemic regions and that can lead to systemic involvement. The musculoskeletal system is frequently affected, and the disease can exhibit clinical involvements such as arthritis, spondylitis, spondylodiscitis, osteomyelitis, tenosynovitis and bursitis. Spondylitis and spondylodiscitis, common complications of brucellosis, predominantly affect the lumbar and thoracic vertebrae.

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

    Directory of Open Access Journals (Sweden)

    Charalampos Papagoras

    2009-05-01

    Full Text Available 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 (TNFα, 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 these trials adalimumab has been shown to be effective in reducing disease activity, slowing radiographic disease progression and improving patients’ quality of life, while at the same time demonstrating an acceptable safety profile. Furthermore, release of adalimumab on the market, prospective observational studies, as well as open-label extensions of the original double-blind trials have provided experience and data about the long-term efficacy and safety of the drug. Initial effectiveness, in terms of reducing disease activity, is sustained, while in most cases patients treated with adalimumab experienced a slower radiographic progression and consequently less disability and improved health-related quality-of-life outcomes. Moreover, long-standing treatment of thousands of patients with adalimumab outside the controlled context of clinical trials was not related to new safety signals, with the most common adverse events being respiratory infections. The most common serious adverse events seem to be tuberculosis reactivation, while a putative association with malignant lymphoma development is not yet proven. Besides, both of these adverse reactions pertain to the whole TNFα blocker group. In conclusion, adalimumab is a safe and effective option for the treatment of patients with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and juvenile idiopathic arthritis. Keywords: adalimumab, tumor necrosis factor-alpha, rheumatoid arthritis, ankylosing spondylitis

  11. POSSIBILITIES FOR RADIODIAGNOSIS OF TUBERCULOUS SPONDYLITIS

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    S. V. Smerdin

    2014-01-01

    Full Text Available The presented case illustrates the possibilities of complex radiodiagnosis in a patient with tuberculous spondylitis. The specific features of displaying a spinal tuberculous lesion during X-ray study, tomosynthesis, computed tomography, and magnetic resonance imaging are described. A rational algorithm for the examination and treatment of patients with this disease is proposed, by comparing the clinical manifestations of spinal tuberculous lesion and the results of its radiological studies.

  12. Toll-like receptors and NOD-like receptors in rheumatic diseases.

    LENUS (Irish Health Repository)

    McCormack, William J

    2012-02-01

    The past 10 years have seen the description of families of receptors that drive proinflammatory cytokine production in infection and tissue injury. Two major classes have been examined in the context of inflammatory joint disease--the Toll-like receptors (TLRs) and NOD-like receptors (NLRs). TLRs such as TLR2 and TLR4 are being implicated in the pathology of rheumatoid arthritis, ankylosing spondylitis, lyme arthritis and osteoarthritis. Nalp3 has been identified as a key NLR for IL-1beta production and has been shown to have a particular role in gout. These findings present new therapeutic opportunities, possibly allowing for the replacement of biologics with small molecule inhibitors.

  13. Radiological sacroiliitis, a hallmark of spondylitis, is linked with CARD15 gene polymorphisms in patients with Crohn's disease

    OpenAIRE

    Peeters, Harald; Vander Cruyssen, Bert; Laukens, Debby; Coucke, Paul; MARICHAL, DENIS; VAN DEN BERGHE, MARTINA; Cuvelier, Claude; Remaut, Erik; Mielants, Herman; De Keyser, Filip; De Vos, Martine

    2004-01-01

    Background: Sacroiliitis is a common extraintestinal manifestation of Crohn's disease but its association with the HLA-B27 phenotype is less evident. Polymorphisms in the CARD15 gene have been linked to higher susceptibility for Crohn's disease. In particular, associations have been found with ileal and fibrostenosing disease, young age at onset of disease, and familial cases.

  14. Does the KIR2DS5 gene protect from some human diseases?

    Directory of Open Access Journals (Sweden)

    Izabela Nowak

    Full Text Available BACKGROUND: KIR2DS5 gene encodes an activating natural killer cell receptor whose ligand is not known. It was recently reported to affect the outcome of hematopoietic stem cell transplantation. METHODOLOGY/PRINCIPAL FINDINGS: In our studies on KIR2DS5 gene associations with human diseases, we compared the frequencies of this gene in patients and relevant controls. Typing for KIR2DS5 gene was performed by either individual or multiplex polymerase chain reactions which, when compared in the same samples, gave concordant results. We noted an apparently protective effect of KIR2DS5 gene presence in several clinical conditions, but not in others. Namely, this effect was observed in ankylosing spondylitis (p=0.003, odds ratio [OR]=0.47, confidence interval [CI]=0.28-0.79, endometriosis (p=0.03, OR=0.25, CI = 0.07-0.82 and acute rejection of kidney graft (p=0.0056, OR=0.44, CI=0.24-0.80, but not in non-small-cell lung carcinoma, rheumatoid arthritis, spontaneous abortion, or leukemia (all p>0.05. In addition, the simultaneous presence of KIR2DS5 gene and HLA-C C1 allotype exhibited an even stronger protective effect on ankylosing spondylitis (p=0.0003, OR=0.35, CI=0.19-0.65, whereas a lack of KIR2DS5 and the presence of the HLA-C C2 allotype was associated with ankylosing spondylitis (p=0.0017, OR=1.92, CI=1.28-2.89, whereas a lack of KIR2DS5 and presence of C1 allotype was associated with rheumatoid arthritis (p=0.005, OR=1.47, CI=1.13-1.92. The presence of both KIR2DS5 and C1 seemed to protect from acute kidney graft rejection (p=0.017, OR=0.47, CI=0.25-0.89, whereas lack of KIR2DS5 and presence of C2 seemed to favor rejection (p=0.0015, OR=2.13, CI=1.34-3.37. CONCLUSIONS/SIGNIFICANCE: Our results suggest that KIR2DS5 may protect from endometriosis, ankylosing spondylitis, and acute rejection of kidney graft.

  15. Scintigraphic investigation of sacroiliac disease

    International Nuclear Information System (INIS)

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

    1977-01-01

    Bone scintigraphs obtained with both technetium-99m polyphosphate and technetium-99m pyrophosphate have been abnormal at the sacroiliac joints of 44 patients with definite ankylosing spondylitis (AS). Because of the normal registration of the sacroiliac joints on bone scintigraphy, it has been necessary to develop a profile-scan technique to quantify the abnormality that proves to be significantly different from the normal finding. In 17 patients with a strong clinical suspicion of AS but normal radiographs, the sacroiliac joints have frequently been abnormal. This finding is meaningful because there is a common occurrence in this group of the histocompatibility antigen HL A-B27, known to be a marker of AS. We also note the frequency of abnormal sacroiliac scintigrams in 26 patients with rheumatoid arthritis and in a group of other diseases--Crohn's disease, uveitis, psoriasis, ulcerative colitis, and Reiters' disease--all of which share some of the manifestations of AS

  16. Patients with inflammatory bowel disease have increased risk of autoimmune and inflammatory diseases

    DEFF Research Database (Denmark)

    Halling, Morten L; Kjeldsen, Jens; Knudsen, Torben

    2017-01-01

    were significantly increased (P celiac disease, type 1 diabetes (T1D), sarcoidosis, asthma, iridocyclitis, psoriasis, pyoderma gangrenosum, rheumatoid arthritis, and ankylosing spondylitis. Restricted to UC (P ...AIM: To investigate whether immune mediated diseases (IMD) are more frequent in patients with inflammatory bowel disease (IBD). METHODS: In this population based registry study, a total of 47325 patients with IBD were alive and registered in the Danish National Patient Registry on December 16, 2013....... Controls were randomly selected from the Danish Civil Registration System (CRS) and matched for sex, age, and municipality. We used ICD 10 codes to identify the diagnoses of the included patients. The IBD population was divided into three subgroups: Ulcerative colitis (UC), Crohn's disease (CD) and Both...

  17. The scintigraphic investigation of sacroiliac disease.

    Science.gov (United States)

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

    1977-06-01

    Bone scintigraphs obtained with both Technetium-99m polyphosphate and Technetium-99m pyrophosphate have been abnormal at the sacroiliac joints of 44 patients with definite ankylosing spondylitis (AS). Because of the normal registration of the sacroiliac joints on bone scintigraphy, it has been necessary to develop a profile-scan technique to quantify the abnormality that proves to be significantly different from the normal finding. In 17 patients with a strong clinical suspicion of AS but normal radiographs, the sacroiliac joints have frequently been abnormal. This finding is meaningful because there is a common occurence in this group of the histocompatibility antigen HL A-B27, known to be a marker of AS. We also note the frequency of abnormal sacroiliac scinitigrams in 26 patients with rheumatoid arthritis and in a group of other diseases-Crohn's disease, uveitis, psoriasis, ulcerative colitis, and Reiter's disease-all of which share some of the manifestations of AS.

  18. The role of gut microbiota in the pathogenesis of rheumatic diseases.

    Science.gov (United States)

    Zhong, Danli; Wu, Chanyuan; Zeng, Xiaofeng; Wang, Qian

    2018-01-01

    Rheumatic diseases refer to many diseases with a loss of immune self-tolerance, leading to a chronic inflammation, degeneration, or metabolic derangement in multiple organs or tissues. The cause of rheumatic diseases remains to be elucidated, though both environmental and genetic factors are required for the development of rheumatic diseases. Over the past decades, emerging studies suggested that alteration of intestinal microbiota, known as gut dysbiosis, contributed to the occurrence or development of a range of rheumatic diseases, including rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, systemic sclerosis, and Sjogren's syndrome, through profoundly affecting the balance between pro- and anti-inflammatory immune responses. In this article, we discussed the role of gut microbiota in the pathogenesis of rheumatic diseases based on a large number of experimental and clinical materials, thereby providing a new insight for microbiota-targeted therapies to prevent or cure rheumatic diseases.

  19. [Inflammatory spinal diseases: axial spondyloarthritis : Central importance of imaging].

    Science.gov (United States)

    Baraliakos, X; Fruth, M; Kiltz, U; Braun, J

    2017-03-01

    The diagnosis of axial spondyloarthritis (axSpA) includes classical ankylosing spondylitis (AS) as well as earlier stages and abortive courses of the disease, in which structural alterations have not yet occurred. These are classified as non-radiographic axSpA (nr-axSpa). Inflammatory changes in the entire axial skeleton are characteristic for axSpA and can be visualized by magnetic resonance imaging (MRI), while in most patients structural alterations, such as new bone formation with syndesmophytes and ankylosis develop in the later course of the disease. These bony alterations can best be visualized by conventional radiography and by computed tomography. Certain MRI sequences are nowadays considered as the standard method for depiction of inflammatory changes in axSpA. The introduction of MRI has led to a paradigm shift for this disease because the inflammatory lesions characteristic for the disease can be visualized at an early stage using appropriate MRI sequences.

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

    Science.gov (United States)

    Scotece, Morena; Conde, Javier; Gómez, Rodolfo; López, Verónica; Pino, Jesús; González, Antonio; Lago, Francisca; Gómez-Reino, Juan J.; Gualillo, Oreste

    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 enhanced cardiovascular risk in this population. Obesity and its pathologic alteration of fat mass and dysfunction, due to an altered pattern of secretion of proinflammatory adipokines, could be one of the links between cardiovascular and rheumatic diseases. Indeed, the incidence of CVDs is augmented in obese individuals with rheumatic disorders. Thus, in this paper we explore in detail the relationships among adipokines, rheumatic diseases, and cardiovascular complications by giving to the reader a holistic vision and several suggestions for future perspectives and potential clinical implications. PMID:22910888

  1. Radiographic observation for tuberculous spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chul Se; Jung, Marn Kyoon; Kim, Byung Soo [College of Medicine, Busan National University, Busan (Korea, Republic of)

    1974-04-15

    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.

  2. High frequency of association of rheumatic/autoimmune diseases and untreated male hypogonadism with severe testicular dysfunction

    Science.gov (United States)

    Jimenez-Balderas, F Javier; Tapia-Serrano, Rosario; Fonseca, M Eugenia; Arellano, Jorge; Beltran, Arturo; Yañez, Patricia; Camargo-Coronel, Adolfo; Fraga, Antonio

    2001-01-01

    Our goal in the present work was to determine whether male patients with untreated hypogonadism have an increased risk of developing rheumatic/autoimmune disease (RAD), and, if so, whether there is a relation to the type of hypogonadism. We carried out neuroendocrine, genetic, and rheumatologic investigations in 13 such patients and 10 healthy male 46,XY normogonadic control subjects. Age and body mass index were similar in the two groups. Nine of the 13 patients had hypergonadotropic hypogonadism (five of whom had Klinefelter's syndrome [karyotype 47,XXY]) and 4 of the 13 had hypogonadotropic hypogonadism (46,XY). Of these last four, two had Kallmann's syndrome and two had idiopathic cryptorchidism. Eight (61%) of the 13 patients studied had RADs unrelated to the etiology of their hypogonadism. Of these, four had ankylosing spondylitis and histocompatibility B27 antigen, two had systemic lupus erythematosus (in one case associated with antiphospholipids), one had juvenile rheumatoid arthritis, and one had juvenile dermatomyositis. In comparison with the low frequencies of RADs in the general population (about 0.83%, including systemic lupus erythematosus, 0.03%; dermatomyositis, 0.04%; juvenile rheumatoid arthritis, 0.03%; ankylosing spondylitis, 0.01%; rheumatoid arthritis, 0.62%; and other RAD, 0.1%), there were surprisingly high frequencies of such disorders in this small group of patients with untreated hypogonadism (P hypogonadism and was associated with marked gonadal failure with very low testosterone levels. PMID:11714390

  3. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available Appointments • Support Our Research Arthritis Information Disease Information Rheumatoid Arthritis Psoriatic Arthritis Ankylosing Spondylitis Osteoarthritis Gout Lyme Disease Osteoporosis News Rheumatoid Arthritis News ...

  4. 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 L

    2010-01-01

    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....

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

    DEFF Research Database (Denmark)

    Madsen, Ole R; Rytter, Anne; Hansen, Lonnie B

    2010-01-01

    the reproducibility of the indices in anti-TNF-treated SpA patients already familiar with the use of the indices. Testing was performed twice on two different days (median interval 7 days, range 4-10 days) under standardised conditions in 26 out-clinic patients (median age 39 years, range 22-56 years). Limits...

  6. Integrated Analyses of Gene Expression Profiles Digs out Common Markers for Rheumatic Diseases

    Science.gov (United States)

    Wang, Lan; Wu, Long-Fei; Lu, Xin; Mo, Xing-Bo; Tang, Zai-Xiang; Lei, Shu-Feng; Deng, Fei-Yan

    2015-01-01

    Objective Rheumatic diseases have some common symptoms. Extensive gene expression studies, accumulated thus far, have successfully identified signature molecules for each rheumatic disease, individually. However, whether there exist shared factors across rheumatic diseases has yet to be tested. Methods We collected and utilized 6 public microarray datasets covering 4 types of representative rheumatic diseases including rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, and osteoarthritis. Then we detected overlaps of differentially expressed genes across datasets and performed a meta-analysis aiming at identifying common differentially expressed genes that discriminate between pathological cases and normal controls. To further gain insights into the functions of the identified common differentially expressed genes, we conducted gene ontology enrichment analysis and protein-protein interaction analysis. Results We identified a total of eight differentially expressed genes (TNFSF10, CX3CR1, LY96, TLR5, TXN, TIA1, PRKCH, PRF1), each associated with at least 3 of the 4 studied rheumatic diseases. Meta-analysis warranted the significance of the eight genes and highlighted the general significance of four genes (CX3CR1, LY96, TLR5, and PRF1). Protein-protein interaction and gene ontology enrichment analyses indicated that the eight genes interact with each other to exert functions related to immune response and immune regulation. Conclusion The findings support that there exist common factors underlying rheumatic diseases. For rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis and osteoarthritis diseases, those common factors include TNFSF10, CX3CR1, LY96, TLR5, TXN, TIA1, PRKCH, and PRF1. In-depth studies on these common factors may provide keys to understanding the pathogenesis and developing intervention strategies for rheumatic diseases. PMID:26352601

  7. EFFECTIVENESS OF INFLIXIMAB IN PATIENTS WITH JUVENILE ANKYLOSING SPONDYLARTHRITIS

    Directory of Open Access Journals (Sweden)

    A.L. Kozlova

    2009-01-01

    Full Text Available The objective of open-labeled study was estimation of effectiveness and safety of infliximab — monoclonal antibodies to tumor necrosis factor (TNF - in treatment of 48 patients with juvenile ankylosing spondylarthritis. Duration of observation was 6 weeks — 1,5 years. Anticytokine treatment was administrated on the ground of therapy with immunosuppressive agents in 96% of patients. Infliximab was administrated in median dose 7,4 ± 3,7 mg/kg of body weight by standard scheme (0–2–6 — week and further every 8 weeks intravenously. Results of a trial showed that infliximab has evident anti-inflammatory effect. Treatment with infliximab provided development of remission of articular syndrome, decreasing and normalization of laboratory indices of activity of disease, the rate of disability, and increasing of quality of life in 84% of patients. Effect of this medication was registered after first infusion and continued during all period of follow up. Adverse effects included transfusion reactions: fever, head ache, nausea/vomiting in 10% of patients, allergic arthritis — in 2% of patients. Thus, treatment of infliximab is pathogenetically grounded, effective and safe in patients with juvenile ankylosing spondylarthritis.Key words: children, juvenile ankylosing spondylarthritis, infliximab, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(2:20-26

  8. Undifferentiated seronegative spondyloarthritis with inflammatory bowel disease and a family history of psoriasis. Sicca syndrome

    Directory of Open Access Journals (Sweden)

    Norma Marigliano

    2013-04-01

    Full Text Available Background: Seronegative spondyloarthritis is characterized by the presence of subcutaneous nodules, asymmetrical peripheral arthritis, sacroileitis with or without spondylitis, and rheumatoid-factor negativity. Other common clinical manifestations include oral ulcers, conjunctivitis, and cutaneous lesions such as psoriasis. Familial aggregation has also been described. According to the 1986 classification, corresponding clinical entities include ankylosing spondylitis, psoriatic arthritis, Reiter’s syndrome, arthritis associated with inflammatory bowel disease (IBD, and undifferentiated spondyloarthritis. The disease is also frequently associated with the HLA B27 antigen. From the clinical point of view, there are often incomplete forms of spondyloarthritis, such as reactive arthritis triggered by asymptomatic infections, psoriatic arthritis without psoriasis itself, initial phases of specific forms of spondyloarthritis or the phase of ankylosing spondylitis characterized by sacroiliac lesions, and all forms that remain undifferentiated for long periods of time. Moreover, there are close relations between arthropathy and IBDs, such as Crohn’s disease, ulcerative colitis, and Whipple’s syndrome. Recently, microscopic inflammatory bowel lesions and psoriatic arthritis have been described. Case report: A 30-year-old man (HLA B27-negative who had been vaccinated against TBC and HBV presented with a 6-year history of recurrent episodes of predominantly left-sided sciatica. The pain was worse at night and during rest. He was suffering from bilateral sacroileitis without spondylitis. Three to five times a day, usually after eating, he passed watery feces containing mucous and small amounts of bright red blood. Colonoscopy revealed pancolitis with histological evidence of chronic inflammation interspersed with areas of acute inflammation, edema, hyperemia, and glandular distortion. One year later, the clinical manifestations and histological

  9. Radiological evaluation of tuberculous spondylitis with computed tomography

    International Nuclear Information System (INIS)

    Lim, Seung Soo; Kim, Chung Hyun; Cho, June Sik; Rhee, Byung Chull

    1986-01-01

    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.

  10. Decreased plasma levels of soluble CD18 link leukocyte infiltration with disease activity in spondyloarthritis

    DEFF Research Database (Denmark)

    Kragstrup, Tue Wenzel; Jalilian, Babak; Hvid, Malene

    2014-01-01

    of arthritis patients to have anti-inflammatory functions. Here, we study the mechanisms for these alterations and their association with SpA disease activity. METHODS: Plasma levels of sCD18 in a study population with 84 SpA patients and matched healthy controls were analyzed with a time resolved......A patients compared with healthy volunteers (P levels in the HLA-B27-positive subgroup (P levels exhibited an inverse correlation with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (P level of morning...... immunoflourometric assay (TRIFMA). Binding of sCD18 to endothelial cells and fibroblast-like synovial cells (FLS) was studied with confocal microscopy. Shedding of CD18 from peripheral blood mononuclear cells (PBMC) was studied with flow cytometry and TRIFMA. RESULTS: Plasma levels of sCD18 were decreased in Sp...

  11. Recommendations on the use of biosimilars by the Brazilian Society of Rheumatology, Brazilian Society of Dermatology, Brazilian Federation of Gastroenterology and Brazilian Study Group on Inflammatory Bowel Disease--Focus on clinical evaluation of monoclonal antibodies and fusion proteins used in the treatment of autoimmune diseases.

    Science.gov (United States)

    Azevedo, Valderílio Feijó; Meirelles, Eduardo de Souza; Kochen, Jussara de Almeida Lima; Medeiros, Ana Cristina; Miszputen, Sender J; Teixeira, Fábio Vieira; Damião, Adérson Osmar Mourão Cintra; Kotze, Paulo Gustavo; Romiti, Ricardo; Arnone, Marcelo; Magalhães, Renata Ferreira; Maia, Cláudia Pires Amaral; de Carvalho, André Vicente E

    2015-09-01

    The Brazilian Societies of Rheumatology (SBR) and Dermatology (SBD), the Brazilian Federation of Gastroenterology (FBG) and the Brazilian Study Group on Inflammatory Bowel Disease (GEDIIB) gathered a group of their respective specialists on the topic of interest to discuss the most relevant issues regarding the clinical use of biosimilar medicines in Brazil. The main aim of that meeting was to prepare a document with recommendations to guide medical specialists and to help the national regulatory and policy-making agencies as concerns the authorization for marketing biosimilars used in autoimmune diseases, such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, Crohn's disease, juvenile idiopathic arthritis and ulcerative colitis. In addition to considerations on the typical differences between innovator medicines and biosimilars, the specialists established a set of seven recommendations on regulatory advances related to clinical studies, indication extrapolation, nomenclature, interchangeability, automatic substitution and pharmacovigilance. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Swiss ball exercises improve muscle strength and walking performance in ankylosing spondylitis: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Marcelo Cardoso de Souza

    Full Text Available ABSTRACT Objective: The purpose was to evaluate the effectiveness of a progressive muscle strengthening program using a Swiss ball for AS patients. Methods: Sixty patients with AS were randomized into the intervention group (IG or the control group (CG. Eight exercises were performed by the IG patients with free weights on a Swiss ball two times per week for 16 weeks. The evaluations were performed by a blinded evaluator at baseline and after 4, 8, 12 and 16 weeks using the following instruments: the one-repetition maximum test (1 RM, BASMI, BASFI, HAQ-S, SF-36, 6-minute walk test, time up and go test, BASDAI, ASDAS, ESR and CRP dosage and Likert scale. Results: There was a statistical difference between groups for: strength (1 RM capacity in the following exercises: abdominal, rowing, squat, triceps and reverse fly (p < 0.005; 6-minute walk test (p < 0.001; timed up and go test (p = 0.025 and Likert scale (p < 0.001, all of them with better results for the IG. No differences were observed between the groups with respect to the functional capacity evaluation using the BASFI, HAQ-S, BASMI, SF-36, TUG, ASDAS, ESR and CPR dosage. Conclusions: Progressive muscle strengthening using a Swiss ball is effective for improving muscle strength and walking performance in patients with AS.

  13. Continuous NSAID use reverts the effects of inflammation on radiographic progression in patients with ankylosing spondylitis

    NARCIS (Netherlands)

    Kroon, Féline; Landewé, Robert; Dougados, Maxime; van der Heijde, Désirée

    2012-01-01

    The aim was to compare continuous and on-demand NSAID treatment with respect to their ability to suppress radiographic progression in subgroups of patients with high/elevated CRP-levels, ESR, ASDAS-levels or BASDAI-levels in comparison to patients with normal levels. Post-hoc analyses were performed

  14. Experience with long-term infliximab therapy in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Oksana Alekseevna Rumyantseva

    2010-01-01

    Results. The mean age of all the patients was 32.7 years; the mean duration of AS was 13.4 years; the mean therapy duration was 2.5 years. The therapy was performed for more than 3 and more than 5 years in 13 and 22 patients, respectively. According to therapy response, all the patients were divided into 3 groups: 1 those with ASAS improvement; 2 those with partial remission; 3 those with secondary inefficiency. Partial remission was observed in 35 (57% patients; ASAS 40 improvement was seen in 15 (24%; secondary inefficiency developed in 12 (19% patients. Peripheral arthritis was significantly less common in the group of patients who had achieved partial remission versus those who had achieved 40% improvement and those who had developed secondary inefficiency (p 16- week interruption, it is expedient to use cetirizine for 5 days and/or premedication with GC (prednisolone in a dose of 50 mg or dexaven in a dose of 8 mg.

  15. Relative and absolute risk models for cancer mortality in ankylosing spondylitis patients

    International Nuclear Information System (INIS)

    Muirhead, C.R.; Darby, S.C.

    1989-01-01

    The updated analyses presented in this paper have indicated that, even after allowing for the effects of other variables, the relative risk of all cancers excluding leukaemia and colon cancer among the irradiated spondylitics tails off beyond twenty-five years following exposure. Additionally, the corresponding absolute excess risk also tails off. This is still the only major study to show a wearing off of the radiation-related risk for such a grouping of cancers (although some wearing off has been seen for individual cancers such as bone in other studies). Further analysis of the spondylitic data (Darby, Doll and Smith, 1988) has not found any artificial explanation for the tailing off in risk, such as changes in lifestyle. However, it is noticeable that the dose was delivered to the spondylitics in fractions (see Lewis et al., 1988, table IV) rather than instantaneously, although it is not immediately obvious why this should have affected the temporal pattern of the risk. (author)

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

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Sørensen, Inge Juul; Garnero, Patrick

    2011-01-01

    To investigate the relation between ankylosing spondylitis disease activity score (ASDAS), Bath ankylosing spondylitis disease activity index (BASDAI) and treatment response and biomarkers of inflammation (C-reactive protein (CRP), interleukin-6 (IL-6), YKL-40), angiogenesis (vascular endothelial...... spondyloarthritis initiating tumour necrosis factor alpha (TNFa) inhibitor therapy....

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

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Sørensen, Inge Juul; Garnero, Patrick

    2011-01-01

    To investigate the relation between ankylosing spondylitis disease activity score (ASDAS), Bath ankylosing spondylitis disease activity index (BASDAI) and treatment response and biomarkers of inflammation (C-reactive protein (CRP), interleukin-6 (IL-6), YKL-40), angiogenesis (vascular endothelial...... spondyloarthritis initiating tumour necrosis factor alpha (TNFα) inhibitor therapy....

  18. Biomarkers in rheumatic diseases: how can they facilitate diagnosis and assessment of disease activity?

    Science.gov (United States)

    Mohan, Chandra; Assassi, Shervin

    2015-11-26

    Serological and proteomic biomarkers can help clinicians diagnose rheumatic diseases earlier and assess disease activity more accurately. These markers have been incorporated into the recently revised classification criteria of several diseases to enable early diagnosis and timely initiation of treatment. Furthermore, they also facilitate more accurate subclassification and more focused monitoring for the detection of certain disease manifestations, such as lung and renal involvement. These biomarkers can also make the assessment of disease activity and treatment response more reliable. Simultaneously, several new serological and proteomic biomarkers have become available in the routine clinical setting--for example, a protein biomarker panel for rheumatoid arthritis and a myositis antibody panel for dermatomyositis and polymyositis. This review will focus on commercially available antibody and proteomic biomarkers in rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis (scleroderma), dermatomyositis and polymyositis, and axial spondyloarthritis (including ankylosing spondylitis). It will discuss how these markers can facilitate early diagnosis as well as more accurate subclassification and assessment of disease activity in the clinical setting. The ultimate goal of current and future biomarkers in rheumatic diseases is to enable early detection of these diseases and their clinical manifestations, and to provide effective monitoring and treatment regimens that are tailored to each patient's needs and prognosis. © BMJ Publishing Group Ltd 2015.

  19. Abdominal scintigraphy using 99mTc-HMPAO-labelled leucocytes in patients with seronegative spondylarthropathies without clinical evidence of inflammatory bowel disease

    International Nuclear Information System (INIS)

    Alonso, J.C.; Lopez-Longo, F.J.; Lampreave, J.L.; Gonzalez, C.M.; Vegazo, O.; Carreno, L.; Almoguera, I.

    1996-01-01

    Abdominal scintigraphy with technetium-99m hexamethylpropylene amine oxime ( 99m Tc-HMPAO)-labelled leucocytes is an excellent tool for evaluating disease extent and activity of intestinal lesions in patients with inflammatory bowel disease (IBD). In some cases of seronegative spondylarthropathies (SSp), IBD may remain subclinical. The aim of this study was to evaluate the presence of positive abdominal scintigraphy in patients with SSp and without clinical symptoms or signs of IBD. To this end we studied 32 patients with active SSp (European Spondylarthropathy Study Group 1991 criteria) without clinical evidence of IBD (eight had ankylosing spondylitis, four psoriatic arthritis, three reactive arthritis an 17 undifferentiated SSp) and 11 controls without SSp. All SSp and control patients received similar doses of non-steroidal anti-inflammatory drugs (NSAIDs). Abdominal scintigraphic images were obtained at 30 and 120 min after re-injection of 99m Tc-HMPAO-labelled leucocytes. The 99m Tc-HMPAO-labelled leucocyte scan was positive in 17 patients with SSp (53.1%) (six with ankylosing spondylitis, three with psoriatic arthritis, two with reactive arthritis and six with undifferentiated SSp). Fourteen patients scored from 2 to 4 on the intensity of uptake scale. The colon and terminal ileum were predominantly involved. Axial involvement was more frequent in patients with a positive scan than in patients with negative results (P 99m Tc-HMPAO-labelled leucocyte scan shows increased uptake among patients with SSp without evidence of IBD. These findings provide new evidence linking SSp with intestinal inflammation and suggest that in some cases a bowel-related process could contribute to the development of SSp. Long-term follow-up studies with more patients are necessary to evaluate the diagnostic and therapeutic implications of these results. (orig.). With 3 figs., 3 tabs

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-11-01

    In cases where MRT fails to reveal abscess formation or typical vertebral changes to confirm the preliminary diagnosis, further examinations are necessary to exclude diseases other than spondylitis. More remote possibilities like insufficiency fracture, rheumatic disorders and neoplasm can mostly be ruled out on the basis of conventional X-ray pictures. Conventional tomography and computed tomography should also be carried out in addition to MRT in the rare case of unconfirmed activated arthrosis or disc removal syndrome. In order to distinguish between infective and non-infective/reactive changes, contrast-enhanced repeat MRT following antibiotic treatment may be very helpful. (orig.) [Deutsch] Wenn bei einer Spondylitis ein dafuer beweisender Abszess oder eine typische Destruktion des Wirbelkoerpers nicht vorliegt, ist auch nach Durchfuehrung einer MRT oft eine differentialdiagnostische Abgrenzung gegenueber anderen Ursachen erforderlich. Ferner stehende Differentialdiagnosen wie Insuffizienzfraktur, rheumatische Erkrankungen und eine Neoplasie koennen mit den Moeglichkeiten des konventionellen Roentgenbildes meist ausgeschlossen werden. An die konventionelle- und Computertomographie sollte - auch nach Durchfuehrung der MRT - noch in unklaren Einzelfaellen von aktivierter Arthrose oder Postdisketomie-Syndrom gedacht werden. Eine gute differentialdiagnostische Moeglichkeit zur Unterscheidung zwischen einem Infekt und einem nicht infektioesen/reaktivem Geschehen ist die Wiederholungs-MRT mit KM-Applikation nach durchgefuehrter antibiotischer Behandlung. (orig.)

  1. Demyelinating Disease following Anti-TNFa Treatment: A Causal or Coincidental Association? Report of Four Cases and Review of the Literature

    Directory of Open Access Journals (Sweden)

    E. Andreadou

    2013-01-01

    Full Text Available Tumor necrosis factor antagonists (anti-TNFa are an established therapeutic option for several autoimmune and inflammatory bowel diseases. Despite their clinical effectiveness, neurological adverse events have been reported and literature data suggest a potential role of anti-TNFa in the induction of demyelination of the CNS. We present four patients treated with anti-TNFa who developed symptoms suggestive of CNS demyelination. The first patient, a 17-year-old male who received etanercept for psoriatic arthritis for eight months, presented with dysesthesias up to T4 level. The second patient, a 30-year-old male treated with adalimumab for three years due to ankylosing spondylitis, presented with right unilateral tinnitus. The third case, a 47-year-old female, received etanercept for four years because of psoriatic arthritis and developed persistent headache and left-sided face and head numbness. Finally, the fourth patient, a 57-years-old female treated with etanercept for six years due to ankylosing spondylitis, presented with difficulty in speech, swallowing, and ptosis of the right corner of the mouth. In all cases, brain MRI showed lesions suggestive of demyelination, while positive oligoclonal bands were detected in the CSF. Anti-TNFa treatments were discontinued and patients showed clinical improvement with pulsed intravenous corticosteroid therapy. CNS demyelination following anti-TNFa treatment represents a relatively rare but potential serious complication. Close follow-up and MRI monitoring of these patients is mandatory to elucidate whether the clinical manifestations represent adverse events occurring during anti-TNFa therapy or a first demyelinating episode.

  2. Role of bone scan in rheumatic disease

    International Nuclear Information System (INIS)

    Choi, Yun Young

    2003-01-01

    Rheumatic diseases can be categorized by pathology into several specific types of musculoskeletal problems, including synovitis (e.g. rheumatoid arthritis), enthesopathy (e.g. ankylosing spondylitis) and cartilage degeneration (e.g. osteoarthritis). Skeletal radiographs have contributed to the diagnosis of these articular diseases, and some disease entities need typical radiographic changes as a factor of the diagnostic criteria. However, they sometimes show normal radiographic findings in the early stage of disease, when there is demineralization of less than 30-50%. Bone scans have also been used in arthritis, but not widely because the findings are nonspecific and it is thought that bone scans do not add significant information to routine radiography. Bone scans do however play a different role than simple radiography, and it is a complementary imaging method in the course of management of arthritis. The image quality of bone scans can be improved by obtaining regional views and images under al pin-hole collimator, and through a variety of scintigraphic techniques including the three phase bone scan and bone SPECT. Therefore, bone scans could improve the diagnostic value, and answer multiple clinical questions, based on the pathophysiology of various forms of arthritis

  3. Real-life experience of using conventional disease-modifying anti-rheumatic drugs (DMARDs) in psoriatic arthritis (PsA). Retrospective analysis of the efficacy of methotrexate, sulfasalazine, and leflunomide in PsA in comparison to spondyloarthritides other than PsA and literature review of the use of conventional DMARDs in PsA

    Science.gov (United States)

    Roussou, Euthalia; Bouraoui, Aicha

    2017-01-01

    Objective With the aim of assessing the response to treatment with conventional disease-modifying anti-rheumatic drugs (DMARDs) used in patients with psoriatic arthritis (PsA), data on methotrexate, sulfasalazine (SSZ), and leflunomide were analyzed from baseline and subsequent follow-up (FU) questionnaires completed by patients with either PsA or other spondyloarthritides (SpAs). Material and Methods A single-center real-life retrospective analysis was performed by obtaining clinical data via questionnaires administered before and after treatment. The indices used were erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Function Index (BASFI), wellbeing (WB), and treatment effect (TxE). The indices measured at baseline were compared with those measured on one occasion in a FU visit at least 1 year later. Results A total of 73 patients, 51 with PsA (mean age 49.8±12.8 years; male-to-female ratio [M:F]=18:33) and 22 with other SpAs (mean age 50.6±16 years; M:F=2:20), were studied. BASDAI, BASFI, and WB displayed consistent improvements during FU assessments in both PsA patients and controls in comparison to baseline values. SSZ exhibited better efficacy as confirmed by TxE in both PsA patients and controls. ESR and CRP displayed no differences in either the PsA or the SpA group between the cases before and after treatment. Conclusion Real-life retrospective analysis of three DMARDs used in PsA (and SpAs other than PsA) demonstrated that all three DMARDs that were used brought about improvements in BASDAI, BASFI, TxE, and WB. However, the greatest improvements at FU were seen with SSZ use in both PsA and control cohorts. PMID:28293446

  4. Role of inflammasomes in inflammatory autoimmune rheumatic diseases.

    Science.gov (United States)

    Yi, Young-Su

    2018-01-01

    Inflammasomes are intracellular multiprotein complexes that coordinate anti-pathogenic host defense during inflammatory responses in myeloid cells, especially macrophages. Inflammasome activation leads to activation of caspase-1, resulting in the induction of pyroptosis and the secretion of pro-inflammatory cytokines including interleukin (IL)-1β and IL-18. Although the inflammatory response is an innate host defense mechanism, chronic inflammation is the main cause of rheumatic diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), and Sjögren's syndrome (SS). Since rheumatic diseases are inflammatory/autoimmune disorders, it is reasonable to hypothesize that inflammasomes activated during the inflammatory response play a pivotal role in development and progression of these diseases. Indeed, previous studies have provided important observations that inflammasomes are actively involved in the pathogenesis of inflammatory/autoimmune rheumatic diseases. In this review, we summarize the current knowledge on several types of inflammasomes during macrophage-mediated inflammatory responses and discuss recent research regarding the role of inflammasomes in the pathogenesis of inflammatory/autoimmune rheumatic diseases. This avenue of research could provide new insights for the development of promising therapeutics to treat inflammatory/autoimmune rheumatic diseases.

  5. Comparative imaging features of brucellar and tuberculous spondylitis

    International Nuclear Information System (INIS)

    Sharif, H.S.; Aldeyan, O.; Clark, D.C.; Madkour, M.M.

    1987-01-01

    Images obtained with various modalities in 17 patients with Brucella spondylitis and 12 patients with tuberculous spondylitis were analyzed in order to identify distinguishing features. All patients underwent radiography, 21 underwent bone scintigraphy, and all underwent high-resolution CT and/or MR imaging. Characteristic findings in Brucella spondylitis included a predilection for the lumbar spine, bone destruction limited to the end-plates and associated with sclerosis, and disk space collapse (16 of 19) with disk vacuum phenomenon in eight and localized soft-tissue edema. MR imaging showed diffuse increased signal in vertebrae, disks, and adjacent soft tissues on long repetition time/long echo time studies (four patients). Tuberculosis spondylitis was characterized by a midthoracic predilection, diffuse vertebral destruction with gibbus deformity, severe disk collapse, and extensive paraspinal abscesses. MR imaging findings (three patients) were similar to but more severe than findings in Brucella spondylitis

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

    International Nuclear Information System (INIS)

    Gratz, S.; Behr, T.M.; Behe, M.; Doerner, J.; Fischer, U.; Grabbe, E.; Altenvoerde, G.; Meller, J.; Becker, W.

    2002-01-01

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

  7. The Microbiome: a Revolution in Treatment for Rheumatic Diseases?

    Science.gov (United States)

    Rosenbaum, James T; Asquith, Mark J

    2016-10-01

    The microbiome is the term that describes the microbial ecosystem that cohabits an organism such as humans. The microbiome has been implicated in a long list of immune-mediated diseases which include rheumatoid arthritis, ankylosing spondylitis, and even gout. The mechanisms to account for this effect are multiple. The clinical implications from observations on the microbiome and disease are broad. A growing number of microbiota constituents such as Prevotella copri, Porphyromonas gingivalis, and Collinsella have been correlated or causally related to rheumatic disease. The microbiome has a marked effect on the immune system. Our understanding of immune pathways modulated by the microbiota such as the induction of T helper 17 (Th17) cells and secretory immunoglobulin A (IgA) responses to segmented filamentous bacteria continues to expand. In addition to the gut microbiome, bacterial communities of other sites such as the mouth, lung, and skin have also been associated with the pathogenesis of rheumatic diseases. Strategies to alter the microbiome or to alter the immune activation from the microbiome might play a role in the future therapy for rheumatic diseases.

  8. Autoimmunity in Rheumatic Diseases Is Induced by Microbial Infections via Crossreactivity or Molecular Mimicry

    Directory of Open Access Journals (Sweden)

    Taha Rashid

    2012-01-01

    Full Text Available A general consensus supports fundamental roles for both genetic and environmental, mainly microbial, factors in the development of autoimmune diseases. One form of autoimmune rheumatic diseases is confined to a group of nonpyogenic conditions which are usually preceded by or associated with either explicit or occult infections. A previous history of clinical pharyngitis, gastroenteritis/urethritis, or tick-borne skin manifestation can be obtained from patients with rheumatic fever, reactive arthritis, or Lyme disease, respectively, whilst, other rheumatic diseases like rheumatoid arthritis (RA, ankylosing spondylitis (AS, and Crohn’s disease (CD are usually lacking such an association with a noticeable microbial infection. A great amount of data supports the notion that RA is most likely caused by Proteus asymptomatic urinary tract infections, whilst AS and CD are caused by subclinical bowel infections with Klebsiella microbes. Molecular mimicry is the main pathogenetic mechanism that can explain these forms of microbe-disease associations, where the causative microbes can initiate the disease with consequent productions of antibacterial and crossreactive autoantibodies which have a great impact in the propagation and the development of these diseases.

  9. The prevalence of severe fatigue in rheumatic diseases: an international study.

    Science.gov (United States)

    Overman, Cécile L; Kool, Marianne B; Da Silva, José A P; Geenen, Rinie

    2016-02-01

    Fatigue is a common, disabling, and difficult-to-manage problem in rheumatic diseases. Prevalence estimates of fatigue within rheumatic diseases vary considerably. Data on the prevalence of severe fatigue across multiple rheumatic diseases using a similar instrument is missing. Our aim was to provide an overview of the prevalence of severe fatigue across a broad range of rheumatic diseases and to examine its association with clinical and demographic variables. Online questionnaires were filled out by an international sample of 6120 patients (88 % female, mean age 47) encompassing 30 different rheumatic diseases. Fatigue was measured with the RAND(SF)-36 Vitality scale. A score of ≤35 was taken as representing severe fatigue (90 % sensitivity and 81 % specificity for chronic fatigue syndrome). Severe fatigue was present in 41 to 57 % of patients with a single inflammatory rheumatic disease such as rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, Sjögren's syndrome, psoriatic arthritis, and scleroderma. Severe fatigue was least prevalent in patients with osteoarthritis (35 %) and most prevalent in patients with fibromyalgia (82 %). In logistic regression analysis, severe fatigue was associated with having fibromyalgia, having multiple rheumatic diseases without fibromyalgia, younger age, lower education, and language (French: highest prevalence; Dutch: lowest prevalence). In conclusion, one out of every two patients with a rheumatic disease is severely fatigued. As severe fatigue is detrimental to the patient, the near environment, and society at large, unraveling the underlying mechanisms of fatigue and developing optimal treatment should be top priorities in rheumatologic research and practice.

  10. A comparison of disease burden in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis.

    Directory of Open Access Journals (Sweden)

    Brigitte Michelsen

    Full Text Available The main objective of this study was to compare disease burden in rheumatoid arthritis (RA, psoriatic arthritis (PsA and axial spondyloarthritis (ax-SpA.In this cross-sectional study, all the RA (1093, PsA (365 and ax-SpA (333 patients who visited the out-patient clinic of the Hospital of Southern Norway Trust during the year 2013 were included; the RA patients all had a RA diagnosis verified by the treating rheumatologist, the PsA patients all fulfilled the ClASsification for Psoriatic ARthritis (CASPAR criteria and the ax-SpA patients all fulfilled the Assessment of SpondyloArthritis international Society (ASAS classification criteria for ax-SpA. Patient-reported health status, demographic variables, medications, and composite scores of disease activity were assessed. The main analyses were performed using General Linear Models adjusted for age, sex and multiple comparisons. Correlation analyses were performed using Spearman's rho.The reported pain, joint pain, patient's global assessment and fatigue were similar in PsA and ax-SpA, but significantly lower in RA. The 28-joint Disease Activity Score (DAS28 (0.3±0.1, p = 0.003, Clinical Disease Activity Index (CDAI (1.0±0.4, p = 0.028 and Routine Assessment of Patient Index Data 3 (RAPID3 (0.4±0.1, p = 0.004 were all significantly higher in PsA vs. RA. RAPID3 showed moderate to high correlation with DAS28 (rho = 0.521, p<0.001 and CDAI (rho = 0.768, p<0.001 in RA and PsA, and with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI (rho = 0.902, p<0.001 and Bath Ankylosing Spondylitis Functional Index (BASFI (0.865, p<0.001 in ax-SpA and PsA.In conclusion, patient- reported outcome measures were similar in our population of PsA and ax-SpA patients, but significantly lower for the RA patients. Composite disease activity measures were lower in RA than in PsA and ax-SpA, but the magnitude of these differences was small and probably not of clinical significance. Our study indicates that

  11. The Effects of Whole-Body Vibration on Health

    Science.gov (United States)

    1979-03-01

    strains, sciatica, lumbar disc syndrome, and facet syndrome), cardiovascular system (hypertension, coronary artery disease, obstructive syndromes...compression fractures, Schmorl’s nodes, ankylosing spondylitis, spondylolisthesis, spondylosis , Scheur- man’s disease, supply spondylosis , detached retina

  12. African Journal of Neurological Sciences - 2009 Vol. 28 No 1

    African Journals Online (AJOL)

    Keywords : myasthenia, spondylarthropathy, autoimmune diseases, ankylosing spondylitis. RESUME. Propos ... We report the case of an association : myasthenia-spondylarthropathy which is an original observation because this .... myasthenia gravis: autoimmune diseases and their relation to thymectomy. Acta Neurol ...

  13. hCG Test (Pregnancy Test)

    Science.gov (United States)

    ... Acidosis and Alkalosis Adrenal Insufficiency and Addison Disease Alcoholism Allergies Alzheimer Disease Anemia Angina Ankylosing Spondylitis Anthrax ... Patient Resources For Health Professionals Subscribe Search hCG Pregnancy Send Us Your Feedback Choose Topic At a ...

  14. Correlation of Periodontal Disease With Inflammatory Arthritis in the Time Before Modern Medical Intervention.

    Science.gov (United States)

    Rothschild, Bruce

    2017-03-01

    Controversy exists regarding possible correlation of periodontal disease with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Confounding factors may relate to stringency of inflammatory disease diagnosis and the effect of therapeutic intervention for RA on periodontal disease. These factors are investigated in this study. Forty-five individuals with documented RA (n = 15), spondyloarthropathy (n = 15), and calcium pyrophosphate deposition disease (CPPD) (n = 15), from the Hamann-Todd collection of human skeletons compiled from 1912 to 1938, and 15 individuals contemporarily incorporated in the collection were examined for tooth loss, cavity occurrence, average and maximum lingual and buccal depth of space between tooth and bone, periosteal reaction, serpentine bone resorption, abscess formation, and root penetration of the bone surface and analyzed by analysis of variance. Tooth loss was common, but actual number of teeth lost, cavity occurrence, average and maximum lingual and buccal depth of space between tooth and bone, periosteal reaction, serpentine grooving surrounding teeth (considered a sign of inflammation), abscess formation, and root exposure (penetration of bone surface) were indistinguishable among controls and individuals with RA, spondyloarthropathy, and CPPD. Although many factors can affect periodontal disease, presence of inflammatory arthritis does not appear to be one of them. The implication is that dental disease was common in the general population and not necessarily associated with arthritis, at least before the advent of modern rheumatologic medications. As specific diagnosis did not affect prevalence, perhaps current prevalence controversy may relate to current intervention, a subject for further study.

  15. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases

    Science.gov (United States)

    Gabriel, Sherine E; Michaud, Kaleb

    2009-01-01

    Epidemiology is the study of the distribution and determinants of disease in human populations. Over the past decade there has been considerable progress in our understanding of the fundamental descriptive epidemiology (levels of disease frequency: incidence and prevalence, comorbidity, mortality, trends over time, geographic distributions, and clinical characteristics) of the rheumatic diseases. This progress is reviewed for the following major rheumatic diseases: rheumatoid arthritis (RA), juvenile rheumatoid arthritis, psoriatic arthritis, osteoarthritis, systemic lupus erythematosus, giant cell arteritis, polymyalgia rheumatica, gout, Sjögren's syndrome, and ankylosing spondylitis. These findings demonstrate the dynamic nature of the incidence and prevalence of these conditions – a reflection of the impact of genetic and environmental factors. The past decade has also brought new insights regarding the comorbidity associated with rheumatic diseases. Strong evidence now shows that persons with RA are at a high risk for developing several comorbid disorders, that these conditions may have atypical features and thus may be difficult to diagnose, and that persons with RA experience poorer outcomes after comorbidity compared with the general population. Taken together, these findings underscore the complexity of the rheumatic diseases and highlight the key role of epidemiological research in understanding these intriguing conditions. PMID:19519924

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

    Energy Technology Data Exchange (ETDEWEB)

    Manaster, B.J.

    1988-03-01

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

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

    International Nuclear Information System (INIS)

    Manaster, B.J.

    1988-01-01

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

  18. Rheumatic Diseases in China

    Science.gov (United States)

    Zeng, Qing Yu; Chen, Ren; Darmawan, John; Xiao, Zheng Yu; Chen, Su Biao; Wigley, Richard; Le Chen, Shun; Zhang, Nai Zheng

    2008-01-01

    Introduction Epidemiological studies of rheumatic diseases have been conducted during the past 20 years in China. The aim of this study was to clarify prevalence rates of common rheumatic diseases in China. Methods Relevant reports of population-based surveys conducted from 1980 to 2006 were retrieved. Studies using the World Health Organization-International League of Associations for Rheumatology COPCORD (Community Oriented Program for Control of Rheumatic Diseases) protocol and those that did not employ this protocol but were published in recognized journals were identified and analyzed. Results Thirty-eight surveys including 241,169 adults from 25 provinces/cities were pooled for analysis. The prevalence of rheumatic complaints ranged from 11.6% to 46.4%, varying by locality, study protocol and age of the people surveyed. Prevalence of symptomatic osteoarthritis (OA) varied from 5.1% to 20.8%, with common sites of involvement being the lumbar spine, knee joint and cervical spine. Compared with rates of radiographic and symptomatic knee OA in the USA, elderly men in Beijing exhibited similar prevalence rates and elderly women exhibited a higher prevalence. The prevalence of hip OA and hand OA was much lower in Chinese than in Caucasian populations, but both kinds of OA were more common in coal miners. The prevalence of ankylosing spondylitis ranged from 0.2% to 0.54% among Han ethnic Chinese and were lower among mixed ethnic populations. The prevalence of psoriatic arthritis ranged from 0.01% to 0.1%, and that of reactive arthritis was 0.02%; undifferentiated spondyloarthropathy was identified in 0.64% to 1.2% of the individuals included in the surveys. The prevalence of rheumatoid arthritis (RA) ranged from 0.2% to 0.93%, with the highest rate being reported from a Taiwan urban area. In mainland China there were no significant differences in prevalence of RA between the northern and southern parts of China, or between different ethnic groups. The prevalence of

  19. Fibromyalgia in patients with other rheumatic diseases: prevalence and relationship with disease activity.

    Science.gov (United States)

    Haliloglu, Sema; Carlioglu, Ayse; Akdeniz, Derya; Karaaslan, Yasar; Kosar, Ali

    2014-09-01

    Fibromyalgia (FM) is a syndrome characterized by chronic widespread pain and the presence of specific tender points. The prevalence of FM has been estimated at 2-7 % of the general global population. The presence of FM in several rheumatic diseases with a structural pathology has been reported as 11-30 %. The objectives of this study were to determine the prevalence of FM and to evaluate the possible relationship between FM existence and disease activity among rheumatic diseases. The study group included 835 patients--197 rheumatoid arthritis (RA), 67 systemic lupus erythematosus (SLE), 119 ankylosing spondylitis (AS), 238 osteoarthritis (OA), 14 familial Mediterranean fever (FMF), 53 Behçet's disease (BD), 71 gout, 25 Sjögren's syndrome (SS), 20 vasculitis, 29 polymyalgia rheumatica (PMR), and two polymyositis (PM)--with or without FM. Recorded information included age, gender, laboratory parameters, presence of fatigue, and disease activity indexes. The prevalence of FM in patients with rheumatologic diseases was found to be 6.6 % for RA, 13.4 % for SLE, 12.6 % for AS, 10.1 % for OA, 5.7 % for BD, 7.1 % for FMF, 12 % for SS, 25 % for vasculitis, 1.4 % for gout, and 6.9 % for PMR. One out of two patients with PM was diagnosed with FM. Some rheumatologic cases (AS, OA) with FM were observed mostly in female patients (p = 0.000). Also, there were significant correlations between disease activity indexes and Fibromyalgia Impact Questionnaire scores for most rheumatologic patients (RA, AS, OA, and BD) (p diseases, and its recognition is important for the optimal management of these diseases. Increased pain, physical limitations, and fatigue may be interpreted as increased activity of these diseases, and a common treatment option is the prescription of higher doses of biologic agents or corticosteroids. Considerations of the FM component in the management of rheumatologic diseases increase the likelihood of the success of the treatment.

  20. Discussion: DMARDs and biologic therapies in the management of inflammatory joint diseases.

    Science.gov (United States)

    Vaz, Austin; Lisse, Jeffrey; Rizzo, Warren; Albani, Salvatore

    2009-05-01

    Therapy for inflammatory joint diseases, such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis, includes various conventional disease-modifying antirheumatic drugs (DMARDs). These therapeutic agents are termed DMARDs because they have the potential to reduce or prevent joint damage and preserve joint integrity and function. Conventional DMARDs are used as monotherapy or in combination and include methotrexate, leflunomide, azathioprine, ciclosporin, hydroxychloroquine, sulfasalazine, gold and minocycline. Biologic response modifiers, which are based on proteins made by living cells, are newer agents available for the treatment of various inflammatory joint diseases. Biologic therapies now approved for use in inflammatory joint diseases are TNF inhibitors, T-cell modulators and B-cell depleters. They have all been shown to have clinical efficacy and are able to retard structural damage. However, all current immune-modulating therapies also have potential side effects, and the decision to use a particular agent for treatment should be based on a thorough discussion of the benefits and risks with the patient. Newer biologic response modifiers and other immunologic therapies are currently being developed for the treatment of inflammatory joint diseases and are discussed in this review.

  1. Bone Disease in Axial Spondyloarthritis.

    Science.gov (United States)

    Van Mechelen, Margot; Gulino, Giulia Rossana; de Vlam, Kurt; Lories, Rik

    2018-05-01

    Axial spondyloarthritis is a chronic inflammatory skeletal disorder with an important burden of disease, affecting the spine and sacroiliac joints and typically presenting in young adults. Ankylosing spondylitis, diagnosed by the presence of structural changes to the skeleton, is the prototype of this disease group. Bone disease in axial spondyloarthritis is a complex phenomenon with the coexistence of bone loss and new bone formation, both contributing to the morbidity of the disease, in addition to pain caused by inflammation. The skeletal structural changes respectively lead to increased fracture risk and to permanent disability caused by ankylosis of the sacroiliac joints and the spine. The mechanism of this new bone formation leading to ankylosis is insufficiently known. The process appears to originate from entheses, specialized structures that provide a transition zone in which tendon and ligaments insert into the underlying bone. Growth factor signaling pathways such as bone morphogenetic proteins, Wnts, and Hedgehogs have been identified as molecular drivers of new bone formation, but the relationship between inflammation and activation of these pathways remains debated. Long-standing control of inflammation appears necessary to avoid ankylosis. Recent evidence and concepts suggest an important role for biomechanical factors in both the onset and progression of the disease. With regard to new bone formation, these processes can be understood as ectopic repair responses secondary to inflammation-induced bone loss and instability. In this review, we discuss the clinical implications of the skeletal changes as well as the underlying molecular mechanisms, the relation between inflammation and new bone formation, and the potential role of biomechanical stress.

  2. Real-life effectiveness of spa therapy in rheumatic and musculoskeletal diseases: a retrospective study of 819 patients

    Science.gov (United States)

    Karagülle, Mine; Kardeş, Sinan; Karagülle, Müfit Zeki

    2017-11-01

    The objective of this study is to determine the use and efficacy of spa therapy in patients with a wide spectrum of rheumatic and musculoskeletal diseases under real-life clinical practice circumstances. In this retrospective observational study at the Medical Ecology and Hydroclimatology Department of Istanbul Faculty of Medicine, the records of all adult patients with rheumatic and musculoskeletal diseases who were prescribed a spa therapy in various health resorts in Turkey between 2002 and 2012 were analyzed. Patients sojourned to and stayed at a health resort and followed a usual 2-week course of spa therapy. The patients were examined within a week before and after the spa therapy at the department by the physicians and outcome measures were pain intensity (visual analog scale, VAS), patient's general evaluation (VAS), physician's general evaluation (VAS), Health Assessment Questionnaire (HAQ), Lequesne's Functional Index (LFI), Western Ontario and McMaster Universities Index (WOMAC), Waddell Index (WI), Neck Pain and Disability Scale (NPDS), Shoulder Disability Questionnaire (SDQ), Fibromyalgia Impact Questionnaire (FIQ), and Beck's Depression Inventory (BDI). In total, 819 patients were included in the analysis. The diagnoses were 536 osteoarthritis; 115 fibromyalgia; 50 lumbar disc herniation; 34 cervical disc herniation; 23 nonspecific low back pain; 22 ankylosing spondylitis; 16 rheumatoid arthritis; 9 rotator cuff tendinitis; and 14 other conditions/diseases including scoliosis, stenosing flexor tenosynovitis, congenital hip dislocation in adult, Behçet's disease, de Quervain tendinopathy, psoriatic arthritis, osteoporosis, fracture rehabilitation, and diffuse idiopathic skeletal hyperostosis. Statistically significant decrease in pain scores was found in all patients except hip osteoarthritis ( p = 0.063) and rheumatoid arthritis ( p = 0.134) subgroups; and statistically significant improvement in function in all patients except hip osteoarthritis ( p

  3. Sick leave in patients with ankylosing spondylitis before and after anti-TNF therapy: a population-based cohort study.

    Science.gov (United States)

    Kristensen, Lars E; Petersson, Ingemar F; Geborek, Pierre; Jöud, Anna; Saxne, Tore; Jacobsson, Lennart T H; Englund, Martin

    2012-02-01

    To study levels of sick leave and disability pension before and after TNF-antagonist therapy in AS patients. Using the population-based South Swedish Arthritis Treatment Group register, we identified 139 AS patients (aged 18-58 years, 78% men), who between January 2002 and December 2008 started their first treatment with adalimumab, etanercept or infliximab. We linked data to the payment register by the Swedish Social Insurance Agency and calculated the proportion on sick leave in 30-day intervals from 12 months before treatment start until 12 months after. For each AS patient, we randomly selected four subjects from the general population matched for age, sex and area of residence. One to 3 months before treatment, an average of 24% of AS patients were on sick leave. During the first 6 months after treatment start, this fraction dropped to 15%, and further declined to 12% at 12 months (P patients with the general population, the relative risk of being on sick leave 3 months before treatment, treatment start and 12 months after treatment start was 8.0 (95% CI 4.6, 13.9), 9.2 (95% CI 5.4, 15.7) and 4.0 (95% CI 2.1, 6.3), respectively. The decrease in sick leave was not substantially offset by changes in disability pension. There is a decline in sick leave during the first 12 months after initiation of TNF-antagonist treatment in AS patients not explained by societal factors or secular trends. The proportion of AS patients on disability pension remained unchanged during the observation period.

  4. 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; Hermann, Kay-Geert

    2007-01-01

    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...

  5. The effect of golimumab on haemoglobin levels in patients with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis.

    Science.gov (United States)

    Furst, Daniel E; Kay, Jonathan; Wasko, Mary Chester; Keystone, Edward; Kavanaugh, Arthur; Deodhar, Atul; Murphy, Frederick T; Magnus, Jeanette H; Hsia, Elizabeth C; Hsu, Benjamin; Xu, Stephen; Rahman, Mahboob U; Doyle, Mittie K

    2013-10-01

    To evaluate the effect of golimumab on haemoglobin levels in patients with RA, PsA or AS. Secondary analysis was performed on integrated data from five randomized controlled studies: three RA, one PsA and one AS (2303 patients total). Golimumab 50 or 100 mg was injected s.c. every 4 weeks with or without MTX. Control groups received placebo injections plus MTX or background therapy. Patients with haemoglobin levels below the age- and sex-specific normal ranges were considered to have anaemia. Ferritin levels were used to distinguish anaemia of mixed aetiology (≥ 15 and <60 ng/ml) and anaemia of inflammation (≥ 60 ng/ml). Changes from baseline to weeks 14 and 24 in haemoglobin level were compared between treatment groups using an an