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Sample records for rheumatic joint erosions

  1. The development of EERA: software for assessing rheumatic joint erosions.

    Science.gov (United States)

    Emond, Patrick D; Choi, Abram; O'Neill, John; Xie, Jason; Adachi, Rick; Gordon, Chris L

    2009-04-01

    The principal aim of this study was to create a segmentation program, to be used by nonmusculoskeletal or junior fellows, that defines the bones in the metacarpophalangeal joint in a dynamic 3-dimensional image that will lead to higher inter-reader agreement of bone erosion scores. The second to fifth metacarpal head and phalangeal bases of 15 participants were rated according to the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring system by one trained and one untrained reader. Two comparisons were made. The first comparison was between the 2 readers using only the traditional 2-dimensional magnetic resonance image set. The second comparison was between the 2 readers, with the untrained reader using a custom segmentation program with traditional 2-dimensional magnetic resonance image set. The software marginally increased inter-reader reliability with the exception of the second metacarpal head, for which reliability was increased substantially. Future work will concentrate on improving image acquisition, better delineate erosions from surrounding bone oedema, and address methods to directly determine erosion volumes. Software designed to display dynamic 3-dimensional images enables a relatively untrained user to score the metacarpophalangeal joints in the hand for erosions equivalent to that produced by an expert using the manual methods.

  2. The development of EERA: software for assessing rheumatic joint erosions

    Energy Technology Data Exchange (ETDEWEB)

    Emond, P.D.; Choi, A. [St Joseph' s Hospital, McMaster Univ., Hamilton, Ontario (Canada)], E-mail: emondpd@mcmaster.ca; O' Neill, J. [Diagnostic Imaging Dept., St Joseph' s Healthcare, Hamilton, Ontario (Canada); Xie, J.; Adachi, R. [St Joseph' s Hospital, McMaster Univ., Hamilton, Ontario (Canada); Gordon, C.L. [McMaster Univ., Hamilton, Ontario (Canada)

    2009-04-15

    The principal aim of this study was to create a segmentation program, to be used by nonmusculoskeletal or junior fellows, that defines the bones in the metacarpophalangeal joint in a dynamic 3-dimensional image that will lead to higher inter-reader agreement of bone erosion scores. The second to fifth metacarpal head and phalangeal bases of 15 participants were rated according to the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring system by one trained and one untrained reader. Two comparisons were made. The first comparison was between the 2 readers using only the traditional 2-dimensional magnetic resonance image set. The second comparison was between the 2 readers, with the untrained reader using a custom segmentation program with traditional 2-dimensional magnetic resonance image set. The software marginally increased inter-reader reliability with the exception of the second metacarpal head, for which reliability was increased substantially. Future work will concentrate on improving image acquisition, better delineate erosions from surrounding bone oedema, and address methods to directly determine erosion volumes. Software designed to display dynamic 3-dimensional images enables a relatively untrained user to score the metacarpophalangeal joints in the hand for erosions equivalent to that produced by an expert using the manual methods. (author)

  3. Magnetic resonance imaging of peripheral joints in rheumatic diseases

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Duer, Anne; Møller, Uffe

    2004-01-01

    The need for better methods than the conventional clinical, biochemical and radiographical examinations in the management of inflammatory joint diseases is evident, since these methods are not sensitive or specific to early pathologies and subtle changes. Magnetic resonance imaging (MRI) offers...... improved sensitivity to early inflammatory and destructive changes in peripheral joints in rheumatoid arthritis (RA) and, even though less well documented, in other inflammatory joint diseases. Good evidence is available that MRI bone erosions represent true bone abnormalities and are predictors......, this chapter discusses the potential for the use of MRI in the clinical management of patients with suspected and diagnosed inflammatory joint diseases, as well as research priorities and clinical situations where the use of MRI could be suggested...

  4. HIV and Rheumatic Disease

    Science.gov (United States)

    ... A Patient / Caregiver Diseases & Conditions HIV & Rheumatic Diseases HIV and Rheumatic Disease Fast Facts Rheumatic diseases related ... knows he or she has HIV. What are HIV-associated rheumatic diseases? Some diseases of the joints ...

  5. Magnetic resonance imaging of peripheral joints in rheumatic diseases

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Duer, Anne; Møller, Uffe

    2004-01-01

    The need for better methods than the conventional clinical, biochemical and radiographical examinations in the management of inflammatory joint diseases is evident, since these methods are not sensitive or specific to early pathologies and subtle changes. Magnetic resonance imaging (MRI) offers...

  6. Physical activity in the elderly who underwent joint replacement surgery in the course of rheumatic diseases.

    Science.gov (United States)

    Prusinowska, Agnieszka; Komorowski, Arkadiusz; Przepióra, Wiktor; Księżopolska-Orłowska, Krystyna

    2016-01-01

    According to the forecasts of the Central Statistical Office of Poland, in 2030 people at the age of 65 and older will account for 23.8%, i.e. their number will amount to approx. 8.5 m people. Geriatric rheumatic patients more often decide to undergo surgical joint replacement. According to the National Health Fund, the number of joint replacement services provided in 2014 increased by 93%, as compared to 2005. Improving the physical performance of this constantly expanding group of patients requires taking into account many factors to raise their functional status, reduce the risk of falling, teach rules of proper functioning with an artificial joint and encourage unassisted physical activity. Restoring fitness and independence is a difficult but necessary task due to an increasing number of seniors with replaced joint.

  7. Rheumatic fever

    Science.gov (United States)

    ... condition are: Loss of control of emotions, with bouts of unusual crying or laughing Quick, jerky movements ... minor criteria include: Fever High ESR Joint pain Abnormal EKG You'll likely be diagnosed with rheumatic ...

  8. Spectrum of Magnetic Resonance Imaging Appearances of Juvenile Temporomandibular Joints (TMJ) in Non-Rheumatic Children

    Energy Technology Data Exchange (ETDEWEB)

    Tzaribachev, N. (Dept. of Hematology, Oncology, and General Pediatrics, Univ. Children' s Hospital, Eberhard-Karls-Univ., Tuebingen (Germany)). e-mail. tzari@o2online.de; Fritz, J. (Russell H. Morgan Dept. of Radiology and Radiological Science, Johns Hopkins Univ. School of Medicine, Baltimore, MD (United States)); Horger, M. (Dept. of Diagnostic Radiology, Eberhard-Karls-Univ., Tuebingen (Germany))

    2009-12-15

    Background: Temporomandibular joints (TMJ) are frequently involved in children with juvenile idiopathic arthritis (JIA), and gadolinium-enhanced magnetic resonance imaging (MRI) is the only modality for an early diagnosis. However, only very few data exist on the appearance of contrast-enhanced MRI of normal juvenile TMJ. Purpose: To define the spectrum of normal MRI findings of juvenile TMJ, and to assess a possible overlap with findings typical for active synovitis in JIA. Material and Methods: 96 children (192 TMJ), 51 boys and 45 girls with a median age of 7.8 years (range 3-13 years), underwent a head MRI. The presence of autoimmune disease, including JIA, was excluded via chart history, available laboratory findings, and the absence of known typical pathological MRI changes (degree of synovial enhancement, hyperintense signal on T2-weighted images in the synovia or bone marrow, and morphologic changes of the mandibular condyle) of the TMJ affected by JIA. Results: In 90 (94%) children, the TMJ showed no MRI abnormalities compatible with arthritis. In three children (3%), the only abnormal MRI finding was a small bilateral joint effusion. A further three children (3%) had a mild synovial enhancement seen on both axial and coronal MR planes in one child and only in the axial plane in the other two children. Signal hyperintensity on T2-weighted images and other corresponding characteristics of TMJ inflammation were lacking in all these six patients. Conclusion: The vast majority of juvenile TMJ in non-rheumatic children shows no MRI abnormalities. Exceptions, including a discrete enhancement of the synovial membrane (3%) or small joint effusions (3%), can occur in a minority of patients, but none of them are accompanied by other signs of inflammation or morphological changes of the TMJ

  9. Evaluation of early rheumatic disorders in PIP joints using a cw-transillumination method: first clinical results

    Science.gov (United States)

    Prapavat, Viravuth; Luhmann, Till; Krause, Andreas; Backhaus, Marina; Beuthan, Juergen; Mueller, Gerhard J.

    1998-01-01

    This paper presents first clinical results of an in vivo experimental study on the detection of early pathological changes of rheumatoid arthritis (RA) using a near IR cw- transillumination method on finger joints (PIP). The inflammation of a joint system when caused by RA leads to changes in the synovial membrane and synovial. Measurements have shown that these rheumatic induced processes results in a variation in optical properties within the joint system. Using a cw system the PIP-joint is transilluminated with diode lasers at the articular cavity in order to use the entire scattered distribution of the transmitted radiation intensity for diagnostic purposes. The study includes results of in vivo measurements on 24 joints with known status and the evaluation of the feasibility of different distribution properties for detection of early RA.

  10. Minimally invasive surgical treatment for temporomandibular joint in patients with various rheumatic diseases

    Directory of Open Access Journals (Sweden)

    A. Yu. Drobyshev

    2017-01-01

    Full Text Available Temporomandibular joint (TMJ involvement occurs in patients with different rheumatic diseases (RDs. Pain, limitation of mouth opening can lead to significant problems in both oral hygiene and when eating. Conservative treatments for TMJ lesions are not always effective. Objective: to evaluate the efficiency of minimally invasive surgical interventions (TMJ arthrocentesis and arthroscopy in patients with RDs. Patients and methods. The investigation enrolled 64 patients with different RDs (43 with rheumatoid arthritis, 11 with psoriatic arthritis, 8 with systemic lupus erythematosus, and 2 with ankylosing spondylitis who were divided into three groups in relation to the severity of TMJ involvement in accordance with the Wilkes classification. All the patients underwent TMJ magnetic resonance imaging at baseline and 6 months after treatment. Also at baseline, 14 days, and 1, 6, and 12 months after surgery, the investigators assessed TMJ pain intensity by visual analogue scale and the parameters of mandibular movements. Patients with Wilkes stages IV and V TMJ involvement underwent arthroscopic intervention into the TMJ and those with III stage received TMJ arthrocentesis with arthrolavage. Results and discussion. After surgical treatment, all the groups were noted to have a significant decrease in TMJ pain intensity compared with the baseline level; moreover, the severity of TMJ pain most significantly decreased on day 7 after surgery. Later on, positive changes remained within subsequent follow-up months. There were data similar in the higher degree of mouth opening. The results of surgical treatment in patients with Wilkes stage V TMJ involvement were worse than in those with stages III and IV. Conclusion. Minimally invasive TMJ surgery in patients with RDs is effective and associated with the low frequency of postoperative complications and exacerbations of RDs. The efficiency of minimally invasive TMJ surgery is higher in patients with the

  11. PERIPROSTHETIC JOINT INFECTION IN PATIENTS WITH RHEUMATIC DISEASES: THE PROBLEMS OF DIAGNOSIS, PREVENTION, AND TREATMENT

    Directory of Open Access Journals (Sweden)

    A. E. Khramov

    2015-01-01

    Full Text Available One of the most menacing complications of large joint total endoprosthesis (TE in patients with rheumatic diseases (RD is the development of periprosthetic infection (PI, progression of which may give rise not only to limb loss, but also death. At the same time, early diagnosis and adequate surgical care make it possible not only to arrest the infectious process, but also to preserve an implanted joint.Objective: to define criteria for the diagnosis, prevention, and treatment of PI after hip and knee joint (HJ and KJ TE in patients with RD.Subjects and methods. In 2009 to 2013, 654 KJ and 549 HJ TE was performed in the V.A. Nasonova Research Instituteof Rheumatology performed KJ (n = 654 and HJ (n = 549 joint ERs.Results and discussion. PI developed in 12 (3.63% and 8 (2.95% patients after KJ and HJ ER, respectively. Early, delayed, and late PI was seen in 11, 6, and 3 patients, respectively. Eleven patients with early PI underwent joint revision/ debridement with preservation of an endoprosthesis and replacement of HJ endoprosthetic inserts and heads. The operations were completed with the collagen hemobiotics being left in the wound and its drainage. Systemic antibiotic therapy was used for 4–6 weeks. No recurrent infection was observed in 9 cases. Two patients underwentresurgery, by setting suction-irrigation systems. Nine patients with delayed or late PI had the following operations: A single-stage revision operation (the endoprosthesis was removed and a new one was implanted was performed in two cases of stable endoprosthetic components and accurately verified low-virulent microorganisms susceptible to certain antibiotics. It was imperative to use cement with an antibiotic, collagen hemobiotics, and systemic antibiotic therapy for 6 weeks. The other 7 patients with unstable endoprosthetic components underwent two-stage revision: Stage 1, endoprosthetic removal and antibiotic-loaded spacer implantation; 6-12 weeks after

  12. Imaging of the hip in patients with rheumatic disorders

    Energy Technology Data Exchange (ETDEWEB)

    Boutry, Nathalie [Department of Musculoskeletal Radiology, Roger Salengro Hospital, Centre Hospitalier Universitaire de Lille (France)]. E-mail: nboutry@chru-lille.fr; Khalil, Chadi [Department of Musculoskeletal Radiology, Roger Salengro Hospital, Centre Hospitalier Universitaire de Lille (France); Jaspart, Matthieu [Department of Musculoskeletal Radiology, Roger Salengro Hospital, Centre Hospitalier Universitaire de Lille (France); Department of Anatomy, Faculty of Medicine, Centre Hospitalier Universitaire de Lille (France); Marie-Helene, Vieillard [Department of Rheumatology, Roger Salengro Hospital, Centre Hospitalier Universitaire de Lille (France); Demondion, Xavier [Department of Musculoskeletal Radiology, Roger Salengro Hospital, Centre Hospitalier Universitaire de Lille (France); Department of Anatomy, Faculty of Medicine, Centre Hospitalier Universitaire de Lille (France); Cotten, Anne [Department of Musculoskeletal Radiology, Roger Salengro Hospital, Centre Hospitalier Universitaire de Lille (France)

    2007-07-15

    Hip joint abnormalities are commonly encountered in patients with rheumatic disorders. Although conventional radiography remains the mainstay for diagnosis of joint damage and subsequent follow-up, magnetic resonance imaging and, to a lesser extent, ultrasound have afforded the ability to detect early signs of articular involvement (i.e., synovitis and bone erosions), and to assess disease activity in treated patients. In more advanced stages of rheumatic disorders, magnetic resonance imaging and ultrasound are both useful in assessing paraarticular involvement (i.e., bursitis and synovial cysts)

  13. US-guided interventional joint procedures in patients with rheumatic diseases-When and how we do it?

    Energy Technology Data Exchange (ETDEWEB)

    Goncalves, B., E-mail: belarmino.goncalves@gmail.com [Department of Radiology, Hospitais da Universidade de Coimbra - HUC, Coimbra (Portugal); Ambrosio, C.; Serra, S. [Department of Rheumatology, Hospitais da Universidade de Coimbra - HUC, Coimbra (Portugal); Alves, F.; Gil-Agostinho, A.; Caseiro-Alves, F. [Department of Radiology, Hospitais da Universidade de Coimbra - HUC, Coimbra (Portugal)

    2011-09-15

    Objective: To describe the main indications and the technical steps to perform ultrasound guided procedures in patients with rheumatic diseases. To access procedures accuracy, safety and effectiveness. Materials and methods: 27 patients with pain related to articular complications of rheumatic diseases and according to previous radiographic or US exam were submitted to several US-guided procedures. 42% of patients (n = 11) had rheumatoid arthritis, 11% (n = 3) spondyloarthropathies, 18% (n = 5) psoriatic arthritis, 15% (n = 4) undifferentiated arthritis, 3% (n = 1) Sjoegren syndrome and 11% (n = 3) had gout. Described procedures are synovial biopsies, intra-articular injections of corticosteroids, radiation synovectomy and synovial cysts drainage procedures. When a therapeutical procedure was made, patients were evaluated by 2 rheumatologists. Corticosteroids used were Prednisolone and Triamcinolone. Yttrium-90 was used for synovectomy. Results: In all cases success was achieved with correct needle placement inside the joint. After injection/aspiration symptoms successfully solved with all patients improving their health status. No complications were recorded during follow-up period. Conclusions: US-guidance is very reliable to afford a safety procedure always checking the injection, biopsy or aspiration. Guided-biopsy has high success rates obtaining several samples. Thus is also possible to use more powerful/long acting therapeutic drugs aggressive to extra-articular structures avoiding complications.

  14. Inter- and intra-observer agreement of high-resolution ultrasonography and power Doppler in assessment of joint inflammation and bone erosions in patients with rheumatoid arthritis.

    Science.gov (United States)

    Chávez-López, Mario Alfredo; Hernández-Díaz, Cristina; Moya, Carlos; Pineda, Carlos; Ventura-Ríos, Lucio; Möller, Ingrid; Naredo, Esperanza; Espinosa, Rolando; Peña, Angélica; Rosas-Cabral, Alejandro; Filippucci, Emilio

    2013-01-01

    To assess the inter- and intra-observer reproducibility of musculoskeletal ultrasonography among rheumatologist in detecting inflammatory and morphostructural changes in small joints of the hands in patients with rheumatoid arthritis (RA). Five members of the "Escuela de Ecografía del Colegio Mexicano de Reumatología" tested their inter- and intra-observer reliabilities in the assessment of basic sonographic findings of joint inflammation and bone erosion. Their results were compared to those obtained by a group of international experts from European League Against Rheumatism. A clinical rheumatologist evaluated eight RA patients. Five Siemens Acuson Antares ultrasound machines (7-13 MHz linear probes) were used. The OMERACT preliminary definitions of joint effusion, synovial hypertrophy, bone erosions and tenosynovitis were adopted. Inter-observer and intra-observer agreement was calculated by overall agreement and kappa statistics. Mean kappa value for joint effusion was good, 0.654 (85%); synovial hypertrophy, 0.550 (77.2%); power Doppler signal, 0.550 (82.5%); bone erosions, 0.549 (81%); and tenosynovitis, 0.500 (91.5%). Mean and overall intra-observer agreement for semiquantitative score was good for joint effusion, 0.630 (77.2%) and bone erosions, 0.605 (56.25%); and moderate to synovial hypertrophy, 0.476 (65%) and power Doppler signal, 0.471 (80%). Mean kappa value for joint effusion was 0.381 (95%), synovial hypertrophy, 0.447 (72%); power Doppler signal, 0.496 (81%); bone erosions, 0.294 (81%); and tenosynovitis, 0.030 (66%). Mean and overall inter-observer agreement for semiquantitative score was poor for joint effusion, 0.325 (57%) and bone erosions, 0.360 (43%); and moderate to synovial hypertrophy, 0.431 (55%) and power Doppler signal, 0.496 (81%). Intra-observer variability reached the highest levels of agreement. Factors related to the experience of the rheumatologist, the time spent in each examination and knowledge of the software ultrasound

  15. Are bone erosions detected by magnetic resonance imaging and ultrasonography true erosions? A comparison with computed tomography in rheumatoid arthritis metacarpophalangeal joints

    DEFF Research Database (Denmark)

    Møller Døhn, Uffe; Ejbjerg, B.; Court-Payen, M.

    2006-01-01

    The objective of the study was, with multidetector computed tomography (CT) as the reference method, to determine whether bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) joints detected with magnetic resonance imaging (MRI) and ultrasonography (US), but not with radiography......, represent true erosive changes. We included 17 RA patients with at least one, previously detected, radiographically invisible MCP joint MRI erosion, and four healthy control individuals. They all underwent CT, MRI, US and radiography of the 2nd to 5th MCP joints of one hand on the same day. Each imaging...... modality was evaluated for the presence of bone erosions in each MCP joint quadrant. In total, 336 quadrants were examined. The sensitivity, specificity and accuracy, respectively, for detecting bone erosions (with CT as the reference method) were 19%, 100% and 81% for radiography; 68%, 96% and 89% for MRI...

  16. The specificity of ultrasound-detected bone erosions for rheumatoid arthritis

    DEFF Research Database (Denmark)

    Zayat, Ahmed S; Ellegaard, Karen; Conaghan, Philip G

    2015-01-01

    Bone erosion is one of the hallmarks of rheumatoid arthritis (RA), but also seen in other rheumatic diseases. The objective of this study was to determine the specificity of ultrasound (US)-detected bone erosions (including their size) in the classical 'target' joints for RA....

  17. Are bone erosions detected by magnetic resonance imaging and ultrasonography true erosions? A comparison with computed tomography in rheumatoid arthritis metacarpophalangeal joints

    DEFF Research Database (Denmark)

    Møller Døhn, Uffe; Ejbjerg, B.; Court-Payen, M.

    2006-01-01

    , represent true erosive changes. We included 17 RA patients with at least one, previously detected, radiographically invisible MCP joint MRI erosion, and four healthy control individuals. They all underwent CT, MRI, US and radiography of the 2nd to 5th MCP joints of one hand on the same day. Each imaging......; and 42%, 91% and 80% for US. When the 16 quadrants with radiographic erosions were excluded from the analysis, similar values for MRI (65%, 96% and 90%) and US (30%, 92% and 80%) were obtained. CT and MRI detected at least one erosion in all patients but none in control individuals. US detected at least......The objective of the study was, with multidetector computed tomography (CT) as the reference method, to determine whether bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) joints detected with magnetic resonance imaging (MRI) and ultrasonography (US), but not with radiography...

  18. Acute rheumatic fever and rheumatic heart disease in indigenous populations.

    Science.gov (United States)

    Steer, Andrew C; Carapetis, Jonathan R

    2009-12-01

    Acute rheumatic fever and rheumatic heart disease are diseases of socioeconomic disadvantage. These diseases are common in developing countries and in Indigenous populations in industrialized countries. Clinicians who work with Indigenous populations need to maintain a high index of suspicion for the potential diagnosis of acute rheumatic fever, particularly in patients presenting with joint pain. Inexpensive medicines, such as aspirin, are the mainstay of symptomatic treatment of rheumatic fever; however, antiinflammatory treatment has no effect on the long-term rate of progression or severity of chronic valvular disease. The current focus of global efforts at prevention of rheumatic heart disease is on secondary prevention (regular administration of penicillin to prevent recurrent rheumatic fever), although primary prevention (timely treatment of streptococcal pharyngitis to prevent rheumatic fever) is also important in populations in which it is feasible.

  19. Large-scale assessment of soil erosion in Africa: satellites help to jointly account for dynamic rainfall and vegetation cover

    Science.gov (United States)

    Vrieling, Anton; Hoedjes, Joost C. B.; van der Velde, Marijn

    2015-04-01

    Efforts to map and monitor soil erosion need to account for the erratic nature of the soil erosion process. Soil erosion by water occurs on sloped terrain when erosive rainfall and consequent surface runoff impact soils that are not well-protected by vegetation or other soil protective measures. Both rainfall erosivity and vegetation cover are highly variable through space and time. Due to data paucity and the relative ease of spatially overlaying geographical data layers into existing models like USLE (Universal Soil Loss Equation), many studies and mapping efforts merely use average annual values for erosivity and vegetation cover as input. We first show that rainfall erosivity can be estimated from satellite precipitation data. We obtained average annual erosivity estimates from 15 yr of 3-hourly TRMM Multi-satellite Precipitation Analysis (TMPA) data (1998-2012) using intensity-erosivity relationships. Our estimates showed a positive correlation (r = 0.84) with long-term annual erosivity values of 37 stations obtained from literature. Using these TMPA erosivity retrievals, we demonstrate the large interannual variability, with maximum annual erosivity often exceeding two to three times the mean value, especially in semi-arid areas. We then calculate erosivity at a 10-daily time-step and combine this with vegetation cover development for selected locations in Africa using NDVI - normalized difference vegetation index - time series from SPOT VEGETATION. Although we do not integrate the data at this point, the joint analysis of both variables stresses the need for joint accounting for erosivity and vegetation cover for large-scale erosion assessment and monitoring.

  20. [Unclassifiable inflammatory rheumatism with HLA B27].

    Science.gov (United States)

    Meyer, O; Vignoli, M; Ryckewaert, A

    1982-01-01

    The authors report on 25 patients carrying the HLA B27 histocompatibility antigen and suffering from un-classifiable inflammatory rheumatism. The group included 12 men and 13 women. At the time of the initial observation, the inflammatory rheumatism was localised particularly in the lower limbs, knees, ankles and heels, in 14 of the cases; 7 of the cases revealed chronic polyarthritis, with a largely symmetrical involvement of the joints in the fingers. At the end of the observation period, which lasted 38 months, on average (from 6 months to 1 1/2 years), the series included 3 cases of sero-negative polyarthritis, with symmetrical involvement of the fingers and bony erosions which can probably be classified with cases of rheumatoid polyarthritis (HLA B27 being a coincidence), 2 certain and 3 possible cases of ankylosing spondylarthritis. For several years following the onset of the disease, the majority of the other patient continued to suffer rheumatism of the lower limbs in exacerbations and often accompanied by talalgia.

  1. Fibroblastic rheumatism

    Directory of Open Access Journals (Sweden)

    Jyoti Ranjan Parida

    2017-01-01

    Full Text Available Fibroblastic rheumatism (FR is a rare dermoarthopathy reported from different parts of the world since 1980. Although the exact cause is unknown, few reports implicate infection may be a triggering event. Patients usually present with multiple skin nodules and polyarthropathy with progressive skin contractures. Laboratory parameters including acute phase reactants are usually normal. The confirmatory diagnosis is based on histopathologic study of skin nodules, which demonstrate fibroblastic proliferation, thickened collagen fibers, dermal fibrosis, and decreased number of elastic fibers. Immunoreactivity for b-catenin, smooth muscle actin, and the monoclonal antibody HHF35 show myofibroblastic differentiation. Treatments with oral prednisolone and other disease-modifying drugs such as methotrexate, infliximab, and interferon have been tried with variable success. In general, skin lesions respond more aptly than joint symptoms indicating that skin fibroblast is more amenable to treatment than synovial fibroblasts. Awareness regarding this orphan disease among clinicians and pathologists will help in more reporting of such cases and finding out optimal treatment regimen.

  2. Erosion of Premium Connection Cross-over Joint in Solid-liquid Flow

    Directory of Open Access Journals (Sweden)

    Zhao Yong’an

    2015-01-01

    Full Text Available Hydraulic fracturing is a new technique which is used in oil yield to maximize its own production. The pumping of fracturing slurry flow through tubing collar can cause considerable mass loss of inner surface materials. This may pose a significantly potential risk even a well loss. Especially, the erosion phenomenon is particularly serious in the structure of variable diameter. Numerical simulation in this paper was used to get particle impact parameters, and it is combined with jet experiments to find out the main factors of BG-13Cr mass loss. Finally, the equation with experimental data was applied to predict erosion rate of premium connection cross-over joint inner wall.

  3. Effectiveness of digital subtraction radiography in detecting artificially created osteophytes and erosions in the temporomandibular joint

    Energy Technology Data Exchange (ETDEWEB)

    Kocasarac, Husniye Demirturk [Dept. of Comprehensive Dentistry, The University of Texas Health Science Center, San Antonio (United States); Celenk, Peruze [Dept. of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ondokuz Mayis University, Samsun (Turkmenistan)

    2017-06-15

    Erosions and osteophytes are radiographic characteristics that are found in different stages of temporomandibular joint (TMJ) osteoarthritis. This study assessed the effectiveness of digital subtraction radiography (DSR) in diagnosing simulated osteophytes and erosions in the TMJ. Five intact, dry human skulls were used to assess the effectiveness of DSR in detecting osteophytes. Four cortical bone chips of varying thicknesses (0.5 mm, 1.0 mm, 1.5 mm, and 2.0 mm) were placed at the medial, central, and lateral aspects of the condyle anterior surface. Two defects of varying depth (1.0 mm and 1.5 mm) were created on the lateral, central, and medial poles of the condyles of 2 skulls to simulate erosions. Panoramic images of the condyles were acquired before and after artificially creating the changes. Digital subtraction was performed with Emago dental image archiving software. Five observers familiar with the interpretation of TMJ radiographs evaluated the images. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic accuracy of the imaging methods. The area under the ROC curve (Az) value for the overall diagnostic accuracy of DSR in detecting osteophytic changes was 0.931. The Az value for the overall diagnostic accuracy of panoramic imaging was 0.695. The accuracy of DSR in detecting erosive changes was 0.854 and 0.696 for panoramic imaging. DSR was remarkably more accurate than panoramic imaging in detecting simulated osteophytic and erosive changes. The accuracy of panoramic imaging in detecting degenerative changes was significantly lower than the accuracy of DSR (P<.05). DSR improved the accuracy of detection using panoramic images.

  4. Plenum of the All-Union Committee on the Study of Rheumatism and Diseases of the Joints at the Presidium of the Academy of Medical Sciences USSR - USSR

    National Research Council Canada - National Science Library

    Shcherbatenko, S

    1960-01-01

    .... The report on the prophylaxis of rheumatism was submitted by Active Member of the Acad. Med. Sci. USSR, Prof. A. I. Nesterov (Moscow). Experience shows that the streptococcus plays the principal role in the development of rheumatism...

  5. Assessing the Reliability of a Semiautomated Segmentation Algorithm for Quantifying Erosions in the Metacarpophalangeal Joints of Patients with Rheumatoid Arthritis.

    Science.gov (United States)

    Tomizza, Michael A; Jessome, Matthew A; Barbosa, Joshua; Beattie, Karen A; Bensen, William G; Bobba, Raja S; Cividino, Alfred A; Emond, Patrick D; Gordon, Chris; Hart, Lawrence; Ioannidis, George; Koh, Melissa X P; Larché, Maggie; Tavares, Ruben; Tytus, Stephen; Adachi, Jonathan D

    2015-09-01

    Assess the reliability of early erosions in rheumatoid arthritis (EERA) software for quantifying erosive damage to the metacarpophalangeal joints of patients with rheumatoid arthritis (RA). One hundred magnetic resonance image sets from 68 patients with early referral RA were evaluated. Reliability was assessed using 95% limits of agreement and intraclass correlation coefficient (ICC) with 95% CI. Limits of agreement linearly depended on erosion volume: 0.44× between readers and 0.19× within readers. Interrater ICC was 0.976 (95% CI 0.965-0.984) and intrarater ICC was 0.996 (95% CI 0.994-0.997). EERA is highly reproducible for quantifying erosions in patients with early RA.

  6. Rheumatic Fever

    Science.gov (United States)

    ... without the antibiotics in your bloodstream, the streptococcal bacteria can still multiply and affect your heart and other organs. If your strep infection leads to rheumatic fever, your doctor may prescribe anti-inflammatory medicines or aspirin to reduce the swelling ...

  7. Scintigraphy in rheumatic diseases.

    Science.gov (United States)

    Colamussi, Paolo; Prandini, Napoleone; Cittanti, Corrado; Feggi, Luciano; Giganti, Melchiore

    2004-12-01

    The aim of this review is to summarise the clinical role of nuclear medicine in rheumatology taking into consideration the most specific diagnostic applications and other worthwhile therapeutic contributions. Traditional bone scintigraphy and recent inflammation-targeting radiopharmaceuticals, such as radiolabelled leucocytes and immunoscintigraphy, now allow us to obtain highly sensitive total-body and tomographical imaging information that can be used for the diagnosis of osteoarticular disease. The most common extra-articular manifestations of rheumatic diseases due to digestive, central nervous, respiratory and cardiovascular system involvement can be diagnosed by specific scintigraphic methods. Radiosynovectomy plays an important role in providing effective treatment for some joint diseases that are resistant to pharmacological therapy. Diagnostic and therapeutic applications of nuclear medicine show the highest efficacy in the early phase of rheumatic diseases. In more advanced stages, scintigraphical techniques play a complementary role to radiographical investigations in the assessment of prognosis and therapy efficacy.

  8. Optimised, low cost, low field dedicated extremity MRI is highly specific and sensitive for synovitis and bone erosions in rheumatoid arthritis wrist and finger joints

    DEFF Research Database (Denmark)

    Ejbjerg, B J; Narvestad, E; Jacobsen, Søren

    2005-01-01

    To evaluate a low field dedicated extremity MRI unit for detection of bone erosions, synovitis, and bone marrow oedema in wrist and metacarpophalangeal (MCP) joints, with a high field MRI unit as the standard reference....

  9. Tumour necrosis factor blockade for the treatment of erosive osteoarthritis of the interphalangeal finger joints: a double blind, randomised trial on structure modification.

    Science.gov (United States)

    Verbruggen, Gust; Wittoek, Ruth; Vander Cruyssen, Bert; Elewaut, Dirk

    2012-06-01

    Adalimumab blocks the action of tumor necrosis factor-α and reduces disease progression in rheumatoid arthritis and psoriatic arthritis. The effects of adalimumab in controlling progression of structural damage in erosive hand osteoarthritis (HOA) were assessed. Sixty patients with erosive HOA on radiology received 40 mg adalimumab or placebo subcutaneously every two weeks during a 12-month randomized double-blind trial. Response was defined as the reduction in progression of structural damage according to the categorical anatomic phase scoring system. Furthermore, subchondral bone, bone plate erosion, and joint-space narrowing were scored according to the continuous Ghent University Score System (GUSSTM). The disease appeared to be active since 40.0% and 26,7% of patients out of the placebo and adalimumab group, respectively, showed at least one new interphalangeal (IP) joint that became erosive during the 12 months follow-up. These differences were not significant and the overall results showed no effect of adalimumab. Risk factors for progression were then identified and the presence of palpable soft tissue swelling at baseline was recognized as the strongest predictor for erosive progression. In this subpopulation at risk, statistically significant less erosive evolution on the radiological image (3.7%) was seen in the adalimumab treated group compared to the placebo group (14.5%) (P = 0.009). GUSSTM scoring confirmed a less rapid rate of mean increase in the erosion scores during the first 6 months of treatment in patients in adalimumab-treated patients. Palpable soft tissue swelling in IP joints in patients with erosive HOA is a strong predictor for erosive progression. In these joints adalimumab significantly halted the progression of joint damage compared to placebo.

  10. Tumour necrosis factor blockade for the treatment of erosive osteoarthritis of the interphalangeal finger joints: a double blind, randomised trial on structure modification

    Science.gov (United States)

    Verbruggen, Gust; Wittoek, Ruth; Cruyssen, Bert Vander; Elewaut, Dirk

    2012-01-01

    Background Adalimumab blocks the action of tumor necrosis factor-α and reduces disease progression in rheumatoid arthritis and psoriatic arthritis. The effects of adalimumab in controlling progression of structural damage in erosive hand osteoarthritis (HOA) were assessed. Methods Sixty patients with erosive HOA on radiology received 40 mg adalimumab or placebo subcutaneously every two weeks during a 12-month randomized double-blind trial. Response was defined as the reduction in progression of structural damage according to the categorical anatomic phase scoring system. Furthermore, subchondral bone, bone plate erosion, and joint-space narrowing were scored according to the continuous Ghent University Score System (GUSSTM). Results The disease appeared to be active since 40.0% and 26,7% of patients out of the placebo and adalimumab group, respectively, showed at least one new interphalangeal (IP) joint that became erosive during the 12 months follow-up. These differences were not significant and the overall results showed no effect of adalimumab. Risk factors for progression were then identified and the presence of palpable soft tissue swelling at baseline was recognized as the strongest predictor for erosive progression. In this subpopulation at risk, statistically significant less erosive evolution on the radiological image (3.7%) was seen in the adalimumab treated group compared to the placebo group (14.5%) (P = 0.009). GUSSTM scoring confirmed a less rapid rate of mean increase in the erosion scores during the first 6 months of treatment in patients in adalimumab-treated patients. Conclusion Palpable soft tissue swelling in IP joints in patients with erosive HOA is a strong predictor for erosive progression. In these joints adalimumab significantly halted the progression of joint damage compared to placebo. PMID:22128078

  11. Magnetic resonance imaging of wrist and finger joints in healthy subjects occasionally shows changes resembling erosions and synovitis as seen in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Ejbjerg, Bo; Narvestad, Eva; Rostrup, Egill

    2004-01-01

    OBJECTIVE: To explore the presence of changes resembling rheumatoid arthritis erosions and synovitis in metacarpophalangeal (MCP) and wrist joints of healthy individuals on magnetic resonance imaging (MRI) and to compare the MRI findings with conventional radiographic, clinical, and biochemical f....... These signs may thus prove to be very specific in the distinction between arthritic and normal joints...

  12. Conventional radiography requires a MRI-estimated bone volume loss of 20% to 30% to allow certain detection of bone erosions in rheumatoid arthritis metacarpophalangeal joints

    DEFF Research Database (Denmark)

    Ejbjerg, B.; Vestergaard, Aage Steen; Jacobsen, S.

    2006-01-01

    The aim of this study was to demonstrate the ability of conventional radiography to detect bone erosions of different sizes in metacarpophalangeal (MCP) joints of rheumatoid arthritis (RA) patients using magnetic resonance imaging (MRI) as the standard reference. A 0.2 T Esaote dedicated extremity...... MRI unit was used to obtain axial and coronal T1-weighted gradient echo images of the dominant 2nd to 5th MCP joints of 69 RA patients. MR images were obtained and evaluated for bone erosions according to the OMERACT recommendations. Conventional radiographs of the 2nd to 5th MCP joints were obtained...

  13. No erosive progression revealed by MRI in rheumatoid arthritis patients treated with etanercept, even in patients with persistent MRI and clinical signs of joint inflammation

    DEFF Research Database (Denmark)

    Døhn, Uffe Møller; Skjødt, Henrik; Hetland, Merete

    2007-01-01

    The aim of this study is to investigate the course of magnetic resonance imaging (MRI) signs of inflammatory and destructive changes in rheumatoid arthritis (RA) wrist and metacarpophalangeal (MCP) joints during etanercept treatment. MRI of the non-dominant wrist and second to fifth MCP joints...... was performed in five clinical active RA patients before and 4 and 16 weeks after initiation of etanercept treatment. MRI was evaluated according to the EULAR-OMERACT RA MRI reference image atlas. The median 28-joint count disease activity score (DAS28; erythrocyte sedimentation rate based) was 5.6 (range 5...... patient showed erosive regression, while no patient showed erosive progression on MRI during 16 weeks of etanercept therapy; even though clinical and MRI signs of joint inflammation remained. This small study supports that erosive progression judged by MRI is minimal in RA patients treated with etanercept...

  14. Tumor necrosis factor inhibitor therapy but not standard therapy is associated with resolution of erosion in the sacroiliac joints of patients with axial spondyloarthritis

    DEFF Research Database (Denmark)

    Pedersen, Susanne J; Wichuk, Stephanie; Chiowchanwisawakit, Praveena

    2014-01-01

    Research Consortium of Canada (SPARCC) MRI Sacroiliac Joint (SIJ) Structural Score (SSS) assesses a spectrum of structural lesions (erosion, fat metaplasia, backfill, ankylosis) and its potential to discriminate between therapies requires evaluation. METHODS: The SSS score assesses five consecutive coronal...... slices through the cartilaginous portion of the joint on T1-weighted sequences starting from the transitional slice between cartilaginous and ligamentous portions of the joint. Lesions are scored dichotomously (present/absent) in SIJ quadrants (fat metaplasia, erosion) or halves (backfill, ankylosis...... of treatment by multivariate stepwise regression adjusted for severity of baseline structural damage and demographic variables. RESULTS: A significant increase in mean SSS score for fat metaplasia (P = 0.017) and decrease in mean SSS score for erosion (P = 0.017) was noted in anti-TNFα treated patients...

  15. Effect of Combination Therapy on Joint Destruction in Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Graudal, N.; Hubeck-Graudal, T.; Tarp, S.

    2014-01-01

    Background: Despite significant cost differences, the comparative effect of combination treatments of disease modifying anti-rheumatic drugs (DMARDs) with and without biologic agents has rarely been examined. Thus we performed a network meta-analysis on the effect of combination therapies...... on progression of radiographic joint erosions in patients with rheumatoid arthritis (RA). Methods and Findings: The following combination drug therapies compared versus single DMARD were investigated: Double DMARD: 2 DMARDs (methotrexate, sulfasalazine, leflunomide, injectable gold, cyclosporine, chloroquine...

  16. Magnetic resonance imaging of wrist and finger joints in healthy subjects occasionally shows changes resembling erosions and synovitis as seen in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Ejbjerg, Bo; Narvestad, Eva; Rostrup, Egill

    2004-01-01

    OBJECTIVE: To explore the presence of changes resembling rheumatoid arthritis erosions and synovitis in metacarpophalangeal (MCP) and wrist joints of healthy individuals on magnetic resonance imaging (MRI) and to compare the MRI findings with conventional radiographic, clinical, and biochemical.......5%), while only minimal early synovial enhancement was detected by dynamic MRI. Three subjects had elevated serum levels of C-reactive protein, and these subjects displayed 44.5% of the synovitis-like changes and 41.7% of the erosion-like changes. Bone marrow edema-like changes were not found in any joints...

  17. Conventional radiography requires a MRI-estimated bone volume loss of 20% to 30% to allow certain detection of bone erosions in rheumatoid arthritis metacarpophalangeal joints

    DEFF Research Database (Denmark)

    Ejbjerg, Bo Jannik; Vestergaard, Aage; Jacobsen, Søren

    2006-01-01

    The aim of this study was to demonstrate the ability of conventional radiography to detect bone erosions of different sizes in metacarpophalangeal (MCP) joints of rheumatoid arthritis (RA) patients using magnetic resonance imaging (MRI) as the standard reference. A 0.2 T Esaote dedicated extremity...

  18. Rheumatic diseases and pregnancy

    African Journals Online (AJOL)

    In rheumatoid arthritis, on the other hand, there is spontaneous improvement in disease symptoms. However, rheumatic diseases and their treatment can have a significant impact on pregnancy outcomes. Poor pregnancy outcomes are largely associated with high disease activity. Pregnant women with rheumatic diseases ...

  19. Different amounts of protein-bound citrulline and homocitrulline in foot joint tissues of a patient with anti-citrullinated protein antibody positive erosive rheumatoid arthritis.

    Science.gov (United States)

    Turunen, Sanna; Koivula, Marja-Kaisa; Melkko, Jukka; Alasaarela, Eeva; Lehenkari, Petri; Risteli, Juha

    2013-09-23

    Antibodies binding to citrullinated proteins are a frequent finding in rheumatoid arthritis patients and may precede the onset of clinical symptoms several years. The antibodies are a predisposing factor for bone erosions but their origin is unknown. In this study we analyze in detail the levels of protein bound citrulline and homocitrulline in several tissue samples of a single erosive arthritic surgery patient. Serum antibodies binding to CCP, MCV and citrulline- or homocitrulline-containing type I and II collagen carboxytelopeptides were measured. Tissue samples of a single RA patient, taken in two separate operations performed with two-year time span were hydrolyzed and analyzed for citrulline and homocitrulline content by HPLC. Protein-bound citrulline and homocitrulline were found in several joint tissues of a RA patient with ACPA-positive erosive disease. The amount of homocitrulline stayed relatively constant between the different tissues. The amount of citrulline in erosive tissue was 3-times higher than in non-erosive tissue in the first operation. In the samples of the second operation 3-4-times higher mean amounts of citrulline were found in two out of the six tissues investigated. Homocitrulline is present in rheumatoid nodule together with citrulline. There is more variation in the amount of citrulline than in the amount of homocitrulline between the tissues. The tissue sample containing the most citrulline was the most erosive.

  20. Validation of the 28-joint Disease Activity Score (DAS28) and European League Against Rheumatism response criteria based on C-reactive protein against disease progression in patients with rheumatoid arthritis, and comparison with the DAS28 based on erythrocyte sedimentation rate

    Science.gov (United States)

    Wells, G; Becker, J-C; Teng, J; Dougados, M; Schiff, M; Smolen, J; Aletaha, D; van Riel, P L C M

    2009-01-01

    Objective: To validate and compare the definition of the Disease Activity Score 28 based on C-reactive protein (DAS28 (CRP)) to the definition based on erythrocyte sedimentation rate (ESR). Methods: Data were analysed from two randomised, double-blind, placebo-controlled trials of abatacept of 6-month and 12-month duration in patients with rheumatoid arthritis. European League Against Rheumatism (EULAR) response criteria and the proportion of patients in remission (DAS28 <2.6) based on the two DAS28 definitions were examined. Trends in radiographic progression (erosion score, joint space narrowing score and total score) and physical function (Health Assessment Questionnaire Disability Index (HAQ-DI)) across the EULAR responder states (none, moderate and good) were analysed. Results: There was general agreement in determining the EULAR responder state using both DAS28 definitions (κ = 0.80, 95% CI 0.76 to 0.83). Overall, there was 82.4% agreement on the EULAR response criteria; when disagreements occurred, the DAS28 (CRP) yielded a better EULAR response more often then DAS28 (ESR) (12.6% vs 4.9%, respectively). There was also agreement in determining remission: κ = 0.69 (95% CI 0.60 to 0.78). Radiographic progression decreased in patients treated with abatacept across EULAR states (from none to moderate to good) based on both definitions. For patients treated with placebo, the trend was not as pronounced, with radiographic scores higher for moderate vs non-responders. For physical function, similar trends were observed across the EULAR states for both DAS28 definitions. Conclusions: The DAS28 (CRP) has been validated against radiographic progression and physical function. While the DAS28 (CRP) yielded a better EULAR response more often than the DAS28 (ESR), the validation profile was similar to the DAS28 (ESR), indicating that both measures are useful for assessing disease activity in patients with rheumatoid arthritis. PMID:18490431

  1. Ultrasonic cavitation erosion of 316L steel weld joint in liquid Pb-Bi eutectic alloy at 550°C.

    Science.gov (United States)

    Lei, Yucheng; Chang, Hongxia; Guo, Xiaokai; Li, Tianqing; Xiao, Longren

    2017-11-01

    Liquid lead-bismuth eutectic alloy (LBE) is applied in the Accelerator Driven transmutation System (ADS) as the high-power spallation neutron targets and coolant. A 19.2kHz ultrasonic device was deployed in liquid LBE at 550°C to induce short and long period cavitation erosion damage on the surface of weld joint, SEM and Atomic force microscopy (AFM) were used to map out the surface properties, and Energy Dispersive Spectrometer (EDS) was applied to the qualitative and quantitative analysis of elements in the micro region of the surface. The erosion mechanism for how the cavitation erosion evolved by studying the element changes, their morphology evolution, the surface hardness and the roughness evolution, was proposed. The results showed that the pits, caters and cracks appeared gradually on the erode surface after a period of cavitation. The surface roughness increased along with exposure time. Work hardening by the bubbles impact in the incubation stage strengthened the cavitation resistance efficiently. The dissolution and oxidation corrosion and cavitation erosion that simultaneously happened in liquid LBE accelerated corrosion-erosion process, and these two processes combined to cause more serious damage on the material surface. Contrast to the performance of weld metal, base metal exhibited a much better cavitation resistance. Copyright © 2017. Published by Elsevier B.V.

  2. Detection of bone erosions in rheumatoid arthritis wrist joints with magnetic resonance imaging, computed tomography and radiography

    DEFF Research Database (Denmark)

    Døhn, Uffe Møller; Ejbjerg, Bo J; Hasselquist, Maria

    2008-01-01

    BACKGROUND: The objectives of the present study were, with multidetector computed tomography (CT) as the reference method, to determine the performance of magnetic resonance imaging (MRI) and radiography for the detection of bone erosions in rheumatoid arthritis wrist bones, and to test whether m...... sensitivity and good specificity and accuracy for detection of erosions in rheumatoid arthritis and healthy wrist bones, while radiography showed very low sensitivity. The tested volumetric method was highly reproducible and correlated to scores of erosions....... of the Outcome Measures in Rheumatology Rheumatoid Arthritis MRI Scoring System (CT and MRI) and the Sharp/van der Heijde (radiographs) scoring methods. Measurements of erosion volumes of all erosions were performed twice with a 1-week interval. RESULTS: With CT as the reference method, the overall sensitivity.......90 (both P persons' total erosion volume and total score (all P

  3. Fibroblastic rheumatism: Scientific Letter | Kawtar | African Journal of ...

    African Journals Online (AJOL)

    Fibroblastic Rheumatism (FR) is a rare rheumatologic entity of unknown etiology. The pathophysiological mechanism involving fibroblast proliferation is characterized by symmetrical polyarthritis associated with sudden onset of cutaneous nodules, flexion contractures. Bone erosion can occur as the disease progresses and ...

  4. Importance of Joint Spacing and Rock Hardness on the Pattern and Efficiency of Glacial Erosion in Alpine Settings: an Example From Yosemite National Park, California.

    Science.gov (United States)

    Duhnforth, M.; Anderson, R. S.; Ward, D. J.; Stock, G. M.

    2008-12-01

    Two topics of interest in alpine glacial valleys can be explored by sampling glacial polish for cosmogenic 10Be dating. First, deglaciation histories can be reconstructed if the sample surfaces are fully reset by glacial erosion during the last glacial cycle. Second, samples that are not completely reset can be used to document the pattern and rates of glacial erosion. We systematically sampled glacially-polished bedrock surfaces in the Tuolumne River watershed in Yosemite National Park, a landscape renowned for its glacially polished granites and granodiorites, for cosmogenic 10Be exposure dating. The samples were collected along an 80 km transect from the Tuolumne River drainage divide at 4000 m down to an elevation of 730 m just below Hetch Hetchy reservoir. The lowest sample position corresponds to the glacier terminus in the Tuolumne valley during the last glacial maximum (LGM). Samples were taken from at least eight different granitic/granodioritic units, which show differences in their hardness and joint spacing. These included the massive, flawless Cathedral Peak granodiorite and El Capitan granite. When inverted for exposure age, 17 out of our total of 23 measured 10Be samples yield ages between 3 and 20 ka ignoring any correction for snow shielding. These ages young from 15 ka to 3 ka with distance upvalley from the LGM terminal position. These samples constrain the post-LGM deglaciation history of the valley when the snow shielding correction is included. This pattern of fully reset samples is, however, interrupted at six sample locations with anomalously high concentrations of 10Be that far exceed those expected from exposure since deglaciation between 20 and 15 ka. These samples with significant inheritance all come from the poorly jointed, massive Cathedral Peak granodiorite and El Capitan granite. We interpret our results as indicating that rock type plays an important role in glacial erosion, and that in particular joint spacing strongly controls

  5. Oncohematologic diseases and rheumatic disorders

    Directory of Open Access Journals (Sweden)

    Nelson Hamerschlak

    2008-03-01

    Full Text Available Mielodysplasia, leukemia, lynfoma and multiple myeloma are themain oncohematologic diseases related to rheumatic manifestations.In multiple myeloma the pain manifestation is caused by fracturefrom bone lesions as a direct consequence of the disease, not beingan associateda true rheumatic manifestation. An interesting aspectof this subject is that many rheumatic manifestations occur beforehematologic diseases as, for example, lymphomas. Therefore we cansay that some rheumatic diseases are associated to a greater riskof oncohematologic diseases. On the other hand, oncohematologicdiseases can present rheumatic manifestations in articulations,muscles and vessels. Theses cases are usually interpreted as paraneoplasics.This chapter is divided in three parts: oncohematologicdiseases with rheumatic manifestations; rheumatic diseases thatpresent greater risk of oncohematologic pathologies; and the mainrheumatic manifestations of oncohematologic diseases.

  6. Paraneoplastic rheumatic syndromes

    Directory of Open Access Journals (Sweden)

    Lucia Stella Seiffert de Assis Goulart

    2008-03-01

    Full Text Available This article makes a review of the literature on paraneoplasticrheumatic syndromes. Rheumatic diseases may sometimeshave manifestations associated with the development of tumorprocesses, being considered paraneoplastic. Certain manifestationshave studies confi rming a strong association with malignancy;among these are hypertrophic osteoarthropathy, paraneoplasticpolyarthritis, dermatomyositis, and vasculitis. On the otherhand, chemotherapy and radiotherapy can induce rheumatologiccomplications in cancer patients.

  7. Rheumatic manifestations among HIV positive adults attending the ...

    African Journals Online (AJOL)

    Background: Rheumatic manifestations in HIV are common and sometimes the initial presentation of the disease. HIV is now a common infection at the Infectious Disease Clinic, Mulago. The spectrum of joint diseases seen depend on a number of factors such as, the CD4 count, HLA status and current therapy. Objective: ...

  8. [HL-A W27 antigen and atypical rheumatic pelvispondylitis].

    Science.gov (United States)

    Sany, J; Serre, H; Seignalet, J

    1976-02-01

    The authors report 26 cases of atypical inflammatory rheumatism in which the discovery of HL-A W27 antigen indicated the possibility of atypical ankylosing spondylarthritis. These patients included 17 men and 9 women with an average age of 35.6 years. The clinical symptoms included :--pelvic or vetebral signs alone in 8 cases,--pelvic or vertebral signs combined with peripheral inflammatory rheumatism, the latter being always cleaarly evident, in 9 cases,--extravertebral signs alone without any involvement of the vertebral column or of the sacroiliac joints in 9 cases (8 cases of peripheral inflammatory rheumatism, 1 case of talalgia). The vertebral radiograms were normal in 84 percent of cases. The sacroiliac joints were clear radiologically in 65 percent of cases. In the other cases the lesions, generally unilateral, were extremely discrete. In all the cases, the Waaler-Rose reaction was negative. The therapeutic test with non-hormonal anti inflammatory products were generally positive. The evolution of the condition confirmed the diagnosis of rheumatic pelvispondylitis in 2 cases. The patients have been under observation for insufficient time to be sure whether all the cases presented represent authentic cases of ankylosing spondylarthritis that were at first atypical. The authors emphasize the high percentage of female cases (38 percent) the high frequency of extra-vertebral manifestations. They also emphasize the value of looking for HL-A W27 antigen in patients with atypical inflammatory rheumatism.

  9. Management of patients with rheumatic fever and rheumatic heart ...

    African Journals Online (AJOL)

    McLaren M, Markowitz M, Gerber M. Rheumatic heart disease in developing countries. Ann. Intern Med 1994; 120: 243-244. 2. Marcus R, Sareli P, Pocock W, Barlow J. The spectrum of severe rheumatic mitral valve disease in a developing country. Correlations among clinical presentation, surgical pathologic findings and ...

  10. Rheumatic fever and rheumatic heart disease in Gauteng on the ...

    African Journals Online (AJOL)

    Objective. To review the observed decline in numbers of children seen at the. Paediatric Cardiology Unit at CHBAH with a diagnosis of ARF and. RHD and those undergoing corrective valve surgery over the past two decades. Rheumatic fever and rheumatic heart disease in Gauteng on the decline: Experience at Chris Hani ...

  11. Rheumatic fever and rheumatic heart disease among children ...

    African Journals Online (AJOL)

    Primary episodes of ARF occur mainly in children aged 5 - 15 years and are rare in ... Advocate for resources and promote Prevention programmes (ASAP), aiming for the control ... Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain significant causes of morbidity and mortality in resource-limited ...

  12. [Soft tissue rheumatism in erderly].

    Science.gov (United States)

    Szczepański, Leszek

    2008-01-01

    Disorders of soft, peri-articular tissues are a common cause of musculoskeletal pain in elderly patients. Nevertheless, most physicians underestimate the role of soft tissue rheumatism in the pathomechanism of the pain. The impairments of soft tissue can not be diagnosed by X-rays examinations, whereas degenerative lesions of joints are easy diagnosed using this method even despite of their uncertain role in producing the symptoms. The incidence of pain syndromes originated from soft tissues differ regarding to the age of patients. In young subjects the incidence of all of them is generally low. Syndromes provoked by overloading during work: repetitive strain syndrome, canal tunnel syndrome, tennis elbow, golfers elbow, shoulder tendon coin disorders and myofascial pain syndrome are common in middle-aged patients. The morbidity of fibromialgia syndrome is also lower in old people probably as the result of diminished numbers and degenerative changes in nociceptive fibers. The syndromes prevailing in elderly patients include trochanteric syndrome and the pain syndromes provoked by muscle spasm depended on posture abnormalities. In the soft tissue pain syndrome prevention adapted to old age kinesitherapy and avoiding muscle overloading are recommended. Soft tissue pain syndromes are usually treated with non steroidal anti inflammatory drugs. In local pain syndromes better results can be obtained by local treatment. Local injections of glikocorticosteroids are usually very effective and safe.

  13. What rheumatologists should know about orofacial manifestations of autoimmune rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Aline Lauria Pires Abrão

    Full Text Available ABSTRACT Orofacial manifestations occur frequently in rheumatic diseases and usually represent early signs of disease or of its activity that are still neglected in clinical practice. Among the autoimmune rheumatic diseases with potential for oral manifestations, rheumatoid arthritis (RA, inflammatory myopathies (IM, systemic sclerosis (SSc, systemic lupus erythematosus (SLE, relapsing polychondritis (RP and Sjögren's syndrome (SS can be cited. Signs and symptoms such as oral hyposalivation, xerostomia, temporomandibular joint disorders, lesions of the oral mucosa, periodontal disease, dysphagia, and dysphonia may be the first expression of these rheumatic diseases. This article reviews the main orofacial manifestations of rheumatic diseases that may be of interest to the rheumatologist for diagnosis and monitoring of autoimmune rheumatic diseases.

  14. Osteoblast Role in Rheumatic Diseases

    Directory of Open Access Journals (Sweden)

    Addolorata Corrado

    2017-06-01

    Full Text Available Alterations in osteoblast growth, differentiation and activity play a role in the pathogenesis of several rheumatic diseases, such as rheumatoid arthritis, spondyloarthritides, osteoarthritis, and osteoporosis. In fact, in these rheumatic diseases, abnormal activity of Wnt signaling, receptor activator of nuclear factor-κB (RANK-RANK ligand (RANKL-osteoprotegerin (OPG signaling, bone morphogenetic proteins (BMPs pathway and other mechanisms have been described in osteoblasts. This review article is focused on current knowledge on the role of osteoblast dysregulation occurring in rheumatic diseases.

  15. [Rheumatic fibromyalgia: psychiatric features].

    Science.gov (United States)

    Sarró Alvarez, S

    2002-01-01

    Rheumatic fibromyalgia, also known as fibrositis or myofascial pain, is a common syndrome whose diagnoses, founded mainly on physical examination, usually delays due to symptom unspecificity, amount of complementary tests requested and intercourse with psychiatric disorders. Psychyatrists and psychologists get often involved in fibromyalgia treatment. Its proper knowledge prevents not only physicians and patients' psychological discourage but also development of depression and mental health expenses, as well as allows designing a treatment plan according to the main symptoms which may offer improvement chances to fibromyalgia patients. This article intends to offer an up-to-date and complete information about this entity, focused on psychiatric aspects, to better identify and manage such a puzzling disease.

  16. Role of erosions typical of rheumatoid arthritis in the 2010 ACR/EULAR rheumatoid arthritis classification criteria: results from a very early arthritis cohort.

    Science.gov (United States)

    Brinkmann, Gina Hetland; Norli, Ellen S; Bøyesen, Pernille; van der Heijde, Désirée; Grøvle, Lars; Haugen, Anne J; Nygaard, Halvor; Bjørneboe, Olav; Thunem, Cathrine; Kvien, Tore K; Mjaavatten, Maria D; Lie, Elisabeth

    2017-11-01

    To determine how the European League Against Rheumatism (EULAR) definition of erosive disease (erosion criterion) contributes to the number of patients classified as rheumatoid arthritis (RA) according to the 2010 American College of Rheumatology/EULAR RA classification criteria (2010 RA criteria) in an early arthritis cohort. Patients from the observational study Norwegian Very Early Arthritis Clinic with joint swelling ≤16 weeks, a clinical diagnosis of RA or undifferentiated arthritis, and radiographs of hands and feet were included. Erosive disease was defined according to the EULAR definition accompanying the 2010 RA criteria. We calculated the additional number of patients being classified as RA based on the erosion criteria at baseline and during follow-up. Of the 289 included patients, 120 (41.5%) fulfilled the 2010 RA criteria, whereas 15 (5.2%) fulfilled only the erosion criterion at baseline. 118 patients had radiographic follow-up at 2 years, of whom 6.8% fulfilled the 2010 RA criteria and only one patient fulfilled solely the erosion criterion during follow-up. Few patients with early arthritis were classified as RA based on solely the erosion criteria, and of those who did almost all did so at baseline. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Targeting distress in rheumatic diseases

    NARCIS (Netherlands)

    Vriezekolk, J.E.

    2011-01-01

    Psychological distress is highly prevalent in patients with rheumatic diseases. It is associated with a variety of negative outcomes, including pain, fatigue, disability, and maladaptive cognitive behavioural coping strategies. In this thesis, psychological distress was studied both as an outcome

  18. Impact of smoking and obesity on rheumatic disease in persons of productive age

    Directory of Open Access Journals (Sweden)

    Lusianawaty Tana

    2016-02-01

    Full Text Available Arthritis is a disease of the joints that causes pain and musculoskeletal stiffness, and may cause limitation of joint movement. Age, obesity, smoking behavior, and occupation are risk factors for rheumatic diseases. The objective of the present study was to evaluate the role of body mass index (BMI, smoking behavior, and occupation on rheumatic disease among persons of productive age in Indonesia. A cross-sectional study was conducted using National Basic Health Research data. The inclusion criterion was age 15-64 years. Rheumatic disease diagnosis was based on interview results and was defined as the presence of a history of rheumatic disease diagnosed by health professionals and/or rheumatic symptoms in the past 12 months. The study sample consisted of 609.097 persons who fulfilled the inclusion criterion. Compared to persons with normal BMI, rheumatic disease was more prevalent in the overweight (OR 1.25; 95%CI 1.21—1.29 and the obese (OR 1.52; 95%CI 1.47—1.56, but less prevalent in the underweight (OR 0.91; 95%CI 0.88—0.93. Compared to non-smokers, rheumatic disease was more prevalent in every day smokers (OR 1.65; 95%CI 1.60—1.70, occasional smokers (OR 1.41; 95%CI 1.35—1.47, and ex-smokers (OR 1.85; 95%CI 1.76—1.95. Measures for prevention of rheumatic disease are needed, e.g. through education to increase knowledge about the impact of smoking and obesity on rheumatic disease.

  19. Ultrasonography in inflammatory rheumatic disease: an overview.

    Science.gov (United States)

    Schirmer, Michael; Duftner, Christina; Schmidt, Wolfgang A; Dejaco, Christian

    2011-07-12

    Modern ultrasonography enables clinicians to sensitively assess the progression of inflammatory joint and tendon disease, and to investigate vasculitides, connective tissue diseases and nerve lesions. Despite the advantages of musculoskeletal ultrasonography for diagnostic, prognostic and monitoring purposes, fewer than 10% of European rheumatologists use this technique in routine clinical practice. The reliability and limitations of rheumatic ultrasonography remain a concern, although good interobserver and intraobserver agreement in results from ultrasonography have been demonstrated among experienced sonographers. International recommendations for assessments and ultrasonography training courses are available, and will improve the standardization of the use of these techniques. In clinical practice, ultrasonography can complement the diagnostic evaluation of patients with rheumatic disease and might have value in confirming and extending clinical findings. Musculoskeletal ultrasonography can also be a valuable follow-up tool to monitor disease activity and support treatment decisions for specific patients. Furthermore, ultrasonography-guided articular injections provide better precision and a higher success rate for synovial fluid aspiration than clinically-guided injections. In the future, three-dimensional ultrasonography techniques, the fusion of ultrasonography and other imaging methods, and real time sonoelastography will be interesting new fields of investigation.

  20. Diagnostic delays in rheumatic diseases with associated arthritis

    Science.gov (United States)

    Raciborski, Filip; Kwiatkowska, Brygida; Batko, Bogdan; Sochocka-Bykowska, Małgorzata; Zoń-Giebel, Aleksandra; Gola, Zbigniew; Guzera, Zbigniew; Maślińska, Maria

    2017-01-01

    Objective The objective of this study was to determine the length of delay in diagnosis of inflammatory rheumatic diseases, and to indicate the main factors responsible for such delays. Material and methods A retrospective multi-centre questionnaire survey carried out among 197 patients with diagnosed inflammatory rheumatic diseases or undergoing the diagnostic process. Results The most common early symptoms of inflammatory rheumatic disease included joint pain (94%), joint swelling (78%), morning joint stiffness (77%), fatigue (76%), and sleep disturbed by joint pain (74%). When asked about the reasons for seeking medical help, most patients indicated intensification of the symptoms (89%) and the fact that the symptoms made them unable to perform daily activities or work (86%). Limited access to specialists (70%) and the conviction that the symptoms will resolve spontaneously (57%) had the biggest impact on delaying a visit to a doctor. Before visiting a rheumatologist, the patients consulted their symptoms with their general practitioners (GPs, 95%), orthopaedicians (43%), and neurologists (29%). Almost half of the patients (48%) consulted their symptoms with at least 2 non-rheumatologists, whereas as many as 21% of patients visited 4 or more specialists. After the onset of symptoms of rheumatic disease, 28% of patients delayed seeing any doctor for 4 months or longer. 36% of patients waited 4 months or longer for a referral to a rheumatologist. The great majority of the patients (85%) made an appointment with a rheumatologist within a month of receiving a referral. 25% of patients waited 4 months or longer to see a rheumatologist. Conclusions Diagnostic delays result from both the level of patients’ awareness (ignoring early symptoms) and improper functioning of the health care system. In the case of the health care system, the source of delays is not only “queues to rheumatologists”, but also referring patients to non-rheumatologists. PMID:29056771

  1. Diagnostic delays in rheumatic diseases with associated arthritis.

    Science.gov (United States)

    Raciborski, Filip; Kłak, Anna; Kwiatkowska, Brygida; Batko, Bogdan; Sochocka-Bykowska, Małgorzata; Zoń-Giebel, Aleksandra; Gola, Zbigniew; Guzera, Zbigniew; Maślińska, Maria

    2017-01-01

    The objective of this study was to determine the length of delay in diagnosis of inflammatory rheumatic diseases, and to indicate the main factors responsible for such delays. A retrospective multi-centre questionnaire survey carried out among 197 patients with diagnosed inflammatory rheumatic diseases or undergoing the diagnostic process. The most common early symptoms of inflammatory rheumatic disease included joint pain (94%), joint swelling (78%), morning joint stiffness (77%), fatigue (76%), and sleep disturbed by joint pain (74%). When asked about the reasons for seeking medical help, most patients indicated intensification of the symptoms (89%) and the fact that the symptoms made them unable to perform daily activities or work (86%). Limited access to specialists (70%) and the conviction that the symptoms will resolve spontaneously (57%) had the biggest impact on delaying a visit to a doctor. Before visiting a rheumatologist, the patients consulted their symptoms with their general practitioners (GPs, 95%), orthopaedicians (43%), and neurologists (29%). Almost half of the patients (48%) consulted their symptoms with at least 2 non-rheumatologists, whereas as many as 21% of patients visited 4 or more specialists. After the onset of symptoms of rheumatic disease, 28% of patients delayed seeing any doctor for 4 months or longer. 36% of patients waited 4 months or longer for a referral to a rheumatologist. The great majority of the patients (85%) made an appointment with a rheumatologist within a month of receiving a referral. 25% of patients waited 4 months or longer to see a rheumatologist. Diagnostic delays result from both the level of patients' awareness (ignoring early symptoms) and improper functioning of the health care system. In the case of the health care system, the source of delays is not only "queues to rheumatologists", but also referring patients to non-rheumatologists.

  2. Disease-modifying anti-rheumatic drug effect of denosumab on radiographic progression in rheumatoid arthritis: a systematic review of the literature.

    Science.gov (United States)

    Boleto, Gonçalo; Dramé, Moustapha; Lambrecht, Isabelle; Eschard, Jean-Paul; Salmon, Jean-Hugues

    2017-08-01

    The aim of this study was to evaluate the structural effect of denosumab on patients with rheumatoid arthritis (RA). We performed a systematic review of the literature in the following databases: PubMed, Cochrane, Web of Science, ClinicalTrials.gov , and the WHO International Clinical Trials Registry Platform. All studies evaluating the structural effect of denosumab on RA and meeting predefined criteria were included. Data regarding disease activity, progression of joint damage, joint space narrowing, and safety were recorded. Among 168 studies identified, only 4 were finally included in this review, involving a total of 687 patients. These 4 studies showed that denosumab is effective on joint damage at 6 and 12 months as compared to placebo, alendronate, and biological disease-modifying anti-rheumatic drugs (bDMARDs) alone. No effect was observed in terms of joint space narrowing, and DAS28 and HAQ scores remained unchanged. No case of osteonecrosis of the jaw or atypical fracture was recorded, and safety was similar in both denosumab and control groups. Denosumab appears to be effective on joint erosion at 6 and 12 months in patients with RA meeting the ACR criteria, treated or not by a biologic, with excellent safety.

  3. What about My Child and Rheumatic Fever?

    Science.gov (United States)

    ... occur after a streptococcal infection of the throat (“strep throat”). Most strep throat infections don’t lead to rheumatic fever. When they do, the time between the strep throat and rheumatic fever is about two to four ...

  4. Management of patients with rheumatic fever and rheumatic heart ...

    African Journals Online (AJOL)

    Marcus R, Sareli P, Pocock W, Barlow J. The spectrum of severe rheumatic mitral valve disease in a .... disease in Nigeria? The epidemiological association between group A f3-haemolytic streptococcal throat infections and the subsequent development of acute RF has been well established.5. ' 6 In 1971, the f3- haemolytic ...

  5. 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative

    Science.gov (United States)

    Neogi, Tuhina; Jansen, Tim L Th A; Dalbeth, Nicola; Fransen, Jaap; Schumacher, H Ralph; Berendsen, Dianne; Brown, Melanie; Choi, Hyon; Edwards, N Lawrence; Janssens, Hein J E M; Lioté, Frédéric; Naden, Raymond P; Nuki, George; Ogdie, Alexis; Perez-Ruiz, Fernando; Saag, Kenneth; Singh, Jasvinder A; Sundy, John S; Tausche, Anne-Kathrin; Vaquez-Mellado, Janitzia; Yarows, Steven A; Taylor, William J

    2015-01-01

    Objective Existing criteria for the classification of gout have suboptimal sensitivity and/or specificity, and were developed at a time when advanced imaging was not available. The current effort was undertaken to develop new classification criteria for gout. Methods An international group of investigators, supported by the American College of Rheumatology and the European League Against Rheumatism, conducted a systematic review of the literature on advanced imaging of gout, a diagnostic study in which the presence of monosodium urate monohydrate (MSU) crystals in synovial fluid or tophus was the gold standard, a ranking exercise of paper patient cases, and a multi-criterion decision analysis exercise. These data formed the basis for developing the classification criteria, which were tested in an independent data set. Results The entry criterion for the new classification criteria requires the occurrence of at least one episode of peripheral joint or bursal swelling, pain, or tenderness. The presence of MSU crystals in a symptomatic joint/bursa (ie, synovial fluid) or in a tophus is a sufficient criterion for classification of the subject as having gout, and does not require further scoring. The domains of the new classification criteria include clinical (pattern of joint/bursa involvement, characteristics and time course of symptomatic episodes), laboratory (serum urate, MSU-negative synovial fluid aspirate), and imaging (double-contour sign on ultrasound or urate on dual-energy CT, radiographic gout-related erosion). The sensitivity and specificity of the criteria are high (92% and 89%, respectively). Conclusions The new classification criteria, developed using a data-driven and decision-analytic approach, have excellent performance characteristics and incorporate current state-of-the-art evidence regarding gout. PMID:26359487

  6. Acute rheumatic fever ID adults

    African Journals Online (AJOL)

    prominent feature. Two patients died and a further 4 required valve replacements as a resuH of the disease. This suggests that local factors are of importance in determining the morbidity of the disease and that physicians should consider acute rheumatic disease in adults who present with unex- plained valvular disease or ...

  7. Case report 511: Fibroblastic rheumatism

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez, R.J.; Martel, W.; Headington, J.T.; Kaufman, R.A.

    1989-03-01

    We report a ten-year-old child with the newly described entity of fibroblastic rheumatism. This child developed rapid, progressive, symmetrical polyarthritis, similar to the radiographic appearance of juvenile rheumatoid arthritis, except for the rapidity of progression. The polyarthritis was preceded by the development of skin nodules with characteristic histological changes. (orig./GDG).

  8. Exercise in pediatric rheumatic diseases.

    Science.gov (United States)

    Klepper, Susan E

    2008-09-01

    The present review discusses the current knowledge about exercise capacity and physical activity in children with rheumatic disease and examines the role of exercise in managing these conditions. Recent studies suggest exercise capacity is significantly impaired in a large proportion of children with juvenile idiopathic arthritis and other rheumatic diseases. These deficits are not limited to children with active inflammation. Children, especially girls, with rheumatoid factor positive polyarticular juvenile idiopathic arthritis, have the greatest deficits. Poor fitness and low levels of weight-bearing physical activity contribute to low bone mass and strength. Children and adolescents with juvenile dermatomyositis and systemic lupus erythematosus also exhibit impaired exercise capacity. There is some evidence that structured aerobic and neuromuscular training may improve exercise capacity, functional performance, and quality of life in children and adolescents with rheumatic disease. A sedentary lifestyle contributes to secondary impairments in aerobic and muscular fitness, bone health, and functional limitations in children and adolescents with rheumatic disease despite advances in the pharmacological management of these inflammatory conditions. Increased levels of moderate to vigorous physical activity and structured exercise may improve exercise capacity, performance of daily activities, and overall quality of life.

  9. Risk of falls in the rheumatic patient at geriatric age

    Directory of Open Access Journals (Sweden)

    Agnieszka Prusinowska

    2017-04-01

    Full Text Available Evaluating the risk of falling of a geriatric rheumatic patient plays an essential role not only in planning and carrying out the physiotherapeutic process. The consequences of falls may be different and, although they do not always result in serious repercussions such as fractures or injuries, it is sufficient that they generate the fear of falling and cause a significant reduction in physical activity. Assessing functional capacity to define the risk of falling is of utmost importance in the case of patients after joint arthroplasty surgeries. The specificity of rheumatic patient’s falls is determined by numerous factors. It is not always possible to avoid them. However, it becomes vital to include fall prevention in the rehabilitation process as well as to prepare the house for the needs of an elderly person so that they are safe and as self-dependent as possible.

  10. Risk of falls in the rheumatic patient at geriatric age.

    Science.gov (United States)

    Prusinowska, Agnieszka; Komorowski, Arkadiusz; Sadura-Sieklucka, Teresa; Księżopolska-Orłowska, Krystyna

    2017-01-01

    Evaluating the risk of falling of a geriatric rheumatic patient plays an essential role not only in planning and carrying out the physiotherapeutic process. The consequences of falls may be different and, although they do not always result in serious repercussions such as fractures or injuries, it is sufficient that they generate the fear of falling and cause a significant reduction in physical activity. Assessing functional capacity to define the risk of falling is of utmost importance in the case of patients after joint arthroplasty surgeries. The specificity of rheumatic patient's falls is determined by numerous factors. It is not always possible to avoid them. However, it becomes vital to include fall prevention in the rehabilitation process as well as to prepare the house for the needs of an elderly person so that they are safe and as self-dependent as possible.

  11. Radiosynovectomy in rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Jarosław B. Ćwikła

    2014-09-01

    Full Text Available Radiosynovectomy is a safe and repeatable treatment method of chronic synovitis with synovial overgrowth and refractory chronic or acute inflammatory joint effusion. It consist in the intraarticular administration of a radioactive isotope in the form of a colloid causing the extinguishing of active synovitis. The radiocolloid causes permanent irradiation of the synovium with beta ray electron beams, which ultimately leads to its fibrosis and extinguishes the inflammatory process destroying the joint. The main indications for radiosynovectomy include chronic and acute arthritis in the course of systemic diseases, intraarticular bleeding in hemorrhagic diatheses (hemophilia, selected cases of osteoarthritis, recurrent effusions following surgery, e.g. arthroplasty, or other iatrogenic post-surgery complications causing arthritis. Radiosynovectomy is also performed in pigmented villonodular synovitis and crystal synovitis. The most common method used to determine the eligibility for radiosynovectomy is an ultrasound, which shows the location and activity of the thickened synovium. The administration of a radiocolloid into the joint, sheath or bursa should also be performed under the control of the ultrasound image, as this ensures a precise location of the puncture needle and full control of the isotope administration process. Clinical efficacy of radiosynovectomy depends on the proper qualification of patients for the procedure. The success rate of radiosynovectomy in common indications is 65–80%. It is confirmed by the visualization of avascular (fibrotic synovium in follow-up ultrasound tests. The aim of this article is to present techniques and indications for the radiosynovectomy treatment.

  12. Update on diagnosis of acute rheumatic fever: 2015 Jones criteria.

    Science.gov (United States)

    Eroğlu, Ayşe Güler

    2016-03-01

    In the final Jones criteria, different diagnostic criteria were established for the diagnosis of acute rheumatic fever for low risk and moderate-high risk populations. Turkey was found to be compatible with moderate-high risk populations as a result of regional screenings performed in terms of acute rheumatic fever and rheumatic heart disease. The changes in the diagnostic criteria for low-risk populations include subclinical carditis found on echocardiogram as a major criterion in addition to carditis found clinically and a body temperature of 38.5°C and above as a minor criterion. In moderate-high risk populations including Turkey, subclinical carditis found on echocardiogram in addition to clinical carditis is used as a major criterion as a new amendment. In addition, aseptic monoarthritis and polyarthralgia are used as major criteria in addition to migratory arthritis and monoarhtralgia is used as a minor criterion among joint findings. However, differentiation of subclinical carditis from physiological valve regurgitation found in healthy individuals and exclusion of other diseases involving joints when aseptic monoarthritis and polyarthralgia are used as major criteria are very important. In addition, a body temperature of 38°C and above and an erythrocyte sedimentation rate of 30 mm/h and above have been accepted as minor criteria. The diagnostic criteria for the first attack have not been changed; three minor findings have been accepted in presence of previous sterptococcal infection in addition to the old cirteria for recurrent attacks. In the final Jones criteria, it has been recommended that patients who do not fully meet the diagnostic criteria of acute rheumatic fever should be treated as acute rheumatic fever if another diagnosis is not considered and should be followed up with benzathine penicilin prophylaxis for 12 months. It has been decided that these patients be evaluated 12 months later and a decision for continuation or discontinuation of

  13. Rheumatic fever and rheumatic heart disease in Bangladesh: A review.

    Science.gov (United States)

    Islam, A K M Monwarul; Majumder, A A S

    2016-01-01

    Rheumatic fever (RF) and rheumatic heart disease (RHD) are the most-common cardiovascular disease in young people aged poverty, overcrowding, ignorance, and insufficient health care services were responsible for the high incidence and prevalence of these diseases over the last century. In concert with the progresses in socioeconomic indicators, advances in health sectors, improved public awareness, and antibiotic prophylaxis, acute RF came into control. However, chronic RHD continues to be prevalent, and the actual disease burden may be much higher. RHD predominantly affects the young adults, seriously incapacitates them, follows a protracted course, gets complicated because of delayed diagnosis and is sometimes maltreated. The treatment is often palliative and expensive. Large-scale epidemiological and clinical researches are needed to formulate evidence-based national policy to tackle this important public health issue in future. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  14. Rheumatic fever prophylaxis: Gisborne experience.

    Science.gov (United States)

    Frankish, J D

    1984-10-10

    There were 300 admissions to the Cook Hospital with rheumatic fever in 1958-83. During 1958-73 oral penicillin was used for secondary prophylaxis and 77 (35%) of 223 admissions were recurrences. From 1974-83 when parenteral benzathine penicillin was increasingly used there were 77 admissions of which 14 (18%) were readmissions. An effective programme of secondary prophylaxis using benzathine penicillin and co-ordination of hospital and community health services is outlined. One hundred and eight patients with a first attack of rheumatic fever were seen in 1968-82. The chance of a recurrence in patients in whom oral prophylaxis was instituted was 15% two years after the initial attack and 35% after six years. Institution of parenteral prophylaxis significantly reduced the risk of recurrence (p = 0.0009) which was 2% six years after the first attack.

  15. Splash erosion

    NARCIS (Netherlands)

    Fernández-Raga, María; Palencia, Covadonga; Keesstra, Saskia; Jordán, Antonio; Fraile, Roberto; Angulo-Martínez, Marta; Cerda Bolinches, Artemio

    2017-01-01

    Soil erosion is a serious ecological and environmental problem, and the main cause of land degradation in many ecosystems at global scale. Detachment of soil particles by raindrop splash is the first stage in the soil erosion process. A review of the scientific literature published in

  16. Targeting distress in rheumatic diseases

    OpenAIRE

    Vriezekolk, J.E.

    2011-01-01

    Psychological distress is highly prevalent in patients with rheumatic diseases. It is associated with a variety of negative outcomes, including pain, fatigue, disability, and maladaptive cognitive behavioural coping strategies. In this thesis, psychological distress was studied both as an outcome measure and as a therapeutic target in the context of multidisciplinary rehabilitation. The longitudinal role of coping in psychological distress was systematically reviewed, a questionnaire to asses...

  17. Histopathologic characterization of lesios in rheumatic valvulopathy

    OpenAIRE

    R. Ricca; M. Mora; L. Abete; E. Fulcheri

    2010-01-01

    Cardiac valvulopathies may be caused by acquired or congenital diseases and result in valvular stenosis and/or insufficiency. For a correct diagnostic evaluation of cardianc valves, and in particular of rheumatic valvulopathy, pathologists should know the patient's clinical history, the degree of insufficiency and/or stenosis and echographiacal data. Histopathologic features of rheumatic valvulopathy include precocious, tardy and terminal lesions. Rheumatic valvulopathy may produce mitral ins...

  18. The impact of joint disease on the Modified Health Assessment Questionnaire scores in rheumatoid arthritis patients: A cross-sectional study using the National Database of Rheumatic Diseases by iR-net in Japan.

    Science.gov (United States)

    Ono, Kumiko; Ohashi, Satoru; Oka, Hiroyuki; Kadono, Yuho; Yasui, Tetsuro; Omata, Yasunori; Nishino, Jinju; Tanaka, Sakae; Tohma, Shigeto

    2016-07-01

    To investigate the effect of bilateral and unilateral joint disease on the Modified Health Assessment Questionnaire (MHAQ) scores and the differences in joint weighting in rheumatoid arthritis patients. A total of 9212 subjects from the Japanese nationwide cohort database NinJa, 2011, were analyzed. The presence or absence of disease in each joint, including swelling and/or tenderness, was investigated. The correlations between bilateral and unilateral disease in each joint and MHAQ scores were investigated using multivariable logistic regression analysis. The patients' mean age and disease duration was 63.2 and 12.2 years, respectively. The Disease Activity Score-28 was 3.3. The odds ratios of physical impairment according to the MHAQ using multivariable logistic regression models for bilateral and unilateral joints, respectively, were: shoulder, 4.0 and 1.8; elbow, 2.6 and 1.8; wrist, 1.9 and 1.5; hip, 1.7 and 3.0; knee, 2.6 and 1.9; ankle, 2.3 and 2.0, finger, 1.4 and 1.2; and toe, 1.0 and 1.1. The shoulder, elbow, wrist, knee, and ankle had a significant effect on physical impairment. The MHAQ score was significantly affected by shoulder, elbow, wrist, knee, and ankle joint disease. Furthermore, bilateral disease tended to have a greater effect on physical impairment than unilateral disease.

  19. A comparative study on the results of the modified Ludloff osteotomy for hallux valgus deformities with minimal erosion of the metatarsophalangeal joints in rheumatoid patients versus non-rheumatoid patients.

    Science.gov (United States)

    Sung, Il-Hoon; Sung, Yoon-Kyoung; Huh, Dong-Ryul; Kim, Sung-Jae

    2015-09-01

    We aimed to compare the outcomes of joint-preserving surgery for hallux valgus deformities with minimal erosion of the metatarsophalangeal joint in rheumatoid patients with non-rheumatoid controls, and to determine the prognostic factors of recurrence in rheumatoid patients. A total of 18 rheumatoid patients (20 feet, Group I) and 35 non-rheumatoid patients (39 feet, Group II) were included. The mean follow-up was 29.6 months. Radiographic and clinical outcomes were compared. To identify the prognostic factors for recurrences in rheumatoid patients, subgroup analyses were done in Group I. Most of the outcomes showed favorable results in both groups. However, Group II had better results in hallux valgus angle (HVA) (15.9° vs. 7.9°, p hallux valgus deformities in rheumatoid forefoot deformity showed favorable results in mid-term follow-up; however, it should be warned of possible recurrent deformities.

  20. Regional Rheumatic Disorders and Rehabilitation in Older Adults.

    Science.gov (United States)

    Acevedo, Ana T; Jackson, Adrienne; Alter, Katharine E

    2017-02-01

    Musculoskeletal problems are the most frequently reported complaints among older adults living in the community. The impact of the aging process on skeletal muscles and joints can have a profound effect on the ability of individuals with and without disabilities to function. This article reviews the rehabilitation medicine approach to the evaluation of older adults with regional rheumatic disorders, and the rehabilitation medicine considerations for clinical interventions. Future research considerations are encouraged in order to gain a greater understanding of the subject matter and its impact on the provision of care and patients' quality of life. Published by Elsevier Inc.

  1. No erosive progression revealed by MRI in rheumatoid arthritis patients treated with etanercept, even in patients with persistent MRI and clinical signs of joint inflammation

    DEFF Research Database (Denmark)

    Døhn, Uffe Møller; Skjødt, Henrik; Hetland, Merete Lund

    2007-01-01

    The aim of this study is to investigate the course of magnetic resonance imaging (MRI) signs of inflammatory and destructive changes in rheumatoid arthritis (RA) wrist and metacarpophalangeal (MCP) joints during etanercept treatment. MRI of the non-dominant wrist and second to fifth MCP joints...

  2. ANTI-RHEUMATIC FORMULATIONS FROM AYURVEDA

    Science.gov (United States)

    Raut, A. A.; Joshi, A. D.; Antarkar, D. S.; Joshi, V. R.; Vaidya, A. B.

    1991-01-01

    Rheumatic disorders like Amavata, Sandhivata and Vatarakta are elaborately described in ayurvedic literature. Preliminary survey of literature shows that about 247 formulations are recommended for these rheumatic disorders. These formulations generally include guggulu compounds, compounds of plant powders, decoctions, medicated ghees, oils, electuaries etc. Therapeutic potential of ayurvedic concepts and a brief review of Ayurvedic formulations are also discussed. PMID:22556565

  3. Global research priorities in rheumatic fever and rheumatic heart disease

    Science.gov (United States)

    Carapetis, Jonathan R; Zühlke, Liesl J

    2011-01-01

    We now stand at a critical juncture for rheumatic fever (RF) and rheumatic heart disease (RHD) control. In recent years, we have seen a surge of interest in these diseases in regions of the world where RF/RHD mostly occur. This brings real opportunities to make dramatic progress in the next few years, but also real risks if we miss these opportunities. Most public health and clinical approaches in RF/RHD arose directly from programmes of research. Many unanswered questions remain, including those around how to implement what we know will work, so research will continue to be essential in our efforts to bring a global solution to this disease. Here we outline our proposed research priorities in RF/RHD for the coming decade, grouped under the following four challenges: Translating what we know already into practical RHD control; How to identify people with RHD earlier, so that preventive measures have a higher chance of success; Better understanding of disease pathogenesis, with a view to improved diagnosis and treatment of ARF and RHD; and Finding an effective approach to primary prevention. We propose a mixture of basic, applied, and implementation science. With concerted efforts, strong links to clinical and public health infrastructure, and advocacy and funding support from the international community, there are good prospects for controlling these RF and RHD over the next decade. PMID:21677798

  4. Effects of exercise on physical limitations and fatigue in rheumatic diseases.

    Science.gov (United States)

    Musumeci, Giuseppe

    2015-11-18

    Physical activity covers not just sports but also simple everyday movements such as housework, walking and playing. Regular exercise has a great importance in maintaining good health, indeed inactivity is a risk factor for different chronic diseases. Physical exercise can play a crucial role in the treatment of rheumatic diseases, optimizing both physical and mental health, enhancing energy, decreasing fatigue and improving sleep. An exercise program for patients with rheumatic diseases aims to preserve or restore a range of motion of the affected joints, to increase muscle strength and endurance, and to improve mood and decrease health risks associated with a sedentary lifestyle. In this editorial I describe the benefits of the exercise on physical limitations and fatigue in rheumatic diseases that seem to have a short and long-term effectiveness. A literature review was conducted on PubMed, Scopus and Google Scholar using appropriate keywords based on the present editorial.

  5. Prevalence of HFE and TFR2 gene mutation in 118 Ligurian rheumatic patients.

    Science.gov (United States)

    Rovetta, G; Monteforte, P; Buffrini, L; Grignolo, M C; Franchin, F

    2004-12-01

    HFE gene is associated to haemochromatosis, an inherited autosomal recessive disorder responsible of an overload of iron in intestine, liver, pancreas, heart, cutis and joints. Articular and periarticular calcifications may occur. H63D mutation may play a role in the pathogenesis of rheumatoid arthritis. DNA of 118 consecutive patients (28 males, 90 females, mean age 58.5+/-13.44) living in Liguria and affected by different rheumatic diseases was examined to evaluate the presence of HFE mutations. Analysis data showed that in 45% (53/118) of patients almost one mutation of HFE gene was present and the presence of H63D mutation in the rheumatic patients was particularly elevated. Data obtained in this study have permitted to reveal that 25 patients of 53 (47.1%) with 1 of 11 HFE mutations suffered from symptomatic or silent chondrocalcinosis. The conclusion is drawn that this mutation may be correlated to various rheumatic diseases.

  6. The prevalence of rheumatic diseases in central Greece: a population survey

    Directory of Open Access Journals (Sweden)

    Koutroumpas Athanasios

    2010-05-01

    Full Text Available Abstract Background Rheumatic diseases are a major health and financial burden for societies. The prevalence of rheumatic diseases may change over time, and therefore, we sought to estimate the prevalence of rheumatic diseases in an adult population of central Greece. Methods In this prospective cross-sectional population survey, a random sample of adult population was drawn from poll catalogues of a region in central Greece. A postal questionnaire was sent to 3,528 people for the presence of any rheumatic disease. All positive cases were further confirmed by clinical examination using the American College of Rheumatoloy criteria. Multiple regression analysis was used to assess risk factors for rheumatic diseases. Results The response rate was 48.3% (1,705 answers. Four hundred and twenty individuals (24.6% had a rheumatic disease. The prevalence of rheumatoid arthritis was 0.58% (95% confidence interval [CI], 0.32-0.87, of psoriatic arthritis was 0.35% (95% CI, 0.33-1.13, of ankylosing spondylitis was 0.29% (95% CI, 0.28-0.94, of primary Sjögren's syndrome was 0.23% (95% CI, 0.22-0.75 and of systemic lupus erythematosus was 0.11% (95% CI, 0.11-0.37. One individual had systemic sclerosis (prevalence, 0.058%, 1 individual had dermatomyositis (prevalence, 0.058%; 95% CI, 0.05-0.18, 2 individuals had vasculitis (prevalence 0.11%; 95% CI, 0.11-0.37, 81 individuals had gout (prevalence, 4.75%; 95% CI, 4.41-5.13, and 304 individuals had osteoarthritis (OA (prevalence 17.82%; 95% CI, 16.50-19.34. Gout was associated with male gender, diabetes mellitus, and hypertension, and OA was associated with age, female gender, and hypertension. Conclusions Rheumatic diseases are common in central Greece, affecting nearly a quarter of adult population. OA and gout are the most common joint disorders.

  7. Association between rheumatic diseases and cancer: results from a clinical practice cohort study.

    Science.gov (United States)

    Bellan, Mattia; Boggio, Enrico; Sola, Daniele; Gibbin, Antonello; Gualerzi, Alessandro; Favretto, Serena; Guaschino, Giulia; Bonometti, Ramona; Pedrazzoli, Roberta; Pirisi, Mario; Sainaghi, Pier Paolo

    2017-08-01

    The association between cancer and immune-mediated rheumatic conditions is controversial, especially as far as polymyalgia rheumatica (PMR) is concerned. Furthermore, no clinical feature has been shown to be suggestive of a paraneoplastic rheumatic syndrome. With the present study, we aim to address both these issues. The study population comprised N = 1750 patients, including N = 100 with PMR, who attended our tertiary immuno-rheumatology clinic between January 1, 2005 and November 30, 2012. A rheumatic disease was deemed paraneoplastic if cancer had been diagnosed in the 2 years preceding or following its onset. The probability of a significant association between a specific rheumatic disease and cancer was evaluated by computing the odds ratio (OR): N = 702 patients with osteoarthritis serving as controls. Furthermore, clinical features distinguishing paraneoplastic rheumatic diseases were searched for by univariate and multivariate analysis. Sjogren's syndrome (SS) [OR 3.6 (CI 95% 1.7-7.5)], PMR (OR 5.1 CI 95% 2.9-8.9), dermatomyositis/polymyositis [OR 12.09 (CI 95% 2.6-55.8)] and vasculitis [OR 3.70 (CI 95% 1.81-7.52)] are associated with cancer. At multivariate analysis, older age is associated with cancer among SS patients (p = 0.03), while in the PMR group, older age, male gender, and ≥6 tender joints are independent predictors of paraneoplastic PMR (p Cancer frequently either heralds or follows rheumatic manifestations, including PMR. Older age, male gender and a more extensive joint involvement should be considered red flags for paraneoplastic PMR.

  8. 15 years in promoting the use of isotopic and nuclear technique for combating land degradation and soil erosion: the contribution of the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture

    Science.gov (United States)

    Mabit, Lionel; Toloza, Arsenio; Heng, Lee

    2017-04-01

    The world population will exceed 9 billion by the year 2050 and food production will need to be approximately doubled to meet this crucial demand. Most of this increase will occur in developing countries, where the majority of the population depends on agriculture and their land for their livelihoods. Reports from the Intergovernmental Panel on Climate Change (IPCC) predicted negative impact of climate change, threatening global food security. In addition, the intensification of agricultural activities has increased pressure on land and water resources, resulting in different forms of soil degradation, of which soil erosion and associated sedimentation are worsening. Worldwide economic costs of agricultural soil loss and associated sedimentation downstream have been estimated at US 400 billion per year. As a result of climate change, world average soil erosion is expected to further increase significantly. Adapting to climate change requires agricultural soil and water management practices that make agricultural production systems resilient to drought, floods and land degradation, to enhance the conservation of the natural resource base for sustainable upland farming. These current concerns with ensuring sustainable use and management of agroecosystems create an urgent need for reliable quantitative data on the extent and magnitude of soil resource degradation over several spatial and time scales to formulate sound policies and management measures. Integrated isotopic approaches can help in targeting adapted and effective soil-water conservation measures to control soil degradation and therefore contribute to positive feedback mechanisms to mitigate climate change impact on soil and water resources. Set up 60 years ago as the world's centre for cooperation in the nuclear field, the International Atomic Energy Agency (IAEA) promotes the safe, secure and peaceful use of nuclear technologies. Since the end of the 1990s, the Joint FAO/IAEA Division of Nuclear

  9. Gastro-intestinal complications as one of causes of death in patients with rheumatic diseases

    Directory of Open Access Journals (Sweden)

    V N Sorotskaya

    2005-01-01

    Full Text Available Objective. To assess frequency of gastro-intestinal (Gl bleeding and ulcer perforation as direct cause of death in pts with rheumatic diseases. Material and methods. Statistical analysis of Tula region patient care institutions documentation was performed to assess frequency and character of severe GI complications leading to death of pts. 300 cases of death which took place during 5 years (1996-2000 in 3 rheumatologic (105 cases and 10 therapeutic (195 cases departments of Tula region patient care institutions were studied. Results. Gl bleeding and ulcer perforation were the direct causes of death in 15 pts with rheumatic diseases i.e. in 5% from the whole number of died. GI complications caused death in 4 pts with chronic rheumatic heart disease (HRHD (1,7%, in 7 (15,2%with rheumatoid arthritis -, in 2 with ankylosing spondylitis and systemic lupus erythematosus (8,0 and 22,2% respectively. Pts with systemic sclerosis did not die because of GI damage. GI changes most frequently localized in duodenum (8 pts. 4 pts had complications connected with gastric ulcer and in 2 diffuse erosive damage of Gl mucosa was the source of bleeding. Conclusion. Severe Gl complications quite often lead to death of pts with rheumatic diseases in Tula region.

  10. Social implications of rheumatic diseases.

    Science.gov (United States)

    Kłak, Anna; Raciborski, Filip; Samel-Kowalik, Piotr

    2016-01-01

    Social consequences of a disease constitute limitations in performing roles relating to working life as well as family and social life caused by the disease, mainly chronic. The aim of the study was to analyze the social consequences of rheumatic diseases in the aspect of disability pensions with respect to incapacity for work and quality of life. The occurrence of rheumatic diseases is related not only to increased risk of different types of organic changes, but above all disability. In Europe almost 50% of persons suffering from diseases of the musculoskeletal system who are currently unemployed were breadwinners. Nearly 60% of them received legal disability status. The loss of work ability is, among other things, the consequence of progressive disability. In Europe 40% of persons suffering from rheumatoid arthritis (RA) had to stop working due to the disease. Most of the persons diagnosed with RA were of working age. It results in the decrease in the quality of life as well as economic difficulties (decreased incomes and increased disease-related costs). In Poland the results of the analysis of the Social Insurance Institution (ZUS) of first-time disability recognition issued for the purpose of disability pensions in 2014 showed that the incapacity for work was caused by diseases relating to general health condition (65.5%). Diseases of the musculoskeletal system were the cause of partial inability to work of 21.6% of persons who received a disability pension for the first time (as many as 5,349 certificates were issued). Early diagnosis and implementation of effective treatment are the necessary conditions for a patient to sustain activity, both professional and social, which is of crucial importance to reduce the negative effects of the disease.

  11. Social implications of rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Anna Kłak

    2016-06-01

    Full Text Available Social consequences of a disease constitute limitations in performing roles relating to working life as well as family and social life caused by the disease, mainly chronic. The aim of the study was to analyze the social consequences of rheumatic diseases in the aspect of disability pensions with respect to incapacity for work and quality of life. The occurrence of rheumatic diseases is related not only to increased risk of different types of organic changes, but above all disability. In Europe almost 50% of persons suffering from diseases of the musculoskeletal system who are currently unemployed were breadwinners. Nearly 60% of them received legal disability status. The loss of work ability is, among other things, the consequence of progressive disability. In Europe 40% of persons suffering from rheumatoid arthritis (RA had to stop working due to the disease. Most of the persons diagnosed with RA were of working age. It results in the decrease in the quality of life as well as economic difficulties (decreased incomes and increased disease-related costs. In Poland the results of the analysis of the Social Insurance Institution (ZUS of first-time disability recognition issued for the purpose of disability pensions in 2014 showed that the incapacity for work was caused by diseases relating to general health condition (65.5%. Diseases of the musculoskeletal system were the cause of partial inability to work of 21.6% of persons who received a disability pension for the first time (as many as 5,349 certificates were issued. Early diagnosis and implementation of effective treatment are the necessary conditions for a patient to sustain activity, both professional and social, which is of crucial importance to reduce the negative effects of the disease.

  12. Disturbances of cellular immunity in rheumatic fever.

    Science.gov (United States)

    Georgescu, C; Gheorghiu, M

    1976-01-01

    The alteration of cellular reactivity was investigated in 20 patients with rheumatic fever at the first rheumatic attack or in relapse with confirmed heart damage. The results obtained by studying in parallel ESR, the ASLO titer, IDR to streptococci and the degree of leukocyte migration inhibition proved that the onset of rheumatic attack was preceded by a deep disturbance of the cellular immunity. The migration inhibition values were between 50 and 60% (as compared with 10% in the normal controls) in over 85% of the patients investigated. It is emphasized that the selection of cases of streptococcal angina should be made very carefully and that sometimes it is necessary to use a more specific method for the detection of rheumatic fever in its preclinical stage.

  13. Surgical treatment of synovial chondromatosis of the temporomandibular joint with erosion of the skull base: a case report and review of the literature.

    Science.gov (United States)

    Pau, M; Bicsák, A; Reinbacher, K E; Feichtinger, M; Kärcher, H

    2014-05-01

    Synovial chondromatosis (SC) is a rare metaplastic disease of the larger joints. It is rarely observed in smaller joints, especially in the temporomandibular joint (TMJ). This disease is considered to be metaplastic and shows no malignant tendencies, but can become locally aggressive, erode the cranial base, and even spread intracranially. To date, nine cases of spread into the intracranial space have been reported in the literature; however, the disease remained extradural in all cases. The authors present a review of the literature and report the case of a 70-year-old man with SC of the right TMJ that had eroded the cranial base, reaching the dura mater; a large intracranial mass was not present. The disease was considered to be stage 3 according to Milgram's classification. The patient was treated surgically, the tumour mass was removed, reconstruction of the cranial base was performed using titanium mesh, and the joint was reconstructed with a temporal muscle interposition flap. Diagnostic images and intraoperative photographs are also presented. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Effect of a treat-to-target strategy based on methotrexate and intra-articular betamethasone with or without additional cyclosporin on MRI-assessed synovitis, osteitis, tenosynovitis, bone erosion, and joint space narrowing in early rheumatoid arthritis: results from a 2-year randomized double-blind placebo-controlled trial (CIMESTRA)

    DEFF Research Database (Denmark)

    Møller-Bisgaard, S.; Ejbjerg, B. J.; Eshed, I.

    2017-01-01

    in the MRI substudy, and had contrast-enhanced MR images of the non-dominant hand at months 0, 6, 12, and 24. MR images were evaluated for osteitis, synovitis, tenosynovitis, bone erosion, and joint space narrowing (JSN), using validated scoring methods.Results: Significant reductions were seen at 6months...

  15. Rheumatic Diseases: from Theory to Reality

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Serra Valdés

    2013-12-01

    Full Text Available Rheumatic diseases are a significant health problem worldwide because of their morbidity, their resulting disabilities and their economic impact due the high costs they entail for health institutions and patients. They should be included in the non-communicable chronic diseases when considering the following aspects for its definition: risk factors, chronic course, impact on quality of life, incidence and prevalence in the general population, mortality, etc.; aspects that coexists in rheumatic diseases.

  16. Erhversbetinget erosion?

    DEFF Research Database (Denmark)

    Dige, Irene; Gjørup, Hans; Nyvad, Bente

    2012-01-01

    Baggrund – I forbindelse med dental erosion er en grundig udredning af patienten vigtig, således at årsagen til erosionernes opståen findes, og der kan iværksættes adækvat forebyggende indsats. En sådan udredning er ikke mindst vigtig, når arbejdsmiljøet mistænkes. Patienttilfælde – En 30-årig...... arbejdsskade, men ikke anerkendt, da erosioner ikke er optaget på Arbejdsskadestyrelsens liste over erhvervssygdomme. En systematisk registrering af lignende tilfælde kunne imidlertid på sigt ændre retspraksis for fremtidige patienter med arbejdsbetinget erosion....

  17. Hand function in rheumatic diseases: patient and physician evaluations.

    Science.gov (United States)

    López López, Carlos Omar; Alvarez-Hernández, Everardo; Medrano Ramirez, Gabriel; Montes Castillo, Ma Luz; Hernández-Díaz, Cristina; Ventura Rios, Lucio; Arreguin Lopez, Roberto; Vázquez-Mellado, Janitzia

    2014-11-01

    Rheumatic diseases have repercussions in hand function. The m-SACRAH (modified Score for the Assessment and quantification of Chronic Rheumatoid Affections of the Hands) questionnaire evaluates hand function according to the patient's opinion. Our aim was to look for the clinical and para-clinical variables that correlate with m-SACRAH in rheumatic diseases. Consecutive patients with diagnoses of rheumatoid arthritis (RA), osteoarthritis (OA), gout, and systemic sclerosis (SS) with hand involvement and who agreed to participate, answered the m-SACRAH and Health Assessment Questionnaire Disability Index (HAQ-DI) and underwent blinded and independent rheumatologist and physiatrist evaluations. Nerve conduction studies (NCS) and hand ultrasonography (USG) were performed. Spearman's correlation and the Mann-Whitney U-test. Forty patients were included. There were 72% women and mean age of 49.25 ± 14.2 years. According to m-SACRAH patients were dived into two groups (mild vs. moderate-severe), only the number limited to motion joints were different among them (median 2 vs. 8 P = 0.036). Patients' perspective variables had a good correlation (HAQ-DI/mSACRAH: r = 0.43, P hand function with physiatrist evaluations: passive range of motion (r = -0.49, P = 0.001), sum of affected pinches (r = 0.66, P = 0.001), limited to motion joints (r = 0.34, P < 0.05) and palm-finger distance (r = 0.50, P = 0.05). Regarding para-clinical evaluations, only tenosynovitis by ultrasonography correlated with HAQ-Di (r = 0.357, P < 0.05). Patients' perspectives correlated with the number of limited motion joints but with none of the other physicians' and para-clinical evaluations. The patients' opinion about their function should play a major role in their management. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  18. Consensus guidelines on pediatric acute rheumatic fever and rheumatic heart disease.

    Science.gov (United States)

    Saxena, Anita; Kumar, R Krishna; Gera, Rani Prem Kumar; Radhakrishnan, S; Mishra, Smita; Ahmed, Z

    2008-07-01

    Acute rheumatic fever and rheumatic chronic valvular heart disease is an important preventable cause of morbidity and mortality in suburban and rural India. Its diagnosis is based on clinical criteria. These criteria need verification and revision in the Indian context. Furthermore, there are glaring differences in management protocols available in literature. These facts prompted Indian Academy of Pediatrics to review the management of rheumatic fever. Management of Rheumatic fever was reviewed and recommendation was formulated at national consultative meeting on 20th May 2007 at New Delhi. To formulate uniform guidelines on management of acute rheumatic fever and rheumatic heart disease in the Indian context. Guidelines were formulated for the management of streptococcal pharyngitis, acute rheumatic fever and its cardiac complication as well as secondary prophylaxis for recurrent episodes. (1) Streptococcal eradication with appropriate antibiotics (Benzathine penicillin single dose or penicillin V oral or azithromycin). (2) Diagnosis of rheumatic fever based on Jones criteria. (3) Control inflammatory process with aspirin with or without steroids (total duration of treatment of 12 weeks). (4) Treatment of chorea according to severity (therapy to continue for 2-3 weeks after clinical improvement). (5) Protocol for managing cardiac complication like valvular heart disease, congestive heart failure and atrial fibrillation. (6) Secondary prophylaxis with benzathine penicillin and management of anaphylaxis.

  19. Monitoring total-body inflammation and damage in joints and entheses: the first follow-up study of whole-body magnetic resonance imaging in rheumatoid arthritis.

    Science.gov (United States)

    Axelsen, M B; Eshed, I; Østergaard, M; Hetland, M L; Møller, J M; Jensen, D V; Krintel, S B; Hansen, M S; Terslev, L; Klarlund, M; Poggenborg, R P; Balding, L; Pedersen, S J

    2017-07-01

    To investigate changes in whole-body magnetic resonance imaging (WBMRI) inflammatory and structural lesions in most joints and entheses in patients with rheumatoid arthritis (RA) treated with adalimumab. WBMRI was obtained at weeks 0, 6, 16, and 52 in a 52 week follow-up study of 37 RA patients starting treatment with adalimumab. Readability and reliability of WBMRI were investigated for 76 peripheral joints, 23 discovertebral units, the sacroiliac joints, and 33 entheses. Changes in WBMRI joint and entheses counts were investigated. The readability of peripheral and axial joints was 82-100%, being less for elbows and small joints of the feet. For entheses, 72-100% were readable, except for entheses at the anterior chest wall, elbow, knee, and plantar fascia. The intrareader agreement was high for bone marrow oedema (BMO), bone erosion (80-100%), and enthesitis (77-100%), and slightly lower for synovitis and soft tissue inflammation (50-100%). All synovitis, BMO, and soft tissue inflammation counts decreased numerically during treatment. The 26-joint synovitis WBMRI count decreased significantly during the first 16 weeks for patients with a good European League Against Rheumatism (EULAR) response (from median 6 to 4, p joints and entheses in RA patients and can visualize a decrease in inflammatory counts during treatment. This first WBMRI follow-up study of patients with RA encourages further investigation of the usefulness of WBMRI in RA.

  20. [Pulmonary hypertension in rheumatic diseases].

    Science.gov (United States)

    Manganelli, P; Salaffi, F; Carotti, M; Delsante, G; Mozzani, F

    1999-03-01

    In rheumatic diseases (RD) pulmonary hypertension (PH) may result by either direct damage of the pulmonary arteries (isolated PH) or pulmonary interstitial fibrosis and other causes. PH is an important cause of morbidity and mortality in systemic sclerosis in which it is more frequently isolated in the limited cutaneous variant and secondary to interstitial fibrosis in the diffuse type. In isolated PH the main histopathological finding is an occlusive arteriopathy. The role of recurrent vasospasm ("lung Raynaud's phenomenon") is still being debated. In systemic lupus erythematosus, although uncommon, PH is being increasingly reported and may recognize multiple etiological factors including vasoconstriction, vasculitis, in-situ pulmonary thrombosis or chronic recurrent thromboembolism. PH may be a severe and often fatal complication of mixed connective tissue disease and dermato/polymyositis. PH may also be diagnosed in patients with rheumatoid arthritis, primary Sjögren's syndrome and primary antiphospholipid syndrome. Doppler echocardiography is the technique of choice for the evaluation of PH because it is nonivasive and allows serial determinations of the arterial pulmonary pressure. The therapy of PH associated with RD includes corticosteroids, immunosuppressive drugs, calcium-antagonists, ACE-inhibitors, anticoagulants, O2, prostacyclin or its stable analogue, iloprost. Carefully selected patients may benefit from single lung or heart-lung transplantation.

  1. OPPORTUNISTIC MICROORGANISMS IN RHEUMATIC DISEASES

    Directory of Open Access Journals (Sweden)

    M. Yu. Gulneva

    2016-01-01

    Full Text Available The paper gives the data available in the literature on the role of opportunistic microorganisms (OMs in rheumatic diseases (RDs. OMs are anticipated to be involved as triggers initiating the development of chronic inflammation. Along with this, OMs in autoimmune diseases may play a defensive role through the interaction with Toll-like receptors and the activation of T cells that have suppressor activity. The possible involvement of OMs in the pathogenesis of RDs provides support not only the isolation of microorganisms, but also the detection of antibacterial antibodies of different classes. Of great importance are OMs in the etiology of comorbid infections, the risk of which is due to both the presence of autoimmune RDs and the necessity of using the drugs having immunosuppressive activity. The active clinical introduction of biological agents is followed by a rise in the rate and severity of different infections, including those caused by OMs. Having a marked biological and environmental plasticity, OMs are able to persist long when there are changes in the immune defense of patients with RDs. There is evidence for the higher adhesive properties and persistent potential of the microorganisms that colonize the body of patients with RDs. In the latter, OMs that are distinguished by pronounced antibiotic polyresistance are isolated, making the treatment and prevention of opportunistic infections more difficult in rheumatology. The results of the papers analyzed in the review suggest that the study of OMs in RDs is of practical importance.

  2. Recommendations of the ESSR Arthritis Subcommittee for the Use of Magnetic Resonance Imaging in Musculoskeletal Rheumatic Diseases

    DEFF Research Database (Denmark)

    Sudoł-Szopińska, Iwona; Jurik, Anne Grethe; Eshed, Iris

    2015-01-01

    This article presents the recommendations of the European Society of Musculoskeletal Radiology Arthritis Subcommittee regarding the standards of the use of MRI in the diagnosis of musculoskeletal rheumatic diseases. The recommendations discuss (1) the role of MRI in current classification criteri...... and peripheral joints; (4) MRI interpretation and reporting for axial and peripheral joints; and finally, (5) methods for assessing MR images including quantitative, semiquantitative, and dynamic contrast-enhanced MRI studies....

  3. Contraception for adolescents with chronic rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Benito Lourenço

    Full Text Available ABSTRACT Contraception is an important issue and should be a matter of concern in every medical visit of adolescent and young patients with chronic rheumatic diseases. This narrative review discusses contraception methods in adolescents with juvenile systemic lupus erythematosus (JSLE, antiphospholipid syndrome (APS, juvenile idiopathic arthritis (JIA and juvenile dermatomyositis (JDM. Barrier methods are safe and their use should be encouraged for all adolescents with chronic rheumatic diseases. Combined oral contraceptives (COC are strictly prohibited for JSLE and APS patients with positive antiphospholipid antibodies. Reversible long-acting contraception can be encouraged and offered routinely to the JSLE adolescent patient and other rheumatic diseases. Progestin-only pills are safe in the majority of rheumatic diseases, although the main concern related to its use by adolescents is poor adherence due to menstrual irregularity. Depot medroxyprogesterone acetate injections every three months is a highly effective contraception strategy, although its long-term use is associated with decreased bone mineral density. COC or other combined hormonal contraceptive may be options for JIA and JDM patients. Oral levonorgestrel should be considered as an emergency contraception method for all adolescents with chronic rheumatic diseases, including patients with contraindication to COC.

  4. Histopathologic characterization of lesios in rheumatic valvulopathy

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    R. Ricca

    2010-01-01

    Full Text Available Cardiac valvulopathies may be caused by acquired or congenital diseases and result in valvular stenosis and/or insufficiency. For a correct diagnostic evaluation of cardianc valves, and in particular of rheumatic valvulopathy, pathologists should know the patient's clinical history, the degree of insufficiency and/or stenosis and echographiacal data. Histopathologic features of rheumatic valvulopathy include precocious, tardy and terminal lesions. Rheumatic valvulopathy may produce mitral insufficiency. Mitral valve incompetence has been calssified into three types by echography (Carpentier, 1980. 56 cases of valvular samples have been examinated at our institution from January 2004 to January 2008. Any case was processed according to diagnostic/opeartive protocol we prepared carefully: gross examination, photographic documentation, sampling, standard stains and histochemical special stains. On the basis of the operative diagnostic protocol, histopathologic diagnosis of rheumatic valvulopathy was effected in three cases. Special methods of histochemistry, in addition to hematoxylin and eosin, are fundamental for the differential diagnosis of valvulopathies. Histopathologic diagnosis of rheumatic valvulopathy is complex and requests several histomorphologic data: our operative diagnostic protocol is extremely useful to reach an anatomo-pathologic diagnosis of surgical sample, which constitutes an essential element to confirm preoperative clinical-echographic diagnosis.

  5. Challenges to developing effective streptococcal vaccines to prevent rheumatic fever and rheumatic heart disease

    Directory of Open Access Journals (Sweden)

    Sharma A

    2014-05-01

    Full Text Available Abhinay Sharma, D Patric Nitsche-SchmitzDepartment of Medical Microbiology, Helmholtz Center for Infection Research, Braunschweig, GermanyAbstract: Acute rheumatic fever is a sequela of Streptococcus pyogenes and potentially of Streptococcus dysgalactiae subsp. equisimilis infections. Acute rheumatic fever is caused by destructive autoimmunity and inflammation in the extracellular matrix and can lead to rheumatic heart disease, which is the most frequent cardiologic disease that is acquired in youth. Although effective treatments are available, acute rheumatic fever and rheumatic heart disease remain serious threats to human health, which affect millions and cause high economic losses. This has motivated the search for a vaccine that prevents the causative streptococcal infections. A variety of potential vaccine candidates have been identified and investigated in the past. Today, new approaches are applied to find alternative candidates. Nevertheless, several obstacles lie in the way of an approved S. pyogenes vaccine for use in humans. Herein, a subjective selection of promising vaccine candidates with respect to the prevention of acute rheumatic fever/rheumatic heart disease and safety regarding immunological side effects is discussed.Keywords: autoimmune disease, side effects, M protein vaccine, molecular mimicry, coiled-coil, collagen binding, PARF

  6. EVALUATION OF THE WORKING ABILITIES OF THE PATIENTS SUFFERING FROM RHEUMATISM

    Directory of Open Access Journals (Sweden)

    Jovica Jovanović

    2000-03-01

    Full Text Available The rheumatic diseases are present to a high percentage in the working - active population. There is a great number of professional causes of the diseases as well as specific job's requirements that can unfavorably affect the emergence and the evolution of the rheumatic diseases. The evaluation of the working ability is a procedure that correlates and brings into accord the job's requirements with the morphological- functional state of the engaged systems and of the organs of the exposed worker. This is a very delicate and responsible task aiming at placing the worker at such a job that most corresponds to his psycho-physical characteristics, that is, at a job at which he will best carry out his assigned duties without violating his health. The proper attitude in evaluating the working ability of the rheumatic patients is an important step to be taken in order to prevent the rheumatic disease complications. The removal of the sick worker from the job at which there are some potential professional disease causes as well as the requirements that unfavorably affect the bone-joint, muscular and vascular system of the exposed worker represents an important therapeutic and preventive measure since it can slow down the disease's evolution and thus ease the workers' troubles. The recognition of the professional disease, of the bodily damage and of the right to the care and aid represents an important assistance to the sick worker thus helping him to exert his right concerning the medical, social and disabled protection.

  7. Structure of rheumatic diseases among adult population of Russia according to data of an epidemiological study (preliminary results

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    E A Galushko

    2009-01-01

    Full Text Available Preliminary results of interregional program “Social and economic consequences of rheumatic diseases” diagnostic stage are presented.Objective. Clinical examination of persons with joint pathology revealed during screening to determine the diagnosis.Material and methods. A group of persons, who had joint complaints at the examination or during the previous year, was randomly formed according to the results of screening. Thorough uniform clinical examination with participation of a qualified rheumatologist aimed to precise determination of rheumatic pathology character was performed in all cases. During screening 1755 from 2723 persons examined at diagnostic stage positively answered question about presence of joint swelling and 968 complained of pain in knee and hip joints.Results. In 1971 from 2723 persons (72,4% different rheumatic diseases were diagnosed. Nonrheumatic pathology was revealed in 371 (13,6%, low back pain – in 218 (8% persons. In 163 (6% persons no disease was determined. Osteoarthritis (49% and rheumatoid arthritis (3% were the most frequent causes of joint complaints. Other RD were revealed in 20%.Conclusion. Preliminary results of program diagnostic stage demonstrated significance of joint pathology problem and allowed to get the first data about structure of RD among adult inhabitants of Russia.

  8. Contraception in Patients with Rheumatic Disease.

    Science.gov (United States)

    Sammaritano, Lisa R

    2017-05-01

    Contraception represents an important area of reproductive health for patients with rheumatic diseases given the potential pregnancy risks associated with active disease, teratogenic medications, and severe disease-related damage. A high proportion of patients with rheumatic disease do not use effective contraception. Long-acting contraceptives are most effective. Antiphospholipid-negative patients with stable systemic lupus erythematosus may use oral combined contraceptives. Antiphospholipid-positive patients, or patients with rheumatic disease with other risk factors for thrombosis, should avoid estrogen-containing contraceptives. Contraceptive methods should be addressed by both the rheumatologist and gynecologist to determine the safest, most effective, and most convenient form for each patient. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Valvular aspects of rheumatic heart disease.

    Science.gov (United States)

    Remenyi, Boglarka; ElGuindy, Ahmed; Smith, Sidney C; Yacoub, Magdi; Holmes, David R

    2016-03-26

    Acute rheumatic fever and rheumatic heart disease remain major global health problems. Although strategies for primary and secondary prevention are well established, their worldwide implementation is suboptimum. In patients with advanced valvular heart disease, mechanical approaches (both percutaneous and surgical) are well described and can, for selected patients, greatly improve outcomes; however, access to centres with experienced staff is very restricted in regions that have the highest prevalence of disease. Development of diagnostic strategies that can be locally and regionally provided and improve access to expert centres for more advanced disease are urgent and, as yet, unmet clinical needs. We outline current management strategies for valvular rheumatic heart disease on the basis of either strong evidence or expert consensus, and highlight areas needing future research and development. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Guidelines for the secondary prevention of rheumatic heart disease

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    Abdulrazaq Al-Jazairi

    2017-03-01

    Rheumatic fever and rheumatic heart disease can be prevented with appropriate antibiotics administration to prevent the progression of valve damage. The current use of primary and secondary prevention antibiotics in Saudi Arabia is not known. Therefore, this clinical practice guideline is developed, based on the best available evidence, to promote appropriate antibiotics secondary prophylaxis use for prevention of rheumatic heart disease.

  11. Notification of rheumatic fever in South Africa - evidence for ...

    African Journals Online (AJOL)

    Objective To determine whether under-reporting of rheumatic fever occurs at hospital, municipal, provincial and national levels of the South African health system. Background: Information on the incidence of rheumatic fever (RF) and the prevalence of rheumatic heart disease (RHD) is required for the prevention of valvular ...

  12. Rheumatic diseases presenting as sports-related injuries.

    Science.gov (United States)

    Jennings, Fabio; Lambert, Elaine; Fredericson, Michael

    2008-01-01

    Most individuals seeking consultation at sports medicine clinics are young, healthy athletes with injuries related to a specific activity. However, these athletes may have other systemic pathologies, such as rheumatic diseases, that may initially mimic sports-related injuries. As rheumatic diseases often affect the musculoskeletal system, they may masquerade as traumatic or mechanical conditions. A systematic review of the literature found numerous case reports of athletes who presented with apparent mechanical low back pain, sciatica pain, hip pain, meniscal tear, ankle sprain, rotator cuff syndrome and stress fractures and who, on further investigation, were found to have manifestations of rheumatic diseases. Common systemic, inflammatory causes of these musculoskeletal complaints include ankylosing spondylitis (AS), gout, chondrocalcinosis, psoriatic enthesopathy and early rheumatoid arthritis (RA). Low back pain is often mechanical among athletes, but cases have been described where spondyloarthritis, especially AS, has been diagnosed. Neck pain, another common mechanical symptom in athletes, can be an atypical presentation of AS or early RA. Hip or groin pain is frequently related to injuries in the hip joint and its surrounding structures. However, differential diagnosis should be made with AS, RA, gout, psudeogout, and less often with haemochromatosis and synovial chondochromatosis. In athletes presenting with peripheral arthropathy, it is mandatory to investigate autoimmune arthritis (AS, RA, juvenile idiopathic arthritis and systemic lupus erythematosus), crystal-induced arthritis, Lyme disease and pigmented villonodular synovitis. Musculoskeletal soft tissue disorders (bursitis, tendinopathies, enthesitis and carpal tunnel syndrome) are a frequent cause of pain and disability in both competitive and recreational athletes, and are related to acute injuries or overuse. However, these disorders may occasionally be a manifestation of RA, spondyloarthritis

  13. Renal manifestations of rheumatic diseases. A review.

    Science.gov (United States)

    Horak, Pavel; Smrzova, Andrea; Krejci, Karel; Tichy, Tomas; Zadrazil, Josef; Skacelova, Martina

    2013-06-01

    Renal manifestations of rheumatic diaseases are sometimes very discrete and mild. At others, they can present the leading symptomatology of a given disease. Systemic lupus erythematosus, systemic scleroderma, renal vasculitis, rheumatoid arthritis, mixed connective tissue disease, Sjögren's syndrome and gout can all manifest in or be accompanied by renal impairment. The authors reviewed the literature on renal manifestation of rheumatic diseases using the key words, lupus erythematosus, systemic autoimmune diseases, rheumatoid arthritis, vasculitis and gout. The review below is accompanied by their own histological findings. Diagnosis requires proper interpretation of the clinical situation, laboratory results and image analysis methods plus close interdisciplinary collaboration between nephrologist and clinical pathologist/nephropathologist.

  14. Rheumatic Manifestations in Autoimmune Liver Disease.

    Science.gov (United States)

    Selmi, Carlo; Generali, Elena; Gershwin, Merrill Eric

    2018-02-01

    Autoimmune liver diseases coexist with rheumatic disorders in approximately 30% of cases and may also share pathogenic mechanisms. Autoimmune liver diseases result from an immune-mediated injury of different tissues, with autoimmune hepatitis (AIH) targeting hepatocytes, and primary biliary cholangitis (PBC) and primary sclerosing cholangitis targeting cholangiocytes. Sjogren syndrome is diagnosed in 7% of AIH cases and serologic autoimmunity profiles are a common laboratory abnormality, particularly in the case of serum antimitochondrial (PBC) or anti-liver kidney microsomal antibodies (AIH). Therapeutic strategies may overlap between rheumatic and autoimmune liver diseases and practitioners should be vigilant in managing bone loss. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Cardiac tamponade in acute rheumatic carditis.

    OpenAIRE

    Tan, A T; Mah, P K; Chia, B L

    1983-01-01

    In patients with valvular heart disease, fever, and cardiomegaly echocardiography is an invaluable noninvasive tool. In this report we describe a young female presenting with cardiac tamponade due to acute rheumatic carditis. Echocardiography showed an exudative pericardial effusion which was haemorrhagic on pericardiocentesis. She responded to steroid therapy with resolution of carditis and pericardial effusion.

  16. Recurrent acute rheumatic fever: a forgotten diagnosis?

    Science.gov (United States)

    Kadir, Isaac S; Barker, Thomas A; Clarke, Bernard; Denley, Helen; Grötte, Geir J

    2004-08-01

    The incidence of acute rheumatic fever has seen a dramatic decline over the last 15 to 20 years in most developed countries and treatment of this disease has changed little since. The ease of travel and immigration and the cosmopolitan nature of many cities mean that occasionally the disease will come to the attention of clinicians not familiar with its presentation, resulting in delayed diagnosis and treatment. We present a case of recurrent acute rheumatic fever in a patient who was initially thought to be suffering from acute bacterial endocarditis on her previously diseased rheumatic aortic valve. This culminated in her undergoing urgent aortic valve replacement during a phase of the illness that should have been treated with high dose anti-inflammatory medication. Therefore, clinicians should be aware of this condition and include it in their differential diagnosis of the febrile patient with a previous history of rheumatic fever. We briefly discuss the diagnostic dilemma of patients suffering from this condition and in differentiating it from acute endocarditis.

  17. Perspectives for uveitis treatment in rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Alla Aleksandrovna Godzenko

    2011-01-01

    Full Text Available The paper describes current approaches to treating uveitis in rheumatic diseases and theoretical backgrounds for using tumor necrosis factor-α (TNF-α inhibitors. The data available in the literature suggest that anti-TNF-α therapy is highly effective in relieving and preventing uveitis attacks.

  18. Rheumatic Heart Disease Associated with Secondary Renal ...

    African Journals Online (AJOL)

    of systemic amyloidosis worldwide, AA amyloidosis occurs in the course of chronic inflammatory diseases, hereditary periodic fevers, and with certain neoplasms such as Hodgkin disease and renal cell carcinoma. Amyloidosis due to rheumatic heart disease (RHD) is not common but can be seen. We report here a patient ...

  19. Mycobacterial disease in patients with rheumatic disease.

    NARCIS (Netherlands)

    Ingen, J. van; Boeree, M.J.; Dekhuijzen, P.N.R.; Soolingen, D van

    2008-01-01

    This Review focuses on the emergence of mycobacterial disease in patients undergoing treatment for rheumatic disease with four new drug classes--tumor necrosis factor (TNF) inhibitors, human interleukin (IL)-1 receptor antagonists, anti-CD20 antibodies and CD4(+) T-cell costimulation

  20. The Spanish biology/disease initiative within the human proteome project: Application to rheumatic diseases.

    Science.gov (United States)

    Ruiz-Romero, Cristina; Calamia, Valentina; Albar, Juan Pablo; Casal, José Ignacio; Corrales, Fernando J; Fernández-Puente, Patricia; Gil, Concha; Mateos, Jesús; Vivanco, Fernando; Blanco, Francisco J

    2015-09-08

    The Spanish Chromosome 16 consortium is integrated in the global initiative Human Proteome Project, which aims to develop an entire map of the proteins encoded following a gene-centric strategy (C-HPP) in order to make progress in the understanding of human biology in health and disease (B/D-HPP). Chromosome 16 contains many genes encoding proteins involved in the development of a broad range of diseases, which have a significant impact on the health care system. The Spanish HPP consortium has developed a B/D platform with five programs focused on selected medical areas: cancer, obesity, cardiovascular, infectious and rheumatic diseases. Each of these areas has a clinical leader associated to a proteomic investigator with the responsibility to get a comprehensive understanding of the proteins encoded by Chromosome 16 genes. Proteomics strategies have enabled great advances in the area of rheumatic diseases, particularly in osteoarthritis, with studies performed on joint cells, tissues and fluids. In this manuscript we describe how the Spanish HPP-16 consortium has developed a B/D platform with five programs focused on selected medical areas: cancer, obesity, cardiovascular, infectious and rheumatic diseases. Each of these areas has a clinical leader associated to a proteomic investigator with the responsibility to get a comprehensive understanding of the proteins encoded by Chromosome 16 genes. We show how the Proteomic strategy has enabled great advances in the area of rheumatic diseases, particularly in osteoarthritis, with studies performed on joint cells, tissues and fluids. This article is part of a Special Issue entitled: HUPO 2014. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Radonexposure with the treatment of rheumatic diseases - randomized controlled trials

    Energy Technology Data Exchange (ETDEWEB)

    Falkenbach, A. [Krankenanstalt Gasteiner Heilstollen, Bad Gastein-Boeckstein (Austria)]|[Forschungsinstitut Gastein, Bad Gastein (Austria); Kovac, J.; Brandmaier, P. [Krankenanstalt Gasteiner Heilstollen, Bad Gastein-Boeckstein (Austria); Soto, J. [Dept. of Medical Physics, Univ. of Cantabria (Spain)

    2001-07-01

    The objective was to investigate whether there is evidence for the effectiveness of radon therapy in the treatment of rheumatic diseases. Method: Medline and MedKur databases were searched for randomised controlled clinical trials. Radon therapy centres and experts in the field were contacted, proceedings were hand-searched and bibliographies were checked for references of potential impact. Four clinical trials evaluating the effect of radon in patients suffering from rheumatic diseases with no or only a small number of drop-outs met the inclusion criteria. In patients with degenerative disease of the spine and large joints, two trials [1,2] reported less pain on pressure of painful paraspinal muscle points after a series of radon baths at a concentration of 0.8 kBq/L and 3 kBq/L, respectively. The alleviation of pain was most pronounced in the weeks following the treatment period. [3]. At six months follow-up serial immersion in combined radon and CO{sub 2} baths reduced pain and functional restrictions in patients with rheumatoid arthritis (n=60) more effectively than bathing in CO{sub 2} only. [4] In 130 patients with ankylosing spondylitis a complex rehabilitation program at a health resort (group 1 and 2) showed greater and longer-lasting differences to a control group staying at home (group 3), if speleotherapeutic radon exposure (group 1) was added (as compared to an added sauna treatment, group 2). Conclusion: The four trials meeting the inclusion criteria showed beneficial effects of radon therapy compared to interventions without radon exposure. Up to nine months after the treatment period significantly better results were observed, if radon therapy is added. (orig.)

  2. Cryotherapy in inflammatory rheumatic diseases: a systematic review.

    Science.gov (United States)

    Guillot, Xavier; Tordi, Nicolas; Mourot, Laurent; Demougeot, Céline; Dugué, Benoît; Prati, Clément; Wendling, Daniel

    2014-02-01

    The aim of this article was to review current evidence about cryotherapy in inflammatory rheumatic diseases (therapeutic and biological effects). For therapeutic effects, we performed a systematic review (PubMed, EMBASE, Cochrane Library, LILACS databases, unpublished data) and selected studies including non-operated and non-infected arthritic patients treated with local cryotherapy or whole-body cryotherapy. By pooling 6 studies including 257 rheumatoid arthritis (RA) patients, we showed a significant decrease in pain visual analogic scale (mm) and 28-joint disease activity score after chronic cryotherapy in RA patients. For molecular pathways, local cryotherapy induces an intrajoint temperature decrease, which might downregulate several mediators involved in joint inflammation and destruction (cytokines, cartilage-degrading enzymes, proangiogenic factors), but studies in RA are rare. Cryotherapy should be included in RA therapeutic strategies as an adjunct therapy, with potential corticosteroid and nonsteroidal anti-inflammatory drug dose-sparing effects. However, techniques and protocols should be more precisely defined in randomized controlled trials with stronger methodology.

  3. Management of rheumatic chorea: an observational study

    Directory of Open Access Journals (Sweden)

    Araújo Alexandra Prufer de Queiroz Campos

    2002-01-01

    Full Text Available BACKGROUND: Rheumatic chorea (RC has recently been linked to an antibody-mediated immune mechanism. OBJECTIVE/METHOD: To verify if this knowledge reflected in management changes we conceived a descriptive study. RESULTS: The medical charts of 20 children (13 females aged 6 to 12 years (mean 8 years, diagnosed as RC from June 1996 to June 1999, were reviewed. All patients received some medical treatment. Haloperidol was the most prescribed medication (15 patients - 75 %. Sulpiride, diazepam and valproate were also used as symptomatic treatment. Imune-modulating therapy with prednisone was prescribed for seven children. The shortest course of chorea (16 days occurred in a patient treated with prednisone. CONCLUSION: Prednisone has been prescribed for rheumatic chorea besides the traditional symptomatic approach. A great variety of antichoreic drugs are being employed.

  4. Remission: the goal of rheumatic disease therapy.

    Science.gov (United States)

    Roth, S H

    1982-01-01

    This international symposium is devoted to a discussion of the potential remission-inducing properties of an exciting new agent: auranofin (AF). The definition of remission, however, remains imprecise--meaning "cure" to some and various degrees of improvement to others. The proposed parameters of the ARA Committee for Criteria of Remission in Rheumatoid Arthritis (RA), are compared to physicians' global estimate of disease activity from the ARAMIS (American Rheumatism Association Medical Information System) national rheumatic disease data bank. We report which parameters have corresponded most closely to the suggested criteria for remission of RA. Through such analysis we may be better able to define remission and to determine which patients experience remission during a particular course of therapy.

  5. Fibrositis: Misnomer for a Common Rheumatic Disorder

    OpenAIRE

    Bennett, Robert M.

    1981-01-01

    Fibrositis is a misnomer for a very common form of nonarticular rheumatism. The name implies an inflammatory process in fibroconnective tissue which has never been verified. The symptoms of fibrositis are ill-defined musculoskeletal pain made worse by stress, cold, noise and unaccustomed exercise; there is usually a significant element of depression, nonrestorative sleep, chronic fatigue and early morning stiffness. Results of physical examination are strikingly normal, apart from painful ten...

  6. Fever of unknown origin in rheumatic diseases.

    Science.gov (United States)

    Zenone, Thierry

    2007-12-01

    Noninfectious inflammatory diseases (connective tissue diseases, vasculitis syndromes, granulomatous diseases) emerged as the most frequent cause of fever of unknown origin in western countries. Among these diseases, giant cell arteritis and polymyalgia rheumatica are the most frequent specific diagnosis in the elderly and adult-onset Still's disease the most frequent in younger patients. This article focuses on noninfectious inflammatory diseases as a cause of classic fever of unknown origin (mainly rheumatic diseases, such as vasculitis and connective tissue diseases).

  7. ESOMEPRAZOLE EFFICACY IN TREATMENT OF THE INFLAMMATORY DISEASES OF THE UPPER GASTROINTESTINAL TRACT AMONG CHILDREN, SUFFERING FROM RHEUMATIC DISEASES

    Directory of Open Access Journals (Sweden)

    E.I. Alexeeva

    2007-01-01

    Full Text Available The article deals with the findings of the endoscopic examination and treatment of 80 children, suffering from rheumatic diseases. According to the esophago gastroduodenoscopy data, all the patients turned up to have inflammatory changes in the upper gastrointestinal tract of various degrees of manifestation. Moreover, only 36% of patients complained about pain in the stomach. The application of esomeprazole in the complex therapy contributed to the epithelization of erosive and ulcerous defects and dyspepsia syndrome relief among the majority of the patients. The effects of the complex therapy with esomeprazole were appraised as good among 90% of children and excellent among 9% of patients.Key words: children, rheumatic diseases, esomeprazole, gastrointestinal tract pathology.

  8. Autoimmune rheumatic disease and sleep: a review.

    Science.gov (United States)

    Sangle, Shirish R; Tench, Colin M; D'Cruz, David P

    2015-11-01

    Sleep has an important role to play in the human immune system and it is critical in the restoration and maintenance of homeostasis. Sleep deprivation and disorders may have a profound impact on health, well being and the ability to resist infection. Autoimmune rheumatic diseases are multisystem disorders that involve complicated hormonal and immunological pathophysiology. Previous studies have suggested that sleep deprivation may lead to immunological disturbance in experimental mouse models. Sleep disorders may trigger immune system abnormalities inducing autoantibody production, possibly leading to the development of autoimmune disease such as systemic lupus erythematosus, scleroderma or rheumatoid arthritis. Indeed, in experimental models, it has been suggested that sleep deprivation may induce the onset of autoimmune disease. Chronic deprivation of sleep is common in modern society and has been seen in various autoimmune inflammatory rheumatic diseases. We have reviewed various aspects of sleep deprivation and sleep apnoea syndrome, and their effects on the immune system and their relevance to autoimmune diseases. We hope that these data will encourage greater awareness of the role that improved sleep hygiene may play in the management of these rheumatic diseases.

  9. Epigenetic alterations in autoimmune rheumatic diseases.

    Science.gov (United States)

    Ballestar, Esteban

    2011-05-01

    The potential roles of epigenetic alterations in the pathogenesis of autoimmune rheumatic diseases are raising great expectations among clinicians and researchers. Epigenetic mechanisms regulate gene expression and are sensitive to external stimuli, bridging the gap between environmental and genetic factors. Considerable evidence of epigenetic changes, particularly altered patterns of DNA methylation, exists in diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis. The importance of such changes in the pathology of rheumatic diseases has been demonstrated by examining the relationship between gene-specific methylation and SLE in monozygotic twins discordant for the disease, in whom genetic variability is excluded as a cause for discordance. Several studies have highlighted the importance of the tissue-specificity of DNA methylation changes, an aspect which-in contrast with genetic analysis-must be considered when designing epigenetic studies. Here I discuss the proposed mechanisms and implications of DNA methylation changes in the pathogenesis of autoimmune rheumatic diseases, the prospects for future epigenetic studies in rheumatology, the relevance of specific DNA methylation markers and the potential use of drugs with an epigenetic effect in the clinical management of these diseases.

  10. Resilience in women with autoimmune rheumatic diseases.

    Science.gov (United States)

    Rojas, Manuel; Rodriguez, Yhojan; Pacheco, Yovana; Zapata, Elizabeth; Monsalve, Diana M; Mantilla, Rubén D; Rodríguez-Jimenez, Monica; Ramírez-Santana, Carolina; Molano-González, Nicolás; Anaya, Juan-Manuel

    2017-12-28

    To evaluate the relationship between resilience and clinical outcomes in patients with autoimmune rheumatic diseases. Focus groups, individual interviews, and chart reviews were done to collect data on 188 women with autoimmune rheumatic diseases, namely rheumatoid arthritis (n=51), systemic lupus erythematosus (n=70), systemic sclerosis (n=35), and Sjögren's syndrome (n=32). Demographic, clinical, and laboratory variables were assessed including disease activity by patient reported outcomes. Resilience was evaluated by using the Brief Resilience Scale. Bivariate, multiple linear regression, and classification and regression trees were used to analyse data. Resilience was influenced by age, duration of disease, and socioeconomic status. Lower resilience scores were observed in younger patients (50years) had higher resilience scores regardless of socioeconomic status. There was no influence of disease activity on resilience. A particular behaviour was observed in systemic sclerosis in which patients with high socioeconomic status and regular physical activity had higher resilience scores. Resilience in patients with autoimmune rheumatic diseases is a continuum process influenced by age and socioeconomic status. The ways in which these variables along with exercise influence resilience deserve further investigation. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  11. Rheumatoid arthritis bone erosion volumes on CT and MRI: reliability and correlations with erosion scores on CT, MRI and radiography

    DEFF Research Database (Denmark)

    Møller Døhn, Uffe; Ejbjerg, Bo J; Hasselquist, Maria

    2007-01-01

    OBJECTIVES: To investigate intramodality and intermodality agreements of CT and MRI erosion volumes in metacarpophalangeal (MCP) joints in rheumatoid arthritis (RA), and to compare the volumes with erosion scores for CT, MRI and radiography. METHODS: In total, 17 patients with RA and four healthy...

  12. Clinical significance of erosive azotemic osteodystrophy: a prospective masked study

    Energy Technology Data Exchange (ETDEWEB)

    Falbo, S.E.; Sundaram, M. [Washington Univ., St. Louis, MO (United States). Dept. of Radiology; Ballal, S.; Domoto, D.; Martin, K. [St. Louis Univ., MO (United States). Dept. of Nephrology

    1999-02-01

    Objective. To determine the relationship between joint symptoms and radiographically identifiable erosions in patients on maintenance hemodialysis for 4 or more years. Patients and design. A prospective study was carried out on 21 patients who underwent rheumatological evaluation and radiographic surveys of all clinically examined joints. The radiologist was masked to the clinical information and the clinicians were masked to the radiographic findings. Cuprophane dialyzers were used on all patients. The statistical analysis was performed by unpaired t-test and Fisher`s exact test. Results and conclusions. Ten men and 11 women comprised the 21 patients, of whom 10 had joint symptoms and clinical signs whereas 11 did not. Age, gender, and duration of hemodialysis did not differ significantly between the symptomatic and asymptomatic group. Of the 21 patients, 10 had radiological evidence of erosions and 11 did not. The average age of patients with erosions was 64.9 years; this was significantly different from the age of the group without erosions, which was 54.1 years. The group with radiographic evidence of erosions had been on dialysis for an average of 9.6 years, while those without erosions had received dialysis for an average of 6.4 years. Of the 11 patients without radiographic evidence of erosions, three were symptomatic. Of the 10 patients with erosions, seven had musculoskeletal symptoms, but only in four was there concordance between radiological findings and symptoms of the corresponding joints. The positive predictive value of radiographic erosions in predicting clinically significant disease was 40%. There was poor correlation between the presence of radiographic erosions and clinical signs and symptoms of joint disease. (orig.) With 2 figs., 12 refs.

  13. [From the plant to chemistry--the early history of "rheumatic medication"].

    Science.gov (United States)

    Kaiser, H

    2008-05-01

    The empirical administration of medication of plant, animal and even mineral origin goes back thousands of years. It was only in the 19th century that such therapy gained a scientific basis by means of the possibility to extract the active substances and analyze them chemically, and ultimately create them synthetically and modify them chemically.Meadow saffron was used from the 2nd century BC for the treatment of joint disease and gout; the active ingredient colchicine was discovered in 1819. For 4000 years willow bark has also been considered a remedy against fever, pain and gout. The active ingredient salicin was isolated in 1829, followed by salicyl acid in 1838, while the better tolerated acetylsalicylic acid was synthesized in 1897. Although the antipyretic agent cinchona was never a rheumatic remedy, it was initially considered an important antiinflammatory medication. In 1844, during the search for an alternative to quinin, antipyrin was developed, from which many antiphlogistic, antipyretic and analgetic active substances were later derived. Following the Second World War, the strongest antiinflammatory drug, cortisone, was discovered, derivates of which are still indispensable today for the treatment of inflammatory rheumatic diseases. At about the same time, there was a new wave of research which lead to the development of a large number of so-called non-steroidal antiinflammatory drugs. Following the discovery of proinflammatory cytokines in the 1970s, it became possible in the 1990s to produce antibodies against these substances, which gave rheumatic therapy new perspectives in the form of "biologicals". The sap from poppy seed capsules was already considered to have analgesic properties in the time of Hippocrates. The active ingredient morphine was isolated at the beginning of the 19th century. Today, only synthetically produced"opioids" are used, if at all, for the treatment of rheumatic disease.

  14. Emergency wind erosion control

    Science.gov (United States)

    February through May is the critical time for wind erosion in Kansas, but wind erosion can happen any time when high winds occur on smooth, wide fields with low vegetation and poor soil structure. The most effective wind erosion control is to ensure a protective cover of residue or growing crop thro...

  15. Erosion and Errors

    NARCIS (Netherlands)

    Huisman, H.; Heeres, Glenn; Os, van Bertil; Derickx, Willem; Schoorl, J.M.

    2016-01-01

    Slope soil erosion is one of the main threats to archaeological sites. Several methods were applied to establish the erosion rates at archaeological sites. Digital elevation models (DEMs) from three different dates were used. We compared the elevations from these three models to estimate erosion. We

  16. Evaluation of Frequency and Risk Factors of Soft Tissue Rheumatism of Upper Limbs in Diabetic Patients in Kerman in 2001

    Directory of Open Access Journals (Sweden)

    M.R. Shakibi

    2003-10-01

    Full Text Available Diabetes mellitus is a metabolic disorder that affect different systems in human. Wide range of musculoskeletal syndromes have been described in association with diabetes. To determine the prevalence of upper limb soft tissue rheumatism in diabetes patients. In a cross sectional study 300 diabetic patients was examined by COPCORD questionnaire. The examination was performed by internist and rheumatologist . Data was analyzed by logistic regression. 73.3% of patients were female. Average age of cases was 51.2±13.7 years and mean of duration of disease was 7±6.4 years. 152 cases (50.7% had soft tissue rheumatism in upper limbs. 66 cases had carpal tannel syndrome, 23 cases with Dupuytren’s disease, 23 cases with Flexortenosynovitis, 91 cases with shoulder periarthritis, 4 cases had limited joint mobility and 12 had Elbow Epicandititis. Logestic regression analysis showed that type 2 diabetes, weak control of blood sugur and duration of disease>5years were risk factors for incidence of soft tissue rheumatism in upper limbs. Results have showed the high prevalence of soft tissue rheumatism in diabetic patients.

  17. factors that precipitate heart failure among children with rheumatic

    African Journals Online (AJOL)

    2011-11-11

    Nov 11, 2011 ... heart disease. Design: A descriptive cross-sectional study. Setting: Paediatric wards at the Moi Teaching and Referral Hospital. Subjects: Children with Rheumatic heart disease admitted for ... disease which is a chronic valvular heart disease that ... Clinical diagnosis of rheumatic heart disease and cardiac.

  18. Clinical and echocardiographic features of children with rheumatic ...

    African Journals Online (AJOL)

    Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) constitute important public health problems in developing countries. Children with ARF and RHD seen at ... RHD is manifested with severe valvular lesions and a high TNF alpha indicating and ongoing inflammation. Pan African Medical Journal 2012; 13:36 ...

  19. Factors that precipitate heart failure among children with rheumatic ...

    African Journals Online (AJOL)

    Objective: To identify factors that precipitates heart failure in children with rheumatic heart disease. Design: a descriptive cross-sectional study. Setting: Paediatric wards at the Moi Teaching and Referral Hospital. Subjects: Children with Rheumatic heart disease admitted for in-patient care due to decompensated heart ...

  20. Barriers to effective patient management with chronic rheumatic ...

    African Journals Online (AJOL)

    PAF User

    More research is therefore required to enhance our understanding of the barriers patients encounter when seeking care in order to improve access to services and sustain follow-up treatment. The objective of this ... METHODS: Using the principles of grounded theory, 20 patients with rheumatic fever/rheumatic heart disease.

  1. Echocardiographic patterns of juvenile rheumatic heart disease at ...

    African Journals Online (AJOL)

    Objective: To describe the echocardiographic features of children with rheumatic heart disease seen at the Kenyatta National Hospital. Design: A retrospective study. Setting: The Kenyatta National Hospital Heart Unit. Subjects: Patients aged 20 years and less with echocardiographic diagnosis of rheumatic heart disease.

  2. Hidden bone erosions

    Directory of Open Access Journals (Sweden)

    F. Salaffi

    2011-09-01

    Full Text Available The aim of this pictorial essay was to demonstrate the diagnostic efficacy of high-resolution sonography in detecting bone erosions in a patient with rheumatoid arthritis. Standard X-Ray of the feet did not reveal clearly evident erosions. Ultrasonography was able to detect the presence of bone erosions of the metatarsal heads of both the first toes and of the V toe of the left foot. Because the appearance of bone erosions on radiographs of a patient with a recent onset arthritis indicates a poor prognosis, the possibility of demonstrating small hidden erosions at the level of the early targets of the disease is of relevant practical value.

  3. Endothelial dysfunction in rheumatic autoimmune diseases.

    Science.gov (United States)

    Murdaca, Giuseppe; Colombo, Barbara Maria; Cagnati, Paola; Gulli, Rossella; Spanò, Francesca; Puppo, Francesco

    2012-10-01

    Rheumatic autoimmune diseases have been associated with accelerated atherosclerosis and various types of vasculopathies. Atherosclerosis is an inflammatory condition which starts as a "response to injury" favoring endothelial dysfunction which is associated with increased expression of adhesion molecules, pro-inflammatory cytokines, pro-thrombotic factors, oxidative stress upregulation and abnormal vascular tone modulation. Endothelial dysfunction in rheumatic autoimmune diseases involves innate immune responses, including macrophages and dendritic cells expression of scavenger and toll-like receptors for modified or native LDL as well as neutrophil and complement activation, and dysregulation of adaptive immune responses, including proliferation of autoreactive T-helper-1 lymphocytes and defective function of dendritic and regulatory T cells. Specific differences for endothelial function among different disorders include: a) increased amounts of pro-atherogenic hormones, decreased amounts of anti-atherogenic hormones and increased insulin resistance in rheumatoid arthritis; b) autoantibodies production in systemic lupus erythematosus and antiphospholipid syndrome; c) smooth muscle cells proliferation, destruction of internal elastic lamina, fibrosis and coagulation and fibrinolytic system dysfunction in systemic sclerosis. Several self-antigens (i.e. high density lipoproteins, heat shock proteins, β2-glycoprotein1) and self-molecules modified by oxidative events (i.e. low density lipoproteins and oxidized hemoglobin) have been identified as targets of autoimmune responses. Endothelial dysfunction leads to accelerated atherosclerosis in rheumatoid arthritis, systemic lupus erythematosus and spondyloarthropaties whereas obliterative vasculopathy is associated with systemic sclerosis. In this paper, we will briefly review the most relevant information upon endothelial dysfunction and inflammatory mechanisms in atherosclerosis and we will summarize the similarities

  4. Complementary and alternative medicine for rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Teng Sophia

    2016-08-01

    Full Text Available The use of complementary and alternative medicine is not uncommonly encountered in our patients. This manuscript reviewed the latest evidence on other modalities in treating rheumatic diseases. Treatments that are found to be helpful for rheumatoid arthritis include herbs, fish oil, and acupuncture. Fish oil, vitamin D, N-acetylcysteine, and cognitive behavior treatments are helpful for systemic lupus erythematosus. Hydrotherapy and massage are potentially beneficial for fibromyalgia patients. Diet supplement is not found to be beneficial for osteoarthritis. CAM modalities will need further studies.

  5. Rainfall Erosivity in Europe

    DEFF Research Database (Denmark)

    Panagos, Panos; Ballabio, Cristiano; Borrelli, Pasquale

    2015-01-01

    Rainfall is one the main drivers of soil erosion. The erosive force of rainfall is expressed as rainfall erosivity. Rainfall erosivity considers the rainfall amount and intensity, and is most commonly expressed as the Rfactor in the USLE model and its revised version, RUSLE. At national...... and continental levels, the scarce availability of data obliges soil erosion modellers to estimate this factor based on rainfall data with only low temporal resolution (daily, monthly, annual averages). The purpose of this study is to assess rainfall erosivity in Europe in the form of the RUSLE R-factor, based....... Gaussian Process Regression (GPR) has been used to interpolate the R-factor station values to a European rainfall erosivity map at 1 km resolution. The covariates used for the R-factor interpolation were climatic data (total precipitation, seasonal precipitation, precipitation of driest/wettest months...

  6. Towards a Vaccine Against Rheumatic Fever

    Directory of Open Access Journals (Sweden)

    L. Guilherme

    2006-01-01

    Full Text Available Rheumatic fever (RF is an autoimmune disease which affects more than 20 million children in developing countries. It is triggered by Streptococcus pyogenes throat infection in untreated susceptible individuals. Carditis, the most serious manifestation of the disease, leads to severe and permanent valvular lesions, causing chronic rheumatic heart disease (RHD. We have been studying the mechanisms leading to pathological autoimmunity in RF/RHD for the last 15 years. Our studies allowed us a better understanding of the cellular and molecular pathogenesis of RHD, paving the way for the development of a safe vaccine for a post-infection autoimmune disease. We have focused on the search for protective T and B cell epitopes by testing 620 human blood samples against overlapping peptides spanning 99 residues of the C-terminal portion of the M protein, differing by one amino acid residue. We identified T and B cell epitopes with 22 and 25 amino acid residues, respectively. Although these epitopes were from different regions of the C-terminal portion of the M protein, they showed an identical core of 16 amino acid residues. Antibodies against the B cell epitope inhibited bacterial invasion/adhesion in vitro. Our results strongly indicated that the selected T and B cell epitopes could potentially be protective against S. pyogenes.

  7. KONSUPREN IN THETHERAPY OF RHEUMATIC DISEASES

    Directory of Open Access Journals (Sweden)

    Z S Alekberova

    2001-01-01

    Full Text Available Summary Aim: to assess the efficacy and tolerability of Consupren (Galena, Chekia in some rheumatic diseases. Material and methods. Three months’ therapy by Consupren was studied in 12 patients: 4 with SLE, 4 with Behcet’s disease, 2 with rheumatoid arthritis with systemic manifestations, 2 with juvenile rheumatoid arthritis. Sandimmune therapy was changed for Consupren in 9 patients. All patients were controlled for the level of serum creatinine and AD and had consultations with ophtalmologist. Results. 3 SLE patients treated by Consupren demonstrated decreasing of proteinuria, disease activity by SLAM and SLEDA1, the fourth patient demonstrated fading of diskoid rash and normalizing of temperature. Patients with Behcet’s disease had no episodes of ulcerous stomatitis and uveitis exacerbation, in one patient stable nodular erythema disappeared. Patients with JRA improved articular syndrome, normalized temperature, reduced acute phase indices. Both patients continue taking Consupren, RA patients had long term of onset of the disease and 111-IV radiological stage , thus the effect on the articular syndrome was not so demonstrative but the activity of the disease reduced. Conclusion: consupren is effective and well tolerable drug for patients with systemic manifestations of rheumatic diseases. No side effects were noticed.

  8. Gene polymorphisms of TNF-α and IL-10 related to rheumatic heart ...

    African Journals Online (AJOL)

    Background: Rheumatic fever (RF) is inherited as a single recessive gene. Several genes are Likely to predispose an individual to develop rheumatic fever and rheumatic heart disease (RHD). Polymorphisms of TNF-α gene were associated with susceptibility to develop RF.T cells from all rheumatic fever patients produce ...

  9. Microanatomic studies to define predictive factors for the topography of periarticular erosion formation in inflammatory arthritis

    DEFF Research Database (Denmark)

    McGonagle, Dennis; Tan, Ai Lyn; Møller Døhn, Uffe

    2009-01-01

    OBJECTIVE: The microanatomic basis for formation of erosions in inflammatory arthritis is incompletely understood but is thought to be related to bare areas and the associated cartilage-synovium junction. The purpose of this study was to test the hypothesis that erosion-prone sites are associated...... with microdamage in macroscopically normal joints. METHODS: Histologic evaluation of erosion-prone sites was performed on 20 collateral ligaments (CLs) from the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of 5 normal cadavers. In addition, the MCP joints (n = 17) and PIP joints (n = 3...

  10. Autoimmune vitiligo in rheumatic disease in the mestizo Mexican population

    Science.gov (United States)

    Avalos-Díaz, Esperanza; Pérez-Pérez, Elena; Rodríguez-Rodríguez, Mayra; Pacheco-Tovar, María-Guadalupe; Herrera-Esparza, Rafael

    2016-01-01

    Vitiligo is a chronic disease characterized by the dysfunction or destruction of melanocytes with secondary depigmentation. The aim of the present study was to determine the prevalence of vitiligo associated with autoimmune rheumatic diseases. The clinical records from a 10-year database of patients with rheumatic diseases and associated vitiligo was analysed, with one group of patients having autoimmune rheumatic disease and another non-autoimmune rheumatic disease. Available serum samples were used to assess the anti-melanocyte antibodies. A total of 5,251 individual clinical files were archived in the last 10 years, and these patients underwent multiple rheumatology consultations, with 0.3% of the group presenting with vitiligo. The prevalence of vitiligo in the autoimmune rheumatic disease group was 0.672%, which was mainly associated with lupus and arthritis. However, patients with more than one autoimmune disease had an increased relative risk to develop vitiligo, and anti-melanocyte antibodies were positive in 92% of these patients. By contrast, the prevalence was 0.082% in the group that lacked autoimmune rheumatic disease and had negative autoantibodies. In conclusion, the association between vitiligo and autoimmune rheumatic diseases was relatively low. However, the relative risk increased when there were other autoimmune comorbidities, such as thyroiditis or celiac disease. Therefore, the presence of multiple autoimmune syndromes should be suspected. PMID:27446537

  11. Clinical Characteristics of Nocardia Infection in Patients with Rheumatic Diseases

    Science.gov (United States)

    Yamagata, Mieko; Hirose, Koichi; Ikeda, Kei; Nakajima, Hiroshi

    2013-01-01

    Although Nocardiosis has considerable recurrence and mortality rates, characteristics and risk factors of Nocardia infection have not been assessed in patients with rheumatic diseases. Here, we examined the characteristics and risk factors of Nocardia infection in rheumatic disease patients in our hospital. Ten rheumatic disease patients who developed Nocardia infection were identified by retrospectively reviewing the medical records. Possible predisposing factors for Nocardia infection were high-dose glucocorticoid treatment, concomitant use of immunosuppressants, preexisting pulmonary diseases, and diabetes mellitus. All patients had pulmonary Nocardiosis, and six of them had disseminated Nocardiosis when their pulmonary lesions were identified. PMID:24171035

  12. Septic arthritis and acute rheumatic fever in children: the diagnostic value of serological inflammatory markers.

    Science.gov (United States)

    Mistry, Raakhi M; Lennon, Diana; Boyle, Matthew J; Chivers, Karel; Frampton, Chris; Nicholson, Ross; Crawford, Haemish

    2015-01-01

    Joint pain and raised inflammatory markers are features of both acute rheumatic fever (ARF) and septic arthritis, often posing a diagnostic challenge to clinicians. Important differences in the presenting serological inflammatory marker profile may assist patient diagnosis, however, as clinical experience suggests that ARF is associated with a higher erythrocyte sedimentation rate (ESR), whereas other serological markers may be similarly elevated in these 2 conditions. The goal of this study was to determine the diagnostic value of serological inflammatory markers and white cell count (WCC) in children presenting with acute joint pain secondary to ARF or septic arthritis. Data were obtained from the Auckland regional rheumatic fever database and hospital computer records between 2005 and 2012. Records of all patients under the age of 16 years who were admitted with a new diagnosis of ARF or septic arthritis were analyzed. The diagnosis of ARF was defined on the basis of the New Zealand modification of the Jones Criteria, and the diagnosis of septic arthritis was defined on the basis of joint fluid cytology and culture. Baseline characteristics, serological inflammatory markers, and serum WCC were compared between the ARF and septic arthritis patient groups. Children with ARF displayed significantly higher ESR, higher serum C-reactive protein, and lower serum WCC than children with septic arthritis on presentation to hospital. In children presenting with monoarthritis, an ESR>64.5, serum WCCmedication before hospital presentation, and 74% of these children (25/34) had abnormal echocardiograms on admission. ARF and septic arthritis are important diagnoses to consider in children presenting with acute joint pain in New Zealand. A significant proportion of patients with ARF initially present with acute monoarthritis. Serological inflammatory markers and WCC on presentation differ significantly between children with ARF and septic arthritis.

  13. Protection from erosion following wildfire

    Science.gov (United States)

    Peter R. Robichaud; William J. Elliot

    2006-01-01

    Erosion in the first year after a wildfire can be up to three orders of magnitude greater than the erosion from undisturbed forests. To mitigate potential postfire erosion, various erosion control treatments are applied on highly erodible areas with downstream resources in need of protection. Because postfire erosion rates generally decline by an order of magnitude for...

  14. Rheumatic effects of vibration at work

    Science.gov (United States)

    Palmer, Keith T; Bovenzi, Massimo

    2016-01-01

    Occupational exposures to vibration come in many guises and are very common at a population level. It follows that an important minority of working-aged patients seen by medical services will have been exposed to this hazard of employment. Vibration can cause human health effects which may manifest in the patients that rheumatologists see. In this chapter we identify the health effects of relevance to them, and review their epidemiology, pathophysiology, clinical presentation, differential diagnosis, and vocational and clinical management. On either side of this, we describe the nature and assessment of the hazard, the scale and common patterns of exposure to vibration in the community, and the legal basis for controlling health risks, and comment on the role of health surveillance in detecting early adverse effects and what can be done to prevent the rheumatic effects of vibration at work. PMID:26612239

  15. Refractory Rheumatic Disorder: Atypical Postpregnancy Osteoporosis

    Directory of Open Access Journals (Sweden)

    Cindy Mourgues

    2015-01-01

    Full Text Available This is a case report on a young patient with severe osteoporosis that was initially revealed when she presented with polyarthralgia during her second pregnancy. Postpartum, the pain increased and her X-ray did not show any abnormalities. A bone scintigraphy was performed. It indicated an inflammatory rheumatic disorder. Six months after partum, an investigation of right coxalgia revealed a spontaneous basicervical fracture. Given the persistent polyarthralgia, the patient underwent a new scintigraphy, which revealed areas of what looked to be old rib and L1 fractures. A subsequent full body magnetic resonance imaging (MRI scan revealed signal abnormalities that could indicate multiple lower limb bone fractures. Despite exhaustive biological, radiological, and histological testing, no secondary cause for the osteoporosis was found. The patient was started on teriparatide. We finally concluded that, despite the atypical presentation, the patient was suffering from postpregnancy osteoporosis. It is possible that the frequency of occurrence of this still poorly understood disease is underestimated.

  16. Calprotectin in rheumatic diseases: a review.

    Science.gov (United States)

    Kopeć-Mędrek, Magdalena; Widuchowska, Małgorzata; Kucharz, Eugeniusz J

    2016-01-01

    Calprotectin also known as MRP8/14 or S100A8/A9 is a heterodimeric complex of two S100 calcium-binding proteins: myeloid-related protein 8 (MRP-8 or S100A8) and MRP-14 (or S100A9). At present, according to many authors, it is considered that calprotectin MRP8/14 is a potentially more sensitive biomarker of disease activity in rheumatoid disease than conventional inflammatory indices such as the erythrocyte sedimentation rate, C-reactive protein and others. A review of the literature on concentration of calprotectin in patients with some rheumatic diseases (rheumatoid arthritis, juvenile idiopathic arthritis, adult-onset Still's disease, systemic vasculitis, polymyalgia rheumatica, ankylosis spondylitis, systemic lupus erythematosus, and primary Sjögren's syndrome) is presented.

  17. Defensins: Potential Effectors in Autoimmune Rheumatic Disorders

    Directory of Open Access Journals (Sweden)

    Stefan Vordenbäumen

    2011-08-01

    Full Text Available Defensins are small cationic peptides with antimicrobial properties. They constitute a highly conserved innate immune defense mechanism across species. Based on the arrangement of disulfide-bonds, α- and β-defensins are distinguished in humans. Both types of defensin comprise several distinct molecules that are preferentially expressed at epithelial surfaces and in blood cells. In the last decade, multiple immunomodulatory functions of defensins have been recognized, including chemotactic activity, the promotion of antigen presentation, and modulations of proinflammatory cytokine secretion. These findings suggested a role for defensins not only as a first line of defense, but also as connectors of innate and adaptive immune responses. Recently, increasingly accumulating evidence has indicated that defensins may also be involved in the pathogenesis of autoimmune rheumatic disorders such as systemic lupus erythematosus and rheumatoid arthritis. The current review summarizes the data connecting defensins to autoimmunity.

  18. Primary prevention of acute rheumatic fever and rheumatic heart disease with penicillin in South African children with pharyngitis: a cost-effectiveness analysis

    National Research Council Canada - National Science Library

    Irlam, James; Mayosi, Bongani M; Engel, Mark; Gaziano, Thomas A

    2013-01-01

    .... We describe a cost-effective analysis of 7 strategies for the primary prevention of acute rheumatic fever and rheumatic heart disease in children presenting with pharyngitis in urban primary care...

  19. [Therapeutic strategies in erosive digital polyarthrosis].

    Science.gov (United States)

    Sahinbegovic, E; Schett, G

    2011-06-01

    One of the most common forms of osteoarthritis is hand osteoarthritis. A subgroup, termed erosive hand osteoarthritis (EHOA), shows a highly destructive disease course with involvement of multiple joints, swelling as well as cartilage and bone destruction leading to progressive loss of hand function. EHOA is characterized by subchondral erosions of the finger joints as well as ankylosis. No disease modifying therapy is currently available for the treatment of EHOA and treatment options are confined to the control of symptoms. Acetaminophen and non-steroidal anti-inflammatory drugs are used to treat the signs and symptoms. So far cytokine blocking agents have not shown a convincing therapeutic effect and the effect size of chondroitin sulfate and bisphosphonates in EOHA is small.

  20. Saliva and dental erosion

    Directory of Open Access Journals (Sweden)

    Marília Afonso Rabelo Buzalaf

    2012-10-01

    Full Text Available Dental erosion is a multifactorial condition. The consideration of chemical, biological and behavioral factors is fundamental for its prevention and therapy. Among the biological factors, saliva is one of the most important parameters in the protection against erosive wear. Objective: This review discusses the role of salivary factors on the development of dental erosion. Material and Methods: A search was undertaken on MeDLINe website for papers from 1969 to 2010. The keywords used in the research were "saliva", "acquired pellicle", "salivary flow", "salivary buffering capacity" and "dental erosion". Inclusion of studies, data extraction and quality assessment were undertaken independently and in duplicate by two members of the review team. Disagreements were solved by discussion and consensus or by a third party. Results: Several characteristics and properties of saliva play an important role in dental erosion. Salivary clearance gradually eliminates the acids through swallowing and saliva presents buffering capacity causing neutralization and buffering of dietary acids. Salivary flow allows dilution of the acids. In addition, saliva is supersaturated with respect to tooth mineral, providing calcium, phosphate and fluoride necessary for remineralization after an erosive challenge. Furthermore, many proteins present in saliva and acquired pellicle play an important role in dental erosion. Conclusions: Saliva is the most important biological factor affecting the progression of dental erosion. Knowledge of its components and properties involved in this protective role can drive the development of preventive measures targeting to enhance its known beneficial effects.

  1. Saliva and dental erosion

    Science.gov (United States)

    BUZALAF, Marília Afonso Rabelo; HANNAS, Angélicas Reis; KATO, Melissa Thiemi

    2012-01-01

    Dental erosion is a multifactorial condition. The consideration of chemical, biological and behavioral factors is fundamental for its prevention and therapy. Among the biological factors, saliva is one of the most important parameters in the protection against erosive wear. Objective This review discusses the role of salivary factors on the development of dental erosion. Material and Methods A search was undertaken on MEDLINE website for papers from 1969 to 2010. The keywords used in the research were "saliva", "acquired pellicle", "salivary flow", "salivary buffering capacity" and "dental erosion". Inclusion of studies, data extraction and quality assessment were undertaken independently and in duplicate by two members of the review team. Disagreements were solved by discussion and consensus or by a third party. Results Several characteristics and properties of saliva play an important role in dental erosion. Salivary clearance gradually eliminates the acids through swallowing and saliva presents buffering capacity causing neutralization and buffering of dietary acids. Salivary flow allows dilution of the acids. In addition, saliva is supersaturated with respect to tooth mineral, providing calcium, phosphate and fluoride necessary for remineralization after an erosive challenge. Furthermore, many proteins present in saliva and acquired pellicle play an important role in dental erosion. Conclusions Saliva is the most important biological factor affecting the progression of dental erosion. Knowledge of its components and properties involved in this protective role can drive the development of preventive measures targeting to enhance its known beneficial effects. PMID:23138733

  2. Erosion Negril Beach

    NARCIS (Netherlands)

    Ten Ham, D.; Henrotte, J.; Kraaijeveld, R.; Milosevic, M.; Smit, P.

    2006-01-01

    The ongoing erosion of the Negril Beach has become worse the past decade. In most places along the coast line, the beach will be gone in approximately 10 years. This will result in a major decrease of incomes that are made by the local tourist sector. To prevent the erosion this study has been

  3. OCT inspection of degenerative and rheumatic tendinous cords

    Science.gov (United States)

    Real, Eusebio; Revuelta, José M.; Pontón, Alejandro; Calvo-Díez, Marta; López-Higuera, José M.; Conde, Olga M.

    2017-07-01

    Surgical repair of the mitral valve complex presents high mortality rates, strongly dependent on the surgical procedure. Intensity and polarization sensitive OCT are explored as a feasible degradation inspection method for rheumatic and degenerative chords.

  4. Practice of ultrasound-guided arthrocentesis and joint injection, including training and implementation, in Europe: results of a survey of experts and scientific societies.

    LENUS (Irish Health Repository)

    Mandl, Peter

    2012-01-01

    To document the practice and training opportunities of US-guided arthrocentesis and joint injection (UGAJ) among rheumatologists in the member countries of the European League Against Rheumatism (EULAR).

  5. [Pharmacotherapy in pregnancy and lactation in rheumatic diseases].

    Science.gov (United States)

    Anić, Branimir; Cikes, Nada

    2006-01-01

    The specific pharmacotherapy in pregnant women is of great importance in chronic inflammatory rheumatic diseases. Before every potential pregnancy or afterwards the knowledge of pregnancy of women with inflammatory rheumatic disease, it is necessary to evaluate the pregnancy risk for patient and child. The purpose of this review is to give concise informations about the most frequent used drugs in rheumatology and their use in pregnancy and lactation.

  6. Complete Atrioventricular Block in an Adolescent With Rheumatic Fever

    OpenAIRE

    Yoo, Gyeong-Hee

    2009-01-01

    Rheumatic fever is an acute inflammatory sequela following a group A, ?-hemolytic streptococcal infection. Rheumatic fever is characterized by polyarthritis, carditis, chorea, subcutaneous nodules, and erythema marginatum as the major diagnostic criteria. Rarely, advanced heart block may also occur. A 13-year-old boy was admitted to the Pediatric Department for evaluation and management of complete atrioventricular block. The patient had exertional dyspnea for 1 month. Based on the findings o...

  7. Parvovirus B19 infections serological diagnostics in rheumatic diseases

    Directory of Open Access Journals (Sweden)

    L P Ananjeva

    2005-01-01

    Full Text Available Objective. To study contamination with parvovirus B19 of a group of patients with rheumatic diseases (RD. Methods. 77 pts with RD (mean age 42,5 years, 79% female admitted to Institute of Rheumatology of RAMS were examined. 34 of them had rheumatoid arthritis (RA, 11 - systemic lupus erythematosus (SLE and Sjogren's disease (SD, 15 with osteoarthritis (OA and seronegative spondyloarthritides (SS and 17 with early (before a year undifferentiated arthritis (EUA. Quantitative determination of IgM and IgG serum antibodies to parvovirus BI9 was performed by I FA with IBL kits (Hamburg, Germany. Results. Anti-B19 IgG antibodies were found in 52% of pts, IgM antibodies - only in one case. Mean antibodies values in pts with RD of disease duration less then 6 months were significantly higher then in pts with longer disease duration (21,5+36 U/ml and 8,4+14.7 U/ml respectively, p<0,05. Anti-B 19 antibodies were present in 62% of pts with RA, 53% of pts with EUA, 45% of pts with SD, 33% of pts with OA and SS. High levels of antibodies (4-10 times higher positivity threshold were revealed in 13 pts with different RD with short duration of joint syndrome (6,3±7,6 months and fever at presentation. A case of B19 parvovirus infection in a boy of 3 years age accompanied by symptoms of Still's disease is described.

  8. Optimised, low cost, low field dedicated extremity MRI is highly specific and sensitive for synovitis and bone erosions in rheumatoid arthritis wrist and finger joints: comparison with conventional high field MRI and radiography

    DEFF Research Database (Denmark)

    Ejbjerg, B.J; Narvestad, E; Jacobsen, S

    2005-01-01

    were performed. In an initial low field MRI 'sequence selection phase', based on a subset of 10 patients and 10 controls, sequences for comparison with high field MRI were selected. RESULTS: With high field, spin echo MRI considered as the reference method, the sensitivity, specificity, and accuracy...... of low field 3D gradient echo MRI for erosions were 94%, 93%, 94%, while the corresponding values for x ray examination were 33%, 98%, and 83%. Sensitivity, specificity, and accuracy of low field MRI for synovitis were 90%, 96%, and 94%, and for bone marrow oedema 39%, 99%, and 95%. Intraclass......, specificity is high, but sensitivity only moderate. Low cost, patient compliant, low field dedicated extremity MRI provides similar information on bone erosions and synovitis as expensive high field MRI units...

  9. Patient views on the management of rheumatic fever and rheumatic heart disease in the Kimberley: a qualitative study.

    Science.gov (United States)

    Mincham, Christine M; Toussaint, Sandy; Mak, Donna B; Plant, Aileen J

    2003-12-01

    To describe, from a patient perspective, factors leading to suboptimal management of individuals with rheumatic fever (RF) and rheumatic heart disease (RHD) among members of the Kimberley population. Qualitative in-depth semistructured and repeated interviews of seven Kimberley patients, or parents of children, with rheumatic fever and/or rheumatic heart disease, during 1998. Participants showed variable levels of understanding about RF/RHD, often relating to the need for secondary prophylaxis. Compliance with medication was closely linked with positive patient-staff interactions. From the perspective of health care, living in a remote location was frequently described as a negative influence. Participants desire more accessible and culturally appropriate opportunities for learning about their disease. Participants focused on issues closely related to effective and ineffective management of RF/RHD. The lessons learned are indicators for health staff attempting to improve the quality of management that people receive.

  10. Erosive osteoarthritis: a more severe form of radiographic hand osteoarthritis rather than a distinct entity?

    Science.gov (United States)

    Marshall, Michelle; Nicholls, Elaine; Kwok, Wing-Yee; Peat, George; Kloppenburg, Margreet; van der Windt, Danielle; Myers, Helen; Dziedzic, Krysia

    2015-01-01

    Objectives To determine whether erosive osteoarthritis shares the same pattern of joint involvement and risk profile as increasing grades of non-erosive hand osteoarthritis. Methods Participants were from two population-based cohorts, aged ≥50 years, reporting hand symptoms in the previous month. Interphalangeal joints were assessed for erosive osteoarthritis (Verbruggen–Veys erosive or remodelled phase) and radiographic osteoarthritis (sliding cut-offs of K&L≥2, K&L≥3 and K&L=4). At the joint level, similarities in the frequency and pattern of erosive and non-erosive osteoarthritis were assessed by Spearman's rank correlation coefficients and generalised estimating equations. At the person level, individuals with erosive osteoarthritis were compared to those with non-erosive osteoarthritis using logistic regression, adjusted for age and gender (aOR), for the following exposures: family history, previous injury, overuse and metabolic factors (BMI, dyslipidaemia, hypertension, diabetes). Results In 1076 symptomatic participants the ranked frequency of involvement for erosive joints was comparable to joints with K&L≥3 and K&L=4 (r>0.95). Patterns of joint involvement in erosive osteoarthritis were strongest for symmetry (aOR=6.5; 95% CI 3.0 to 14.1), followed by row (2.0; 0.8 to 5.0) and ray (0.3; 0.0 to 2.5), which was similar to joints with K&L≥3 and K&L=4. Individuals with erosive osteoarthritis (n=80) had an increased risk of metabolic syndrome (2.7; 1.0 to 7.1), notably dyslipidaemia (4.7; 2.1 to 10.6) compared with non-erosive osteoarthritis classed K&L≥3 (n=193). Conclusions The similar frequency of radiographic joint involvement and patterning in erosive osteoarthritis and more severe non-erosive osteoarthritis is consistent with prevalent erosive osteoarthritis being a severe form of hand osteoarthritis rather than a distinct entity. Metabolic exposures, dyslipidaemia in particular, may be implicated in erosive osteoarthritis. PMID:24095935

  11. Erosive osteoarthritis: a more severe form of radiographic hand osteoarthritis rather than a distinct entity?

    Science.gov (United States)

    Marshall, Michelle; Nicholls, Elaine; Kwok, Wing-Yee; Peat, George; Kloppenburg, Margreet; van der Windt, Danielle; Myers, Helen; Dziedzic, Krysia

    2015-01-01

    To determine whether erosive osteoarthritis shares the same pattern of joint involvement and risk profile as increasing grades of non-erosive hand osteoarthritis. Participants were from two population-based cohorts, aged ≥50 years, reporting hand symptoms in the previous month. Interphalangeal joints were assessed for erosive osteoarthritis (Verbruggen-Veys erosive or remodelled phase) and radiographic osteoarthritis (sliding cut-offs of K&L≥2, K&L≥3 and K&L=4). At the joint level, similarities in the frequency and pattern of erosive and non-erosive osteoarthritis were assessed by Spearman's rank correlation coefficients and generalised estimating equations. At the person level, individuals with erosive osteoarthritis were compared to those with non-erosive osteoarthritis using logistic regression, adjusted for age and gender (aOR), for the following exposures: family history, previous injury, overuse and metabolic factors (BMI, dyslipidaemia, hypertension, diabetes). In 1076 symptomatic participants the ranked frequency of involvement for erosive joints was comparable to joints with K&L≥3 and K&L=4 (r>0.95). Patterns of joint involvement in erosive osteoarthritis were strongest for symmetry (aOR=6.5; 95% CI 3.0 to 14.1), followed by row (2.0; 0.8 to 5.0) and ray (0.3; 0.0 to 2.5), which was similar to joints with K&L≥3 and K&L=4. Individuals with erosive osteoarthritis (n=80) had an increased risk of metabolic syndrome (2.7; 1.0 to 7.1), notably dyslipidaemia (4.7; 2.1 to 10.6) compared with non-erosive osteoarthritis classed K&L≥3 (n=193). The similar frequency of radiographic joint involvement and patterning in erosive osteoarthritis and more severe non-erosive osteoarthritis is consistent with prevalent erosive osteoarthritis being a severe form of hand osteoarthritis rather than a distinct entity. Metabolic exposures, dyslipidaemia in particular, may be implicated in erosive osteoarthritis. Published by the BMJ Publishing Group Limited. For

  12. ECHOCARDIOGRAPHIC PROFILE OF VALVULAR LESIONS IN CHILDREN WITH ACUTE RHEUMATIC FEVER / RHEUMATIC HEART DISEASE IN A TERTIARY CARE HOSPITAL

    OpenAIRE

    Ramu; Deepak Kumar

    2015-01-01

    CONTEXT (B ACKGROUND): Rheumatic Heart disease is still a leading cause of valvular disease in developing countries like India and constitutes 10 to 50% of the cardiac patients in Indian hospitals. Echocardiography is a very sensitive investigation for the diagnosis of Rheumatic Carditis and its sequalae like Mitral, Aortic and Tricuspid valve disease as well as sub clinical Carditis. AIMS & OBJECTIVES: To study the profile, severity and gender based differences of ...

  13. Erosion in America

    Energy Technology Data Exchange (ETDEWEB)

    1984-03-23

    The US loses about five billion tons of soil a year from erosion, and scientists estimate that from 20 to 50% of world cropland suffers from excessive erosion. The effect of erosion is a loss in both land and water productivity. When combined with the problems of overpopulation, overgrazing, and deforestation, the environmental impacts are very serious. There are some signs that countries are beginning to adopt conservation tilling techniques, but even cooperative government programs in the US such as the 1983 Payment-in-Kind (PIK) program have had only partial success because of expanded production on marginal farmlands. 20 reference 5 figures.

  14. [Rheumatic fever--a review of cases].

    Science.gov (United States)

    Rocha, P; Freitas, S; Alvares, S

    2000-09-01

    To analyse clinical presentation of rheumatic fever (RF), with special emphasis on cardiac involvement, electrocardiographic and echocardiographic findings and the outcome of the cases referred to Maria Pia Children's Hospital from January 1990 to September 1999. We retrospectively analyzed the clinical files of all cases referred to pediatric cardiology clinics with the suspicion of acute RF (Group 1) or with rheumatic valvular disease and heart failure (Group 2). In group 1 we studied the following: age and sex distribution, year of diagnosis, presence of Jones criteria treatment and outcome. In group 2 we analysed provenance, age of initial onset of RF, age of cardiology referral, treatment and outcome. Thirteen cases were identified, 8 in groups 1 and 5 in group 2. Group 1 included 3 girls and 2 boys, mean age of 10 years. The diagnosis of RF was based in the presence of 2 major and 1 minor manifestation (4/8), 1 major and 2 minor manifestations (1/8) and chorea in 3 cases associated with clinical carditis in one and subclinical carditis in another. Colour Doppler echocardiography showed pathological mitral regurgitation jet in 6 cases, associated with aortic regurgitation in 2 and dilatation of left ventricle in 3. All were treated with penicillin associated with anti-inflammatory drugs in 5 and haloperidol in 3. Group 2 included 3 girls and 2 boys, mean age 9.56 years. Four were from African countries (Angola and Guinea), and one came from the north of Portugal. The elapsed time between the initial acute attack and cardiology referral varied from 5 months to 3 years. All presented severe mitral insufficiency associated with aortic and/or tricuspid valve lesions, and heart failure. All five underwent valve surgery. The secondary prophylaxis was recommended in every patient. There was a recurrence in a child who had interrupted chemoprophylaxis. The patients from African countries were lost for follow-up. RF still remains a problem in present times, with

  15. Patterns of magnetic resonance imaging bone erosion in rheumatoid arthritis--which bones are most frequently involved and show the most change?

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Møller Døhn, Uffe; Duer-Jensen, A

    2011-01-01

    To investigate by magnetic resonance imaging (MRI) which bones in wrists and metacarpophalangeal (MCP) joints most frequently show bone erosions, and which most frequently demonstrate erosive progression, in early and established rheumatoid arthritis (RA).......To investigate by magnetic resonance imaging (MRI) which bones in wrists and metacarpophalangeal (MCP) joints most frequently show bone erosions, and which most frequently demonstrate erosive progression, in early and established rheumatoid arthritis (RA)....

  16. Capsule Endoscopy for Obscure Gastrointestinal Bleeding in Patients with Comorbid Rheumatic Diseases

    Directory of Open Access Journals (Sweden)

    Neal Shahidi

    2014-01-01

    Full Text Available Background and Aim. We evaluated the association between patients with rheumatic diseases (RD suffering from obscure gastrointestinal bleeding (OGIB and positive capsule endoscopy (CE findings. Methods. All CE procedures performed on patients with RD and OGIB were assessed from a large database at St. Paul’s Hospital (Vancouver, BC, Canada between December 2001 and April 2011. A positive finding on CE was defined as any pathology, including ulcers/erosions, vascular lesions, and mass lesions, perceived to be the source of bleeding. Results. Of the 1133 CEs performed, 41 (4% complete CEs were for OGIB in patients with RD. Of these, 54% presented with overt bleeding. Mean age was 66 years. Positive findings were seen in 61% of patients. Ulcerations/erosions (36% and vascular lesions (36% were the most common findings. Significant differences between the RD versus non-RD populations included: inpatient status, nonsteroidal anti-inflammatory drug (NSAIDs use, oral steroid use, and mean Charlson index score (all P≤0.008. Similar nonsignificant trends were seen between positive and negative CEs among the RD population. Conclusions. The correlation between RD and positive CE findings is likely influenced by ongoing anti-inflammatory drug use, poorer health status, and a predisposition for angiodysplastic lesions.

  17. The Rheumatic Fever and Rheumatic Heart Disease Control programme--Jamaica.

    Science.gov (United States)

    Millard-Bullock, D

    2012-07-01

    Rheumatic fever (RF) and rheumatic heart disease (RHD) are significant causes of World Health Organization (WHO) and International Society and Federation of Cardiology (ISFC) initiated an International Programme for Prevention of RF/RHD in 16 developing countries, including Jamaica. The Jamaican RF/RHD National Control Programme began in July 1985. The Control Programme promotes the primary prevention of RF/RHD through the appropriate treatment of streptococcal throat infections. Secondary prevention has been the main focus of the Control Programme by administration of benzathine penicillin injections every four weeks to RF/RHD patients. Case finding activities have included two retrospective surveys of case records of RF/RHD patients admitted to the major hospitals in Kingston and St Andrew in the period 1975-1985 (Survey A) and 1989-1995 (Survey B). These surveys provided clinical and laboratory data on RF/RHD in Jamaican patients which were documented and analysed. Records of 1079 patients were reviewed in Survey A and records of 512 patients were reviewed in Survey B. Seventy-seven per cent of 524 patients were aged 5-15 years in initial attacks of RF in Survey A and in Survey B, 82% of 119 patients were between 5 and 15 years in initial attacks. There was no significant sex difference in RF in Survey A and Survey B. A diagnosis of RF had been made in 54% of records in Survey A and 55% of records in Survey B. Diagnosis conformed to the Modified Jones criteria. Carditis occurred in 41% and 70% of RF patients, respectively in survey A and B. Polyarthritis occurred in 73% in Survey A and 74% in Survey B. Chorea occurred in 3% of RF patients in both surveys. Erythema marginatum and subcutaneous nodules occurred rarely in both surveys. Evidence of recent streptococcal infections in RF was found in 74% and 64% in Survey A and B, respectively. Severe carditis occurred in 7% of initial attacks of RF in A and 26% in B. In RHD, mitral incompetence was the commonest

  18. Interdigital erosions: Tinea pedis?

    National Research Council Canada - National Science Library

    Orgaz-Molina, Jacinto; Orgaz-Molina, Maria Carmen; Cotugno, Marilena; Arias-Santiago, Salvador

    2012-01-01

    Interdigital erosions are frequently due to tinea pedis. However, other infectious conditions, such as candidiasis, erythrasma or bacterial infections, can generate lesions that cannot be differentiated at the clinical level...

  19. [Hand ergotherapy for rheumatic diseases and the special importance of hand surgery].

    Science.gov (United States)

    Bureck, W; Illgner, U

    2014-06-01

    Human hands play an important role in overcoming routine daily life. As a consequence of limitations in the function of the hand due to rheumatic diseases, various manual activities can become an enormous challenge or even become absolutely impossible. This review article discusses the possibilities of hand ergotherapy and explains the most important assist devices. The main area of occupational and hand therapy interventions in patients with rheumatoid arthritis is the postoperative or conservative treatment of wrist and finger joints. The main areas of concern are to maintain the mobility of the joints, when necessary and possible mobilization of the joints, strengthen the muscles, the prophylaxis or correction of deformities with thermoplastic splints, conservative pain relief and anti-inflammatory treatment, joint protection precautions and teaching of home exercises for prophylaxis of contracture. Further areas of therapy are instruction and provision of adaptive devices for limitations of the upper and/or lower extremities, especially training of activities of daily living (ADL) and patient education.

  20. The second rheumatic heart disease forum report.

    Science.gov (United States)

    Zühlke, Liesl J; Engel, Mark E; Remenyi, Bo; Wyber, Rosemary; Carapetis, Jonathan

    2013-09-01

    The second rheumatic heart disease (RHD) forum was held on February 18, 2013, at the Sixth World Congress of Pediatric Cardiology and Cardiac Surgery in Cape Town, South Africa, to focus attention on key areas in global RHD control, management, and prevention. Building on the foundation of the first RHD forum, over 150 interested participants met to discuss critical issues on the RHD landscape. Unique to this meeting was a mixture of diverse backgrounds and disciplines, all crucially important to the conversation around RHD control and prevention. Some clear priorities have emerged for RHD activities in the next era: the necessity for political intervention and policy change; increasing the health workforce by incorporating teaching, training, and task-shifting; revitalizing the research agenda by merging basic, clinical, and translational research; and obtaining universal access to high-quality penicillin. There was also an urgent request for new resources; for existing resources to be further developed, improved, and shared across platforms; and for resources to be supported in the nonmedical arena. Finally, the necessity of involving the patient community in the ongoing discussion was highlighted. The participants of both the first and second RHD forum represent a new, thriving, and growing community of RHD activists who should usher in a new era of significant improvements in RHD control and prevention. Copyright © 2013 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

  1. Rheumatic masks of plasma cell dyscrasias

    Directory of Open Access Journals (Sweden)

    Vladimir Ivanovich Vasilyev

    2012-01-01

    Full Text Available Objective: to consider clinical practice problems in the differential diagnosis of different types of plasma cell dyscrasias (PCD. Subjects and methods. Fourteen patients (8 men and 6 women aged 52±12 years, in whom rheumatic diseases (RD were ruled out and who were diagnosed as having primary PCD: different types of myeloma in 7 patients, myeloma + AL-amyloidosis in 2, AL-amyloidosis in 3, and Waldenstrom’s macroglobulinemia in 2, were examined. Results and discussion. The most common maldiagnosed RDs in patients with PCD were seronegative rheumatoid arthritis (RA, systemic lupus erythematosus, Sjogren’s disease, and different forms of vasculitis. The most frequent masks of RD were kidney (78% and osteoarticular system (64% lesions, vascular disorders (36%, peripheral polyneuropathies (36%, and enlarged salivary glands with xerostomia (28.5%. Serum and urine immunochemical study should be performed in all patients who have clinical manifestations of seropositive RA, spondyloarthritis, intensive bone pain syndrome, ulceronecrotic vasculitis, enlarged submandibular salivary glands with macroglossia in the absence of markers of autoimmune disease for the timely diagnosis of PCD and the exclusion of RD. The paper estimates the sensitivity and specificity of main methods used to diagnose different types of PCD.

  2. [Operative differential therapy of rheumatic wrists].

    Science.gov (United States)

    Dinges, H; Fürst, M; Rüther, H; Schill, S

    2007-09-01

    The wrists are affected in the long-term in 90% of people with rheumatism and are often (42%) the first manifestation of a destructive disease. The functionality of the wrist and the whole hand is of great importance because in many cases loss of function of the wrists leads to severe limitations. Local and operative treatment of the wrist in rheumatoid arthritis (RA) is one of the main duties in rheuma-orthopaedics. For operative treatment there is a finely tuned differential therapeutic spectrum available. The diagnostic indications take the local and total pattern of affection, the current systemic therapy as well as patient wishes and patient compliance into consideration. In the early stages according to LDE (Larsen, Dale, Eek), soft tissues operations such as articulo-tenosynovectomy (ATS) are most commonly carried out. In further advanced stages osseus stabilisation must often be performed. At this point a smooth transition from partial arthrodesis to complete fixation is possible. After initial euphoria, arthroplasty of the wrist is being increasingly less used for operative treatment due to the unconvincing long-term results and high complication rate. With reference to the good long-term results of all operative procedures, in particular early ATS with respect to pain, function and protection of tendons, after failure of medicinal treatment and persistence of inflammatory activity in the wrist, patients should be transferred to an experienced rheuma-orthopaedic surgeon.

  3. Role of bone scan in rheumatic disease

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yun Young [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2003-06-01

    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.

  4. [Self-monitoring in inflammatory rheumatic diseases].

    Science.gov (United States)

    Kampling, C; Chehab, G; Schneider, M; Richter, J G

    2014-10-01

    Active involvement of patients in their care has led to better treatment and outcomes. Tight control concepts emphasize the need for regular assessments including patients' active involvement by self-monitoring. The literature was screened with respect to published experiences of self-monitoring of rheumatoid arthritis and spondyloarthritides. The use of "patient-reported outcome" (PRO) instruments can facilitate self-monitoring. Potentially applicable PROs and their correlations to clinical parameters as well as modern data acquisition modes are presented. Some experiences for self-monitoring have been reported. Recommendations from national and international professional rheumatology societies do not yet consider self-monitoring; however, PROs might be used for self-monitoring but instructions for patients on "how to deal with self-monitored PRO values" are missing. Self-monitoring of inflammatory rheumatic diseases seems feasible. Further evaluation studies are warranted to guarantee an optimized direct patient involvement in their management beyond outpatient care in hospitals and private practices so that they can thus contribute to a better outcome.

  5. [Periodontal disease in pediatric rheumatic diseases].

    Science.gov (United States)

    Fabri, Gisele M C; Savioli, Cynthia; Siqueira, José T; Campos, Lucia M; Bonfá, Eloisa; Silva, Clovis A

    2014-01-01

    Gingivitis and periodontitis are immunoinflammatory periodontal diseases characterized by chronic localized infections usually associated with insidious inflammation This narrative review discusses periodontal diseases and mechanisms influencing the immune response and autoimmunity in pediatric rheumatic diseases (PRD), particularly juvenile idiopathic arthritis (JIA), childhood-onset systemic lupus erythematosus (C-SLE) and juvenile dermatomyositis (JDM). Gingivitis was more frequently observed in these diseases compared to health controls, whereas periodontitis was a rare finding. In JIA patients, gingivitis and periodontitis were related to mechanical factors, chronic arthritis with functional disability, dysregulation of the immunoinflammatory response, diet and drugs, mainly corticosteroids and cyclosporine. In C-SLE, gingivitis was associated with longer disease period, high doses of corticosteroids, B-cell hyperactivation and immunoglobulin G elevation. There are scarce data on periodontal diseases in JDM population, and a unique gingival pattern, characterized by gingival erythema, capillary dilation and bush-loop formation, was observed in active patients. In conclusion, gingivitis was the most common periodontal disease in PRD. The observed association with disease activity reinforces the need for future studies to determine if resolution of this complication will influence disease course or severity. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  6. Measurement of erosion: Is it possible?

    NARCIS (Netherlands)

    Stroosnijder, L.

    2005-01-01

    Reasons for erosion measurements are: (1) to determine the environmental impact of erosion and conservation practices, (2) scientific erosion research; (3) development and evaluation of erosion control technology; (4) development of erosion prediction technology and (5) allocation of conservation

  7. Association of rheumatic fever & rheumatic heart disease with plausible early & late-stage disease markers.

    Science.gov (United States)

    Sarkar, Subendu; Rastogi, Mukul; Chaudhary, Priyanka; Kumar, Rajesh; Arora, Priya; Sagar, Vivek; Sahni, Inderpal Singh; Shethi, Sunil; Thakur, Khemraj; Ailawadhi, Sourav; Toor, Devinder; Chakraborti, Anuradha

    2017-06-01

    Rheumatic fever (RF) and rheumatic heart disease (RHD) are the autoimmune sequelae caused by Group A Streptococcus. RHD still remains a major concern in the developing countries due to its poor diagnosis, lack of vaccines and social awareness among population. This study was aimed to identify the plausible early- and late-stage disease markers associated with RF/RHD. A total of 84 patients with confirmed pharyngitis (n=18), RF (n=23) and RHD (n=43) were included in the comparative analysis of different factors involved in host-pathogen interaction during RF/RHD pathogenesis. This study revealed high titre of serum antistreptolysin O (ASO) antibody in pharyngitis compared to RF and RHD patients, whereas procollagen type 1 C-peptide (PICP) level was elevated in RHD which showed an inverse correlation with serum ASO titre. The significant elevation of serum anti-peptide associated with RF (PARF) antibody in RF patients was correlated as a probable stage-specific determinant. In addition, pro-inflammatory cytokine profile revealed high levels of interleukin-12 (IL-12)/IL-23p40, IL-17A in RF, whereas IL-6 concentration was higher in RHD compared to healthy controls. The overall assessment of the factors/ disease markers involved in host-pathogen interaction in RF/RHD may be suggestive of plausible disease marker in different groups of patients. Further studies with larger sample need to be done to better understand RF/RHD pathogenesis.

  8. Interleukin-10: Role in increasing susceptibility and pathogenesis of rheumatic fever/rheumatic heart disease.

    Science.gov (United States)

    Sharma, Neha; Toor, Devinder

    2017-02-01

    Streptococcus pyogenes (group A streptococcus) causes rheumatic fever (RF) which later progresses towards rheumatic heart disease (RHD) in the susceptible individuals. RF and RHD both contribute towards increasing global burden of disease, especially in developing countries. RHD is one of the most common acquired heart diseases causing permanent damage to heart valves which ultimately leads to heart failure. In RHD, heart valve lesions are formed which are mediated by autoimmune reaction between streptococcal antigens (M protein and group A carbohydrate epitope GlcNAc) and heart tissues. On the other hand, inflammatory response generated by cytokines promotes chronicity of the disease. Varying concentrations of interleukin-10 (IL-10) in patients and controls are reported and are also found to be associated with IL-10 gene polymorphism in RF/RHD patients. Although the effect of IL-10 gene polymorphism on the functionality of IL-10 is unknown, many investigations suggest an important role of IL-10 and its polymorphism in immune regulation and progression of disease in RF/RHD. This review summarizes the studies based on association of interleukin-10 with RHD in different populations to understand the role of IL-10 in susceptibility and pathogenesis of the disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Laboratory tests in the diagnosis and follow-up of pediatric rheumatic diseases: an update.

    Science.gov (United States)

    Breda, Luciana; Nozzi, Manuela; De Sanctis, Sara; Chiarelli, Francesco

    2010-08-01

    main indication for synovial fluid analysis is suspected joint infection. Antinuclear antibodies, anti-Smith antigen, and anti-double-stranded DNA antibodies are important in the diagnosis of SLE, are useful prognostic markers, and facilitate clinical and treatment follow-up. Anti-SSA/Ro and anti-SSB/La antibodies are associated with Sjögren's syndrome and congenital heart block, while the anti-U1 small nuclear ribonucleoprotein antibodies show high specificity for mixed connective tissue disease. Repetitive spontaneous abortions, thrombocytopenia, and many types of venous or arterial thrombosis are associated with antiphospholipid antibodies. The presence of cytoplasmic antineutrophil antibodies is essential in the diagnosis of Wegener granulomatosis. The discovery of underlying single causative gene defects led to the identification of several autoinflammatory diseases, a group of genetic disorders characterized by recurrent attacks of inflammation (hereditary periodic fever syndromes). These include familial Mediterranean fever due to mutations in the Mediterranean fever (MEFV) gene, hyperimmunoglobulinemia D syndrome due to mutations in the MK gene for mevalonate kinase, cryopyrinopathies such as Muckle-Wells syndrome or neonatal-onset multisystemic inflammatory disease (neonatal-onset multisystemic inflammatory disease or chronic infantile neurological cutaneous and articular (CINCA)) associated with cold-induced autoinflammatory syndrome 1 gene mutations, and tumor necrosis factor receptor-associated periodic syndrome due to mutation of TNF receptor I gene. Laboratory investigations play an important role in the diagnosis and follow-up of inflammatory rheumatic diseases in children. A good history and a complete physical examination are the best screening tests. Routine laboratory tests are useful to confirm a suspected diagnosis, to assess disease activity, and to measure the response and toxicity to treatment. Only a few tests represent

  10. Hand-related physical function in rheumatic hand conditions

    DEFF Research Database (Denmark)

    Klokker, Louise; Terwee, Caroline B; Wæhrens, Eva Ejlersen

    2016-01-01

    INTRODUCTION: There is no consensus about what constitutes the most appropriate patient-reported outcome measurement (PROM) instrument for measuring physical function in patients with rheumatic hand conditions. Existing instruments lack psychometric testing and vary in feasibility and their psych......INTRODUCTION: There is no consensus about what constitutes the most appropriate patient-reported outcome measurement (PROM) instrument for measuring physical function in patients with rheumatic hand conditions. Existing instruments lack psychometric testing and vary in feasibility...... and their psychometric qualities. We aim to develop a PROM instrument to assess hand-related physical function in rheumatic hand conditions. METHODS AND ANALYSIS: We will perform a systematic search to identify existing PROMs to rheumatic hand conditions, and select items relevant for hand-related physical function...... as well as those items from the Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) item bank that are relevant to patients with rheumatic hand conditions. Selection will be based on consensus among reviewers. Content validity of selected items will be established...

  11. Tactile sensitivity on the hands skin in rheumatic patients.

    Science.gov (United States)

    Kaluga, Elżbieta; Kostiukow, Anna; Samborski, Włodzimierz; Rostkowska, Elżbieta

    2014-06-01

    Clinical symptoms of rheumatic diseases can cause changes in the level of skin tactile sensitivity. To determine the tactile threshold of the hands in female patients with rheumatic diseases. It also attempted to determine correlations between rheumatic patients' tactile sensitivity and the degree of articular movement limitations, the Barthel Index (BI) and Edinburgh Handedness Inventory (EHI) results, the level of disability of the right hand and the left hand as well as age, education and eyesight. Ninety-nine female rheumatic patients aged 19-87 years took part in the study. The control group comprised 45 healthy women aged 23-80 years. The measurement of the tactile threshold was performed using the Touch-Test™ Sensory Evaluators (Semmes-Weinstein Monofilaments Test). The tactile threshold was measured at three sites on the hand: the little finger, the index finger and the metacarpus. The patients' tactile sensitivity ranges were classified as normal, diminished light touch and diminished protective touch. The degree of their disability was correlated with tactile sensitivity. The patients' tactile sensitivity worsens with age, but it is not correlated with the level of education. The lateralization was similar to that of the control group and was not correlated with tactile sensitivity. The worsening eyesight, independent of rheumatic disease, corresponds, however, with decreasing tactile sensitivity. The patients represented a group with a medium level of functional disability and lower tactile sensitivity.

  12. 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.

  13. Immunization of patients with autoimmune inflammatory rheumatic diseases (the EULAR recommendations)

    NARCIS (Netherlands)

    Van Assen, S.; Bijl, M.

    The European League Against Rheumatism (EULAR) recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD) have been recently published. These evidence-based recommendations were based on existing literature in combination with expert opinion. Although

  14. Pulmonary Involvement in Rheumatic Diseases: HRCT Findings

    Directory of Open Access Journals (Sweden)

    Serhat Avcu

    2011-05-01

    Full Text Available Aim: Systemic rheumatic disease (SRD may affect all the components of the pulmonary system. This study was designed to investigate the frequency and pattern of pulmonary involvement of systemic collagen tissue diseases. Material and Methods: A total of 128 patients -44 with rheumatoid arthritis (RA, 8 with giant cell arteritis, 14 with systemic lupus erythematosus (SLE, 8 with juvenile chronic arthritis, 24 with ankylosing spondylitis (AS, 6 with scleroderma, 12 with Behcet’s disease, 4 with mixed connective tissue disease (MCTD, 4 with polymyositis and 4 with dermatomyositis- who had presented to the Department of Physical Medicine and Rehabilitation/Rheumatology between January 2007 and December 2008 were included in the study. All the ptients were informed about the study in detail and all gave written consent before enrollment. HRCT was performed in all patients. Results: Pulmonary involvement was detected in 21 patients with RA (48%, in 8 patients withcSLE (57%, in 16 patients with AS (67%, in 4 patients with scleroderma (67%, and in 4 patients with MCTD (50%. No pulmonary involvement was observed in patients with Behçet’s disease, polymyositis and dermatomyositis. Conclusions: Our results suggest that patients with SRD may present with pulmonary involvement in varying degrees. Pulmonary symptoms may be underdiagnosed due to limited capacity of exercise secondary to musculoskeletal involvement. Therefore, a routine pulmonary X-ray should be performed in the process of the diagnosis and prior to treatment, even in the lack of complaints suggesting pulmonary involvement. Further investigations including HRCT should be performed if needed. 

  15. Neurohumoral relationship in patients with rheumatic diseases

    Directory of Open Access Journals (Sweden)

    I. V. Dryazenkova

    2004-01-01

    Full Text Available Objective. To assess neurohumoral relationship state in pts with systemic vasculitis (SV and systemic connective tissue diseases. Material and Methods. 54 pts with rheumatic diseases (RS were included: 18 with systemic lupus erythematosus (SLE, 16 with systemic sclerosis, 20 with systemic vasculitis (SV. Mean age was 49,3 5,4 years. Disease duration varied from 5 to 10 years. Control group consisted of 20 healthy persons. 24- hours ECG monitoring, heart rate variability (HRV spectral analysis, functional (clinoorthostatic sign and exercise ECG testing (isometric exercise, dynamic load, veloergometry were performed. Plasma histamine level, histaminase activity, plasma serotonin, tryptophan-5-hydrolase, oxytriptophandecar- boxylase, MAO levels were examined to assess vasoactive amine system state. Vasoactive amine system slate was assessed on histamine/serotonin ratio. Histamine/histaminase, serotonin/MAO, histaminase/MAO ratios were used to judge inhibitory activity. Results. Compared with control pts with RS showed marked and significant decrease of ergotropic mediators (noradrenaline, adrenaline and their metabolites concentration which correlated with HRV. Increase of histaminase that processes appropriate biogenic amine excess quantity was found in all forms of RS. More intensive than in healthy persons monoamine metabolism accompanied by their degradation acceleration resulted in enhanced MAO activity (significant in polyarteritis. LF/HF index reflecting summated activity of autonomic influences on heart rate showed significant prevalence of sympathetic effect in SV (3,46 0,31, p<0,05, CRV analysis showed adequate autonomic supply only in 11,7% of pts with RS. Conclusion. Exercise testing in dynamic analysis of quantitative HRV indices should be performed to determine autonomic reactivity ю assess homeostatic possibilities and adaptation reserve in pts with RS.

  16. The prevalence of severe fatigue in rheumatic diseases: an international study

    NARCIS (Netherlands)

    Overman, C.L.; Da Silva, J.A.P.; Kool, M.B.; Geenen, R.

    2016-01-01

    Fatigue is a common, disabling, and difficult-tomanage 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

  17. Vaccination of paediatric patients with rheumatic diseases. Navigating through turbulent waters

    NARCIS (Netherlands)

    Heijstek, M.W.

    2014-01-01

    In this thesis we focus on the safety and efficacy of vaccinations in paediatric patients with rheumatic diseases. With the European League Against Rheumatism (EULAR), we constructed recommendations for vaccination of paediatric patients with rheumatic diseases based on available evidence. Evidence

  18. Causes of persistent joint pain after arthrocentesis of temporomandibular joint.

    Science.gov (United States)

    Honda, Kosuke; Yasukawa, Yoko; Fujiwara, Masanori; Abe, Tetsuya; Urade, Masahiro

    2011-09-01

    The present study was undertaken to elucidate the factors responsible for the failure of arthrocentesis to cure persistent joint pain in patients with nonreducing articular disc displacement in the temporomandibular joint (TMJ). Thirty-six patients with internal derangement of the TMJ were selected. Magnetic resonance imaging was used to examine the configuration and position of the articular discs, cortical changes, and bone marrow abnormalities in the condyle and the presence of joint effusion. Arthrocentesis was then performed, and the patients were followed for 6 weeks. The results were then classified as poor or improved. The effects of arthrocentesis did not depend on the configuration of the disc, disc position and motion, or bone marrow abnormalities. Joints with no or minimal amounts of joint effusion achieved a good response to arthrocentesis. Joints with erosive cortical changes of the condyle were less responsive to arthrocentesis. Persistent joint pain after arthrocentesis is generally associated with extensive amounts of joint effusion or erosive cortical changes of the condyle. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  19. A Case Report of Recurrent Rheumatic Fever: Considerations and Comments

    Directory of Open Access Journals (Sweden)

    Ramin Khamene Bagheri

    2017-06-01

    Full Text Available Rheumatic fever (RF is a prevalent healthcare problem in the developing countries. Recurrence of this disorder is often observed in childhood and adolescence. RF can mimic the presentations of infective endocarditis, and clinicians are not really familiar with this issue. Herein, we present a case of recurrent acute rheumatic fever in a patient suspicious of acute bacterial endocarditis due to her previous RF. Finally, she was definitively diagnosed and underwent valvular replacement surgery and received prophylaxis antibiotics besides regular follow-up

  20. Population Genetics and Natural Selection in Rheumatic Disease.

    Science.gov (United States)

    Ramos, Paula S

    2017-08-01

    Human genetic diversity is the result of population genetic forces. This genetic variation influences disease risk and contributes to health disparities. Natural selection is an important influence on human genetic variation. Because immune and inflammatory function genes are enriched for signals of positive selection, the prevalence of rheumatic disease-risk alleles seen in different populations is partially the result of differing selective pressures (eg, due to pathogens). This review summarizes the genetic regions associated with susceptibility to different rheumatic diseases and concomitant evidence for natural selection, including known agents of selection exerting selective pressure in these regions. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Hypoadrenalism in patients with fatigue and rheumatic disease

    Directory of Open Access Journals (Sweden)

    Dimitra Methiniti

    2010-01-01

    Full Text Available Many patients with rheumatic disease complain of fatigue. Clinicians may interpret this as part of the disease process in the absence of anaemia or hypothyroidism, and sometimes respond with the empiric addition of steroids to therapy. The possibility of true hypoadrenalism is only occasionally considered, and little data exists on the frequency with which it coexists with rheumatic disease. Random serum cortisol may be requested by clinicians to help exclude hypoadrenalism as a factor in fatigue. We undertook a survey to assess how frequently this test was of clinical relevance, what was done in patients with low results, and which patients were most likely to have true adrenal failure. All random cortisol assays requested by the members of a rheumatological team over one year were identified and the notes examined retrospectively. The indication for the request, the result, the ultimate clinical diagnosis and all prior diagnoses were recorded. Where further investigations were undertaken, these too were noted. The results were compared to those in an age and gender matched population of patients with general medical conditions (excluding endocrine disorders for whom cortisol assays had also been requested. Random cortisol was requested by a team of four consultants in 74 patients with a variety of rheumatic disorders over 12 months, usually because of unexplained fatigue. Among the control group of 75 medical patients, the commonest reasons for requesting cortisol assay were fatigue, low sodium and unexplained anaemia. Mean cortisol levels were significantly higher in medical patients (512 nmol/L than those with rheumatic disease (351 nmol/L [P=0.04]. The results were low (<200 nmol/L in 14 rheumatic patients and 7 medical patients. Among these 21 individuals, synacthen tests were performed in 16 and were indicative of hypoadrenalism in 6 cases. Further investigations revealed primary hypoadrenalism in 3 patients, with tertiary adrenal

  2. Response of Fibroblastic Rheumatism to Infliximab

    Directory of Open Access Journals (Sweden)

    Ricardo Romiti

    2009-01-01

    Full Text Available Onset is usually sudden with symmetrical articular involvement of both small and large joints, occurrence of solid skin nodules, and rapid progression. Treatment is generally unrewarding. Here we report a severe and disabling case of FR responding favorably to infliximab therapy. After 32 weeks of continuous treatment, skin lesions dramatically improved and arthropathy partially regressed.

  3. Erosive Lichen Planus.

    Science.gov (United States)

    Mauskar, Melissa

    2017-09-01

    Lichen planus is an inflammatory mucocutaneous condition with a myriad of clinical manifestations. There are 3 forms of lichen planus that effect the vulva: papulosquamous, hypertrophic, and erosive. Erosive lichen planus can progress to vulvar scaring, vaginal stenosis, and squamous cell carcinoma; these long-term sequelae cause sexual distress, depression, and decreased quality of life for patients. Diagnosis is often delayed because of patient embarrassment or clinician misdiagnosis. Early recognition and treatment is essential to decreasing the morbidity of this condition. Multimodal treatment, along with a multidisciplinary approach, will improve outcomes and further clinical advances in studying this condition. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. An Australian guideline for rheumatic fever and rheumatic heart disease: an abridged outline.

    Science.gov (United States)

    Carapetis, Jonathan R; Brown, Alex; Wilson, Nigel J; Edwards, Keith N

    2007-06-04

    Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are diseases of poverty. They occur at world-record rates in Indigenous Australians, yet individual cases are often poorly managed, and most jurisdictions with high rates of these diseases do not have formal control strategies in place. New Australian guidelines formulated in 2005 by the National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand for diagnosis and management of ARF and RHD are a valuable resource for clinicians and policymakers. Key recommendations of the guidelines include: New diagnostic criteria for ARF in high-risk populations, including Indigenous Australians, which include echocardiographic evidence of subclinical valvular disease, and polyarthralgia or aseptic monoarthritis as major manifestations. Clear guidance about treatment of ARF. Non-steroidal anti-inflammatory drugs should be withheld until the diagnosis is confirmed, and corticosteroids may be an option in severe acute carditis. Most cases of chorea do not require medication, but use of carbamazepine or sodium valproate is recommended if medication is needed. Clear guidance about dose, dosing frequency and duration of secondary prophylaxis. Benzathine penicillin G is the preferred medication for this purpose. Establishment of a coordinated control program for all regions of Australia where there are populations with high prevalence of ARF and RHD. Key elements and indicators for evaluation are recommended. Active screening and legislated notification of ARF and RHD, where possible. Development of a structured care plan for all patients with a history of ARF or with established RHD, to be recorded in the patient's primary health care record.

  5. Heart lesion after the first attack of the rheumatic Fever 22 years experience in single centre.

    Science.gov (United States)

    Bejiqi, Ramush A; Retkoceri, Ragip; Zeka, Naim; Bejiqi, Hana; Retkoceri, Arber

    2015-02-01

    Acute rheumatic fever and its sequels, rheumatic heart diseases, remain major unsolved preventable health problems in Kosovo population, particularly among the disadvantages indigenous Albanian and Egyptians people. In Kosovo, despite of performing secondary prophylaxis with benzathine penicillin, acute rheumatic fever hospitalization rates have remained essentially unchanged for the last 20 years. The role of echocardiography in the diagnosis of acute rheumatic carditis was established over the last 20 years. In this study we aimed to determine the prevalence of rheumatic heart disease in children from Kosovo population with first attack of acute rheumatic fever. Also, we presented that echocardiography examination detects a greater prevalence of rheumatic heart disease than other diagnostic procedures. We aimed to compare the sensitivity and specificity of cardiac auscultation, ECG record, lab analysis to echocardiography and to determine the feasibility of specific age in this setting. To optimize accurate diagnosis of rheumatic fever and rheumatic heart disease, we utilized two group models. In the first group of 388 children, hospitalized and treated before 1999, diagnosis of rheumatic fever was decided basing on the clinical and laboratory findings whereas in second group (221 children treated from1999 to 2010) clinical and lab diagnosis were amplified also on the detection by echocardiography. In second group, using echocardiography as a method of diagnosis and assessment children with rheumatic fever, we found high rates of undetected rheumatic heart disease in this high-risk group population. Echocardiographic examination of children with rheumatic fever for rheumatic heart disease may over diagnose rheumatic heart disease unless congenital mitral valve anomalies and physiological regurgitation are excluded.

  6. Clinical studies of dental erosion and erosive wear

    National Research Council Canada - National Science Library

    Huysmans, M.C.D.N.J.M; Chew, H.P; Ellwood, R.P

    2011-01-01

    We define erosion as a partial demineralisation of enamel or dentine by intrinsic or extrinsic acids and erosive tooth wear as the accelerated loss of dental hard tissue through the combined effect...

  7. Lithological responses to sea erosion along selected coastlines ...

    African Journals Online (AJOL)

    Mabel Anim

    Coastal environments are continuously changing due to pressure exerted on them by many opposing .... millimetres a year (Intergovernmental Panel on Climate Change (IPCC), 2007; Appeaning-Addo et al.,. 2008). .... the field that groundwater intrusions along joints and cracks aid marine erosion in disintegrating.

  8. Cardiovascular disease in autoimmune rheumatic diseases.

    Science.gov (United States)

    Hollan, Ivana; Meroni, Pier Luigi; Ahearn, Joseph M; Cohen Tervaert, J W; Curran, Sam; Goodyear, Carl S; Hestad, Knut A; Kahaleh, Bashar; Riggio, Marcello; Shields, Kelly; Wasko, Mary C

    2013-08-01

    Various autoimmune rheumatic diseases (ARDs), including rheumatoid arthritis, spondyloarthritis, vasculitis and systemic lupus erythematosus, are associated with premature atherosclerosis. However, premature atherosclerosis has not been uniformly observed in systemic sclerosis. Furthermore, although experimental models of atherosclerosis support the role of antiphospholipid antibodies in atherosclerosis, there is no clear evidence of premature atherosclerosis in antiphospholipid syndrome (APA). Ischemic events in APA are more likely to be caused by pro-thrombotic state than by enhanced atherosclerosis. Cardiovascular disease (CVD) in ARDs is caused by traditional and non-traditional risk factors. Besides other factors, inflammation and immunologic abnormalities, the quantity and quality of lipoproteins, hypertension, insulin resistance/hyperglycemia, obesity and underweight, presence of platelets bearing complement protein C4d, reduced number and function of endothelial progenitor cells, apoptosis of endothelial cells, epigenetic mechanisms, renal disease, periodontal disease, depression, hyperuricemia, hypothyroidism, sleep apnea and vitamin D deficiency may contribute to the premature CVD. Although most research has focused on systemic inflammation, vascular inflammation may play a crucial role in the premature CVD in ARDs. It may be involved in the development and destabilization of both atherosclerotic lesions and of aortic aneurysms (a known complication of ARDs). Inflammation in subintimal vascular and perivascular layers appears to frequently occur in CVD, with a higher frequency in ARD than in non-ARD patients. It is possible that this inflammation is caused by infections and/or autoimmunity, which might have consequences for treatment. Importantly, drugs targeting immunologic factors participating in the subintimal inflammation (e.g., T- and B-cells) might have a protective effect on CVD. Interestingly, vasa vasorum and cardiovascular adipose tissue may

  9. Incidence of acute rheumatic fever and chronic rheumatic heart disease, trends in deaths in the Tula region (1991—2011

    Directory of Open Access Journals (Sweden)

    Valentina Nikolayevna Sorotskaya

    2013-01-01

    Full Text Available The paper analyzes the incidence of acute rheumatic fever (ARF and chronic rheumatic heart disease (CRHD and theirs outcomes in the Tula Region in 1991 to 2011. In this period, the incidence of ARF decreased to 0.002, which was much lower than Russia's rates. That of CRHD in 2011 accounted for 1.6 per 1,000 adult population, which was comparable to the values in Russia. CRHD mortality rates showed a 2.5-fold decrease. The main causes of fatal outcomes were cardiovascular disorders.

  10. Joint hypermobility syndrome in rheumatology

    Directory of Open Access Journals (Sweden)

    A. M. Satybaldyev

    2017-01-01

    Full Text Available Joint hypermobility syndrome (JHS is a disease characterized by symptoms of locomotor system involvement in the absence of obvious systemic rheumatic diseases (RDs. JHS accompanied by the symptomatology of RDs should be distinguished from isolated joint hypermobility, in which there are no complaints even in cases of its generalized manifestations and the patients feel virtually healthy. The paper provides an overview of the literature on the JHS. It gives diagnostic criteria for JHS (the Brighton criteria encompasses the Beighton score and the clinical manifestation of damages to the locomotor apparatus, visceral organs, and skin in this syndrome. Autonomic nervous system dysfunction as a possible manifestation of JHS and its impact on the daily life of patients are discussed. Attention is paid to the prevention and treatment of JHS. 

  11. EVALUATING EROSION FROM SPACE: A CASE STUDY NEAR UBERLÂNDIA

    Directory of Open Access Journals (Sweden)

    Anton Vrieling

    2005-05-01

    Full Text Available Satellites can offer important spatial data for the assessment of soil erosion. This study was conducted to explore how satellite imagery could be used for evaluating erosion in a 10*10 km area in the Brazilian Cerrados. Products obtained from a variety of satellite sensors were analyzed for the purpose of (1 detecting erosion features; and (2 qualitatively mapping erosion risk. Erosion detection was done through visual image interpretation. Optical TerraASTER images allowed for a better detection and delineation of major gullies as ENVISAT ASAR imagery. Gully dynamics could be assessed by jointly interpreting aerial photos of 1979 and a high-resolution QuickBird image of 2003. QuickBird also allowed for the detection of smaller erosion features, like rills. Erosion risk mapping was performed for the complete study area with a simple qualitative method integrating information on slope and vegetation cover. Slope was calculated from the SRTM DEM, and NDVI, being indicative of vegetation cover, was obtained from a wet-season ASTER image. Both factors were automatically classified based on their relative susceptibility to erosion. The erosion risk map was constructed by combining both classifications with the minimum-operator. The accuracyof the map was good (75 % when compared to field estimates of erosion risk. The method presented therefore allowed for a quick and proper indication of spatial differences of erosion risk in the study area, particularly concerning rill and sheet erosion.

  12. Clinical studies of dental erosion and erosive wear

    NARCIS (Netherlands)

    Huysmans, M.C.D.N.J.M.; Chew, H.P.; Ellwood, R.P.

    2011-01-01

    We define erosion as a partial demineralisation of enamel or dentine by intrinsic or extrinsic acids and erosive tooth wear as the accelerated loss of dental hard tissue through the combined effect of erosion and mechanical wear (abrasion and attrition) on the tooth surface. Most experts believe

  13. Bentonite erosion. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Birgersson, Martin; Boergesson, Lennart; Hedstroem, Magnus; Karnland, Ola; Nilsson, Ulf (Clay Technology AB, Lund (Sweden))

    2009-12-15

    Low saline water may reach KBS-3 repository depth, e.g. during periods of glaciation. Under such aqueous conditions, the montmorillonite part of the bentonite buffer might transform into a sol and thereby be transported away with flowing water in fractures. The primary aim with this report is to improve the understanding of the basic principles for this possible montmorillonite particle release. The report includes experimental and theoretical work performed at Clay Technology. Natural bentonite and ion-exchanged purified montmorillonite from three different geographical origins, Wyoming (U.S.), Milos (Greece) and Kutch (India) have been studied. Experimental and/or theoretical investigations have been performed with respect to: - Free swelling ability; - Rheological properties; - Rate of bentonite loss into fractures; - Filtering; - Ion exchange; - Sol formation ability; - Ion diffusion; - Mass loss due to erosion. The performed erosion experiments show that erosion does not occur in a mixed calcium/sodium montmorillonite with at least 20% calcium in exchange positions, when the external solution contains above 4 mM charge equivalents. This result is in agreement with the presented conceptual view of sol formation and measured equilibrium properties in mixed calcium/sodium montmorillonite. The findings imply that the buffer will be stable for non-glacial conditions. However, erosion due to sol formation cannot be ruled out for glacial conditions.

  14. Controlled ultrasonic tissue erosion

    Science.gov (United States)

    Cain, Charles

    2003-04-01

    Controlled ultrasonic tissue erosion has many clinical applications, including the placement of very precise sharply defined perforations in biological interfaces and membranes with focused ultrasound. With carefully chosen acoustic parameters, tissue can be rapidly eroded away at a constant etching rate. The maximum erosion rate for minimal propagated energy is obtained by using very short high intensity pulses. The etching rate is higher with shorter pulse durations. For short pulses less than 10 cycles of the drive frequency, an optimum pulse repetition rate exists which maximizes the etching rate. Higher gas saturation in the surrounding medium reduces the etching rate and reduces the spatial sharpness of the holes produced. Most of the erosion appears to be produced in the first several cycles of the therapy pulse. For example, a series of short (about 3 cycles) focused pulses of 2100 W/cm2 (Isppa) at 788 kHz can erode a very well defined 2 mm diameter hole in a 1 mm thick sample of fresh pork atrial posterior wall in about 1 min at the optimum pulse repetition rate (about 18 kHz). Controlled ultrasonic tissue erosion may provide an effective image guided noninvasive tool in treatment of neonatal patients with hypoplastic left heart syndrome. Without the mixing of oxygenated blood across perforations placed in the atrial septum, these infants do not survive.

  15. Categorization of erosion control matting.

    Science.gov (United States)

    2012-05-29

    Erosion control is a critical aspect of any Georgia Department of Transportation (GDOT) : construction project, with the extreme negative impacts of high sediment loads in natural : waterways having been well documented. A variety of erosion control ...

  16. Radiographic outcome in Hispanic early rheumatoid arthritis patients treated with conventional disease modifying anti-rheumatic drugs

    Energy Technology Data Exchange (ETDEWEB)

    Contreras-Yanez, Irazu, E-mail: uzari02@hotmail.com.mx [Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico); Rull-Gabayet, Marina, E-mail: rull.marina@gmail.com [Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico); Vazquez-LaMadrid, Jorge, E-mail: docjvlradiologo@yahoo.com [Department of Radiology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico); Pascual-Ramos, Virginia, E-mail: virtichu@gmail.com.mx [Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico)

    2011-08-15

    Objectives: To determine rates of incident erosive disease in early rheumatoid arthritis patients, to identify baseline predictors and to evaluate erosion's impact on patient-reported outcomes. Methods: 82 patients with {<=}12 months of disease duration, {>=}3 years of follow-up and conventional treatment were included. Consecutive evaluations assessed swollen and tender joint counts, treatment and comorbidity, acute reactant-phase determinations and patient-reported outcomes. Digitized radiographs of the hands and feet were obtained at baseline and yearly thereafter. RA was defined as erosive when at least one unequivocal cortical bone defect was detected. Descriptive statistics and Cox regression analysis were performed. Results: At baseline, 71 of the patients were Female Sign , population median (range) age was of 38.7 (16-78.2) years, 58 patients had antibodies and all the patients had active disease and substantial disability. Follow-up cohort was of 299.3 person-years. At last follow-up (49 {+-} 13.8 months), 28 patients developed erosions. Erosion's location was the feet, in 12 patients. Incident rates of erosive disease at one, two, three and four years were of 8.1, 12.8, 13.8 and 5.6 per 100 person-years, respectively. Higher C-reactive protein (HR: 1.20, 95%CI: 1.04-1.4, p = 0.01) and positive antibodies (HR: 5.09, 95%CI: 1.08-23.86, p = 0.04) were baseline predictors of incident erosive disease. Erosions had minor impact on patient-reported outcomes. Conclusion: Rheumatoid arthritis patients with antibodies and higher C reactive protein at baseline are at risk for incident erosions which appear most frequently at the feet. Up to 1/3 patients conventionally treated develop incident erosions, which minimally impact function.

  17. Rheumatic heart disease and the asap programme: fresh insights ...

    African Journals Online (AJOL)

    Acute rheumatic fever (ARF) is the immune-mediated sequel of an innocuous Group A ... In Turkey, 36% of patients presenting with native and prosthetic valve endocarditis had RHD.16 ... Her specific interests are imaging modalities, adult congenital heart disease, preventive cardiology and global health. These have led to ...

  18. prevalence of rheumatic heart disease among primary school pupils

    African Journals Online (AJOL)

    1 January 2013. PREVALENCE OF RHEUMATIC HEART DISEASE AMONG PRIMARY SCHOOL PUPILS IN MID-WESTERN NIGERIA .... valve leaflets. The evidence of valvular incompetence or stenosis was noted. Where there was regurgitation, the length of the regurgitant jet was measured. The function of the heart was ...

  19. Acute rheumatic fever in a child with Ebstein anomaly | Otaigbe ...

    African Journals Online (AJOL)

    Background: Ebstein anomaly (atrialisation of the right ventricle ) alone constitutes 0.5 -1% of congenital heart disease and usually presents as an isolated lesion. Association with mitral valve stenosis has been reported previously. We however present a case of Ebstein's anomaly with recurrent acute rheumatic fever (ARF) ...

  20. Acute rheumatic fever in adults | Whitelaw | South African Medical ...

    African Journals Online (AJOL)

    Two patients died and a further 4 required valve replacements as a resuH of the disease. This suggests that local factors are of importance in determining the morbidity of the disease and that physicians should consider acute rheumatic disease in adults who present with unexplained valvular disease or carditis.

  1. Familial systemic autoimmune rheumatic disease in Nigerians: a ...

    African Journals Online (AJOL)

    SARDs occasionally run in families - among mothers and daughters, among siblings. Such clustering has however not been documented among black Africans. We present four Nigerian families with clustering of systemic autoimmune rheumatic disease. Keywords: Systemic autoimmune disease, Familial clustering, ...

  2. Clinical and echocardiographic features of children with rheumatic ...

    African Journals Online (AJOL)

    Clinical and echocardiographic features of children with rheumatic carditis: correlation with high sensitivity C-reactive protein. ... Mitral regurgitation (MR) was found in 65 patients (98%), it was severe in 42 patients (64%), combined with aortic regurgitation (AR) in 27 patients (41%) and with Mitral stenosis (MS) in 3 patients ...

  3. Complete atrioventricular block in an adolescent with rheumatic Fever.

    Science.gov (United States)

    Yoo, Gyeong-Hee

    2009-03-01

    Rheumatic fever is an acute inflammatory sequela following a group A, beta-hemolytic streptococcal infection. Rheumatic fever is characterized by polyarthritis, carditis, chorea, subcutaneous nodules, and erythema marginatum as the major diagnostic criteria. Rarely, advanced heart block may also occur. A 13-year-old boy was admitted to the Pediatric Department for evaluation and management of complete atrioventricular block. The patient had exertional dyspnea for 1 month. Based on the findings of mitral regurgitation, fever, elevated acute phase reactants, and a high antistreptolysin O titer, the patient was diagnosed with rheumatic fever. A benzathine penicillin injection was administered, as well as salicylate therapy. On the 5(th) day of hospitalization, the electrocardiogram revealed a normal sinus rhythm with a 1(st) degree atrioventricular block. After discharge, the electrocardiogram normalized with the monthly penicillin injections. Herein we report a case of complete atrioventricular block associated with rheumatic fever. The heart block resolved without specific cardiac treatment, other than a non-steroidal anti-inflammatory medication.

  4. Proportion of patients in the Uganda rheumatic heart disease ...

    African Journals Online (AJOL)

    Abstract: Introduction: Since the establishment of the Uganda Rheumatic Heart Registry, over 900 patients have been enrolled. We sought to stratify the patients in the registry according to disease severity and optimal management strategy. Methods: We reviewed data of 618 patients who had enrolled in the Registry ...

  5. Mechanisms and management of heart failure in active rheumatic ...

    African Journals Online (AJOL)

    Fulminating active rheumatic carditis has been observed for over three decades in this environment with no recent alteration in either the incidence or the pattern of presentation. Heart failure (in this context defined as 'an inadequate circulation at rest together with a raised pulmonary venous pressure, with or without an ...

  6. Tetralogy of Fallot with rheumatic mitral stenosis: A case report

    Directory of Open Access Journals (Sweden)

    Sai Krishna Cheemalapati

    2008-04-01

    Full Text Available Abstract Introduction Rheumatic and congenital heart diseases account for the majority of hospital admissions for cardiac patients in India. Tetralogy of Fallot is the most common congenital heart disease with survival to adulthood. Infective endocarditis accounts for 4% of admissions to a specialized unit for adult patients with a congenital heart lesion. This report is unique in that a severe stenotic lesion of the mitral valve, probably of rheumatic aetiology, was noted in an adult male with Tetralogy of Fallot. Case presentation An unusual association of rheumatic mitral stenosis in an adult Indian male patient aged 35 years with Tetralogy of Fallot and subacute bacterial endocarditis of the aortic valve is presented. Conclusion In this case report the diagnostic implications, hemodynamic and therapeutic consequences of mitral stenosis in Tetralogy of Fallot are discussed. In addition, the morbidity and mortality of infective endocarditis in adult patients with congenital heart disease are summarized. The risk of a coincident rheumatic process in patients with congenital heart disease is highlighted and the need for careful attention to this possibility during primary and follow-up evaluation of such patients emphasized.

  7. Determinants of cardiovascular risk in current rheumatic practice

    NARCIS (Netherlands)

    Meek, I.L.

    2014-01-01

    The aim of this thesis was to study cardiovascular risk in arthritis: Firstly, how do different rheumatic diseases compare in the patients’ traditional cardiovascular (CV) risk factor profiles, and does this justify the general focus on rheumatoid arthritis regarding cardiovascular complications in

  8. [Rheumatic cardiopathy in children younger than 6 years of age].

    Science.gov (United States)

    Vázquez-Antona, C; Calderón-Colmenero, J; Attié, F; Zabal, C; Buendía-Hernández, A; Díaz-Medina, L H; Bialkowski, J; García Arenal, F

    1991-01-01

    Most of the published papers on Rheumatic Fever (RF) have not included the younger population. We selected 211 cases of children with RF younger than 6 years of age from 9,471 clinical files from 1944 to 1982. These were followed retrospectively to identify the presence of rheumatic activity, subsequent attacks and penicillin profilaxis. From de 211 cases, 209 had carditis; 57% of them were girls and 43% boys. There were no previous infections of the upper respiratory tract in 36% of the patients. The number of cases with RF increased abruptly after 3 years of age and continued increasing until 5 years of age when 70.5% of the population had there first clinically recognized attack. Lesions were present in the mitral valve in 80% of the cases, in the aortic valve in 12%, in the tricuspid in 5% and in the pulmonary valve in 3%. The death rate during the first attack was 20% being refractory heart failure the main cause of death. Thirteen cases suffered rheumatic pneumonia, 9 of whom died (69.2%). 1) The incidence of acute rheumatic fever in children under 6 years of age has decreased with time. 2) The death rate as well as the valvular damage decreased with the parents cooperation with the treatment. 3) The changes in the clinical picture and the severity of valve sequelea may be due to penicillin profilaxis and the better understanding of the disease.

  9. Itineraries of the rheumatic patients towards the rheumatologist in ...

    African Journals Online (AJOL)

    Objectives: To describe the itineraries of the rheumatic patients towards the rheumatologist. Methods: A descriptive cross-sectional study was performed in patients attending the rheumatology unit of the University Hospital of Kinshasa from 1st October 2012 to 31st March 2013. Data collected were general demographic ...

  10. Overlapping humoral autoimmunity links rheumatic fever and the antiphospholipid syndrome

    DEFF Research Database (Denmark)

    Blank, M; Krause, I; Magrini, L

    2006-01-01

    Rheumatic fever (RF) and the antiphospholipid syndrome (APS) are autoimmune diseases that share similar cardiac and neurological pathologies. We assessed the presence of shared epitopes between M protein, N-acetyl-beta-D-glucosamine (GlcNAc) and beta2 glycoprotein-I (beta2GPI), the pathogenic...

  11. Spectrum of rheumatic heart disease in Zaria, Northern Nigeria ...

    African Journals Online (AJOL)

    Nearly 90 % of the referring Physician made the correct diagnosis of rheumatic heart disease. Forty eight percent of the patients had depressed left ventricular function (EF < 50%). The mitral followed by the aortic valves were the most commonly affected. Sixteen percent of the patients had severe mitral stenosis. Mitral valve ...

  12. An echocardiography audit to determine and characterise rheumatic ...

    African Journals Online (AJOL)

    The commonest valve lesion was mitral regurgitation and half of the patients had surgical indications. The common complications were pulmonary hypertension and left atrial enlargement. Conclusion: This audit shows that rheumatic heart disease is still quite common in patients referred for echocardiography. Lesions are ...

  13. Rheumatic heart disease in Port Harcourt, Nigeria: clinical ...

    African Journals Online (AJOL)

    Background: Rheumatic heart disease is endemic in developing countries especially sub- Saharan Africa. However, there is a growing impression that this disease has been eliminated. Availability of echocardiography with colour flow Doppler facilities has significantly improved diagnosis of cardiac diseases. This study ...

  14. Fife Rheumatic Diseases Unit 10 years on: a personal perspective.

    Science.gov (United States)

    Harkess, Janet

    2005-01-01

    May 2004 marked the 10th anniversary of the Fife Rheumatic Diseases Unit (FRDU) based at the Sir George Sharp Unit, Cameron Hospital in Fife. This article aims to share with the reader FRDU's particular model of service delivery, how FRDU, and the occupational therapy service in particular, has evolved over the past 10 years. Copyright (c) 2005 John Wiley & Sons, Ltd.

  15. New insights into the epigenetics of inflammatory rheumatic diseases.

    Science.gov (United States)

    Ballestar, Esteban; Li, Tianlu

    2017-10-01

    Over the past decade, awareness of the importance of epigenetic alterations in the pathogenesis of rheumatic diseases has grown in parallel with a general recognition of the fundamental role of epigenetics in the regulation of gene expression. Large-scale efforts to generate genome-wide maps of epigenetic modifications in different cell types, as well as in physiological and pathological contexts, illustrate the increasing recognition of the relevance of epigenetics. To date, although several reports have demonstrated the occurrence of epigenetic alterations in a wide range of inflammatory rheumatic conditions, epigenomic information is rarely used in a clinical setting. By contrast, several epigenetic biomarkers and treatments are currently in use for personalized therapies in patients with cancer. This Review highlights advances from the past 5 years in the field of epigenetics and their application to inflammatory rheumatic diseases, delineating the future lines of development for a rational use of epigenetic information in clinical settings and in personalized medicine. These advances include the identification of epipolymorphisms associated with clinical outcomes, DNA methylation as a contributor to disease susceptibility in rheumatic conditions, the discovery of novel epigenetic mechanisms that modulate disease susceptibility and the development of new epigenetic therapies.

  16. Proportion of patients in the Uganda rheumatic heart disease ...

    African Journals Online (AJOL)

    Introduction: Since the establishment of the Uganda Rheumatic Heart Registry, over 900 patients have been enrolled. We sought to stratify the patients in the registry according to disease severity and optimal management strategy. Methods: We reviewed data of 618 patients who had enrolled in the Registry between March ...

  17. Osteoporosis in rheumatic diseases | Basma | African Journal of ...

    African Journals Online (AJOL)

    Other clinical data as history of previous fractures and family history of osteoporosis were also determined. Results: The study included 100 patients who had rheumatic diseases and followed in rheumatology out patients' clinic. Osteoporosis was detected in 37/100 (37%) of patients. Osteopenia occurred in 51/100 (51%) of ...

  18. [Immunization in children and adolescents with rheumatic and musculoskeletal diseases].

    Science.gov (United States)

    Minden, K; Speth, F; Huppertz, H-I; Borte, M

    2014-12-01

    Children and adolescents with inflammatory rheumatic diseases have a disease and treatment-related increased risk of infections. This risk includes vaccine-preventable diseases; therefore, vaccinations represent an important preventive measure against infection in these patients. However, approximately one in three patients with a juvenile rheumatic disease is nowadays still inadequately vaccinated, mostly due to uncertainty regarding the efficacy and safety of vaccination in these patients. This paper summarizes the available evidence regarding the efficacy and safety of vaccinations in children and adolescents with rheumatic diseases and gives recommendations for the clinical practice. Almost 2000 children and adolescents with rheumatic diseases were examined in the more than 30 previously published vaccination studies, comprising nearly all standard vaccinations in the immunization schedule. The immunogenicity was usually sufficient and there was no evidence of a relevant aggravation of the underlying disease. Recommendations for the clinical practice are given also considering data beyond pediatric rheumatology; however, a final benefit-risk assessment is not yet possible.

  19. Spectrum of rheumatic heart disease in Zaria, Northern Nigeria ...

    African Journals Online (AJOL)

    Background: Rheumatic heart disease (RHD) is a disease that is still prevalent in the developing countries and still poses a major medical and cardio-thoracic surgery challenge in Nigeria. Method: A study of data from echocardiography laboratory from October 1999 – September 2002. Results: Forty-seven (47) out of 600 ...

  20. For bitter or worse. Embitterment in rheumatic diseases

    NARCIS (Netherlands)

    Blom, D.

    2014-01-01

    In clinical practice and in the context of work and disability pension examinations, clinical and vocational professionals regularly encounter patients with a rheumatic disease who are embittered. These patients view themselves as victims of external factors, experience a sense of resentment and

  1. Frequency of rheumatic diseases in Portugal: a systematic review.

    Science.gov (United States)

    Monjardino, Teresa; Lucas, Raquel; Barros, Henrique

    2011-01-01

    To describe the frequency of rheuma­tic diseases in Portugal through a systematic review of published literature, critically appraising available information and identifying data collection gaps. We systematically reviewed the literature to retrieve data on the occurrence of rheumatic diseases in Portugal through MEDLINE and Índex das Revistas Médicas Portuguesas searches, PhD theses, and national health surveys reports. Original articles in English or Portuguese published between 1 January 2000 and 31 December 2010 were included. We retrieved information for the prevalence of rheumatic diseases, osteoarthritis, back pain, work-related musculoskeletal disorders (WRMDs), osteoporosis, fibromyalgia, rheumatoid arthritis, spondyloarthritis and other systemic rheumatic diseases and for the incidence of back pain, osteoporotic fracture and other systemic rheumatic diseases. The prevalence of rheumatic diseases ranged from 16.0% to 24.0% and the prevalence of osteoarthritis was 11.1% (95% confidence intervals (95%CI): 9.4-13.1) in the knee and 5.5% (95%CI: 4.3-7.0) in the hip. Regarding back pain, period prevalence ranged from 8.0% (95%CI: 6.1-10.1) to 29.5% (95%CI: 23.4-36.2) in children and from 12.3% (95%CI: 10.5-14.3) to 51.3% (95%CI: 48.6-53.9) in adults. The prevalence of WRMDs ranged from 5.9% to 84.2% (95%CI: 80.8-87.3). The yearly incidence of osteoporotic fracture (per 100 000) ranged from 93.3 to 481 (95%CI: 407-564) in women and from 31.9 to 154 (95%CI: 106-218) in men. The prevalence of osteoporosis in women ranged from 11.0% to 15.4% (95%CI: 13.4-17.6) and in men from 1.1% to 16.8% (95%CI: 12.2-22.3). The prevalence of fibromyalgia ranged from 3.6% (95%CI: 2.0-5.2) to 3.7% (95%CI: 2.0-5.4). The prevalence estimates of ankylosing spondylitis and of spondyloarthritis were 0.6% and 1.6% (95%CI: 0.8-2.7), respectively. The prevalence of systemic lupus erythematosus was estimated in 0.2% (95%CI: 0.1-0.8). There is a broad spectrum of information available

  2. Hypogonadism and the risk of rheumatic autoimmune disease.

    Science.gov (United States)

    Baillargeon, Jacques; Al Snih, Soham; Raji, Mukaila A; Urban, Randall J; Sharma, Gulshan; Sheffield-Moore, Melinda; Lopez, David S; Baillargeon, Gwen; Kuo, Yong-Fang

    2016-12-01

    Testosterone deficiency has been linked with autoimmune disease and an increase in inflammatory markers, such as C-reactive protein (CRP), tumor necrosis factor, and interleukin-6 (IL-6). However, no large-scale longitudinal studies have examined this association. We examined whether untreated hypogonadism was associated with an increased risk of rheumatic autoimmune disease in a large nationally representative cohort. Using one of the nation's largest commercial insurance databases, we conducted a retrospective cohort study in which we identified 123,460 men diagnosed with hypogonadism between January 1, 2002 and December 31, 2014 and with no prior history of rheumatic autoimmune disease. We matched this cohort to 370,380 men without hypogonadism, at a 1 to 3 ratio, on age and index/diagnosis date. All patients were followed until December 31, 2014 or until they lost insurance coverage or were diagnosed with a rheumatic autoimmune disease. Cox proportional hazards regression was used to calculate adjusted hazard ratios (aHRs). Untreated hypogonadism was associated with an increased risk of developing any rheumatic autoimmune disease (HR = 1.33, 95 % CI = 1.28, 1.38), rheumatoid arthritis (HR = 1.31, 95 % CI = 1.22, 1.44), and lupus (HR = 1.58, 95 % CI = 1.28, 1.94). These findings persisted using latency periods of 1 and 2 years. Hypogonadism was not associated with the control outcome, epilepsy (HR = 1.04, 95 % CI = 0.96, 1.15). Patients diagnosed with hypogonadism who were not treated with testosterone had an increased risk of developing any rheumatic autoimmune disease, rheumatoid arthritis, and lupus. Future research should further examine this association, with particular attention to underlying mechanisms.

  3. 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.

  4. ASSOCIATION BETWEEN ULTRASOUND SIGNS OF JOINT INFLAMMATION AND RADIOGRAPHIC PROGRESSION IN PATIENTS WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    O. G. Alekseeva

    2016-01-01

    Full Text Available Rheumatoid arthritis (RA is a chronic inflammatory disease causing joint destructive changes and disability.Objective: to investigate the association between the ultrasound signs of active inflammation and destruction of the joints, as evidenced by radiography, in RA patients treated with a treat-to-target strategy and to study whether ultrasound study (USS of the joints can be used to predict the occurrence of their destructive changes.Subjects and methods. The investigation included 81 patients (medium age 56 [46; 62] years with RA, who had been followed up at the V.A. Nasonova Research Institute of Rheumatology within the first Russian strategic study of pharmacotherapy for RA – REMARCA (Russian invEstigation of MethotrexAte and biologicals for eaRly aCtive Arthritis. In all the patients, methotrexate (Metoject, MEDAS, Germany as the first disease-modifying anti-rheumatic drug was subcutaneously injected at an initial dose of 10 mg/week with its rapid escalation up to 20–25 mg/week. Then the therapy was added by biologicals as the need arose. Clinical and laboratory parameters were analyzed immediately before and then after 12, 24, 36, and 48 weeks. Efficacy was assessed using the European League Against Rheumatism (EULAR criteria, CDAI, and SDAI. USS of eight articular areas (the wrist, second and third metacarpophalangeal, second and third proximal interphalangeal, second and fifth metatarsophalangeal joints in the hand and foot of the clinically dominant side was carried out in all the patients before treatment and then after 12, 24, 36, and 48 weeks. Semiquantitative gray-scale (GS assessment and power Doppler (PD were performed. Radiographic examination was done before and after 48 weeks of therapy. The Sharp method modified by van der Heijde was employed to estimate X-ray changes.Results and discussion. In the group of patients with radiographic progression, the activity of inflammation, as evidenced by PD USS, was significantly

  5. [Tuberculous rheumatism "Poncet's disease". Case report].

    Science.gov (United States)

    Lugo-Zamudio, Gustavo Esteban; Barbosa-Cobos, Rosa Elda; González-Ramírez, Laura Virginia; Delgado-Ochoa, Dolores

    2016-01-01

    Deaths due to tuberculosis have reached 2.5 million cases per year worldwide. Poncet's disease is an infrequent form of tuberculosis characterised by a clinical picture of polyarthritis. A 24-year-old male presented with morning stiffness, arthralgias, bilateral symmetric arthritis of the proximal interphalangeal joints, wrists, knees, ankles, and shoulders, and adenomegalies at the cervical, submandibular, left supraclavicular, axillary and inguinal levels, without fever. Laboratory results were as follows: ESR 44mm/h, C-reactive protein 4.35, normal levels of complement C3 and C4, negative rheumatoid factor and anticyclic citrullinated peptide antibodies, positive antinuclear antibodies with fine speckled pattern (1:320) and cytoplasm (1:160) pattern and negative anti-Smith, -double-stranded DNA, Sjogren's syndrome-antigen A and Sjogren's syndrome-antigen B. Histological report of cervical node tissue revealed granulomatous lesions compatible with tuberculosis. Rheumatoid arthritis and systemic lupus erythematosus were ruled out. Anti-tuberculosis agents were initiated that resolved the clinical picture. Diagnosis of Poncet's disease was confirmed. The differential diagnosis between tuberculosis and autoimmune inflammatory joint diseases is a clinical challenge. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  6. Some problems in long-term prevention of streptococcal infection among children with rheumatic heart disease in Taiwan.

    Science.gov (United States)

    Lue, H C; Chen, C L; Wei, H

    1976-09-01

    In Taiwan, rheumatic fever (RF) and rheumatic heart disease (RHD) remain widespread and constituting a health problem. The long-term prevention of streptococcal infections among rheumatic children has also failed to prevail, and yet has seldom been emphasized. Therefore, recurrence of RF remained prevalent. For an appraisal of the difficulties in the administration of long-term medication prophylaxis, a prospective study was started in 1967. One hundred and five consecutive cases of RF and RHD were followed up for more than 1 year to 6 years with an average of 4.4 years. One hundred and two cases received monthly injections of benzathine penicillin G for 6 months to 6 years, of whom 10 were switched to daily sulfa drugs; 1 case had oral penicillin daily for 6 years; in 12 cases, sulfa drugs were given for 6 months to 5 years. Fifty-one cases (48.6 %) stayed well in the program; 22 (21.0 %) stayed but were not compliant; 32 (30.4 %) dropped out soon or after staying in for more than 1 year. Major risk factors leading to non-compliance are; 1) apparent recovery from the illness or resumption of the normal activity; 2) cram session at school; 3) lack of easy medical care system; and 4) shortage of active participation by the health workers and general practitioners. The present study confirmed that the long-term prevention of streptococcal infection was effective and contributed to the decline of RF recurrence rate from more than 30 % down to 6%. Our study implicates that this important preventive program can not be achieved just only by the hospital staff, but should be approached jointly by all doctors, health and social workers, school teachers and the parents.

  7. short history of anti-rheumatic therapy. IV. Corticosteroids

    Directory of Open Access Journals (Sweden)

    P. Marson

    2011-06-01

    Full Text Available In 1948 a corticosteroid compound was administered for the first time to a patient affected by rheumatoid arthritis by Philip Showalter Hench, a rheumatologist at the Mayo Clinic in Rochester, Minnesota (USA. He was investigating since 1929 the role of adrenal gland-derived substances in rheumatoid arthritis. For the discovery of cortisone and its applications in anti-rheumatic therapy, Hench, along with Edward Calvin Kendall and Tadeusz Reichstein, won the 1950 Nobel Prize for Medicine. In this review we summarize the main stages that led to the identification of the so-called compound E, which was used by Hench. We also consider the subsequent development of steroid therapy in rheumatic diseases, through the introduction of new molecules with less mineralocorticoid effects, such as prednisone, and more recently, deflazacort.

  8. The human microbiome in rheumatic autoimmune diseases: A comprehensive review.

    Science.gov (United States)

    Coit, Patrick; Sawalha, Amr H

    2016-09-01

    The human microbiome consists of the total diversity of microbiota and their genes. High-throughput sequencing has allowed for inexpensive and rapid evaluation of taxonomic representation and functional capability of the microbiomes of human body sites. Autoimmune and inflammatory rheumatic diseases are characterized by dysbiosis of the microbiome. Microbiome dysbiosis can be influenced by host genetics and environmental factors. Dysbiosis is also associated with shifts in certain functional pathways. The goal of this article is to provide a current and comprehensive review of the unique characteristics of the microbiome of patients with autoimmune and inflammatory rheumatic diseases, measured using high-throughput sequencing. We also highlight the need for broader studies utilizing a longitudinal approach to better understand how the human microbiome contributes to disease susceptibility, and to characterize the role of the interaction between host genetics and microbial diversity in the pathogenesis of autoimmune diseases, disease manifestations, and progression. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Anti-B cell antibody therapies for inflammatory rheumatic diseases

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Jayne, David R W

    2014-01-01

    Several monoclonal antibodies targeting B cells have been tested as therapeutics for inflammatory rheumatic diseases. We review important observations from randomized clinical trials regarding the efficacy and safety of anti-B cell antibody-based therapies for rheumatoid arthritis, systemic lupus...... erythematosus, antineutrophil cytoplasmic antibody-associated vasculitis, polymyositis/dermatomyositis, and primary Sjögren's syndrome. For some anti-B cell agents, clinical benefits have been convincingly demonstrated, while other B cell-targeted therapies failed to improve outcomes when added to standard...... and functions in rheumatic disorders. Future studies should also evaluate how to maintain disease control by means of conventional and/or biologic immunosuppressants after remission-induction with anti-B cell antibodies....

  10. Evolution, evidence and effect of secondary prophylaxis against rheumatic fever

    Directory of Open Access Journals (Sweden)

    Rosemary Wyber

    2015-01-01

    Full Text Available The association between group A streptococcal infection and rheumatic fever (RF was established in the early 20 th century. At the time, RF and subsequent rheumatic heart disease (RHD were an untreatable scourge of young people in developed and developing countries. Resultingly, research efforts to understand, treat and prevent the disease were widepread. The development of antibiotics in the 1930s offered therapeutic promise, although antibotic treatment of acute RF had little impact. Improved understanding of the post-infectious nature of RF prompted attempts to use antibiotics prophylactically. Regular doses of sulphonamide antibiotics following RF appeared to reduce disease progression to RHD. Development of penicillin and later, benzathine penicillin G, was a further thereputic advance in the 1950s. No new prophylactic options against RF have emerged in the intervening 60 years, and delivery of regularly scheduled BPG injections remains a world wide challenge.

  11. A terminological matter: paragenesis, antigravitative erosion or antigravitational erosion ?

    Directory of Open Access Journals (Sweden)

    Pasini G.

    2009-07-01

    Full Text Available In the speleological literature three terms are utilized to designate the “ascending erosion”: paragenesis (= paragénésis, coined in1968, antigravitative erosion (= erosione antigravitativa, coined in 1966 and antigravitational erosion (wrong English translation ofthe Italian term erosione antigravitativa, utilized later on. The term paragenesis should be abandoned because of the priority of theterm erosione antigravitativa - on the ground of the “law of priority” – and because of its ambiguous etimology. On the other hand,the term antigravitational erosion should be forsaken in favour of the term antigravitative erosion, given the meaning that the termsgravitation and gravity have in Physics. Therefore, to designate the phenomenon of the “ascending erosion” there would be nothingleft but the term antigravitative erosion.The antigravitative erosion process and its recognizability are illustrated.Examples of caves with evident antigravitative erosion phenomena, developed in different karstifiable rocks and in several partsof the world, are given.It is recalled that the antigravitative erosion is a phenomenon well-known since 1942 and widely proven and supported, and that it isrelatively easy – in many cases - to recognize the antigravitative origin of karstic passages.It is stressed that the antigravitative erosion is an important phenomenon, exclusive of the karstic caves and unique in nature.

  12. Incidental histological diagnosis of acute rheumatic carditis: case report and review of the literature.

    Directory of Open Access Journals (Sweden)

    Guilherme S. Spina

    2014-11-01

    Full Text Available Rheumatic fever remains endemic in many countries and frequently causes heart failure due to severe chronic rheumatic valvular heart disease, which requires surgical treatment. Here, we report on a patient who underwent an elective surgical correction for mitral and aortic valvular heart disease and had a post-operative diagnosis of acute rheumatic carditis. The incidental finding of Aschoff bodies in myocardial biopsies is frequently reported in the nineteenth-century literature, with prevalences as high as 35%, but no clinical or prognostic data on the patients is included. The high frequency of this finding after cardiac surgery in classical reports suggests that these patients were not using secondary prophylaxis for rheumatic fever. We discuss the clinical diagnosis of acute rheumatic myocarditis in asymptomatic patients and the laboratorial and imaging methods for the diagnosis of acute rheumatic carditis. We also discuss the prognostic implications of this finding and review the related literature.

  13. Asymptomatic celiac sprue in juvenile rheumatic diseases children.

    Science.gov (United States)

    Gheita, Tamer A; Fawzy, Samar M; Nour El-Din, Abeer M; Gomaa, Howaida E

    2012-04-01

    Celiac disease (CD) is the most frequent enteropathy in adults and its coexistence with other autoimmune diseases is frequent. To detect asymptomatic CD in children with rheumatic diseases by measuring tissue transglutaminase (tTG) antibodies and finding any relation to disease activity. Setting and study design: The study included 60 children with juvenile rheumatic diseases consecutively from those attending the Rheumatology Clinics of Cairo University Hospitals: 30 juvenile rheumatoid arthritis (JRA), 10 juvenile systemic lupus erythematosus (SLE), 12 juvenile seronegative spondyloarthropathy and eight juvenile systemic sclerosis/polymyositis (SSc/PM) overlap syndrome were recruited during 2010. There were 22 male and 38 female patients. Thirty matched healthy controls were included. All children were subjected to thorough history taking, clinical examination and laboratory investigations. The body mass index (BMI) for age was used. All subjects had no gastrointestinal tract symptoms suggestive of CD and the tTG antibodies (IgA and IgG) were assessed. The mean age of patients was 12.03 ± 3.3 years and disease duration 4.18 ± 3.24 years. The demographic, clinical and laboratory features of the children were studied and compared. The tTG was positive in 32 (53.3%) patients compared to 20% of the controls (P = 0.03), being higher in females. In tTG-positive patients, the BMI was significantly lower, while white blood cell count, erythrocyte sedimentation rate and disease activity were significantly higher. tTG antibodies may be used as a screening test to identify asymptomatic CD associated with juvenile rheumatic diseases, especially those with active JRA or marked reduction in BMI. © 2011 The Authors. International Journal of Rheumatic Diseases © 2011 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.

  14. Coconut Atrium in Long-Standing Rheumatic Valvular Heart Disease

    OpenAIRE

    Onishi, Takahisa; Idei, Yuka; Otsui, Kazunori; Iwata, Sachiyo; Suzuki, Atsushi; Ozawa, Toru; Domoto, Koji; Takei, Asumi; Inamoto, Shinya; Inoue, Nobutaka

    2015-01-01

    Patient: Male, 76 Final Diagnosis: Rheumatic valvular heart disease Symptoms: Breathlessness and leg edema Medication: ? Clinical Procedure: Medical treatment for heart failure Specialty: Cardiology Objective: Rare disease Background: Complete calcification of the left atrium (LA) is called ?coconut atrium?, which decreases the compliance of LA, leading to the elevation of LA pressure that is transmitted to the right-side of the heart. The pathogenesis of LA calcification in patients with rhe...

  15. Macrophage activation syndrome: a potentially fatal complication of rheumatic disorders

    OpenAIRE

    Sawhney, S.; Woo, P; Murray, K.

    2001-01-01

    AIMS—To review the precipitating events, clinical features, treatment, and outcome of macrophage activation syndrome (MAS).
METHODS—Retrospective review of cases of MAS from a prospectively collected database of children with rheumatic diseases from 1980to 2000.
RESULTS—Nine patients (eight girls) were considered to have evidence of MAS. The primary diagnosis was systemic onset juvenile idiopathic arthritis in seven, enthesitis related arthritis in one, and chronic infant...

  16. [Alternative treatment methods in rheumatic diseases; a literature review].

    Science.gov (United States)

    Jacobs, J W; Rasker, J J; Van Riel, P L; Gribnau, F W; van de Putte, L B

    1991-02-23

    To evaluate the effectiveness of several types of complementary medicine in patients with rheumatic diseases, a literature search was performed. Clinical trials, blind or open, comparing the effectiveness of forms of complementary medicine with that of placebo or another control therapy in patients with rheumatoid arthritis, osteoarthritis, soft tissue rheumatism and the fibromyalgia syndrome were selected until half of 1989, using electronic databases. Abstracts and summaries were excluded. The investigation was performed at the department of rheumatology of the Medisch Spectrum Twente hospital at Enschede in cooperation with the department of internal diseases of the Sint Radboud hospital at Nijmegen. For each type of complementary treatment, the results of all the clinical trials were summarized. Furthermore, the placebo-controlled trials were graded according to convincing trials or trials that seemed to be less valid and/or difficult to interpret. Data concerning acupuncture, balneotherapy, dietary measures, enzymic therapy, Seatone, homeopathy, manual therapy and fever few were found. Of these types of complementary medicine in rheumatic diseases, we found no convincing prove that they are more effective than the control or placebo treatment. A considerable number of the studies however can be criticized. It is necessary to perform further studies on the effect of frequently used types of complementary medicine in patients with rheumatic diseases, by or in cooperation with the physicians or paramedics who prescribe or perform these kinds of treatment. This is nearly always possible; directives are given to realize further studies of this kind. If a particular treatment proves to be no more effective than placebo treatment, its use should be discouraged.

  17. Presence of paf-acether in rheumatic diseases.

    OpenAIRE

    Hilliquin, P; Menkes, C J; Laoussadi, S; Benveniste, J; Arnoux, B

    1992-01-01

    Paf-acether (paf) is a naturally occurring phospholipid involved in inflammatory processes. The presence of paf, its precursor lyso paf, and lipo-paf has been determined in blood and synovial fluid from 13 patients with rheumatoid arthritis (RA), 11 with spondylarthropathies, eight with other inflammatory rheumatisms, 13 with chondrocalcinosis, 15 with osteoarthritis, and also in blood from nine healthy subjects. Paf and lipo-paf were measured by rabbit platelet aggregation after isolation by...

  18. Recommendations of the ESSR Arthritis Subcommittee on Ultrasonography in Inflammatory Joint Disease

    DEFF Research Database (Denmark)

    Plagou, Athena; Teh, James; Grainger, Andrew J

    2016-01-01

    This article presents the recommendations of the European Society of Musculoskeletal Radiology Arthritis Subcommittee on the use of ultrasonography (US) in rheumatic disease, focused on the examination of joints in the adult population. The recommended examination technique and protocols used in ...

  19. 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.

  20. Could retinoids be a potential treatment for rheumatic diseases?

    Science.gov (United States)

    Miyabe, Yoshishige; Miyabe, Chie; Nanki, Toshihiro

    2015-01-01

    Retinoid, a derivative of vitamin A, is a general term used to describe compounds that bind to and activate retinoic acid receptors [RARs (RARα, RARβ, and RARγ)] and/or retinoid X receptors [RXRs (RXRα, RXRβ, and RXRγ)]. They have been shown to surpress the differentiation of Th1/Th17 cells and induce the development of Th1/regulatory T cells. They also affect the proliferation of B cells as both an inducer and suppressor. Furthermore, retinoids may induce the maturation of dendritic cells and production of interleukin-10 from monocytes/macrophages. We recently demonstrated that retinoids suppressed the production of reactive oxygen species, the release of elastase from neutrophils by inhibiting mitogen-activated protein kinase signals, and both the migration speed and chemotaxis directionality of neutrophils. Retinoids, such as all-trans retinoic acid and tamibarotene, were previously shown to have positive effects on animal models of several rheumatic diseases, including arthritis, myositis, and vasculitis in vivo. Moreover, retinoids have been used in a pilot study to effectively treat patients with lupus nephritis and systemic sclerosis. We herein reviewed the effects of retinoids on immune cells, animal models of rheumatic diseases, and rheumatic patients.

  1. Genetic architectures of seropositive and seronegative rheumatic diseases.

    Science.gov (United States)

    Kirino, Yohei; Remmers, Elaine F

    2015-07-01

    Rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis and some other rheumatic diseases are genetically complex, with evidence of familial clustering, but not of Mendelian inheritance. These diseases are thought to result from contributions and interactions of multiple genetic and nongenetic risk factors, which have small effects individually. Genome-wide association studies (GWAS) of large collections of data from cases and controls have revealed many genetic factors that contribute to non-Mendelian rheumatic diseases, thus providing insights into associated molecular mechanisms. This Review summarizes methods for the identification of gene variants that influence genetically complex diseases and focuses on what we have learned about the rheumatic diseases for which GWAS have been reported. Our review of the disease-associated loci identified to date reveals greater sharing of risk loci among the groups of seropositive (diseases in which specific autoantibodies are often present) or seronegative diseases than between these two groups. The nature of the shared and discordant loci suggests important similarities and differences among these diseases.

  2. The emerging role of epigenetics in rheumatic diseases.

    Science.gov (United States)

    Gay, Steffen; Wilson, Anthony G

    2014-03-01

    Epigenetics is a key mechanism regulating the expression of genes. There are three main and interrelated mechanisms: DNA methylation, post-translational modification of histone proteins and non-coding RNA. Gene activation is generally associated with lower levels of DNA methylation in promoters and with distinct histone marks such as acetylation of amino acids in histones. Unlike the genetic code, the epigenome is altered by endogenous (e.g. hormonal) and environmental (e.g. diet, exercise) factors and changes with age. Recent evidence implicates epigenetic mechanisms in the pathogenesis of common rheumatic disease, including RA, OA, SLE and scleroderma. Epigenetic drift has been implicated in age-related changes in the immune system that result in the development of a pro-inflammatory status termed inflammageing, potentially increasing the risk of age-related conditions such as polymyalgia rheumatica. Therapeutic targeting of the epigenome has shown promise in animal models of rheumatic diseases. Rapid advances in computational biology and DNA sequencing technology will lead to a more comprehensive understanding of the roles of epigenetics in the pathogenesis of common rheumatic diseases.

  3. Sulfasalazine-Related Hypersensitivity Reactions in Patients With Rheumatic Diseases.

    Science.gov (United States)

    Cildag, Songul; Senturk, Taskin

    2017-03-01

    Sulfasalazine (SSZ), which has an arylamine sulfonamide structure, is an anti-inflammatory drug used in the treatment of many rheumatic diseases. Various adverse effects have been reported related to SSZ. In the present study, we aimed to define the frequency of SSZ-related hypersensitivity reaction in patients with rheumatoid arthritis and ankylosing spondylitis. A total of 136 patients were included in this study. During follow-ups, reaction type, reaction duration, and drug doses were recorded in patients who developed hypersensitivity reactions. Drugs were discontinued in patients who developed reactions, and they were treated with antihistaminics and/or corticosteroids, according to requirements. Drug provocation tests with the drugs and aminosalicylic acid were performed in patients with negative skin prick test individually. A total of 136 patients, with ages ranging from 19 to 71 years (mean, 41.97 [SD, 12.04] years), were included in the study. Hypersensitivity reactions according to the drug provocation test were found against SSZ in 12 patients (8.8%). The SSZ-related hypersensitivity reaction types were urticaria in 7 patients, urticaria and angioedema in 4 patients, and pruritus in 1 patient. Sulfasalazine is widely used by rheumatologists in the treatment of rheumatic diseases. Whereas the frequency of sulfonamide-related hypersensitivity reactions was reported as 3.0% in the population, we detected hypersensitivity reactions to be 8.8% with SSZ usage in rheumatic diseases.

  4. Computed tomography through the hip joint

    Energy Technology Data Exchange (ETDEWEB)

    Dihlmann, W.

    1981-09-01

    Computed tomography through the hip joint should be used only after conventional radiographs (at least a.p. views). It may provide information that is diagnostic or helpful, e.g. in bacterial infections, trauma of praearthrotic states. Indications for surgery may be obtained in the presence of inflammatory-rheumatic and degenerative hip disease, arthritic deformities and trauma, and the type of suitable operation may be indicated. The obturator internus muscle, which can be seen medial to the acetabulum on the scan, is an important diagnostic indicator where there is trauma or bacterial infection of the hip joint. The capsule of the hip joint can be visualized directly. Slice thickness of 6 mm, or less is necessary.

  5. Soil Erosion and Agricultural Sustainability

    National Research Council Canada - National Science Library

    David R. Montgomery

    2007-01-01

    .... The general equivalence of the latter indicates that, considered globally, hillslope soil production and erosion evolve to balance geologic and climate forcing, whereas conventional plow-based...

  6. Multiperspective analysis of erosion tolerance

    Directory of Open Access Journals (Sweden)

    Sparovek Gerd

    2003-01-01

    Full Text Available Erosion tolerance is the most multidisciplinary field of soil erosion research. Scientists have shown lack in ability to adequately analyze the huge list of variables that influence soil loss tolerance definitions. For these the perspectives of erosion made by farmers, environmentalists, society and politicians have to be considered simultaneously. Partial and biased definitions of erosion tolerance may explain not only the polemic nature of the currently suggested values but also, in part, the nonadoption of the desired levels of erosion control. To move towards a solution, considerable changes would have to occur on how this topic is investigated, especially among scientists, who would have to change methods and strategies and extend the perspective of research out of the boundaries of the physical processes and the frontiers of the academy. A more effective integration and communication with the society and farmers, to learn about their perspective of erosion and a multidisciplinary approach, integrating soil, social, economic and environmental sciences are essential for improved erosion tolerance definitions. In the opinion of the authors, soil erosion research is not moving in this direction and a better understanding of erosion tolerance is not to be expected in the near future.

  7. Community Oriented Program for the Control of Rheumatic Diseases: studies of rheumatic diseases in the developing world.

    Science.gov (United States)

    Muirden, Kenneth David

    2005-03-01

    The Community Orientated Program for the Control of Rheumatic Diseases (COPCORD) is based on collecting community data on rheumatic complaints and disability. After identifying significant problems, a search for disease risk factors is made, and control and treatment measures are recommended. This review covers the results of surveys in five countries-China, Brazil, Kuwait, Vietnam, and Australia-published in the last 18 months. Musculoskeletal pain is a major health problem in all surveys undertaken in both developed and developing countries. Knee and low back pain are the most frequent complaints, and osteoarthritis is the most common arthritic disease identified, particularly affecting the knees. The prevalence of rheumatoid arthritis is generally lesser in these studies compared with published surveys of white patients. However, the prevalence of gout varied widely, possibly because of changes in lifestyle and racial factors. Septic arthritis and rheumatic fever were rarely seen except in an Australian aboriginal community, pointing to improvement in standards of living and health care, at least in the urban settings, according to the Vietnamese authors. Population data are required on musculoskeletal complaints as a basis for decisions on health control and treatment programs. Surveys in five countries have identified the frequency of especially knee and low back pain, the prevalence of knee osteoarthritis, and the wide variability in the prevalence of gout, partly because of lifestyle and thus potentially correctable risk factors. Self-medication with potent pharmaceutical products in countries where doctors' prescriptions are not required is a recognizable health hazard.

  8. Antioxidants in vegan diet and rheumatic disorders.

    Science.gov (United States)

    Hänninen; Kaartinen, K; Rauma, A L; Nenonen, M; Törrönen, R; Häkkinen, A S; Adlercreutz, H; Laakso, J

    2000-11-30

    Plants are rich natural sources of antioxidants in addition to other nutrients. Interventions and cross sectional studies on subjects consuming uncooked vegan diet called living food (LF) have been carried out. We have clarified the efficacy of LF in rheumatoid diseases as an example of a health problem where inflammation is one of the main concerns. LF is an uncooked vegan diet and consists of berries, fruits, vegetables and roots, nuts, germinated seeds and sprouts, i.e. rich sources of carotenoids, vitamins C and E. The subjects eating LF showed highly increased levels of beta and alfa carotenes, lycopen and lutein in their sera. Also the increases of vitamin C and vitamin E (adjusted to cholesterol) were statistically significant. As the berry intake was 3-fold compared to controls the intake of polyphenolic compounds like quercetin, myricetin and kaempherol was much higher than in the omnivorous controls. The LF diet is rich in fibre, substrate of lignan production, and the urinary excretion of polyphenols like enterodiol and enterolactone as well as secoisolaricirecinol were much increased in subjects eating LF. The shift of fibromyalgic subjects to LF resulted in a decrease of their joint stiffness and pain as well as an improvement of their self-experienced health. The rheumatoid arthritis patients eating the LF diet also reported similar positive responses and the objective measures supported this finding. The improvement of rheumatoid arthritis was significantly correlated with the day-to-day fluctuation of subjective symptoms. In conclusion the rheumatoid patients subjectively benefited from the vegan diet rich in antioxidants, lactobacilli and fibre, and this was also seen in objective measures.

  9. Erosion mechanism and erosion products in carbon-based materials

    Energy Technology Data Exchange (ETDEWEB)

    Arkhipov, N.; Bakhtin, V.; Barsuk, V.; Kurkin, S.; Mironova, E.; Piazza, G.; Safronov, V. E-mail: vsafr@rico.ttk.ru; Scaffidi-Argentina, F.; Toporkov, D.; Vasenin, S.; Wuerz, H.; Zhitlukhin, A

    2002-12-01

    Plasma/material interaction was studied in disruption simulation experiments at the plasma gun facility MK-200. Graphite and carbon-fibre composites were exposed to pulsed energetic plasma under heat loads typically expected for disruptions in future tokamaks. Erosion rates, erosion mechanisms and the properties of the eroded carbon have been studied.

  10. Rill erosion rates in burned forests

    Science.gov (United States)

    Joseph W. Wagenbrenner; Peter R. Robichaud

    2011-01-01

    Introduction Wildfires often produce large increases in runoff and erosion rates (e.g., Moody and Martin, 2009), and land managers need to predict the frequency and magnitude of postfire erosion to determine the needs for hazard response and possible erosion mitigation to reduce the impacts of increased erosion on public safety and valued resources. The Water Erosion...

  11. Development and validation of the European League Against Rheumatism response criteria for rheumatoid arthritis - Comparison with the preliminary American College of Rheumatology and the World Health Organization International League Against Rheumatism criteria

    NARCIS (Netherlands)

    vanGestel, AM; Prevoo, MLL; vantHof, MA; vanRijswijk, MH; vandePutte, LBA; vanRiel, PLCM

    Objective. To validate the European League Against Rheumatism (EULAR), the American College of Rheumatology (ACR), acid the World Health Organization (WHO)/International League Against Rheumatism (ILAR) response criteria for rheumatoid arthritis (RA). Methods. EULAR response criteria were developed

  12. Rangeland Hydrology and Erosion Model

    Science.gov (United States)

    Nearing, Mark; Pierson, Fred; Hernandez, Mariano; Al-Hamdan, Osama; Weltz, Mark; Spaeth, Ken; Wei, Haiyan; Stone, Jeff

    2013-04-01

    Soil loss rates on rangelands are considered one of the few quantitative indicators for assessing rangeland health and conservation practice effectiveness. An erosion model to predict soil loss specific for rangeland applications has been needed for many years. Most erosion models were developed from croplands where the hydrologic and erosion processes are different, largely due to much higher levels of heterogeneity in soil and plant properties at the plot scale and the consolidated nature of the soils. The Rangeland Hydrology and Erosion Model (RHEM) was designed to fill that need. RHEM is an event-based model that estimates runoff, erosion, and sediment delivery rates and volumes at the spatial scale of the hillslope and the temporal scale of a single rainfall event. It represents erosion processes under normal and fire-impacted rangeland conditions, it adopts a new splash erosion and thin sheet-flow transport equation developed from rangeland data, and it links the model hydrologic and erosion parameters with rangeland plant communities by providing a new system of parameter estimation equations based on 204 plots at 49 rangeland sites distributed across 15 western U.S. states. Recent work on the model is focused on representing intra-storm dynamics, using stream-power as the driver for detachment by flow, and deriving parameters for after-fire conditions.

  13. Dune erosion during storm surges

    NARCIS (Netherlands)

    Van Thiel de Vries, J.S.M.

    2009-01-01

    Large parts of The Netherlands are protected from flooding by a narrow strip of sandy beaches and dunes. The aim of this thesis is to extend the existing knowledge of dune erosion during storm surges as it occurs along the Dutch coast. The thesis discusses: • A large scale dune erosion experiment to

  14. New radiographic bone erosions in the wrists of patients with rheumatoid arthritis are detectable with magnetic resonance imaging a median of two years earlier

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Hansen, Michael; Stoltenberg, Michael

    2003-01-01

    OBJECTIVE: In a 5-year followup study, we investigated the temporal relationship between development of wrist joint erosions as visualized by magnetic resonance imaging (MRI) versus conventional radiography (CR), in patients with rheumatoid arthritis. We also evaluated the risk of erosive...... at 5-year followup was 4.5 (95% confidence interval [95% CI] 2.6-7.6), compared with bones without baseline MRI erosions. If bones with baseline radiographic erosions were excluded from the analysis, the relative risk was 4.1 (95% CI 2.2-7.5). CONCLUSION: Most new radiographic bone erosions (78%) were...... visualized at least 1 year earlier by MRI than by CR. This illustrates that the information on joint destruction provided by CR is considerably delayed compared with that provided by MRI. A significantly increased risk of progression of radiographic erosion in bones with baseline MRI erosions was observed...

  15. Joint ventures

    DEFF Research Database (Denmark)

    Sørensen, Karsten Engsig

    Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret......Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret...

  16. Modeling soil erosion in a watershed

    OpenAIRE

    Lanuza, R.

    1999-01-01

    Most erosion models have been developed based on a plot scale and have limited application to a watershed due to the differences in aerial scale. In order to address this limitation, a GIS-assisted methodology for modeling soil erosion was developed using PCRaster to predict the rate of soil erosion at watershed level; identify the location of erosion prone areas; and analyze the impact of landuse changes on soil erosion. The general methodology of desktop modeling or soil erosion at watershe...

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

    OpenAIRE

    Oliver, Jacqueline E; Silman, Alan J

    2009-01-01

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

  18. Surgery for rheumatic mitral valve disease in sub-saharan African ...

    African Journals Online (AJOL)

    Rheumatic valve disease, a consequence of acute rheumatic fever, remains endemic in developing countries in the sub-Saharan region where it is the leading cause of heart failure and cardiovascular death, involving predominantly a young population. The involvement of the mitral valve is pathognomonic and mitral ...

  19. Comparative study of mitral valve repair in ischemic and rheumatic mitral regurge

    Directory of Open Access Journals (Sweden)

    M. Adel Al-Adawy

    2017-03-01

    Conclusions: Patients with ischemic MVD were in a worse cardiac condition with higher hospital mortality than patients with combined rheumatic MVD and coronary artery bypass grafting. Patients with rheumatic MVD were usually having very complex pathology and in need modifications of standard repair techniques. Once discharged from hospital, both groups had comparable short and mid-term outcomes.

  20. Joint Disorders

    Science.gov (United States)

    A joint is where two or more bones come together, like the knee, hip, elbow, or shoulder. Joints can be damaged by many types of injuries or diseases, including Arthritis - inflammation of a joint. It causes pain, stiffness, and swelling. Over time, ...

  1. Surgery for rheumatic tricuspid valve disease: a 30-year experience.

    Science.gov (United States)

    Bernal, José M; Pontón, Alejandro; Diaz, Begoña; Llorca, Javier; García, Iván; Sarralde, Aurelio; Diago, Carmen; Revuelta, José M

    2008-08-01

    This study was undertaken to assess factors influencing short- and long-term outcomes of surgery for rheumatic disease of the tricuspid valve. Between 1974 and 2005, a total of 328 consecutive patients (mean age 51.3 +/- 13.6 years) underwent tricuspid valve surgery for rheumatic disease. There were 12 cases of isolated tricuspid lesion, 199 of triple-valve disease, 114 of tricuspid and mitral valve disease, and 3 of aortic and tricuspid valve disease. Most patients (72%) had predominantly tricuspid regurgitation. Tricuspid valve prosthetic replacement was performed in 31 cases and valve repair in 297. In-hospital mortality was 7.6%. Late mortality was 52.1%, whereas the expected mortality of the Spanish population of the same age was 24.2%. Predictors of in-hospital mortality were male sex, isolated tricuspid lesion, moderate aortic insufficiency, postclamping time, and tricuspid valve replacement. Mean follow-up was 8.7 years (range 1-31 years). Follow-up was 98.9% complete. Predictors of late mortality were age, New York Heart Association functional class IV, postclamping time, and mitral valve replacement. In total, 114 patients required valve reoperation, but only 4 (3.5%) for isolated tricuspid valve dysfunction. At 30 years, actuarial survival was 12.1% +/- 4.4%, actuarial freedom from reoperation was 27.5% +/- 5.8%, and actuarial freedom from valve-related complications was 2.0% +/- 1.3%. Organic tricuspid valve disease associated with rheumatic mitral or aortic lesions increases hospital and late mortality, but valve repair compared favorably with valve replacement. Long-term results may be considered acceptable for otherwise incurable valve disease.

  2. Secondary prevention for screening detected rheumatic heart disease: opportunities to improve adherence.

    Science.gov (United States)

    Engelman, Daniel; Ah Kee, Maureen; Mataika, Reapi L; Kado, Joseph H; Colquhoun, Samantha M; Tulloch, Jim; Steer, Andrew C

    2017-04-01

    Secondary prevention is an effective treatment for rheumatic heart disease (RHD), but ensuring high adherence to prophylaxis over many years is challenging and requires understanding of local factors. Participants were young people diagnosed with RHD through echocardiographic screening in Fiji. We used a structured interview to evaluate the following: health seeking behaviours; attitudes, practice, barriers and potential improvement strategies for adherence to antibiotic prophylaxis; and adolescent-friendly qualities of the health service. One hundred and one participants were interviewed (median age, 17.2 years). Adherence was very low overall (adequate in 6%). Sore throat and fever with sore joints were experienced in the preceding year by 42% and 28%, respectively. Barriers to receiving treatment included taking alternate treatments and the perception that symptoms were benign and self-limiting. Reasons for missing prophylaxis injections included lack of awareness, feeling well, transport cost and access, and medication unavailability (>40% of participants each). The injection health service had many perceived strengths, but inclusion of adolescents in decision making, and quality of educational materials were deficiencies. Reminder strategies, particularly phone-based reminders, were considered helpful by 94%. We identified several factors influencing secondary prevention that may be used to develop interventions to improve adherence.

  3. Mesenchymal Stromal Cells: Updates and Therapeutic Outlook in Rheumatic Diseases

    Directory of Open Access Journals (Sweden)

    Christian Jorgensen

    2013-10-01

    Full Text Available Multipotent mesenchymal stromal cells or mesenchymal stem cells (MSCs are adult stem cells exhibiting functional properties that have opened the way for cell-based clinical therapies. MSCs have been reported to exhibit immunosuppressive as well as healing properties, improving angiogenesis and preventing apoptosis or fibrosis through the secretion of paracrine mediators. This review summarizes recent progress on the clinical application of stem cells therapy in some inflammatory and degenerative rheumatic diseases. To date, most of the available data have been obtained in preclinical models and clinical efficacy needs to be evaluated through controlled randomized double-blind trials.

  4. Place of cyclosporin A in the therapy of rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Zemfira Sadullaevna Alekberova

    2011-01-01

    Full Text Available The paper considers the major effects of cyclosporin A (CsA in rheumatic diseases (RD. CsA is noted to be effective for a number of RDs and all types of rheumatoid arthritis (RA, including in early RA in adults and juvenile RA; uveitis associated with Behcet's disease (BD (as the drug of choice; in combination with other disease-modifying drugs; in RD with concomitant viral hepatitis C. The diagnostic criteria for (BD and the efficacy of CsA for this disease are given according to different authors.

  5. The place of intravenous immunoglobulin in rheumatic diseases

    Directory of Open Access Journals (Sweden)

    N. V. Seredavkina

    2015-01-01

    Full Text Available Therapy with intravenous human immunoglobulin (IVIG was and continues to remain essential for a number of diseases. At the same time the evidence base for IVIG use is extremely small in rheumatology. Clinical experience shows that IVIG is effective in treating thrombocytopenic purpura, Guillain–Barre syndrome, and chronic inflammatory demyelinating polyneuropathy, which develop in the presence of rheumatic diseases, such as systemic lupus erythematosus, inflammatory myopathies, and antineutrophil cytoplasmic antibody-associated vasculitides. The review considers indications for the use of IVIG, its dosage regimen, benefits, and adverse reactions and analyzes the Russian and foreign literature on this issue.

  6. Case Report: Giant Right Atrium in Rheumatic Mitral Disease

    Directory of Open Access Journals (Sweden)

    Deniz Demir

    2014-06-01

    Full Text Available Dilation and hypertrophy of the atria occur in patients with valvular heart disease especially in mitral regurgitation, mitral stenosis or tricuspid abnormalities. Dilatation of the atriums which occurs slowly in time, becomes evident with ritim disturbances and embolic events. We report a case of an unusual giant right atrium in context of rheumatic mitral stenosis, mitral regurgitation, pulmonar hypertansion and severe tricuspid regurgitation in a 40-year-old man who underwent succesfull operations as mitral valve replacement, Maze-IV radiofrequency ablation, right atrium atrioplasty and De Vega anuloplasty. [J Contemp Med 2014; 4(2.000: 98-102

  7. Incidental histological diagnosis of acute rheumatic myocarditis: case report and review of the literature.

    Science.gov (United States)

    Spina, Guilherme S; Sampaio, Roney O; Branco, Carlos E; Miranda, George B; Rosa, Vitor E E; Tarasoutchi, Flávio

    2014-01-01

    Rheumatic fever (RF) remains endemic in many countries and frequently causes heart failure due to severe chronic rheumatic valvular heart disease, which requires surgical treatment. Here, we report on a patient who underwent an elective surgical correction for mitral and aortic valvular heart disease and had a post-operative diagnosis of acute rheumatic carditis. The incidental finding of Aschoff bodies in myocardial biopsies is frequently reported in the nineteenth-century literature, with prevalences as high as 35%, but no clinical or prognostic data on the patients is included. The high frequency of this finding after cardiac surgery in classical reports suggests that these patients were not using secondary prophylaxis for RF. We discuss the clinical diagnosis of acute rheumatic myocarditis in asymptomatic patients and the laboratorial and imaging methods for the diagnosis of acute rheumatic carditis. We also discuss the prognostic implications of this finding and review the related literature.

  8. Vegetarian children and dental erosion.

    Science.gov (United States)

    al-Dlaigan, Y H; Shaw, L; Smith, A J

    2001-05-01

    There have been recent changes in teenage lifestyle and diet. The increasing consumption of soft drinks and foods containing significant acidic components may play a role in the development of dental erosion. The aims of this investigation were firstly to assess the prevalence of vegetarian children in a cluster random sample of 14-year-old children in Birmingham, United Kingdom. Secondly, to determine the prevalence of dental erosion in these children, and thirdly, to see if there were any differences between vegetarian and non-vegetarian children in the prevalence of dental erosion and dietary intake. A cluster random sample of 418 14-year-old children (209 males and 209 females) were examined from 12 different schools in Birmingham, United Kingdom; a dietary questionnaire was completed and the levels of tooth wear were recorded using a modification of the (TWI) index. All data were analysed using SPSS with t-test and Chi-square analysis. Significance was accepted at the P children were vegetarian; 52% of them had low dental erosion and 48% moderate dental erosion. Statistically there were no significant differences between vegetarian and non-vegetarian children in the prevalence of erosion; however, there were significant differences in some food and drink consumption. It was concluded that dental erosion is common in teenage children, but there were no significant differences in prevalence between vegetarian and non-vegetarian children.

  9. Joint Injection/Aspiration

    Science.gov (United States)

    ... A Patient / Caregiver Treatments Joint Injection / Aspiration Joint Injections (Joint Aspirations) Fast Facts Joint aspiration is used ... is derived from a joint aspiration or joint injection? Joint aspiration usually is done for help with ...

  10. Cavitation erosion size scale effects

    Science.gov (United States)

    Rao, P. V.; Buckley, D. H.

    1984-01-01

    Size scaling in cavitation erosion is a major problem confronting the design engineers of modern high speed machinery. An overview and erosion data analysis presented in this paper indicate that the size scale exponent n in the erosion rate relationship as a function of the size or diameter can vary from 1.7 to 4.9 depending on the type of device used. There is, however, a general agreement as to the values of n if the correlations are made with constant cavitation number.

  11. [Low level laser therapy : A narrative literature review on the efficacy in the treatment of rheumatic orthopaedic conditions].

    Science.gov (United States)

    Baltzer, A W A; Stosch, D; Seidel, F; Ostapczuk, M S

    2017-11-01

    In low level laser therapy (LLLT) low wattage lasers are used to irradiate the affected skin areas, joints, nerves, muscles and tendons without any sensation or thermal damage. Although the exact mechanism of its effect is still unknown, it seems beyond dispute that LLLT induces a variety of stimulating processes at the cellular level affecting cell repair mechanisms, the vascular system and lymphatic system. LLLT has been popular among orthopaedic practitioners for many years, whereas university medicine has remained rather sceptical about it. Overview of studies on the efficacy of LLLT in the treatment of rheumatic orthopaedic conditions, i. e. muscle, tendon lesions and arthropathies. Narrative literature review (PubMed, Web of Science). While earlier studies often failed to demonstrate the efficacy of LLLT, several recent studies of increasing quality proved the efficacy of LLLT in the treatment of multiple musculoskeletal pain syndromes like neck or lower back pain, tendinopathies (especially of the Achilles tendon) and epicondylolpathies, chronic inflammatory joint disorders like rheumatoid arthritis or chronic degenerative osteoarthritis of the large and small joints. In addition, there is recent evidence that LLLT can have a preventive capacity and can enhance muscle strength and accelerate muscle regeneration. LLLT shows potential as an effective, noninvasive, safe and cost-efficient means to treat and prevent a variety of acute and chronic musculoskeletal conditions. Further randomized controlled studies, however, are required to confirm this positive assessment.

  12. Joint hypermobility syndrome and related pain

    Directory of Open Access Journals (Sweden)

    Nilay Sahin

    2016-06-01

    Full Text Available Hypermobility is defined as an abnormally increased range of motion of a joint resulting from the excessive laxity of the soft tissues. This paper is focused on this commonly forgotten cause of several morbidities. The etiology of hypermobility is not very well known. One decade ago, joint hypermobility syndrome was considered as a benign condition, but now it is recognized as a significant contributor to chronic musculoskeletal pain, besides impacting on other organs. Patients with joint hypermobility syndrome often have diffuse, chronic complaints that are inconsistent with the musculoskeletal system. Chronic pain may cause loss of proprioception and so increased sensitivity to microtrauma, premature osteoarthritis de- velopment, soft tissue problems, psychosocial disorders, and neurophysiological deficiencies. Osteoarthritis, pes planus, mechanical low back pain, and soft tissue rheumatisms are frequent musculoskeletal findings as well as subluxations, thoracic outlet syndrome, rectal and uterine prolapses, hernias, and stress incontinence. Joint hypermobility syndrome's treatment is not easy, and nonsteroidal anti-inflammatory drugs are not usually effective or adequate. Proprioceptive and strengthening exercises have been reported to have supportive and therapeutic effects, but we have limited data on this issue. Joint hypermobility syndrome must be accepted as a multisystem connective tissue disorder rather than just joint laxities. As a result; clinicians must be aware of complexities of connective tissue disorders and comorbidities. [Arch Clin Exp Surg 2016; 5(2.000: 105-112

  13. [Juvenile rheumatoid diseases: Endoprosthetic care of destroyed hip joints].

    Science.gov (United States)

    Rehart, S; Henniger, M

    2015-07-01

    Patients with juvenile idiopathic arthritis (JIA) often suffer from involvement of the hip joints, with joint destruction and related functional limitations, making hip replacement necessary. To discover what special features are to be expected in patients with JIA and hip arthroplasty and what impact they have on surgical indication, choice of implant, and technique. Selective literature review and evaluation of our patient population. Compared with osteoarthritis patients, JIA patients are on average much younger at the time of hip replacement. Owing to the onset of the disease in childhood or adolescence and the frequent glucocorticoid therapy, growth disorders or abnormal anatomical findings are common in these patients. Bone density is often reduced at an early age. The perioperative management of medication has to be planned. Special implants for patients with rheumatic diseases do not exist, but the above peculiarities of this group of patients should be considered for surgical procedure and choice of implant and material. Overall, the results of hip arthroplasty in juvenile rheumatic diseases, in terms of pain relief and functional improvement, are good. The limited life of the arthroplasty is problematic. By relieving pain, improvement of the range of motion and activity level very high patient satisfaction is usually achieved by hip arthroplasty in JIA patients. In the case of involvement of the contralateral hip or the ipsilateral knee joint it may be useful to perform a simultaneous, single-stage joint replacement of both joints.

  14. Seasonal variation and climate change impact in Rainfall Erosivity across Europe

    Science.gov (United States)

    Panagos, Panos; Borrelli, Pasquale; Meusburger, Katrin; Alewell, Christine; Ballabio, Cristiano

    2017-04-01

    Rainfall erosivity quantifies the climatic effect on water erosion and is of high importance for soil scientists, land use planners, agronomists, hydrologists and environmental scientists in general. The rainfall erosivity combines the influence of rainfall duration, magnitude, frequency and intensity. Rainfall erosivity is calculated from a series of single storm events by multiplying the total storm kinetic energy with the measured maximum 30-minute rainfall intensity. This estimation requests high temporal resolution (e.g. 30 minutes) rainfall data for sufficiently long time periods (i.e. 20 years). The European Commission's Joint Research Centr(JRC) in collaboration with national/regional meteorological services and Environmental Institutions made an extensive data collection of high resolution rainfall data in the 28 Member States of the European Union plus Switzerland to estimate rainfall erosivity in Europe. This resulted in the Rainfall Erosivity Database on the European Scale (REDES) which included 1,675 stations. The interpolation of those point erosivity values with a Gaussian Process Regression (GPR) model has resulted in the first Rainfall Erosivity map of Europe (Science of the Total Environment, 511: 801-815). In 2016, REDES extended with a monthly component, which allowed developing monthly and seasonal erosivity maps and assessing rainfall erosivity both spatially and temporally for European Union and Switzerland. The monthly erosivity maps have been used to develop composite indicators that map both intra-annual variability and concentration of erosive events (Science of the Total Environment, 579: 1298-1315). Consequently, spatio-temporal mapping of rainfall erosivity permits to identify the months and the areas with highest risk of soil loss where conservation measures should be applied in different seasons of the year. Finally, the identification of the most erosive month allows recommending certain agricultural management practices (crop

  15. Rheumatic heart disease screening: Current concepts and challenges

    Directory of Open Access Journals (Sweden)

    Scott Dougherty

    2017-01-01

    Full Text Available Rheumatic heart disease (RHD is a disease of poverty, is almost entirely preventable, and is the most common cardiovascular disease worldwide in those under 25 years. RHD is caused by acute rheumatic fever (ARF which typically results in cumulative valvular lesions that may present clinically after a number of years of subclinical disease. Therapeutic interventions, therefore, typically focus on preventing subsequent ARF episodes (with penicillin prophylaxis. However, not all patients with ARF develop symptoms and not all symptomatic cases present to a physician or are correctly diagnosed. Therefore, if we hope to control ARF and RHD at the population level, we need a more reliable discriminator of subclinical disease. Recent studies have examined the utility of echocardiographic screening, which is far superior to auscultation at detecting RHD. However, there are many concerns surrounding this approach. Despite the introduction of the World Heart Federation diagnostic criteria in 2012, we still do not really know what constitutes the most subtle changes of RHD by echocardiography. This poses serious problems regarding whom to treat and what to do with the rest, both important decisions with widespread implications for already stretched health-care systems. In addition, issues ranging from improving the uptake of penicillin prophylaxis in ARF/RHD-positive patients, improving portable echocardiographic equipment, understanding the natural history of subclinical RHD and how it might respond to penicillin, and developing simplified diagnostic criteria that can be applied by nonexperts, all need to be effectively tackled before routine widespread screening for RHD can be endorsed.

  16. Macrophage activation syndrome: a potentially fatal complication of rheumatic disorders.

    Science.gov (United States)

    Sawhney, S; Woo, P; Murray, K J

    2001-11-01

    To review the precipitating events, clinical features, treatment, and outcome of macrophage activation syndrome (MAS). Retrospective review of cases of MAS from a prospectively collected database of children with rheumatic diseases from 1980 to 2000. Nine patients (eight girls) were considered to have evidence of MAS. The primary diagnosis was systemic onset juvenile idiopathic arthritis in seven, enthesitis related arthritis in one, and chronic infantile neurological cutaneous articular syndrome in one. Mean age of onset was 5.7 years, and duration prior to MAS, 4.2 years. No medication was identified as a trigger. Eight had infections prior to MAS; specific infectious agents were identified in four. High grade fever, new onset hepatosplenomegaly, and lymphadenopathy were common clinical features. Platelet counts fell dramatically, from an average of 346 to 99 x 10(9)/l. Mean erythrocyte sedimentation rate (in three patients) fell from 115 to 28 mm/h. Eight had abnormal liver function during the disease course, and six had coagulopathy. Bone marrow examination supported the diagnosis with definite haemophagocytosis in four of seven. All received high dose steroids (eight intravenous, one oral), five cyclosporin, two cyclophosphamide, and one antithymocyte globulin. Two of three patients with significant renal impairment died. MAS is a rare and potentially fatal complication of childhood rheumatic disorders. Most of our patients were female, and most cases were preceded by infection. Bone marrow studies support the diagnosis. Deranged renal function may be a poor prognostic sign. Aggressive early therapy is essential.

  17. Ergonomic intervention for employed persons with rheumatic conditions.

    Science.gov (United States)

    Allaire, Saralynn J; Backman, Catherine L; Alheresh, Rawan; Baker, Nancy A

    2013-01-01

    Prior articles in this series on employment and arthritis have documented the major impact arthritis and other rheumatic conditions have on employment. As expected, physically demanding job tasks, including hand use, are substantial risk factors for work limitation. Computer use has been increasing. People with arthritis may choose occupations involving extensive computer use to avoid occupations with other physical demands. But studies show many people with arthritis conditions have difficulty using computers.Ergonomic assessment and implementation helps relieve the physical and other demands of jobs. The Ergonomic Assessment Tool for Arthritis (EATA) is specifically for people with arthritis conditions. Since the EATA can be conducted off worksite, it is feasible to use with workers not wishing to disclose their condition to their employer. Available research supports the effectiveness of ergonomic intervention as a viable method to reduce work limitation for persons with arthritis. Some workers will need additional vocational intervention to remain employed long term. However, ergonomic intervention is a useful first step, as it promotes awareness of arthritis effects on work activities. Assisting workers with arthritis or other rheumatic conditions to use ergonomics to enhance their ability to work well should be an important aspect of managing these conditions.

  18. Radiographic study on the pattern of wrist joint destruction in rheumatoid arthritis.

    Science.gov (United States)

    Kitamura, Takashi; Murase, Tsuyoshi; Hashimoto, Jun; Tomita, Tetsuya; Arimitsu, Sayuri; Yoshikawa, Hideki; Sugamoto, Kazuomi

    2011-03-01

    When planning therapy for rheumatoid arthritis (RA) in the wrist joint, knowing the pattern of joint destruction is important. There were a few studies using the Larsen and modified Larsen method to evaluate RA wrist joint destruction. However, these methods are inadequate for thoroughly assessing the severity of joint destruction because joint bone erosion and joint space narrowing could not be evaluated individually in these methods. To clarify the pattern of RA wrist joint destruction in the different zones of the wrist, we conducted a large-scale radiographic study. We modified the van der Heijde/Sharp method to assess radiographic images. Subjects were 191 RA patients (22 men and 169 women; mean age 57.0 years) who were examined at our center between 2001 and 2003 and underwent plain X-ray of both wrist joints (n = 382). Using X-ray images of the wrist joint, classification was performed based on the severity of wrist joint surface bone erosion and joint space narrowing at different zones, and the results were statistically analyzed. The results showed that joint space narrowing in the midcarpal joint (MCJ) advanced faster than in the radiocarpal joint (RCJ). Conversely, bone erosion in the RCJ advanced faster than in the MCJ. In X-ray diagnosis of RA wrist joint disorders, knowing the pattern of destruction is useful for assessing the presence or absence of early joint destruction and in planning therapy.

  19. Compost for steep slope erosion.

    Science.gov (United States)

    2008-06-01

    This study was initiated to develop guidelines for maintenance erosion control measures for steep slopes. The study focused on evaluating and monitoring KY-31 fescue germination rates using two media treatments 1) 100 percent by weight compost and 2)...

  20. Erosion-resistant composite material

    Science.gov (United States)

    Finch, C.B.; Tennery, V.J.; Curlee, R.M.

    A highly erosion-resistant composite material is formed of chemical vapor-deposited titanium diboride on a sintered titanium diboride-nickel substrate. This material may be suitable for use in cutting tools, coal liquefaction systems, etc.

  1. Wind erosion of soils burned by wildfire

    Science.gov (United States)

    N. S. Wagenbrenner; M. J. Germino; B. K. Lamb; R. B. Foltz; P. R. Robichaud

    2011-01-01

    Wind erosion and aeolian transport processes are largely unstudied in the post-wildfire environment, but recent studies have shown that wind erosion can play a major role in burned landscapes. A wind erosion monitoring system was installed immediately following a wildfire in southeastern Idaho, USA to measure wind erosion from the burned area (Figure 1). This paper...

  2. Rainfall Erosivity in Southeastern Nigeria | Ezemonye | Ethiopian ...

    African Journals Online (AJOL)

    Calabar Owerri and Port-Harcourt recorded the highest erosive storms/ more months of very high erosivity index. The deterministic relationship between kinetic energy of rains and erosivity pattern observed for the different stations showed that erosive rains contribute significantly to detachment of soil materials in the study ...

  3. Are minor echocardiographic changes associated with an increased risk of acute rheumatic fever or progression to rheumatic heart disease?

    Science.gov (United States)

    Rémond, Marc; Atkinson, David; White, Andrew; Brown, Alex; Carapetis, Jonathan; Remenyi, Bo; Roberts, Kathryn; Maguire, Graeme

    2015-11-01

    The World Heart Federation criteria for the echocardiographic diagnosis of rheumatic heart disease (RHD) include a category "Borderline" RHD which may represent the earliest evidence of RHD. We aimed to determine the significance of minor heart valve abnormalities, including Borderline RHD, in predicting the future risk of acute rheumatic fever (ARF) or RHD. A prospective cohort study of Aboriginal and Torres Strait Islander children aged 8 to 18 years was conducted. Cases comprised children with Borderline RHD or other minor non-specific valvular abnormalities (NSVAs) detected on prior echocardiography. Controls were children with a prior normal echocardiogram. Participants underwent a follow-up echocardiogram 2.5 to 5 years later to assess for progression of valvular changes and development of Definite RHD. Interval diagnoses of ARF were ascertained. There were 442 participants. Cases with Borderline RHD were at significantly greater risk of ARF (incidence rate ratio 8.8, 95% CI 1.4-53.8) and any echocardiographic progression of valve lesions (relative risk 8.19, 95% CI 2.43-27.53) than their Matched Controls. Cases with Borderline RHD were at increased risk of progression to Definite RHD (1 in 6 progressed) as were Cases with NSVAs (1 in 10 progressed). Children with Borderline RHD had an increased risk of ARF, progression of valvular lesions, and development of Definite RHD. These findings provide support for considering secondary antibiotic prophylaxis or ongoing surveillance echocardiography in high-risk children with Borderline RHD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Rheumatoid arthritis affecting temporomandibular joint

    Directory of Open Access Journals (Sweden)

    Amandeep Sodhi

    2015-01-01

    Full Text Available Rheumatoid arthritis (RA is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT in diagnosing the bony changes in the early phase of the disease.

  5. Enhanced MR imaging of the shoulder, and sternoclavicular and acromioclavicular joint arthritis in primary hemochromatosis.

    Science.gov (United States)

    Farpour, Farzin; Phan, San J; Burns, Joseph; Tehranzadeh, Jamshid

    2011-03-01

    Shoulder arthritis is a common feature of hemochromatosis. However, a combination of sternoclavicle (SC) and acromioclavicular (AC) joint involvement associated with shoulder is uncommonly seen. We describe the MR imaging findings of the shoulder and SC and AC joint in a patient with primary hemochromatosis. MRI of the left shoulder revealed inflammatory arthritis and 1-cm erosion of the humeral head, enlargement of the anterior glenoid labrum and formation of glenoid labral ovoid mass due to iron deposit. MRI of the AC joint showed inflammation and erosion with joint fluid. Significant contrast enhancement was noted at the SC joint due to inflammation.

  6. Prevalence of Rheumatic Heart Disease in a Public School of Belo Horizonte

    Directory of Open Access Journals (Sweden)

    Lavinia Pimentel Miranda

    2014-08-01

    Full Text Available Background: Previous studies indicate that compared with physical examination, Doppler echocardiography identifies a larger number of cases of rheumatic heart disease in apparently healthy individuals. Objectives: To determine the prevalence of rheumatic heart disease among students in a public school of Belo Horizonte by clinical evaluation and Doppler echocardiography. Methods: This was a cross-sectional study conducted with 267 randomly selected school students aged between 6 and 16 years. students underwent anamnesis and physical examination with the purpose of establishing criteria for the diagnosis of rheumatic fever. They were all subjected to Doppler echocardiography using a portable machine. Those who exhibited nonphysiological mitral regurgitation (MR and/or aortic regurgitation (AR were referred to the Doppler echocardiography laboratory of the Hospital das Clínicas of the Universidade Federal of Minas Gerais (HC-UFMG to undergo a second Doppler echocardiography examination. According to the findings, the cases of rheumatic heart disease were classified as definitive, probable, or possible. Results: Of the 267 students, 1 (0.37% had a clinical history compatible with the diagnosis of acute rheumatic fever (ARF and portable Doppler echocardiography indicated nonphysiological MR and/or AR in 25 (9.4%. Of these, 16 (6% underwent Doppler echocardiography at HC-UFMG. The results showed definitive rheumatic heart disease in 1 student, probable rheumatic heart disease in 3 students, and possible rheumatic heart disease in 1 student. Conclusion: In the population under study, the prevalence of cases compatible with rheumatic involvement was 5 times higher on Doppler echocardiography (18.7/1000; 95% CI 6.9/1000-41.0/1000 than on clinical evaluation (3.7/1000-95% CI.

  7. Prevalence of Rheumatic Heart Disease in a Public School of Belo Horizonte

    Energy Technology Data Exchange (ETDEWEB)

    Miranda, Lavinia Pimentel, E-mail: lavinia.pimentel@globo.com; Camargos, Paulo Augusto Moreira; Torres, Rosália Morais; Meira, Zilda Maria Alves [Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil)

    2014-08-15

    Previous studies indicate that compared with physical examination, Doppler echocardiography identifies a larger number of cases of rheumatic heart disease in apparently healthy individuals. To determine the prevalence of rheumatic heart disease among students in a public school of Belo Horizonte by clinical evaluation and Doppler echocardiography. This was a cross-sectional study conducted with 267 randomly selected school students aged between 6 and 16 years. students underwent anamnesis and physical examination with the purpose of establishing criteria for the diagnosis of rheumatic fever. They were all subjected to Doppler echocardiography using a portable machine. Those who exhibited nonphysiological mitral regurgitation (MR) and/or aortic regurgitation (AR) were referred to the Doppler echocardiography laboratory of the Hospital das Clínicas of the Universidade Federal of Minas Gerais (HC-UFMG) to undergo a second Doppler echocardiography examination. According to the findings, the cases of rheumatic heart disease were classified as definitive, probable, or possible. Of the 267 students, 1 (0.37%) had a clinical history compatible with the diagnosis of acute rheumatic fever (ARF) and portable Doppler echocardiography indicated nonphysiological MR and/or AR in 25 (9.4%). Of these, 16 (6%) underwent Doppler echocardiography at HC-UFMG. The results showed definitive rheumatic heart disease in 1 student, probable rheumatic heart disease in 3 students, and possible rheumatic heart disease in 1 student. In the population under study, the prevalence of cases compatible with rheumatic involvement was 5 times higher on Doppler echocardiography (18.7/1000; 95% CI 6.9/1000-41.0/1000) than on clinical evaluation (3.7/1000-95% CI)

  8. FORECAST THE SOIL EROSION THROUGH THE CARTOGRAMS

    OpenAIRE

    Mădălina - Cristina Marian

    2014-01-01

    Soil erosion in Arges County affects a high percentage of agricultural land. Most agricultural lands are located on slopes undergoing erosion, excess humidity temporarily or permanently, landslides. The importance lies in the need to know theme addressed erosion, the erosive potential of the land, the causes and factors that led to the onset of erosion and its deployment at a accelerated rate and now, because the based on this knowledge to determine the effective measures to prevent and c...

  9. Tolerable soil erosion in Europe

    Science.gov (United States)

    Verheijen, Frank; Jones, Bob; Rickson, Jane; Smith, Celina

    2010-05-01

    Soil loss by erosion has been identified as an important threat to soils in Europe* and is recognised as a contributing process to soil degradation and associated deterioration, or loss, of soil functioning. From a policy perspective, it is imperative to establish well-defined baseline values to evaluate soil erosion monitoring data against. For this purpose, accurate baseline values - i.e. tolerable soil loss - need to be differentiated at appropriate scales for monitoring and, ideally, should take soil functions and even changing environmental conditions into account. The concept of tolerable soil erosion has been interpreted in the scientific literature in two ways: i) maintaining the dynamic equilibrium of soil quantity, and ii) maintaining biomass production, at a location. The first interpretation ignores soil quality by focusing only on soil quantity. The second approach ignores many soil functions by focusing only on the biomass (particularly crop) production function of soil. Considering recognised soil functions, tolerable soil erosion may be defined as 'any mean annual cumulative (all erosion types combined) soil erosion rate at which a deterioration or loss of one or more soil functions does not occur'. Assumptions and problems of this definition will be discussed. Soil functions can generally be judged not to deteriorate as long as soil erosion does not exceed soil formation. At present, this assumption remains largely untested, but applying the precautionary principle appears to be a reasonable starting point. Considering soil formation rates by both weathering and dust deposition, it is estimated that for the majority of soil forming factors in most European situations, soil formation rates probably range from ca. 0.3 - 1.4 t ha-1 yr-1. Although the current agreement on these values seems relatively strong, how the variation within the range is spatially distributed across Europe and how this may be affected by climate, land use and land management

  10. Reusable Solid Rocket Motor Nozzle Joint-4 Thermal Analysis

    Science.gov (United States)

    Clayton, J. Louie

    2001-01-01

    This study provides for development and test verification of a thermal model used for prediction of joint heating environments, structural temperatures and seal erosions in the Space Shuttle Reusable Solid Rocket Motor (RSRM) Nozzle Joint-4. The heating environments are a result of rapid pressurization of the joint free volume assuming a leak path has occurred in the filler material used for assembly gap close out. Combustion gases flow along the leak path from nozzle environment to joint O-ring gland resulting in local heating to the metal housing and erosion of seal materials. Analysis of this condition was based on usage of the NASA Joint Pressurization Routine (JPR) for environment determination and the Systems Improved Numerical Differencing Analyzer (SINDA) for structural temperature prediction. Model generated temperatures, pressures and seal erosions are compared to hot fire test data for several different leak path situations. Investigated in the hot fire test program were nozzle joint-4 O-ring erosion sensitivities to leak path width in both open and confined joint geometries. Model predictions were in generally good agreement with the test data for the confined leak path cases. Worst case flight predictions are provided using the test-calibrated model. Analysis issues are discussed based on model calibration procedures.

  11. Ceramic joints

    Science.gov (United States)

    Miller, Bradley J.; Patten, Jr., Donald O.

    1991-01-01

    Butt joints between materials having different coefficients of thermal expansion are prepared having a reduced probability of failure of stress facture. This is accomplished by narrowing/tapering the material having the lower coefficient of thermal expansion in a direction away from the joint interface and not joining the narrow-tapered surface to the material having the higher coefficient of thermal expansion.

  12. VALUE OF RHEUMATIC PATIENTS' AWARENESS OF HAVING INFECTIOUS COMORBIDITIES

    Directory of Open Access Journals (Sweden)

    Rimma Mikhailovna Balabanova

    2010-01-01

    Results. The patients with RD frequently reported to have nasopharyngeal infection. The latter was accompanied by an exacerbation of articular syndrome in more than half of the patients with RD. The rate of pneumonias experienced by patients with systemic lupus erythematosus (SLE (10/55 engages our attention. Urogenital tract infections (mainly cystitis and pyelonephritis are more typical of patients with rheumatic arthritis (RA and those with osteoarthrosis (OA, respectively. The clinical manifestations of herpes simplex virus type 1 (HSV-1 recurred most frequently in patients with SLE and those with OA and less in patients with RA. The percentage of HSV-1 recurrences was high in the medical staff. Conclusion. The findings suggest that it is necessary to thoroughly collect medical history data especially in patients who need aggressive immunosuppressive therapy as activation of latent infection makes management of these patients difficult

  13. Rheumatic fever pathogenesis: Approach in research needs change

    Directory of Open Access Journals (Sweden)

    Rajendra Tandon

    2012-01-01

    Full Text Available Despite identifying that rheumatic fever (RF is the result of an immunological reaction following group-A beta-hemolytic streptococcal infection, the pathogenesis remains elusive. RF has been incorrectly designated as causing pancarditis, since it does not cause myocarditis. Research directed toward myocarditis, targeting myosin to unravel the pathogenesis has not succeeded in more than 60 years. RF causes permanent damage to cardiac valves. The mitral valve (MV, derived from the wall of the left ventricle, is composed of a central core of connective tissue, covered on both sides by endothelium. The left ventricle does not have either myocardial or intermyocardial connective tissue involvement in RF. By exclusion, therefore, the primary site of RF damage appears to be the endothelium. Evaluation of the histopathology and immunopathology indicates that RF is a disease of the valvular and vascular endothelium. It is not a connective tissue disorder. Research to identify pathogenesis needs to be focused toward valvular endothelium.

  14. The acetyl code in rheumatoid arthritis and other rheumatic diseases.

    Science.gov (United States)

    Angiolilli, Chiara; Baeten, Dominique L; Radstake, Timothy R; Reedquist, Kris A

    2017-04-01

    Growing evidence supports the idea that aberrancies in epigenetic processes contribute to the onset and progression of human immune-mediated inflammatory diseases, such as rheumatoid arthritis (RA). Epigenetic regulators of histone tail modifications play a role in chromatin accessibility and transcriptional responses to inflammatory stimuli. Among these, histone deacetylases (HDACs) regulate the acetylation status of histones and nonhistone proteins, essential for immune responses. Broad-spectrum HDAC inhibitors are well-known anti-inflammatory agents and reduce disease severity in animal models of arthritis; however, selective HDAC inhibitors remain poorly studied. In this review, we describe emerging findings regarding the aberrant acetyl code in RA and other rheumatic disorders which may help identify not only novel diagnostic and prognostic clinical biomarkers for RA, but also new targets for epigenetic pharmacological applications.

  15. Prevention of rheumatic Fever and heart disease: nepalese experience.

    Science.gov (United States)

    Regmi, Prakash Raj; Wyber, Rosemary

    2013-09-01

    Rheumatic heart disease (RHD) is a major public health problem in Nepal that affects young children and adolescents. Historically, many young people suffered severe valvular disease and died awaiting heart valve replacement. For some years, the Nepal Heart Foundation (NHF) advocated for a more comprehensive program to reduce the burden of RHD. In 2007, the government of Nepal announced funding for an RHD control program to be implemented by the NHF. The core focus of the program was to deliver antibiotics for the secondary prophylaxis of RHD. The NHF has developed a program of community awareness, free medication, RHD register development, health worker training, guideline development, and clinical audit. These services are being implemented with expanding geographic scope. This paper provides a narrative overview of the Nepalese experience designing, implementing, and beginning to evaluate this program. Challenges and successes relevant to register-based programs are highlighted. Copyright © 2013 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

  16. Cryotherapy in rheumatic disorders; Kryotherapie bei rheumatischen Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Soerensen, H. [Rheumaklinik Immanuel-Krankenhaus, Berlin (Germany). Innere Rheumatologische Abt.

    1994-12-31

    When applied locally, cold therapy (cryotherapy) has the effect of inhibiting inflammation, occluding blood vessels, and stopping bleeding. Active rheumatic inflammation, activated arthrosis, and swelling after injury can be alleviated by local cold application, while heat application would worsen the situation. In whole-body cryotherapy the whole patient, wearing only a bathing suit, is exposed to a temperature of -100 C. The present paper descrcribes the cold room of the Immanuel Hospital in Berlin-Wannsee. (BWI) [Deutsch] Kaeltetherapie (Kryotherapie) wirkt lokal angewendet entzuendungshemmend, blutgefaessabdichtend und blutstillend. Eine aktive rheumatische Entzuendung, aktivierte Arthrose und Schwellungsreaktionen bei Verletzungen werden durch lokale Kaelteanwendungen gedaempft, wogegen Waerme den akuten Zustand verschlimmern wuerde. In der Ganzkoerperkaeltetherapie wird der ganze Mensch in Badebekleidung einer realen Temperatur von -100 C ausgesetzt. Der vorliegende Beitrag beschreibt die Kaeltekammer des Immanuel Krankenhauses in Berlin Wannsee. (BWI)

  17. Clinical presentation of rheumatic fever in an endemic area.

    Science.gov (United States)

    Cann, Megan P; Sive, Alan A; Norton, Robert E; McBride, William J H; Ketheesan, Natkunam

    2010-06-01

    This study documented whether patients diagnosed with acute rheumatic fever (ARF) in North Queensland, Australia, conformed to the 1992 Revised Jones Criteria (RJC). The authors aimed to determine whether inclusion of subclinical carditis (SCC) and monarthritis as major manifestations and a low-grade temperature as a minor manifestation in the RJC are justified in this population. A retrospective review of patients in whom the diagnosis of ARF relied on the experience of clinicians and who were admitted to the Townsville and Cairns Base Hospitals between 1997 and 2007 was undertaken. Of the 98 cases reviewed, 71.4% satisfied the RJC. Modification of the RJC increased the rate of criteria satisfaction to 91.8%. On presentation, 27 patients had SCC. Of the patients with SCC followed up, 70.5% had long-term valvular consequences. In populations endemic for ARF, monarthritis, SCC and a low-grade temperature should be included in the RJC.

  18. A short history of anti-rheumatic therapy - V. Analgesics

    Directory of Open Access Journals (Sweden)

    P. Marson

    2011-06-01

    Full Text Available The pharmacological treatment of pain has very ancient origins, when plant-derived products were used, including mandrake extracts and opium, a dried latex obtained from Papaver somniferum. In the XVI and XVII centuries opium came into the preparation of two compounds widely used for pain relief: laudanum and Dover’s powder. The analgesic properties of extracts of willow bark were then recognized and later, in the second half of the XIX century, experimental studies on chemically synthesized analgesics were planned, thus promoting the marketing of some derivatives of para-amino-phenol and pyrazole, the predecessors of paracetamol and metamizol. In the XX century, nonsteroidal anti-inflammatory drugs were synthesized, such as phenylbutazone, which was initially considered primarily a pain medication. The introduction on the market of centrally acting analgesics, such as tramadol, sometimes used in the treatment of rheumatic pain. is quite recent.

  19. [Tooth erosion - a multidisciplinary approach].

    Science.gov (United States)

    Strużycka, Izabela; Rusyan, Ewa; Bogusławska-Kapała, Agnieszka

    2016-02-01

    During the last decades, an increasingly greater interest in dental erosion has been observed in clinical dental practice, in dental public health and in dental research because prevalence of erosive tooth wear is still increasing especially in young age group of population. Erosive tooth wear is a multifactorial etiology process characterized by progressive loss of hard dental tissue. It is defined as the exogenous and/or endogenous acids dissolution of the dental tissue, without bacterial involvement. In the development of dental erosive wear, interactions are required which include chemical, biological, behavioral, diet, time, socioeconomic, knowledge, education, and general health factors. Examples of risk groups could be patients with eating disorders, like anorexia nervosa or bulimia nervosa, gastroesophageal reflux disease, chronic alcohol abuse or dependence. Special nutrition habits groups with high consumption of soft or sport drinks, special diets like vegetarian, vegan or raw food diet, the regular intake of drugs, medications and food supplements can also increase the risk for dental erosion. Comprehensive knowledge of the different risk and protective factors is a perquisite for initiating adequate preventive measures. © 2016 MEDPRESS.

  20. The costs of soil erosion

    Directory of Open Access Journals (Sweden)

    Tiago Santos Telles

    2011-04-01

    Full Text Available The aim of this study was a survey of the estimated costs of soil erosion, an issue of fundamental importance in view of the current worldwide discussions on sustainability. A list was drawn up of research papers on erosion (on-site and off-site effects and their respective costs. The estimates indicate the amount of resources spent in the process of soil degradation, raising a general awareness of the need for soil conservation. On-site costs affect the production units directly, while off-site costs create a burden borne by the environment, economy and society. In addition, estimating the costs of soil erosion should be effective to alert the agricultural producers, society and government for the need for measures that can be implemented to bring erosion under control. Among the various estimates of soil erosion costs between 1933 a 2010, the highest figure was 45.5 billion dollars a year for the European Union. In the United States, the highest figure was 44 billion dollars a year. In Brazil, estimates for the state of Paraná indicate a value of 242 million dollars a year, and for the state of São Paulo, 212 million dollars a year. These figures show, above all, that conservation measures must be implemented if crop and livestock farming production are to be sustainable.

  1. Evaluation of foot static disturbances in patients with rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Anna Kuryliszyn-Moskal

    2017-04-01

    Full Text Available Objectives : Rheumatic diseases such as osteoarthritis and rheumatoid arthritis constitute the most frequent pathological states leading to the development of foot deformities, which reduce quality of life and cause disability. The aim of the present study was to compare the results of plantoconturographic examinations, obtained by means of a computer podoscope, in osteoarthritis and rheumatoid arthritis patients. Special attention was paid to the differences in the values of each parameter determining the level of foot function. Material and methods : The study was performed in 94 female patients divided into two groups according to the type of disease. There were 54 patients with rheumatoid arthritis and 40 with osteoarthritis. The control group consisted of 34 healthy women. The plantographic assessment of static foot structure was carried out by means of a device for computer-aided foot examination. Results : A fallen transverse arch of the right foot was statistically much more frequent in the rheumatoid arthritis patients than in osteoarthritis patients or the control group (p < 0.005 and p < 0.05, respectively. Significant differences in the values of the Wejsflog index were observed in the case of left foot between rheumatoid arthritis patients and the control group (p < 0.05. Similarly, there were statistically significant differences in the values of the hallux valgus angle ( for the right foot between rheumatoid arthritis and osteoarthritis patients or control group (in both cases p < 0.05. Conclusions : Rheumatic diseases predispose patients to disturbances of static foot function. The obtained results highlight the importance of diagnosing foot static disturbances in the prevention of destructive changes affecting the functioning of osteoarthritis and rheumatoid arthritis patients.

  2. Evaluation of foot static disturbances in patients with rheumatic diseases.

    Science.gov (United States)

    Kuryliszyn-Moskal, Anna; Kaniewska, Katarzyna; Dzięcioł-Anikiej, Zofia; Klimiuk, Piotr Adrian

    2017-01-01

    Rheumatic diseases such as osteoarthritis and rheumatoid arthritis constitute the most frequent pathological states leading to the development of foot deformities, which reduce quality of life and cause disability. The aim of the present study was to compare the results of plantoconturographic examinations, obtained by means of a computer podoscope, in osteoarthritis and rheumatoid arthritis patients. Special attention was paid to the differences in the values of each parameter determining the level of foot function. The study was performed in 94 female patients divided into two groups according to the type of disease. There were 54 patients with rheumatoid arthritis and 40 with osteoarthritis. The control group consisted of 34 healthy women. The plantographic assessment of static foot structure was carried out by means of a device for computer-aided foot examination. A fallen transverse arch of the right foot was statistically much more frequent in the rheumatoid arthritis patients than in osteoarthritis patients or the control group (p < 0.005 and p < 0.05, respectively). Significant differences in the values of the Wejsflog index were observed in the case of left foot between rheumatoid arthritis patients and the control group (p < 0.05). Similarly, there were statistically significant differences in the values of the hallux valgus angle (α) for the right foot between rheumatoid arthritis and osteoarthritis patients or control group (in both cases p < 0.05). Rheumatic diseases predispose patients to disturbances of static foot function. The obtained results highlight the importance of diagnosing foot static disturbances in the prevention of destructive changes affecting the functioning of osteoarthritis and rheumatoid arthritis patients.

  3. Animal models to investigate the pathogenesis of rheumatic heart disease.

    Science.gov (United States)

    Rush, Catherine M; Govan, Brenda L; Sikder, Suchandan; Williams, Natasha L; Ketheesan, Natkunam

    2014-01-01

    Rheumatic fever (RF) and rheumatic heart disease (RHD) are sequelae of group A streptococcal (GAS) infection. Although an autoimmune process has long been considered to be responsible for the initiation of RF/RHD, it is only in the last few decades that the mechanisms involved in the pathogenesis of the inflammatory condition have been unraveled partly due to experimentation on animal models. RF/RHD is a uniquely human condition and modeling this disease in animals is challenging. Antibody and T cell responses to recombinant GAS M protein (rM) and the subsequent interactions with cardiac tissue have been predominantly investigated using a rat autoimmune valvulitis model. In Lewis rats immunized with rM, the development of hallmark histological features akin to RF/RHD, both in the myocardial and in valvular tissue have been reported, with the generation of heart tissue cross-reactive antibodies and T cells. Recently, a Lewis rat model of Sydenham's chorea and related neuropsychiatric disorders has also been described. Rodent models are very useful for assessing disease mechanisms due to the availability of reagents to precisely determine sequential events following infection with GAS or post-challenge with specific proteins and or carbohydrate preparations from GAS. However, studies of cardiac function are more problematic in such models. In this review, a historical overview of animal models previously used and those that are currently available will be discussed in terms of their usefulness in modeling different aspects of the disease process. Ultimately, cardiologists, microbiologists, immunologists, and physiologists may have to resort to diverse models to investigate different aspects of RF/RHD.

  4. Enhanced anti-rheumatic activity of methotrexate-entrapped ultradeformable liposomal gel in adjuvant-induced arthritis rat model.

    Science.gov (United States)

    Zeb, Alam; Qureshi, Omer Salman; Yu, Chan-Hee; Akram, Muhammad; Kim, Hyung-Seo; Kim, Myung-Sic; Kang, Jong-Ho; Majid, Arshad; Chang, Sun-Young; Bae, Ok-Nam; Kim, Jin-Ki

    2017-06-15

    The aim of this study is to investigate in vivo anti-rheumatic activity of methotrexate-entrapped ultradeformable liposomal gel (MTX-UDLs-gel) in adjuvant-induced arthritis rat model. Methotrexate-entrapped ultradeformable liposomes (MTX-UDLs) with the optimal phosphatidylcholine to Tween 80 ratio (7:3, w/w) were incorporated into 1% Carbopol gel. MTX-UDLs-gel was characterized in terms of appearance, clarity, homogeneity, pH and drug content. The permeation of MTX-UDLs-gel across rat skin was investigated using Franz diffusion cell. In vivo anti-rheumatic activity of MTX-UDLs-gel was assessed in terms of edema volume, paw edema and leukocyte infiltration scores, histopathological analysis and inflammatory cytokines level in complete Freund's adjuvant (CFA)-induced arthritis rat model. MTX-UDLs-gel showed good homogeneity and clarity, neutral pH and about 99.5% drug content. The cumulative amount of MTX permeated for 24h from MTX-UDLs-gel (164.6μg) was 1.5 and 2.15 times higher than that of MTX-CLs-gel (113.3μg) and MTX-plain-gel (76.6μg), respectively. MTX-UDLs-gel significantly alleviated the severity of inflammation by reducing edema volume, histological scores and accumulation of neutrophils and improving tissue architecture in CFA-induced arthritis rat model. MTX-UDLs-gel effectively suppressed the expression of pro-inflammatory cytokines, TNF-α and IL-1β, in paw tissues. In conclusion, the developed MTX-UDLs-gel has a great potential for effective delivery of MTX into the inflamed joints in rheumatoid arthritis. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Bentonite erosion. Laboratory studies

    Energy Technology Data Exchange (ETDEWEB)

    Jansson, Mats (Div. of Nuclear Chemistry, Royal Inst. of Technology, Stockholm (Sweden), School of Chemical Science and Engineering)

    2009-11-15

    This report covers the laboratory studies that have been performed at Nuclear Chemistry, KTH in the project 'Bentonite Erosion'. Many of the experiments in this report were performed to support the work of the modelling group and were often relatively simple. One of the experiment series was performed to see the impact of gravity and concentration of mono- and di-valent cations. A clay suspension was prepared in a test tube. A net was placed in contact with the suspension, the test tube was filled with solutions of different concentrations and the system was left overnight to settle. The tube was then turned upside down and the behaviour was visually observed. Either the clay suspension fell through the net or stayed on top. By using this method surprisingly sharp determinations of the Critical Coagulation (Flocculation) Concentration (CCC/CFC) could be made. The CCC/CFC of Ca2+ was for sodium montmorillonite determined to be between 1 and 2 mM. An artificial fracture was manufactured in order to simulate the real case scenario. The set-up was two Plexiglas slabs separated by 1 mm thick spacers with a bentonite container at one side of the fracture. Water was pumped with a very low flow rate perpendicular to bentonite container and the water exiting the fracture was sampled and analyzed for colloid content. The bentonite used was treated in different ways. In the first experiment a relatively montmorillonite rich clay was used while in the second bentonite where only the readily soluble minerals had been removed was used. Since Plexiglas was used it was possible to visually observe the bentonite dispersing into the fracture. After the compacted bentonite (1,000 kg/m3) had been water saturated the clay had expanded some 12 mm out into the fracture. As the experiment progressed the clay expanded more out into the fracture and seemed to fractionate in two different phases with less material in the outmost phase. A dark rim which was later analyzed to contain

  6. The prevalence of symptomatic hand osteoarthritis in Tehran: Community-oriented program for Control of Rheumatic Diseases- COPCORD

    Directory of Open Access Journals (Sweden)

    Dahaghin S

    2009-09-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Osteoarthritis is the most common form of arthritis in the world. This study presents the evidence on the prevalence of symptomatic hand osteoarthritis in urban community. To add to the evidence on the prevalence of symptomatic hand osteoarthritis in urban community."n"nMethods: Inhabitants (age≥15 yrs in 22 randomly selected districts (Tehran participated in a Community-Oriented Program for Control of Rheumatic Diseases (COPCORD evaluating major rheumatic disorders, including osteoarthritis. Eventually, 10, 291 inhabitants completed a Questionnaire (75% response-rate. Trained interviewers asked participants whether they had had any pain, swelling, tenderness, or morning stiffness in the right/ left hand during previous seven days. Participants underwent a complete physical examination if they had any musculoskeletal complaint or extra-articular manifestation of rheumatic disease. Osteoarthritis was defined as presence of palpable nodules (Heberden's/ Bouchard's nodes, CMC1's squaring, pain, tenderness, swelling, or a combination of them on that joint (DIP-PIP-MCP-CMC1. Clinical hand osteoarthritis was positive if at least one joint showed osteoarthritis. "n"nResults: Symptomatic hand

  7. European League Against Rheumatism recommendations for the inclusion of patient representatives in scientific projects

    NARCIS (Netherlands)

    de Wit, M.P.T.; Berlo, S.E.; Aanerud, G.J.; Aletaha, D.; Bijlsma, J.W.; Croucher, L.; Da Silva, J.A.P.; Glusing, B.; Gossec, L.; Hewlett, S.; Jongkees, M.; Magnusson, D.; Scholte-Voshaar, M.; Richards, P.; Ziegler, C.; Abma, T.A.

    2011-01-01

    Objective: To develop recommendations to enable successful inclusion of the patient perspective in European League Against Rheumatism (EULAR)-funded scientific research projects. Methods: The EULAR standardised operational procedures for guideline development were followed. A systematic literature

  8. Analysis of skin blood microflow oscillations in patients with rheumatic diseases

    Science.gov (United States)

    Mizeva, Irina; Makovik, Irina; Dunaev, Andrey; Krupatkin, Alexander; Meglinski, Igor

    2017-07-01

    Laser Doppler flowmetry (LDF) has been applied for the assessment of variation in blood microflows in patients with rheumatic diseases and healthy volunteers. Oscillations of peripheral blood microcirculation observed by LDF have been analyzed utilizing a wavelet transform. A higher amplitude of blood microflow oscillations has been observed in a high frequency band (over 0.1 Hz) in patients with rheumatic diseases. Oscillations in the high frequency band decreased in healthy volunteers in response to the cold pressor test, whereas lower frequency pulsations prevailed in patients with rheumatic diseases. A higher perfusion rate at normal conditions was observed in patients, and a weaker response to cold stimulation was observed in healthy volunteers. Analysis of blood microflow oscillations has a high potential for evaluation of mechanisms of blood flow regulation and diagnosis of vascular abnormalities associated with rheumatic diseases.

  9. Evidence-based recommendations for treatment with methotrexate in rheumatic disorders

    DEFF Research Database (Denmark)

    Madsen, Ole Rintek; Faurschou, Mikkel; Loft, Anne Gitte

    2010-01-01

    The aim of this study was to develop 3E (Evidence, Expertise, Exchange) recommendations (RCs) on the use of methotrexate in rheumatic disorders and to assess the agreement among Danish rheumatologists....

  10. The role of psychological factors in inflammatory rheumatic diseases: From burden to tailored treatment

    NARCIS (Netherlands)

    Middendorp, H. van; Evers, A.W.M.

    2016-01-01

    Inflammatory rheumatic diseases have a long-lasting effect on patients' physical and psychological functioning, for instance, due to disabling symptoms and unpredictable disease course. Consequently, many patients show adjustment problems such as depressed mood, which in turn can negatively

  11. Rheumatic diseases induced by drugs and environmental factors: the state-of-the-art - part one.

    Science.gov (United States)

    Niklas, Karolina; Niklas, Arkadiusz A; Majewski, Dominik; Puszczewicz, Mariusz

    2016-01-01

    The majority of rheumatic diseases belong to the group of autoimmune diseases and are associated with autoantibody production. Their etiology is not fully understood. Certain medications and environmental factors may have an influence on the occurrence of rheumatic diseases. Establishing a cause-effect relationship between a certain factor and disease induction is not always simple. It is important to administer the drug continuously or monitor exposure to a given factor in the period preceding the onset of symptoms. The lack of previously diagnosed autoimmune disease, or finally the lack of symptoms within a few weeks/months after discontinuation of the drug/cessation of exposure, is also important. The most frequently mentioned rheumatic diseases caused by drugs and environmental factors include systemic lupus erythematosus, scleroderma, systemic vasculitis, polymyositis, dermatomyositis, and Sjögren's syndrome. The objective of this study is to summarize current knowledge on rheumatic diseases induced by drugs and environmental factors.

  12. Rheumatic diseases induced by drugs and environmental factors: the state-of-the-art - part two.

    Science.gov (United States)

    Niklas, Karolina; Niklas, Arkadiusz A; Majewski, Dominik; Puszczewicz, Mariusz J

    2016-01-01

    The majority of rheumatic diseases belong to the group of autoimmune diseases and are associated with autoantibody production. Their etiology is not fully understood. Certain medications and environmental factors may have an influence on the occurrence of rheumatic diseases. Establishing a cause-effect relationship between a certain factor and disease induction is not always simple. It is important to administer the drug continuously or monitor exposure to a given factor in the period preceding the onset of symptoms. The lack of early diagnosed autoimmune disease, or finally the lack of symptoms within a few weeks/months after discontinuation of the drug/cessation of exposure, is also important. The most frequently mentioned rheumatic diseases caused by drugs and environmental factors include systemic lupus erythematosus (SLE), scleroderma, systemic vasculitis, polymyositis, dermatomyositis, and Sjögren's syndrome. The objective of this study is to summarize current knowledge on rheumatic diseases induced by drugs and environmental factors.

  13. Modified radial v/s biatrial maze for atrial fibrillation in rheumatic valvular heart surgery

    Directory of Open Access Journals (Sweden)

    Sajid A. Sayed

    2014-09-01

    Discussion: In patients with AF undergoing rheumatic valvular surgery, radiofrequency radial approach is as effective as modified Cox's maze III for conversion to NSR with better atrial transport function.

  14. Soil erosion in Slovene Istria

    Directory of Open Access Journals (Sweden)

    Matjaž Mikoš

    2009-12-01

    Full Text Available From the end of nineties of the 20th century, intense hydrologic and geomorphologic research is taking place in the Slovene Istria. As a part of this research also studies on soil erosion were undertaken in the period from 2005 to 2008. The field measurements were under taken onclosed 1m2 large erosion plots under three different land uses (on bare soils in an olive grove, on an overgrown meadow, in a forest, placed south of the Marezige village in the Rokava River basin.We show weekly measurements of surface erosion (interrill erosion for the period of 13 months (the end of March 2005 – the end of April 2006, as well as monthly and seasonal averages together with selected linear statistical correlations between soil erosion and weather parameters.From May 2005 to April 2006 the interrill erosion on bare soils in an olive grove with an inclination of 5.5° amounted to 9013 g/m2 (90 t/ha that corresponds to surface lowering rate of 8.5 mm/yr; on an overgrown meadow with an inclination of 9.4° it amounted to 168 g/m2 (1,68 t/ha that corresponds to surface lowering rate of 0.16 mm//yr; and in a forest with an inclination of 7.8° it amounted to 391 g/m2 (3,91 t/ha and in a forest with an inclination of 21.4° it amounted to 415 g/m2 (4,15 t/ha, respectively, that corresponds to surface lowering rate of 0.4 mm/yr.

  15. Myocardial Infarction in a Young Female with Palindromic Rheumatism: A Consequence of Negative Remodeling

    Directory of Open Access Journals (Sweden)

    Timothy R. Larsen

    2012-01-01

    Full Text Available Palindromic rheumatism is a rare disease associated with systemic inflammation. Negative or constrictive coronary artery remodeling is typically not seen until the 7th or 8th decade of life. We report a case of a young female with palindromic rheumatism who suffered a non-ST segment elevation myocardial infarction secondary to a flow-limiting lesion that demonstrated negative remodeling by intravascular ultrasound (IVUS.

  16. Adherence to secondary prophylaxis and disease recurrence in 536 Brazilian children with rheumatic fever

    OpenAIRE

    de Oliveira Sheila KF; Torres Juliana M; Lopez-Benitez Jorge M; Pelajo Christina F

    2010-01-01

    Abstract Background More than 15 million people worldwide have rheumatic fever (RF) and rheumatic heart disease due to RF. Secondary prophylaxis is a critical cost-effective intervention for preventing morbidity and mortality related to RF. Ensuring adequate adherence to secondary prophylaxis for RF is a challenging task. This study aimed to describe the rates of recurrent episodes of RF, quantify adherence to secondary prophylaxis, and examine the effects of medication adherence to the rates...

  17. Penicillin Therapy in Children with Acute Rheumatic Fever: Side Effects, Malpractice and Anaphylactic Reactions

    OpenAIRE

    Murat Çiftel; Ayşe Süleyman; Halil Ertuğ

    2015-01-01

    Acute rheumatic fever (ARF) is more common in developing countries. ARF is a systemic disorder, which develops in children following group A streptococcal (GAS) pharyngitis. Rheumatic valvular disease is caused by autoimmune responses. Penicillin is used in the treatment of GAS tonsillopharyngitis and in primary and secondary prophylaxis against ARF. A single intramuscular (IM) injection of benzathine penicillin or oral penicillin V (phenoxymethylpenicillin) is administered as primary prophyl...

  18. Analysis of the affected joints in rheumatoid arthritis patients in a large Japanese cohort.

    Science.gov (United States)

    Kanazawa, Teruhisa; Nishino, Jinju; Tohma, Shigeto; Tanaka, Sakae

    2013-01-01

    Rheumatoid arthritis (RA) is a chronic inflammatory disorder involving multiple joints. We investigated the distribution of the affected joints and the relationships among this distribution, the disease activity, and the disease duration in Japanese RA patients by cross-sectional analysis using the National Database of Rheumatic Diseases by iR-net in Japan. A total of 6408 RA patients registered in the database were analyzed. In each patient, the location of joint swelling and joint tenderness of 68 joints was examined, and the relationships among the distribution of the affected joints, the disease activity as determined using the DAS28-ESR, and the disease duration were analyzed statistically. For the 6408 RA patients examined, the wrist was the most frequently affected site. There were some differences in the prevalence of tenderness and swelling; tenderness was frequently observed in large joints such as the knee, elbow and shoulder, while swelling was frequently observed in small joints such as the metacarpophalangeal joints. Although the frequency of involvement increased in all joints as disease activity increased, the pattern of distribution was not affected by disease activity. Furthermore, the distribution was not influenced by disease duration. Based on the results of this study, we can draw the following conclusions: (1) the wrist was the most affected joint; (2) there was a discrepancy between the distribution of swollen joints and that of tender joints; and (3) the distribution of affected joints was uniform regardless of disease activity.

  19. Clinical assessment and echocardiography follow-up results of the children with acute rheumatic fever

    Directory of Open Access Journals (Sweden)

    Ahmet Basturk

    2016-04-01

    Full Text Available Acute rheumatic fever (ARF is an inflammatory collagenous tissue disease which shows its cardinal signs in joints, heart, skin and nervous system while affecting whole connective tissue system more or less. This study was conducted in order to investigate the clinical pattern and severity of ARF, echocardiographic findings and the course of the patients with heart valve involvement by studying the clinical and laboratory aspects of the patients diagnosed with ARF according to updated Jones criteria. The study included 214 patients diagnosed with ARF for the first time between January 2005 and May 2008. All patients were scanned with doppler echocardiography (ECHO between certain intervals. Severity of carditis was grouped into 3 groups of mild, moderate and severe. The frequency of carditis was 57.9%, arthritis was 73.4%, chorea was 11.7% and erythema marginatum was 0.9% but no subcutaneous nodules. Recovery was observed in 22% of the cases of isolated aortic insufficiency (AI, 50% of the cases with isolated mitral insufficiency (MI and 80% of the cases with mitral and aortic insufficiencies together (MI+AI. Recovery in isolated MI was significantly much more than recovery in isolated AI. However, recovery in AI was significantly much more than in MI in cases of mitral and aortic insufficiencies together. In conclusion, ARF is a cause of acquired and preventable heart disease and it can be reversed through right diagnosis and appropriate treatment. Isolated mitral insufficiency, isolated aortic insufficiency and both mitral and aortic insufficiency are observed during a valvular disease. Remission among valvular diseases are most commonly in those with mitral insufficiency and remissions in both mitral and aortic insufficiency occur most commonly in aortic ones. Regular prophylaxis is the key element for long term prevention of patients with ARF.

  20. Rainfall erosivity in New Zealand

    Science.gov (United States)

    Klik, Andreas; Haas, Kathrin; Dvorackova, Anna; Fuller, Ian

    2014-05-01

    Rainfall and its kinetic energy expressed by the rainfall erosivity is the main driver of soil erosion processes by water. The Rainfall-Runoff Erosivity Factor (R) of the Revised Universal Soil Loss Equation is one oft he most widely used parameters describing rainfall erosivity. This factor includes the cumulative effects of the many moderate-sized storms as well as the effects oft he occasional severe ones: R quantifies the effect of raindrop impact and reflects the amopunt and rate of runoff associated with the rain. New Zealand is geologically young and not comparable with any other country in the world. Inordinately high rainfall and strong prevailing winds are New Zealand's dominant climatic features. Annual rainfall up to 15000 mm, steep slopes, small catchments and earthquakes are the perfect basis for a high rate of natural and accelerated erosion. Due to the multifacted landscape of New Zealand its location as island between the Pacific and the Tasmanian Sea there is a high gradient in precipitation between North and South Island as well as between West and East Coast. The objective of this study was to determine the R-factor for the different climatic regions in New Zealand, in order to create a rainfall erosivity map. We used rainfall data (breakpoint data in 10-min intervals) from 34 gauging stations for the calcuation of the rainfall erosivity. 15 stations were located on the North Island and 19 stations on the South Island. From these stations, a total of 397 station years with 12710 rainstorms were analyzed. The kinetic energy for each rainfall event was calculated based on the equation by Brown and Foster (1987), using the breakpoint precipitation data for each storm. On average, a mean annual precipitation of 1357 mm was obtained from the 15 observed stations on the North Island. Rainfall distribution throughout the year is relatively even with 22-24% of annual rainfall occurring in spring , fall and winter and 31% in summer. On the South Island

  1. Increased risk of pulmonary and extra-pulmonary tuberculosis in patients with rheumatic diseases.

    Science.gov (United States)

    Lu, M-C; Lai, C-L; Tsai, C-C; Koo, M; Lai, N-S

    2015-12-01

    Impaired immunity in patients with rheumatic diseases can increase the risk of pulmonary tuberculosis (PTB). However, it is less clear whether rheumatic diseases affect the risk of extra-pulmonary tuberculosis (EPTB). To investigate the risk of PTB and EPTB in patients with rheumatic diseases using a population-based database. From Taiwan's National Health Insurance Research Database, 8536 patients with tuberculosis (TB) were frequency-matched with 42,680 controls for sex, 10-year age group and index year. Subjects were retrospectively traced back for their first diagnosis of rheumatic diseases. The association between TB and rheumatic diseases was assessed using multivariate logistic regression analyses. The risk of developing PTB was significantly higher in patients with systemic lupus erythematosus (adjusted odds ratio [aOR] 4.90, P EPTB were significantly higher in RA patients (aOR 4.67, P EPTB were associated with various rheumatic diseases. Rheumatologists should be vigilant to the possibility of TB, and particularly EPTB, in their patients.

  2. Repair Strategies Based on Pathological Characteristics of the Rheumatic Mitral Valve in Chinese Patients.

    Science.gov (United States)

    Tiange, Luo; Xu, Meng

    2017-06-28

    We aimed to clarify the pathological characteristics of rheumatic mitral valve disease in Chinese individuals, as well as to determine the appropriate rheumatic mitral valve repair strategy according to such characteristics. We obtained detailed statistics regarding the pathological characteristics of patients who underwent mitral valve repair or replacement for rheumatic disease during the past year at our centre. The outcomes of different repair techniques were compared. Multivariate logistic regression analyses were used to identify predictive factors for successful rheumatic mitral valve repair. Between August 2015 and August 2016, 163 patients underwent rheumatic mitral valve repair (77 cases) or replacement (61 cases) at our centre. Although the prevalence of pathological lesions was typically high, the prevalence of severe lesions was low in the leaflets and high in the commissure and subvalvular apparatus (more than one-third of all lesions in these areas). Commissurotomy (97.40%) and leaflet thinning (84.42%) were performed most frequently. On multivariate logistic regression analysis, pathological score >17.5 (odds ratio [OR] for success, 0.049; pmitral valve repair. Lesions of the commissure and subvalvular apparatus are the main pathological features in Chinese patients with rheumatic mitral valve disease. The commissure processing technique is beneficial in most such patients. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  3. Detection of rheumatoid arthritis bone erosions by two different dedicated extremity MRI units and conventional radiography

    DEFF Research Database (Denmark)

    Duer-Jensen, A.; Vestergaard, A.; Dohn, U.M.

    2008-01-01

    Objectives: To compare the ability of two different dedicated extremity MRI (E-MRI) units and conventional radiography (CR) for identifying bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) and wrist joints. Methods: CR and two MRI examinations (using 0.2 T Esaote Artoscan and 0...

  4. Detection of rheumatoid arthritis bone erosions by 2 different dedicated extremity MRI units and conventional radiography

    DEFF Research Database (Denmark)

    Duer, Anne; Vestergaard, Aage; Døhn, Uffe Møller

    2008-01-01

    OBJECTIVES: To compare the ability of 2 different dedicated extremity magnetic resonance imaging (E-MRI) units and conventional radiography (CR) for identifying bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) and wrist joints. METHODS: CR and 2 MRI-examinations (on 0.2T Esaote...

  5. Pattern of bone erosion and bone proliferation in psoriatic arthritis hands

    DEFF Research Database (Denmark)

    Poggenborg, René Panduro; Bird, P; Boonen, A

    2014-01-01

    are described and the imaging modalities compared. RESULTS: Ninety percent of bone erosions detected by CT were located in the metacarpal heads, and most frequently in the 2nd-3rd MCP joints. Radial (37%) and ulnar (31%) surfaces were more frequently eroded than dorsal (10%) and palmar (22%) sites. Using CT...

  6. Joint Commission

    Science.gov (United States)

    ... Commission Websites Quick Links The Center for Transforming Healthcare Blogs DataMart Event ... Table of Contents and Abstracts for The Joint Commission Journal on Quality and Patient Safety Monday October 2, ...

  7. Joint pain

    Science.gov (United States)

    ... or conditions. It may be linked to arthritis , bursitis , and muscle pain . No matter what causes it, ... Autoimmune diseases such as rheumatoid arthritis and lupus Bursitis Chondromalacia patellae Crystals in the joint: Gout (especially ...

  8. Chronic erosive seropositive arthritis in a patient with chronic hepatitis C

    Directory of Open Access Journals (Sweden)

    L P Ananjeva

    2008-01-01

    Full Text Available Joint syndrome evolution was prospectively followed up in a 49-year-old woman who had serum hepatitis in 1990. When she came to a rheumatologist for the first time in 1999 she complained of occasional joint pain. She did not have joint inflammatory changes at that time but chronic hepatitis С was revealed at the examination. Hepatitis С diagnosis was confirmed by morphological and repeated virological evaluations. During antiviral treatment the pt developed symmetrical polyarthritis involving hand joints. Elevation of cryoglobuline, rheumatoid factor and antinuclear antibodies level was revealed. During the next year polyarthritis recurred and later acquired undulatory course with periods of exacerbation and stabilization. Attempts of treatment with sulfasalazine failed due to transaminase elevation. In 2006 ulnar deviation appeared and rheumatoid factor level remained elevated. MRI showed multiple erosions of carpal bones. Considering features of joint syndrome development joint damage in this pt was regarded as arthritis associated with chronic hepatitis C.

  9. [The biological rhythms of cardiac activity based on cardiointervalography in children with rheumatism during readaptation after sanatorium treatment].

    Science.gov (United States)

    Alymkulov, D A; Smanova, D K

    1997-01-01

    Heart rate as an integral characteristic of systemic condition in rheumatism was studied in 11-13-year-old children with rheumatic heart disease. The children achieved remission by clinical and laboratory tests and were experiencing postsanatorium readaptation. Pretreatment amplitude of the fluctuations from the mean circadian values were reduced in the patients compared to healthy controls. This shows low compensatory potential of the rheumatic children. Adaptation after sanatorium treatment aggravates the above amplitude diminution, acrophases shifted to later local time.

  10. Clinical manifestations in uveitis patients with and without rheumatic disease in a Chinese population in Taiwan

    Directory of Open Access Journals (Sweden)

    Shi-Ting Tseng

    2017-12-01

    Full Text Available Background/Purpose: Uveitis can be a local eye disease or a manifestation of systemic rheumatologic disorders. However, the differences of clinical manifestations between uveitis patients with or without systemic rheumatologic disease have been seldom described in literature. We investigated the clinical features and complications of rheumatic disease-related uveitis, and compared the characteristics in patients with and without rheumatic disease in a Chinese population in Taiwan. Methods: A retrospective review was performed for all patients who had been diagnosed with uveitis between January 2009 and June 2014 at the Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan. Results: A total of 823 uveitis patients were enrolled in the study, including 123 patients with rheumatic diseases. The most frequent rheumatic diseases included ankylosing spondylitis (5.8%, followed by Behçet's disease (2.8%, sarcoidosis (1.4%, psoriasis (1.1%, and juvenile idiopathic arthritis (1.1%. Compared with patients without rheumatic disease, those with rheumatic disease-related uveitis had a lower mean age at onset (35.1 ± 15.8 years vs. 44.0 ± 17.5 years, a longer follow-up period (27.1 ± 25.3 months vs. 22.2 ± 23.0 months, a higher incidence of anterior uveitis (69.0% vs. 46.3%, less frequent posterior uveitis (4.9% vs. 21.4%, a higher incidence of recurrence (26.8% vs. 14.1%, more frequent bilateral involvement (53.7% vs. 38.8%, and more frequent posterior synechiae (17.2% vs. 9.4%. Conclusion: The disease course and clinical manifestations of rheumatic disease-related uveitis were different from those unrelated. Patients with rheumatic disease-related uveitis had a higher recurrent rate and more frequent posterior synechiae than patients without rheumatic diseases. Keywords: autoimmune disease, epidemiology, rheumatic disease, uveitis

  11. Soil erosion in humid regions: a review

    Science.gov (United States)

    Daniel J. Holz; Karl W.J. Williard; Pamela J. Edwards; Jon E. Schoonover

    2015-01-01

    Soil erosion has significant implications for land productivity and surface water quality, as sediment is the leading water pollutant worldwide. Here, erosion processes are defined. The dominant factors influencing soil erosion in humid areas are reviewed, with an emphasis on the roles of precipitation, soil moisture, soil porosity, slope steepness and length,...

  12. Natural and anthropogenic rates of soil erosion

    Science.gov (United States)

    Regions of land that are brought into crop production from native vegetation typically undergo a period of soil erosion instability, and long term erosion rates are greater than for natural lands as long as the land continues being used for crop production. Average rates of soil erosion under natur...

  13. Soil Erosion. LC Science Tracer Bullet.

    Science.gov (United States)

    Buydos, John F., Comp.

    Soil erosion is the detachment and movement of topsoil or soil material from the upper part of the soil profile. It may occur in the form of rill, gully, sheet, or wind erosion. Agents of erosion may be water, wind, glacial ice, agricultural implements, machinery, and animals. Soil conservation measures require a thorough understanding of the…

  14. Sugar, dental caries and the incidence of acute rheumatic fever: a cohort study of Māori and Pacific children.

    Science.gov (United States)

    Thornley, Simon; Marshall, Roger J; Bach, Katie; Koopu, Pauline; Reynolds, Gary; Sundborn, Gerhard; Ei, Win Le Shwe Sin

    2017-04-01

    To determine whether dental caries, as an indicator of cumulative exposure to sugar, is associated with the incidence of acute rheumatic fever and chronic rheumatic heart disease, in Māori and Pacific children aged 5 and 6 years at their first dental visit. A cohort study was undertaken which linked school dental service records of caries with national hospital discharge and mortality records. Cox models were used to investigate the strength of the association between dental caries and rheumatic fever incidence. A total of 20 333 children who were free of rheumatic heart disease at enrolment were available for analysis. During a mean follow-up time of 5 years, 96 children developed acute rheumatic fever or chronic rheumatic heart disease. After adjustment for potential confounders, children with five or more primary teeth affected by caries were 57% (95% CI: 20% to 106%) more likely to develop disease during follow-up, compared to children whose primary teeth were caries free. The population attributable to the risk for caries in this cohort was 22%. Dental caries is positively associated with the incidence of acute rheumatic fever and chronic rheumatic heart disease in Māori and Pacific children. Sugar intake, an important risk factor for dental caries, is also likely to influence the aetiology of rheumatic fever. 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. HLA class I and class II HLA DRB profiles in Egyptian children with rheumatic valvular disease.

    Science.gov (United States)

    El-Hagrassy, Nashwa; El-Chennawi, Farha; Zaki, Maysaa El-Sayed; Fawzy, Hossam; Zaki, Adel; Joseph, Nabeil

    2010-07-01

    Poststreptococcal sequelae, especially acute rheumatic fever/rheumatic heart disease continues to occur in significant proportions in many parts of the world, especially in less developed countries. An important factor in the study of rheumatic heart disease is the human genetic susceptibility to the disease. The aim of the present study was to detect the most prevalent HLA class I and class II types associated with risk of rheumatic heart disease in Egyptian children. Our study was performed on 100 patients with rheumatic valvular heart diseases and 71 control subjects. Patients were recruited from the Heart Institute, Embaba, Egypt. HLA typing for HLA class I was performed by serotyping and HLDR allele genotyping was performed using INNO-LiPA kits. In the study of HLA class I, there was a statistically significant increase in the B5 allele (P = 0.03; odds ratio, 3.46 [1.12-10.72]) in patients compared to controls, while B49 and B52 alleles (P = 0.004 and P = 0.02) were found in controls only. There was a statistically significant increase in HLA DR* 04-02, 3.46 (1.12-10.72) and HLA DR *10-0101 5.75 (1.27-25.98) in patients. Meanwhile HLA DR*1309120 was found only in controls (P = 0.02). Our study provides further information on the genetic predisposition for rheumatic valvular disease and the protective genotypes in rheumatic heart disease. Further insight into the molecular mechanisms of the disease will be a useful tool for predicting clinical outcome in those patients and, thus, potentially offer new means and approaches to treatment and prophylaxis, including a potential vaccine.

  16. Cyclophosphamide administration routine in autoimmune rheumatic diseases: a review.

    Science.gov (United States)

    Teles, Kaian Amorim; Medeiros-Souza, Patrícia; Lima, Francisco Aires Correa; Araújo, Bruno Gedeon de; Lima, Rodrigo Aires Correa

    2016-09-17

    Cyclophosphamide (CPM) is an alkylating agent widely used for the treatment of malignant neoplasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeutic guidelines for the patient. The routine is schematized in three phases: pre-chemotherapy (pre-ChT), administration of cyclophosphamide, and post-chemotherapy (post-ChT), taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis. Adverse reactions can alter laboratory tests; thus, this routine included clinical management for changes in white blood cells, platelets, neutrophils, and sodium, including cyclophosphamide dose adjustment in the case of kidney disease. Cyclophosphamide is responsible for other rare-but serious-side effects, for instance, hepatotoxicity, severe hyponatremia and heart failure. Other adverse reactions include hair loss, amenorrhea and menopause. In this routine, we also entered guidelines to post-chemotherapy patients. The compatibility of injectable drugs with the vehicle used has been described, as well as stability and infusion times. The routine aimed at the rational use of cyclophosphamide, with prevention of adverse events and relapse episodes, factors that may burden the health care system. Copyright © 2016. Published by Elsevier Editora Ltda.

  17. [A short history of anti-rheumatic therapy. II. Aspirin].

    Science.gov (United States)

    Pasero, G; Marson, P

    2010-01-01

    The discovery of aspirin, an antipyretic, anti-inflammatory and analgesic drug, undoubtedly represents a milestone in the history of medical therapy. Since ancient times the derivatives of willow (Salix alba) were used to treat a variety of fevers and pain syndromes, although the first report dates back to 1763 when the English Reverend Edward Stone described the effect of an extract of the bark willow in treating malaria. In the XIX century many apothecaries and chemists, including the Italian Raffaele Piria and Cesare Bertagnini, developed the biological processes of extraction and chemical synthesis of salicylates, and then analyzed their therapeutic properties and pharmacokinetic and pharmacodynamic characteristics. In 1899 the Bayer Company, where Felix Hoffmann, Heinrich Dreser and Arthur Eichengrün worked, recorded acetyl-salicylic acid under the name "Aspirin". In the XX century, besides the definition of the correct applications of aspirin in the anti-rheumatic therapy being defined, Lawrence L. Crawen identified the property of this drug as an anti-platelet agent, thus opening the way for more widespread uses in cardiovascular diseases.

  18. A short history of anti-rheumatic therapy. II. Aspirin

    Directory of Open Access Journals (Sweden)

    P. Marson

    2011-06-01

    Full Text Available The discovery of aspirin, an antipyretic, anti-inflammatory and analgesic drug, undoubtedly represents a milestone in the history of medical therapy. Since ancient times the derivatives of willow (Salix alba were used to treat a variety of fevers and pain syndromes, although the first report dates back to 1763 when the English Reverend Edward Stone described the effect of an extract of the bark willow in treating malaria. In the XIX century many apothecaries and chemists, including the Italian Raffaele Piria and Cesare Bertagnini, developed the biological processes of extraction and chemical synthesis of salicylates, and then analyzed their therapeutic properties and pharmacokinetic and pharmacodynamic characteristics. In 1899 the Bayer Company, where Felix Hoffmann, Heinrich Dreser and Arthur Eichengrün worked, recorded acetyl-salicylic acid under the name “Aspirin”. In the XX century, besides the definition of the correct applications of aspirin in the anti-rheumatic therapy being defined, Lawrence L. Crawen identified the property of this drug as an anti-platelet agent, thus opening the way for more widespread uses in cardiovascular diseases.

  19. Cyclophosphamide administration routine in autoimmune rheumatic diseases: a review

    Directory of Open Access Journals (Sweden)

    Kaian Amorim Teles

    Full Text Available Abstract Cyclophosphamide is an alkylating agent widely used for the treatment of malignant neoplasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeutic guidelines for the patient. The routine is schematized in three phases: pre-chemotherapy, administration of cyclophosphamide, and post-chemotherapy, taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis. Adverse reactions can alter laboratory tests; thus, this routine included clinical management for changes in white blood cells, platelets, neutrophils, and sodium, including cyclophosphamide dose adjustment in the case of kidney disease. Cyclophosphamide is responsible for other rare - but serious - side effects, for instance, hepatotoxicity, severe hyponatremia and heart failure. Other adverse reactions include hair loss, amenorrhea and menopause. In this routine, we also entered guidelines to post-chemotherapy patients. The compatibility of injectable drugs with the vehicle used has been described, as well as stability and infusion times. The routine aimed at the rational use of cyclophosphamide, with prevention of adverse events and relapse episodes, factors that may burden the health care system.

  20. Vitamin D endocrine system involvement in autoimmune rheumatic diseases.

    Science.gov (United States)

    Cutolo, Maurizio; Pizzorni, Carmen; Sulli, Alberto

    2011-12-01

    Vitamin D is synthesized from cholesterol in the skin (80-90%) under the sunlight and then metabolized into an active D hormone in liver, kidney and peripheral immune/inflammatory cells. These endocrine-immune effects include also the coordinated activities of the vitamin D-activating enzyme, 1alpha-hydroxylase (CYP27B1), and the vitamin D receptor (VDR) on cells of the immune system in mediating intracrine and paracrine actions. Vitamin D is implicated in prevention and protection from chronic infections (i.e. tubercolosis), cancer (i.e. breast cancer) and autoimmune rheumatic diseases since regulates both innate and adaptive immunity potentiating the innate response (monocytes/macrophages with antimicrobial activity and antigen presentation), but suppressing the adaptive immunity (T and B lymphocyte functions). Vitamin D has modulatory effects on B lymphocytes and Ig production and recent reports have demonstrated that 1,25(OH)2D3 does indeed exert direct effects on B cell homeostasis. A circannual rhythm of trough vitamin D levels in winter and peaks in summer time showed negative correlation with clinical status at least in rheumatoid arthritis and systemic lupus erythematosus. Recently, the onset of symptoms of early arthritis during winter or spring have been associated with greater radiographic evidence of disease progression at 12 months possibly are also related to seasonal lower vitamin D serum levels. Copyright © 2011 Elsevier B.V. All rights reserved.

  1. Familial early onset sarcoidosis with bone cysts and erosions

    Energy Technology Data Exchange (ETDEWEB)

    Blank, Norbert; Max, Regina; Lorenz, Hanns-Martin [University of Heidelberg, Department of Internal Medicine V, Division of Rheumatology, Heidelberg (Germany); Autschbach, Frank [University of Heidelberg, Department of Pathology, Heidelberg (Germany); Libicher, Martin [University of Cologne, Department of Radiology, Cologne (Germany)

    2007-09-15

    Early onset sarcoidosis is a granulomatous disease which is characterized by synovitis, polyarthritis, skin and eye involvement. We report the skeletal features of one patient with a family history and clinical symptoms suggestive of early onset sarcoidosis (EOS) which was confirmed by skin biopsy. Radiographs reveal postarthritic deformities of the MCP joints, contractures, a coarsened trabecular pattern at the PIP joints and small bone cysts resembling osteitis cystoides multiplex. Similar lesions were described in radiographs of the older sister and an uncle of our patient. This is the first report demonstrating bone cysts and erosions which could be a diagnostic feature in this rare disease and may help to differentiate other rheumatoid disorders. (orig.)

  2. Splash erosion. A bibliometric Review

    Science.gov (United States)

    Fernández Raga, M. B.

    2012-04-01

    Ellison (1944) developed the splash board as a system for measuring splash erosion that was both cheap and reliable. Bollinne (1975), Morgan (1978, 1981). Mutchler (1967) described another different type of splash detectors according to whether they were passive or could register data. In the study mentioned above these authors included bottles, funnels, glasses, photography, markers. After that several devices has been made up like the splash sampler (Leguedois et al., 2005), soil tray (Van Dijk et al., 2002), splash funnel (Terry, 1989) and several rain cups (Fernandez-Raga et al., 2010; Molina and Llinares, 1996; Torri et al., 1987). Splash erosion research has materialized in the form of a number of papers published in international journals. The database of bibliographic references employed has been one of the most prestigious ones: theWeb of Science (ISI). The search was carried out on January 27th 2012. Among the 3x10^8 scholarly documents included in the Science Citation Index Expanded (SCI-EXPANDED) 1899 to present , the searching engine located 439 containing the word "splash erosion*", where the asterisk acts as a wildcard for any letter or group of letters. Of these, 383 were classified as articles, 87 as proceeding papers, 5 as editorial material, 2 as notes and 1 as correction. These documents have been published in 163 different journals, although four are particularly recurrent: Earth surface processes and Landforms, Catena, Soil Science Society of America Journal and Hydrological processes, with 41, 35, 35 and 26 published documents respectively. A geographic analysis of these articles has been carried out in an attempt to determine in what parts of the world research projects were making use of splash erosion. The results are that anglo-saxon countries, as USA, England and Australia dominate, particularly USA, with 130 articles. China and Japan are large communities of researches too, and some Central European countries as Belgium, France Germany

  3. Soil Erosion Threatens Food Production

    Directory of Open Access Journals (Sweden)

    Michael Burgess

    2013-08-01

    Full Text Available Since humans worldwide obtain more than 99.7% of their food (calories from the land and less than 0.3% from the oceans and aquatic ecosystems, preserving cropland and maintaining soil fertility should be of the highest importance to human welfare. Soil erosion is one of the most serious threats facing world food production. Each year about 10 million ha of cropland are lost due to soil erosion, thus reducing the cropland available for world food production. The loss of cropland is a serious problem because the World Health Organization and the Food and Agricultural Organization report that two-thirds of the world population is malnourished. Overall, soil is being lost from agricultural areas 10 to 40 times faster than the rate of soil formation imperiling humanity’s food security.

  4. Sports drinks and dental erosion.

    Science.gov (United States)

    Noble, Warden H; Donovan, Terence E; Geissberger, Marc

    2011-04-01

    Sports drinks were originally developed to improve hydration and performance in athletes taking part in intense or endurance sporting events. These drinks contain relatively high amounts of carbohydrates (sugars), salt, and citric acid. These ingredients create the potential for dental ramifications and overall public health consequences such as obesity and diabetes. High intake of sports drinks during exercise, coupled with xerostomia from dehydration, may lead to the possibility of erosive damage to teeth.

  5. Dental erosion in French adolescents

    OpenAIRE

    Muller-Bolla, Mich?le; Courson, Fr?d?ric; Smail-Faugeron, Violaine; Bernardin, Thibault; Lupi-P?gurier, Laurence

    2015-01-01

    Background Since the 2000s, different epidemiological studies focusing on the prevalence or the aetiology of DE in adolescents recognised them as an at-risk population due to their eating behaviours. None was carried out in French adolescents. The primary objective of this study was to assess the prevalence of dental erosion (DE) using the total BEWE score among adolescents in the department of Alpes Maritimes, France. The secondary objectives were to observe changes in prevalence estimates d...

  6. Further Simplification of the Simple Erosion Narrowing Score With Item Response Theory Methodology.

    Science.gov (United States)

    Oude Voshaar, Martijn A H; Schenk, Olga; Ten Klooster, Peter M; Vonkeman, Harald E; Bernelot Moens, Hein J; Boers, Maarten; van de Laar, Mart A F J

    2016-08-01

    To further simplify the simple erosion narrowing score (SENS) by removing scored areas that contribute the least to its measurement precision according to analysis based on item response theory (IRT) and to compare the measurement performance of the simplified version to the original. Baseline and 18-month data of the Combinatietherapie Bij Reumatoide Artritis (COBRA) trial were modeled using longitudinal IRT methodology. Measurement precision was evaluated across different levels of structural damage. SENS was further simplified by omitting the least reliably scored areas. Discriminant validity of SENS and its simplification were studied by comparing their ability to differentiate between the COBRA and sulfasalazine arms. Responsiveness was studied by comparing standardized change scores between versions. SENS data showed good fit to the IRT model. Carpal and feet joints contributed the least statistical information to both erosion and joint space narrowing scores. Omitting the joints of the foot reduced measurement precision for the erosion score in cases with below-average levels of structural damage (relative efficiency compared with the original version ranged 35-59%). Omitting the carpal joints had minimal effect on precision (relative efficiency range 77-88%). Responsiveness of a simplified SENS without carpal joints closely approximated the original version (i.e., all Δ standardized change scores were ≤0.06). Discriminant validity was also similar between versions for both the erosion score (relative efficiency = 97%) and the SENS total score (relative efficiency = 84%). Our results show that the carpal joints may be omitted from the SENS without notable repercussion for its measurement performance. © 2016, American College of Rheumatology.

  7. Mapping monthly rainfall erosivity in Europe

    DEFF Research Database (Denmark)

    Ballabio, C; Meusburger, K; Klik, A

    2017-01-01

    Rainfall erosivity as a dynamic factor of soil loss by water erosion is modelled intra-annually for the first time at European scale. The development of Rainfall Erosivity Database at European Scale (REDES) and its 2015 update with the extension to monthly component allowed to develop monthly...... events. Consequently, spatio-temporal mapping of rainfall erosivity permits to identify the months and the areas with highest risk of soil loss where conservation measures should be applied in different seasons of the year....... to Eastern Europe. The maps also show a clear delineation of areas with different erosivity seasonal patterns, whose spatial outline was evidenced by cluster analysis. The monthly erosivity maps can be used to develop composite indicators that map both intra-annual variability and concentration of erosive...

  8. Identification of inflammation sites in arthritic joints using hyperspectral imaging

    Science.gov (United States)

    Paluchowski, Lukasz A.; Milanic, Matija; Bjorgan, Asgeir; Grandaunet, Berit; Dhainaut, Alvilde; Hoff, Mari; Randeberg, Lise L.

    2014-03-01

    Inflammatory arthritic diseases have prevalence between 2 and 3% and may lead to joint destruction and deformation resulting in a loss of function. Patient's quality of life is often severely affected as the disease attacks hands and finger joints. Pathology involved in arthritis includes angiogenesis, hyper-vascularization, hyper-metabolism and relative hypoxia. We have employed hyperspectral imaging to study the hemodynamics of affected- and non-affected joints and tissue. Two hyperspectral, push-broom cameras were used (VNIR-1600, SWIR-320i, Norsk Elektro Optikk AS, Norway). Optical spectra (400nm - 1700nm) of high spectral resolution were collected from 15 patients with visible symptoms of arthritic rheumatic diseases in at least one joint. The control group consisted of 10 healthy individuals. Concentrations of dominant chromophores were calculated based on analytical calculations of light transport in tissue. Image processing was used to analyze hyperspectral data and retrieve information, e.g. blood concentration and tissue oxygenation maps. The obtained results indicate that hyperspectral imaging can be used to quantify changes within affected joints and surrounding tissue. Further improvement of this method will have positive impact on diagnosis of arthritic joints at an early stage. Moreover it will enable development of fast, noninvasive and noncontact diagnostic tool of arthritic joints

  9. Modeling regional wind erosion using different model

    Science.gov (United States)

    Guo, Zhongling; Chang, Chunping; Wang, Rende; Li, Jifeng; Li, Qing

    2017-04-01

    Wind erosion is an important factor causing soil degradation in arid and semi-arid regions. The need to quantitatively evaluate wind induced soil erosion yields many wind erosion models. These models include Wind Erosion Equation (WEQ), Revised Wind Erosion Equation (RWEQ),Wind Erosion Predicted System (WEPS) etc. at a field scale and Wind Erosion Assessment Model (WEAM), Integrated Wind Erosion Modeling System (IWEMS), AUStralian Land Erodibility Model (AUSLEM) etc. at a regional scale. The challenge of precisely estimating wind erosion at a regional scale still remain to date. To assess regional wind erosion, WEQ, RWEQ and WEPS have been scaled up to regional versions. However, no attempt is performed to compare these models for regional wind erosion modeling. In this study, the regional versions of WEQ, RWEQ, WEPS and WEAM, IWEMS, AUSLEM will be selected to model regional wind erosion of farmlands in the Kangbao County of northern China with annual soil loss by wind erosion based on 137 Cs analysis. Remote sensing image is used to determine the size and shape of local farmlands. Weather data of 2000-2010, China Soil Survey and published soil data, crops rotations etc. are compiled to generate raster layers of inputs for selected models using ArcGIS 10.2. These models were rebuilt based on ArcGIS Model-builder Module. Spatial distribution of annual soil loss by wind erosion determined from different model will be tested using annual soil loss data by 137 Cs analysis. Performances of these models will be investigated, and restrictions of these models will be further ascertained.

  10. Digestive comorbidity in patients with rheumatic diseases: Not only NSAID-induced gastropathy

    Directory of Open Access Journals (Sweden)

    A. E. Karateev

    2016-01-01

    Full Text Available Digestive comorbidity is a serious problem that significantly aggravates the course of rheumatic diseases. Diseases of the gastrointestinal tract (GIT, liver, and pancreatobiliary system may present a threat to life and substantially worsen its quality. The incidence of many digestive diseases, such as gastric ulcer (including its complicated forms, cholelithiasis, and acute pancreatitis, in patients with rheumatic diseases (at least in those with rheumatoid arthritis is considerably higher than in the population. The presence of this comorbidity poses substantial challenges during active anti-rheumatic therapy. Rheumatologists are very familiar with issues in the prevention of GIT complications due to the use of nonsteroidal anti-inflammatory drugs. However, new time presents new challenges. The widespread use of immunosuppressive agents and biologic agents requires careful monitoring of complications associated with liver and bowel diseases. This review considers a relationship of rheumatic diseases and anti-rheumatic therapy to comorbidities, such as cholelithiasis, acute pancreatitis, viral hepatitis B and C, and intestinal diverticula. 

  11. Rheumatic symptoms following an outbreak of campylobacter enteritis: a five year follow up.

    Science.gov (United States)

    Bremell, T; Bjelle, A; Svedhem, A

    1991-01-01

    Eighty six of 106 (81%) guests attending a party were followed up after an outbreak of Campylobacter jejuni enterocolitis. Acute diarrhoeal illness was reported in 35 subjects (33%), of whom seven showed acute rheumatic symptoms either alone or with other symptoms of infection with C jejuni. The antibody response to C jejuni corresponded well with the intensity of the disease. In the early phase of the gastrointestinal disease the patients with acute rheumatic symptoms displayed significantly higher IgM antibody levels in serum samples than the other patients in this study. Levels of antibodies to C jejuni were increased in serum samples from 31 patients (29%) without symptoms of infection with C jejuni. At a follow up after five and a half years, four of these patients suffered from chronic rheumatic disorders. One HLA-B27 positive woman developed reactive arthritis with a relapse seven years later. The remaining 20 subjects (19%) remained healthy and their antibody tests and stool cultures were negative for C jejuni. It is concluded that C jejuni enterocolitis is significantly associated with rheumatic symptoms in the early phase and may also cause chronic rheumatic disorders. PMID:1768164

  12. The challenges of managing rheumatic disease of the mitral valve in Jamaica.

    Science.gov (United States)

    Little, Sherard G

    2014-12-01

    Between January, 2009 and December, 2013, 84 patients were identified who underwent isolated mitral valve surgery in Jamaica at The University Hospital of the West Indies and The Bustamante Hospital for Children. The most common pathology requiring surgery was rheumatic heart disease, accounting for 84% of the procedures performed. The majority of patients had regurgitation of the mitral valve (67%), stenosis of the mitral valve (22%), and mixed mitral valve disease (11%). The most common procedure performed was replacement of the mitral valve (69%), followed by mitral valve repair (29%). Among the patients, one underwent closed mitral commissurotomy. The choice of procedure differed between age groups. In the paediatric population (mitral valve (89%). In the adult population (18 years and above), the majority of patients underwent mitral valve replacement (93%). Overall, of all the patients undergoing replacement of the mitral valve, 89% received a mechanical valve prosthesis, whereas 11% received a bioprosthetic valve prosthesis. Of the group of patients who underwent mitral valve repair for rheumatic heart disease, 19% required re-operation. The average time between initial surgery and re-operation was 1.2 years. Rheumatic fever and rheumatic heart disease remain significant public health challenges in Jamaica and other developing countries. Focus must remain on primary and secondary prevention strategies in order to limit the burden of rheumatic valvulopathies. Attention should also be directed towards improving access to surgical treatment for young adults.

  13. Rheumatic fever: a multicenter study in the State of São Paulo

    Directory of Open Access Journals (Sweden)

    Silva Carlos Henrique Martins da

    1999-01-01

    Full Text Available Rheumatic fever is still the most commonly seen rheumatic disease in Brazilian pediatric rheumatology clinics. It remains a significant health problem since subsequent cardiac sequelae represent one of the most important causes of chronic heart disease in children. We reviewed the clinical manifestations of rheumatic fever in 786 patients, followed at seven pediatric rheumatology clinics in the state of São Paulo, Brazil. All patients were diagnosed according to revised Jones' criteria. Regarding major criteria, 396 (50.4% children exhibited carditis, 453 (57.6% polyarthritis, 274 (34.8% chorea, 13 (1.6% erythema marginatum, and 12 (1.5% subcutaneous nodules. Valvular lesions documented by echocardiography in the absence of accompanying auscultatory findings were found in 144 (18.3% patients. Migratory polyarthritis was observed in 290 (64.0% patients with articular involvement. Documented previous streptococcal infection assessed by serum antistreptolysin (ASO titers occurred in 531 (67.5% patients. Even though prophylaxis with benzathine penicillin was recommended to all patients, recurrent attacks were observed in 147 (18.7%. We emphasize the high frequency of chorea, silent carditis and recurrences in our series as well as the variable clinical presentation of arthritis in rheumatic fever. Multicenter studies should be encouraged to improve our understanding of the clinical features of rheumatic diseases in children and adolescents.

  14. What's new in our understanding of the role of adipokines in rheumatic diseases?

    Science.gov (United States)

    Gómez, Rodolfo; Conde, Javier; Scotece, Morena; Gómez-Reino, Juan Jesus; Lago, Francisca; Gualillo, Oreste

    2011-08-02

    Important advances in our understanding of the relationships between adipokines, inflammation and the immune response have been achieved in the past 10 years. White adipose tissue has emerged as a highly dynamic organ that releases a plethora of immune and inflammatory mediators that are involved in numerous diseases, including not only rheumatic diseases such as rheumatoid arthritis, osteoarthritis and systemic lupus erythematosus, but also cardiovascular and metabolic complications that are frequently observed in rheumatic diseases. Our rapidly growing knowledge of adipokine biology is revealing the complexity of these amazing proteins, thereby redefining white adipose tissue as a key element of the inflammatory and immune response in rheumatic diseases. Adipokines exert potent modulatory actions on target tissues and cells involved in rheumatic disease, including cartilage, synovium, bone and various immune cells. In this Review, we describe the most recent advances in adipokine research in the context of rheumatic diseases, focusing primarily on leptin, adiponectin, visfatin and resistin, and also the potential role of newly identified adipokines such as chemerin, lipocalin 2 and serum amyloid A3.

  15. Joint purpose?

    DEFF Research Database (Denmark)

    Pristed Nielsen, Helene

    2013-01-01

    of anti-discrimination in Europe today? And what empirical evidence may be found for such a joint approach? The paper discusses how the contemporary EU context differs from the American context which prompted Crenshaw to raise the point about intersectionality, and it analyses documents and interviews...

  16. Points to consider for reporting, screening for and preventing selected comorbidities in chronic inflammatory rheumatic diseases in daily practice : a EULAR initiative

    NARCIS (Netherlands)

    Baillet, Athan; Gossec, Laure; Carmona, Loreto; de Wit, Maarten; van Eijk-Hustings, Yvonne; Bertheussen, Heidi; Alison, Kent; Toft, Mette; Kouloumas, Marios; Ferreira, Ricardo J. O.; Oliver, Susan; Rubbert-Roth, Andrea; van Assen, Sander; Dixon, William G.; Finckh, Axel; Zink, Angela; Kremer, Joel; Kvien, Tore K.; Nurmohamed, Michael; van der Heijde, Desiree; Dougados, Maxime

    In chronic inflammatory rheumatic diseases, comorbidities such as cardiovascular diseases and infections are suboptimally prevented, screened for and managed. The objective of this European League Against Rheumatism (EULAR) initiative was to propose points to consider to collect comorbidities in

  17. When erosion ruins the chronology

    Science.gov (United States)

    Wolters, Steffen; Enters, Dirk; Blume, Katharina; Lücke, Andreas

    2016-04-01

    Human land-use has considerably shaped the landscape of north-western Germany over the past millennia. Deforestation and agriculture created a predominantly open scenery preserved until today with only a few remnants of former landscape elements such as woodlands, peat bogs, heath lands and lakes. Here we present a multi-proxy approach including sedimentological and geochemical parameters (e. g. element concentrations and stable isotopes) as well as biological proxies (pollen, macro fossils and diatoms) combined with an archaeological site analysis to investigate the effects of prehistoric land-use on lake systems and their catchment areas with a special focus on changes of the water quality, e. g. eutrophication and acidification and its natural regeneration during phases of weaker land-use impact. The study reveals a millenia-long history of erosion processes caused by successive selective woodland clearances starting in Neolithic Times. The geochemical evidence of soil erosion is recorded by distinct peaks of the terrigenic elements K and Ti. However, due to (1) the low sensitivy of the XRF scanner for Si and (2) the prevalence of diatom related biogenic silicon XRF-scanning of highly organic lake sediments fails to reflect the actual sand input caused by erosion. Particularly single quartz grains are not detected in the organic sediment matrix. Therefore we make successful use of mineral grain analysis which previously has only been applied to record aeolian input in bogs. K and Ti concentrations are not correlated with the content of mineral grains which suggest two different erosion processes. Our efforts to construct robust age-depth relationships based on AMS 14C-dates of terrestrial plant macrofossils reveal a specific dating issue of northwest German lakes. Especially in younger sediments we observe 14C-dates which are on the one hand too old and on the other hand among themselves roughly contemporaneous. We explain this feature with the extensive bog

  18. Preventing joint damage as the best measure of biologic drug therapy.

    Science.gov (United States)

    Bresnihan, Barry

    2002-09-01

    Joint damage occurs progressively in patients with rheumatoid arthritis (RA), leading to functional decline and disability. The proinflammatory cytokines interleukin 1 (IL-1) and tumor necrosis factor-alpha (TNF-alpha) are thought to play a key role in promoting cartilage and bone erosion in the rheumatoid joint. In randomized clinical trials, inhibitors of these cytokines significantly slowed the rate of progressive joint damage as assessed by radiographic techniques. The IL-1 receptor antagonist anakinra significantly reduced erosions, joint space narrowing, and total joint damage when a modified Sharp score was used to evaluate serial hand radiographs. The maximum benefit of anakinra on joint space narrowing was achieved within the first 24 weeks and was maintained during continued treatment, whereas the slowing of erosions by anakinra increased with continued treatment beyond 24 weeks. In terms of TNF-alpha inhibition, infliximab significantly reduced joint damage in patients with long-standing RA, when used in combination with methotrexate (MTX), whereas etanercept significantly reduced erosions relative to MTX in patients with early stage disease. Comparisons among the cytokine inhibitors are made problematic by differences in the designs, patient populations, and outcome measures of these trials. Nevertheless, these studies demonstrate that IL-1 or TNF-alpha inhibition effectively suppresses the pathophysiological mechanisms associated with cartilage degradation and bone erosion, resulting in a slowing of further radiographic progression.

  19. Comparison of erosion and erosion control works in Macedonia, Serbia and Bulgaria

    Directory of Open Access Journals (Sweden)

    Ivan Blinkov

    2013-12-01

    Natural conditions in the Balkan countries contribute to the appearance of various erosion forms and the intensity of the erosion processes. Over the history of these countries, people who settled this region used the available natural resources to fill their needs (tree cutting, incorrect plugging, overgrazing, which contributed to soil erosion. Organized erosion control works in the Balkans started in the beginning of the 20th century (1905 in Bulgaria. The highest intensity of erosion control works were carried out during the period 1945 – 1990. Various erosion control works were launched. Bulgaria had a large anti-erosion afforestation, almost 1 million ha. Bulgaria's ecological river restoration approach has been in use for almost 50 years. Serbia contributed significant erosion and torrent control works on hilly agricultural areas. Specific screen barrages and afforestation on extremely dry areas are characteristic in Macedonia. A common characteristic for all countries is a high decrease in erosion control works in the last 20 years.

  20. Percutaneous mitral valvotomy in rheumatic mitral stenosis: a new approach.

    Science.gov (United States)

    Commeau, P; Grollier, G; Huret, B; Foucault, J P; Potier, J C

    1987-01-01

    Three patients with rheumatic mitral stenosis were treated with percutaneous mitral valvotomy. A Brockenbrough catheter was advanced transseptally into the left atrium and then into the left ventricle over a long guide wire. An angle wire loop retriever was advanced through a 10 Fr straight catheter via the femoral artery into the left ventricle. The retriever was used to catch the flexible end of the long guide wire. This end of the long guide wire was then drawn out of the right femoral artery by the retriever through the straight catheter. The straight catheter was left in the descending aorta; the Brockenbrough catheter was removed and a 7 Fr balloon catheter was introduced percutaneously over the long guide wire through the femoral vein. This balloon catheter was used for interatrial septal dilatation and right femoral venous dilatation. In two patients this catheter was replaced over the long guide wire with a 9 Fr Schneider-Medintag Grüntzig catheter (3 X 12 mm diameter when inflated) and in the other by a Mansfield (18 mm diameter when inflated). The procedure was well tolerated in these three patients and there were no complications. Haemodynamic function improved, there was appreciable decrease in dyspnoea, and exercise tolerance was increased. This procedure has several advantages: the balloon is more easily positioned through the mitral valve; the stability of the balloon during inflation is improved by traction at both ends of the long guide wire; and there is the option of rapidly exchanging one balloon for a larger one over the long guide wire. This technique seems to be less arrhythmogenic and results in less blood loss because manual compression of the femoral vessels after the procedure is easier. Images Fig 1 Fig 2 Fig 3 Fig 4 Fig 5 PMID:3620253

  1. Preoperative CT scanning of 70 cases of rheumatic valvular disease

    Energy Technology Data Exchange (ETDEWEB)

    Take, Akira; Matuzaki, Shigeru; Oki, Shinichi (Jichi Medical School, Minamikawachi, Tochigi (Japan)) (and others)

    1992-05-01

    Seventy patients with rheumatic valvular disease were evaluated with preoperative CT scanning. The correlation of the obtained CT images to the operative findings were examined. Left atrial thrombi were found in 24 cases at the operation. CT scan had detected thrombi in 19 cases (79.2%) and echocardiography in 15 (62.5%). CT failed to find them in 5 cases in which the left atrial thrombi were less than 3 g. Echocardiogram, however, failed to detect thrombi in 9 cases, the largest being 14 g. There were 15 cases with left atrial calcification, in which 10 cases had left atrial thrombi. Nine cases out of these 10 cases had rough left atrial surface after thrombectomy. Early postoperative CT of 10 with left atrial calcification showed recurrent left atrial thrombi in 4 (40%) cases. Mitral valve calcification was found in 42 cases during operation. CT scan was able to detect it in 40 (95.2%), while echocardiogram detected in 34 cases (81.0%) (p<0.05). All mitral valves with calcification required replacement. Out of 30 cases with non calcified mitral valves, 9 underwent OMC, and the other 21 underwent mitral valve replacement. Aortic valve calcification was found in 9 out of 11 cases of aortic stenosis. All has been diagnosed by CT scan. In conclusion, 1. in detecting the left atrial thrombi, CT scan was superior to echo-cardiography, and provided useful information for planning the operative procedure including atrial approach and valvular manipulation, 2. CT scan could detect calcification of left atrial wall which had high incidence of thrombus formation and rough left atrial surface, 3. CT scan could detect calcification of both mitral and aortic valve, and showed the severity of valvular structural changes. (author).

  2. Outcomes of borderline rheumatic heart disease: A prospective cohort study.

    Science.gov (United States)

    Bertaina, Geneviève; Rouchon, Bernard; Huon, Bertrand; Guillot, Nina; Robillard, Corinne; Noël, Baptiste; Nadra, Marie; Tribouilloy, Christophe; Marijon, Eloi; Jouven, Xavier; Mirabel, Mariana

    2017-02-01

    The advent of systematic screening for rheumatic heart disease (RHD) by echocardiography in endemic regions has led to a new entity: borderline RHD. The pathogenicity and natural history of borderline RHD needs to be addressed. The aim of this study was to assess the outcomes of children detected by echocardiography as having borderline RHD. Schoolchildren in 4th grade (i.e., aged 9-10years) who were prospectively echo-screened for RHD (2012-2014) in Nouméa, New Caledonia, were asked to participate. Children with borderline RHD according to consistent independent review by two cardiologists were included and followed-up in 2015. Among the 8684 schoolchildren screened, 49 were diagnosed with borderline RHD according to the Cardiologist clinically involved in the child's management plan. After independent review by two cardiologists, 25 children were consistently diagnosed with borderline RHD and included in the follow-up study. Overall, inter-observer agreement was moderate with diagnostic kappa values of 0.63 (95% CI 0.45-0.78). After a median follow-up of 23months (IQR (20.5-33.0), 15 children (60.0%) had stability of valvular lesions, 8 (32.0%) had normal findings according to the WHF criteria. Two children (8.0%) had definite RHD on the follow-up echocardiogram, but no clinical events or audible pathological murmur during the study period. No factor could be identified as prognostic of either stability or progression. Borderline RHD diagnosed by systematic screening in high-risk populations remains mostly unchanged at 2years follow-up. Diagnosis of borderline RHD may require two reviewers for consistency. Copyright © 2016. Published by Elsevier Ireland Ltd.

  3. [Inpatient aftercare in rheumatic diseases--concept, trial, and acceptance].

    Science.gov (United States)

    Ehlebracht-König, I; Bönisch, A

    2004-12-01

    A one-week booster group treatment in rheumatic diseases (rheumatoid arthritis, spondylarthropathies, fibromyalgia) was developed in order to stabilize rehabilitation effects after medical rehabilitation. The program took place in an inpatient setting 3 - 5 months after rehabilitation, aimed at refreshing and deepening already learnt contents as well as teaching new subjects (e. g. about dietetics). Training and educational elements are given priority in this concept. A total of 140 patients participated in 19 booster weeks. At the end of each booster week the acceptance was assessed by questionnaire and in a round-table discussion. Comprehensibility and group atmosphere were judged very positively. The course was also considered very helpful, helpfulness being rated with marks about 2 (1 = very helpful, 6 = not at all helpful). Participants especially appreciated the course's framework as a group setting emphasising the exchange of experience with co-patients. At the same time, however, participants wished more individualized treatment such as physiotherapy or massage. With regard to the quantity of the various therapy elements, participants would have preferred more traditional spa therapy, more medical treatment by a physician, more group physiotherapy and sports. They would also have liked more breaks. In general fewer psychological elements, less discussion and reflection but more physical activity was wished for. Little difference was found between the various diagnoses, but the program was rated slightly more positively by the patients with spondylarthropathies. Overall, the great number of people participating in the program and their acceptance of the booster week are positive. Patients appreciated the group setting and the possibilities of exchanging experience on a high level. But it was difficult to change patients' traditional expectations concerning medical rehabilitation to a behaviour-orientated course like ours. It is worth thinking about whether

  4. Interventions aiming to reduce early retirement due to rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Pedro Almeida Laires

    2017-07-01

    Full Text Available Introduction: Aging of the population and early retirement translates into productivity losses to society. Persistence of working life is crucial to counteract this sustainability issue faced by western countries. Musculoskeletal and rheumatic diseases (RD may cause work disability and early exit from work, including early retirement. The objective of this article is to review the current knowledge about interventions aiming to reduce early retirement due to RD. Methods: We searched PubMed and The Cochrane Library for studies either in English or Portuguese between January 2000 and June 2016 that evaluated the impact of interventions targeting early retirement in RD patients still at work. We also searched for grey literature from Portuguese institutional repositories. Results: We identified several published studies testing pharmacologic and non-pharmacologic vocational rehabilitation interventions. None was specifically identified for Portugal. The general low quality of the literature and its inconsistency makes it unfeasible to draw definitive conclusions. However, some broad recommendations might be outlined. An effective intervention must: 1 act upon different levels (e.g. RD patient, workplace, involving several stakeholders (e.g. rheumatologists, occupational physicians, employers; 2 prioritize the right patients (e.g. more disabling RD; and 3 consider the patients’ role, for instance by including an element of patient education and support. Despite the lack of good quality evidence on this field, there seems to be a growing interest in the international scientific community with several ongoing studies promoting such interventions. This promising data will be very useful to set up effective policies. Conclusions: This article summarizes the current knowledge about the impact of interventions to avoid or mitigate early retirement in RD patients. It highlights the demand for further research and it also contributes to aware decision

  5. Health related quality of life measure in systemic pediatric rheumatic diseases and its translation to different languages

    DEFF Research Database (Denmark)

    Moorthy, Lakshmi Nandini; Roy, Elizabeth; Kurra, Vamsi

    2014-01-01

    BACKGROUND: Rheumatic diseases in children are associated with significant morbidity and poor health-related quality of life (HRQOL). There is no health-related quality of life (HRQOL) scale available specifically for children with less common rheumatic diseases. These diseases share several feat...

  6. Frequency and severity of rheumatic heart disease in the catchment area of Gauteng hospitals, 1993-1995

    NARCIS (Netherlands)

    Clur, Sally-Ann

    2006-01-01

    OBJECTIVE: Identification of frequency and severity of rheumatic fever/rheumatic heart disease (RF/RHD) in the catchment area of Gauteng hospitals. DESIGN: A retrospective descriptive analysis using hospital-based computer databases. SETTING: Helen Joseph, Chris Hani Baragwanath and Johannesburg

  7. Rudolf Virchow's medical school dissertation on rheumatism and the cornea: overlooked tribute to the cornea in biomedical research.

    Science.gov (United States)

    Margo, Curtis E; Harman, Lynn E

    2015-02-01

    To critique Rudolf Virchow's medical school dissertation on rheumatism and the cornea and to determine whether it might have anticipated his remarkable career in medicine. Review of the English translation of Rudolf Virchow's de Rheumate Praesertim Corneae written in 1843. The dissertation was more than 7000 words long. Virchow considered rheumatism as an irritant disorder not induced by acid as traditionally thought but by albumin. He concluded that inflammation was secondary to a primary irritant and that the "seat" of rheumatism was "gelatinous" (connective) tissues, which included the cornea. He divided kerato-rheumatism into different varieties. The prognosis of keratitis was variable, and would eventually lapse into "scrofulosis, syphilis, or arthritis of the cornea." Virchow's dissertation characterizes rheumatism in terms of chemical and tissue interactions that make little sense in the context of today's knowledge of rheumatic disease and keratitis. Ironically, many of these concepts were made obsolete by the cellular model of disease that Virchow championed. Virchow decided to pursue the study of rheumatism through the cornea because he thought that the cornea was an ideal tissue to study disease. This discernment was passed on to his students whose seminal contributions to general pathology were based on research with the cornea. It is debatable whether Virchow's insight into the importance of the cornea in biomedical research at such an early stage of his career could have predicted his monumental contributions to medicine.

  8. Validating and Improving Interrill Erosion Equations

    Science.gov (United States)

    Zhang, Feng-Bao; Wang, Zhan-Li; Yang, Ming-Yi

    2014-01-01

    Existing interrill erosion equations based on mini-plot experiments have largely ignored the effects of slope length and plot size on interrill erosion rate. This paper describes a series of simulated rainfall experiments which were conducted according to a randomized factorial design for five slope lengths (0.4, 0.8, 1.2, 1.6, and 2 m) at a width of 0.4 m, five slope gradients (17%, 27%, 36%, 47%, and 58%), and five rainfall intensities (48, 62.4, 102, 149, and 170 mm h−1) to perform a systematic validation of existing interrill erosion equations based on mini-plots. The results indicated that the existing interrill erosion equations do not adequately describe the relationships between interrill erosion rate and its influencing factors with increasing slope length and rainfall intensity. Univariate analysis of variance showed that runoff rate, rainfall intensity, slope gradient, and slope length had significant effects on interrill erosion rate and that their interactions were significant at p = 0.01. An improved interrill erosion equation was constructed by analyzing the relationships of sediment concentration with rainfall intensity, slope length, and slope gradient. In the improved interrill erosion equation, the runoff rate and slope factor are the same as in the interrill erosion equation in the Water Erosion Prediction Project (WEPP), with the weight of rainfall intensity adjusted by an exponent of 0.22 and a slope length term added with an exponent of −0.25. Using experimental data from WEPP cropland soil field interrill erodibility experiments, it has been shown that the improved interrill erosion equation describes the relationship between interrill erosion rate and runoff rate, rainfall intensity, slope gradient, and slope length reasonably well and better than existing interrill erosion equations. PMID:24516624

  9. Joint Hypermobility: What Causes Loose Joints?

    Science.gov (United States)

    ... result in a higher incidence of dislocations and sprains. Your doctor might suggest physical therapy to help strengthen the muscles surrounding these joints. See your doctor if your loose joints also cause you pain. Rarely, joint hypermobility is a sign ...

  10. Exercise as a therapeutic tool to counteract inflammation and clinical symptoms in autoimmune rheumatic diseases.

    Science.gov (United States)

    Perandini, Luiz Augusto; de Sá-Pinto, Ana Lúcia; Roschel, Hamilton; Benatti, Fabiana Braga; Lima, Fernanda Rodrigues; Bonfá, Eloisa; Gualano, Bruno

    2012-12-01

    Chronic inflammation is a common feature shared by several autoimmune rheumatic diseases, such as rheumatoid arthritis, systemic lupus erythematosus, idiopathic inflammatory myopathies, systemic sclerosis, and ankylosing spondylitis. Therefore, blocking or reducing inflammation is one of the major treatment strategies in these diseases. In this context, exercise training has emerged as a potential therapeutic tool in counteracting systemic inflammation, thereby leading to better clinical outcomes. The aims of this review are i) to provide a summary of the clinical effects of exercise training in selected autoimmune rheumatic diseases; and ii) to discuss the potential anti-inflammatory role of exercise training in autoimmune rheumatic diseases, stressing the gaps in literature and the clinical and scientific perspectives in the field. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. A scientific update on biosimilar infliximab (CT-P13) in rheumatic diseases.

    Science.gov (United States)

    Taylor, Peter

    2015-01-01

    The development of biologic drugs has undoubtedly enhanced the spectrum of treatments available for immune-mediated inflammatory rheumatic diseases such as rheumatoid arthritis. However, despite their clear clinical benifits, use of biologics is often hindered by their high costs. The manufacture and subsequent approval of more cost-effective 'biosimilar' versions of these drugs may address this issue and improve patient access. CT-P13 (Remsima(®), Inflectra(®)), a biosimilar of infliximab (Remicade(®)), has shown comparable efficacy, safety and pharmacokinetics to its originator drug in clinical studies. The articles in this supplement present a scientific update on the development and use of biosimilars in rheumatic disorders, with specific focus on CT-P13. The information discussed highlights the predicted positive clinical and economic impact of biosimilars on the management of rheumatic diseases.

  12. Effectiveness of Percutaneous Balloon Mitral Valvuloplasty for Rheumatic Mitral Stenosis with Mild to Severe Mitral Regurgitation

    Directory of Open Access Journals (Sweden)

    LinXiang Lu

    2016-01-01

    Full Text Available This study is designed to test whether percutaneous balloon mitral valvuloplasty (PBMV is effective for rheumatic mitral stenosis in Chinese patients with moderate to severe mitral regurgitation. Fifty-six patients with rheumatic mitral valve stenosis were divided into the mild, moderate, and severe regurgitation groups. Cardiac ultrasonography was measured before and 1 to 2 days after PBMV. Following PBMV, the mitral orifice was enlarged, and the left atrial diameter was reduced in the 3 patient groups. The enlargement of the mitral orifice in the mild regurgitation group was greater than that observed in the moderate and severe regurgitation groups. The size of the regurgitation area increased in the mild regurgitation group and decreased in the moderate and severe regurgitation groups, with the decrease in the severe regurgitation group being greater than that in the moderate regurgitation group. Therefore, PBMV is effective for treating rheumatic mitral stenosis in Chinese patients with mild to severe mitral regurgitation.

  13. Postoperative Chondroid Metaplasia in First Metacarpocarpal Joint: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Kyung Eun; Lee, Jin Hye; Kim, Jae Kyung; Jeong, Myeong Ja; Kim, Soo Hyun; Kang, Min Jin; Cho, Hyun Sun; Lee, Han Bee [Dept. of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Kwon, Ji Eun; Kim, Jeong Yeon [Dept. of Pathology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2012-02-15

    Intra-articular chondroid metaplasia is a rare disease; especially in the first metacarpophalangeal (MCP) joint after surgery. In this report, we present a chondroid metaplasia in the left first MCP joint as a soft tissue mass following the repair of the radial collateral ligament and ulnar collateral ligament. A hypointense signal on T2-weighted images and isointense signal on T1-weighted images without enhancement on MR and accompanied adjacent bone erosion were observed.

  14. New radiographic bone erosions in the wrists of patients with rheumatoid arthritis are detectable with magnetic resonance imaging a median of two years earlier

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Hansen, Michael; Stoltenberg, Michael

    2003-01-01

    at 5-year followup was 4.5 (95% confidence interval [95% CI] 2.6-7.6), compared with bones without baseline MRI erosions. If bones with baseline radiographic erosions were excluded from the analysis, the relative risk was 4.1 (95% CI 2.2-7.5). CONCLUSION: Most new radiographic bone erosions (78%) were......OBJECTIVE: In a 5-year followup study, we investigated the temporal relationship between development of wrist joint erosions as visualized by magnetic resonance imaging (MRI) versus conventional radiography (CR), in patients with rheumatoid arthritis. We also evaluated the risk of erosive...... progression on CR associated with the presence of MRI erosions. METHODS: In 10 patients with rheumatoid arthritis, MRI and CR of the dominant wrist were performed annually for 5 years. In each image set, each wrist bone (metacarpal bases, carpal bones, radius, and ulna) was assessed for the absence...

  15. Serum C-reactive protein concentrations in Nova Scotia Duck Tolling Retrievers with immune-mediated rheumatic disease.

    Science.gov (United States)

    Bremer, Hanna Dorotea; Hillström, Anna; Kånåhols, Malin; Hagman, Ragnvi; Hansson-Hamlin, Helene

    2017-04-17

    Nova Scotia Duck Tolling Retrievers (NSDTRs) are a dog breed often affected by immune-mediated rheumatic disease (IMRD), a disorder characterised by chronic stiffness and joint pain. Most, but not all, dogs with IMRD, have antinuclear antibodies (ANA), which are also commonly present in the autoimmune disease systemic lupus erythematosus (SLE). The clinical and diagnostic findings of IMRD indicate that it is an SLE-related disorder. C-reactive protein (CRP), an acute phase protein, is a quantitative marker of inflammation for many diseases and is used for diagnosing and monitoring systemic inflammation in both humans and dogs. However, in human SLE, CRP concentrations are often elevated but correlate poorly with disease activity; they can be low in individual patients with active disease. The aim of the study was to investigate CRP in a group of NSDTRs with the SLE-related disorder IMRD. The hypothesis was that CRP concentrations would be increased in dogs with IMRD compared to healthy dogs, but that the increase would be mild. Serum CRP concentrations were measured in 18 IMRD-affected NSDTRs and 19 healthy control NSDTRs using two different canine-specific CRP assays. Dogs with IMRD and ANA had higher CRP concentrations than the control dogs, but the concentrations were below the clinical decision limit for systemic inflammation for most of the IMRD dogs. These results indicate that CRP concentrations were increased in dogs with IMRD and ANA, but the increase was mild, similar to what has been observed in human SLE.

  16. [Case of rheumatic fever complicating carditis detected by a newly-developed systolic murmur in an adult woman].

    Science.gov (United States)

    Arinuma, Yoshiyuki; Kikuchi, Hirotoshi; Aramaki, Kaori; Takayama, Maki; Asako, Kurumi; Hirohata, Shunsei

    2012-01-01

    A 62-year-old woman presented to a primary care doctor on January 2006 due to a sore throat and high fever, and had received medication for a common cold. She was referred to our hospital in February 2006 because of additional manifestations such as painful rashes on the lower limb similar to erythema nodosum and polyarthralgia on her feet, shoulder and finger joints. She was initially treated with an anti-inflammatory drug (NSAID) for polyarthritis but the symptoms did not improved. In addition, the serum level of anti-streptolysin O antibody (ASO) was elevated at the second visit more than that at the first visit. She was diagnosed to have rheumatic fever (RF) based on the polyarthritis, inflammatory data and an increase of the ASO level. She was treated with 10 mg a day of prednisolone (PSL) and sultamicillin tosilate. However, a systolic murmur that had been never noticed by previous auscultation appeared after the third hospital day and the mitral regurgitation was also detected on echocardiogram. She was then treated with 40 mg a day of PSL because of an appearance of the carditis due to RF. The increased PSL dose promptly improved the systolic murmur as well as the arthritis. This report presented an RF case with carditis detected by an development of the systolic murmur in an adult female.

  17. School-based prevention of acute rheumatic fever: a group randomized trial in New Zealand.

    Science.gov (United States)

    Lennon, Diana; Stewart, Joanna; Farrell, Elizabeth; Palmer, Anne; Mason, Henare

    2009-09-01

    Acute rheumatic fever (ARF) and its sequela, rheumatic heart disease is the commonest cause of childhood cardiac morbidity globally. The current approach to the prevention of a primary attack of rheumatic fever in children using oral medication for streptococcal pharyngitis is poorly supported. The efficacy of injectable penicillin, in high rheumatic fever incidence military environments is indisputable. To evaluate school-based control of rheumatic fever in an endemic area. Fifty-three schools ( approximately 22,000 students) from a rheumatic fever high incidence setting ( approximately 60/100,000) in Auckland, New Zealand were randomized. The control group received routine general practice care. The intervention was a school-based sore throat clinic program with free nurse-observed oral penicillin treatment of group A streptococcal pharyngitis. The outcome measure was ARF in any child attending a study school. Analysis A defined ARF cases using criteria derived from Jones Criteria 1965 (definite) and 1956 (probable) with more precise definitions. Analysis B was based on 1992 Jones criteria but also included echocardiography to determine definite cases. In Analysis A, 24 (55/100,000) cases occurred in clinic schools and 29 (67/100,000) in nonclinic schools, a 21% reduction when adjusted for demography and study design (P = 0.47). Analysis B revealed a 28% reduction 26 (59/100,000) and 33 (77/100,000) cases, respectively (P = 0.27). This study involving 86,874 person-years showed a nonsignificant reduction in the school-based sore throat clinic programs.

  18. [Clinical and demographic characteristics of 99 episodes of rheumatic fever in Acre, the Brazilian Amazon].

    Science.gov (United States)

    Borges, Fátima; Barbosa, Maria Luiza A; Borges, Renata Beyruth; Pinheiro, Olívia C; Cardoso, Carlos; Bastos, Claudilson; Aras, Roque

    2005-02-01

    To report clinical manifestations and demographic characteristics of patients with rheumatic fever treated in a public hospital in the state of Acre. A cross-sectional study was conducted of patients consecutively seen in the Cardiology Ward at FUNDHACRE Demographic, clinical and laboratory data were assessed through a questionnaire. The diagnosis of rheumatic fever was made based on Jones' criteria, associated with laboratory data, electrocardiography, chest X-ray, and bi-dimensional echocardiography. Patients with other heart diseases, diabetes, obesity, inflammatory disease, and infections were excluded. Those who smoked, were pregnant, or used anti-inflammatory medication or hormone therapy were also excluded. From July 2003 to February 2004, 99 patients with rheumatic fever were assessed (mean age, 11 years, SD= +/- 10.18) with a predominance of females (59.6%), and a racial phenotype of a mixture of Caucasian and Indian (60.6%). Three individuals were excluded because they did not meet the diagnostic criteria. Mean age was 9.1 years old, and in 30.4% of the patients, the disease was diagnosed at the first episode of rheumatic fever. The most frequent clinical manifestations were carditis (69.7%), arthritis (21.4%), and chorea (6.1%). Mitral regurgitation was the most common lesion (36.4%) followed by the association of mitral regurgitation and aortic regurgitation (9.1%). Rheumatic carditis was the most common manifestation of rheumatic fever, predominant in the group with a racial mixture of Caucasian and Indian (60.6%). Low compliance with antibiotic therapy contributed to the recurrence of the disease and to cardiac sequelae.

  19. Beyond Fat Mass: Exploring the Role of Adipokines in Rheumatic Diseases

    Directory of Open Access Journals (Sweden)

    Morena Scotece

    2011-01-01

    Full Text Available The cloning of leptin in 1994 by Zhang et al. introduced a novel concept about white adipose tissue (WAT as a very dynamic organ that releases a plethora of immune and inflammatory mediators, such as adipokines and cytokines, which are involved in multiple diseases. Actually, adipokines exert potent modulatory actions on target tissues involved in rheumatic diseases including cartilage, synovial, bone and immune cells. The goal of this paper is to elucidate the recent findings concerning the involvement of adipokines in rheumatic diseases, such as rheumatoid arthritis (RA, osteoarthritis (OA, and systemic lupus erythematosus (SLE.

  20. Exercise as an anti-inflammatory therapy for rheumatic diseases—myokine regulation

    DEFF Research Database (Denmark)

    Benatti, Fabiana B; Pedersen, Bente K

    2015-01-01

    Persistent systemic inflammation, a typical feature of inflammatory rheumatic diseases, is associated with a high cardiovascular risk and predisposes to metabolic disorders and muscle wasting. These disorders can lead to disability and decreased physical activity, exacerbating inflammation...... muscle communicates with other organs by secreting proteins called myokines. Some myokines are thought to induce anti-inflammatory responses with each bout of exercise and mediate long-term exercise-induced improvements in cardiovascular risk factors, having an indirect anti-inflammatory effect...... of exercise, and indirectly, by improving comorbidities and cardiovascular risk factors. We also discuss the mechanisms by which some myokines have anti-inflammatory functions in inflammatory rheumatic diseases....

  1. RHEUMATIC FEVER AS NONVANISHING DISEASE: A PROBLEM STATE AND CLINICAL CASES

    Directory of Open Access Journals (Sweden)

    N. A. Shostak

    2010-01-01

    Full Text Available Early diagnostics and treatment of patients with acute rheumatic fever (RF remains actual problem because rheumatic heart disease is still one of the main causes of acquired valvular lesions. Two cases of acute RF occurred in City Clinical Hospital №1 named after N.I. Pirogov in 2009 are presented. Different outcomes were observed during 6 and 10 months of clinical monitoring. The main approaches to diagnostics and treatment of RF are also described taking into consideration national and international guidelines.

  2. A short history of anti-rheumatic therapy. I. An introduction on traditional and drug treatments

    Directory of Open Access Journals (Sweden)

    G. Pasero

    2011-06-01

    Full Text Available The origins of anti-rheumatic therapy are very old and mainly related to the use of traditional, sometimes extravagant, treatments, as a part of folk medicine. Spa therapy has long been used for the treatment of rheumatic diseases, as well as, in later times, physical treatments, including electrotherapy. Drug treatment has developed beginning from substances of vegetable origin, such as willow and colchicum extracts. Then it has been spread out through the chemical synthesis of compounds with specific action and therefore more effective, owing to the great development of pharmaceutical industry.

  3. A short history of anti-rheumatic therapy - VII. Biological agents

    Directory of Open Access Journals (Sweden)

    B. Gatto

    2011-11-01

    Full Text Available The introduction of biological agents has been a major turning-point in the treatment of rheumatic diseases, particularly in rheumatoid arthritis. This review describes the principle milestones that have led, through the knowledge of the structure and functions of nucleic acids, to the development of production techniques of the three major families of biological agents: proteins, monoclonal antibodies and fusion proteins. A brief history has also been traced of the cytokines most involved in the pathogenesis of inflammatory rheumatic diseases (IL-1 and TNF and the steps which have led to the use of the main biological drugs in rheumatology: anakinra, infliximab, adalimumab, etanercept and rituximab.

  4. Rheumatic disease in a Nigerian lady with sarcoidosis: Case report ...

    African Journals Online (AJOL)

    She developed cough which was associated with occasional chest pain. She had multiple joint pains, fever, oral ulcers and weight loss with associated anorexia. She developed significant hair loss, fatigue, redness of the eyes; with poor vision, and hearing impairment of about 6 years duration at the time of presentation.

  5. Varioliform erosions in the stomach and duodenum

    Energy Technology Data Exchange (ETDEWEB)

    Lotz, W.; Schulz, D.; Munkel, G.

    1984-04-01

    One thousand five hundred and eighty-three patients who were x-rayed for dyspepsia showed varioliform erosions in 15.3%. Men had an incidence of 9.8%, almost twice as common as in women (5.5%). Mucosal polyps, usually of the hyperplastic type, occurred in 2.4%. 15% of patients with gastric ulcers and 16% of patients with duodenal ulcers had varioliform erosions. On the other hand, amongst patients with erosions, 11% had gastric ulcers and 8.3% duodenal ulcers. The definitions of erosion which have been given in the literature are partly contradictory, and are discussed. Varioliform erosions, also known as complete erosions, may be acute or chronic. They are the third most common cause of bleeding from the upper gastrointestinal tract. With modern radiological methods of examining the stomach, they are no longer a rare finding. 5 figs.

  6. DENTAL EROSION IN PRIMARY DENTITION- A REVIEW

    Directory of Open Access Journals (Sweden)

    Rafi Shaik

    2017-06-01

    Full Text Available BACKGROUND The pattern of oral diseases has been influenced by ever changing human lifestyle. Tooth wear especially dental erosion has drawn increasing attention as risk factor for tooth damage or loss in recent years. It is a common condition in primary dentition compared to permanent dentition due to thinner and less mineralised enamel. However, it is more worrying, when this condition is being found in an alarming proportion among children. The presence of dental erosion in children is likely to be associated with a number of general health and dietary factors, but it is also aggravated by the relatively more rapid progression of erosion in the deciduous teeth. An understanding of the aetiologies and risk factors for erosion is important for early recognition of dental erosion to prevent serious irreversible damage to the dentition. This paper discusses the erosion in children with regard to its epidemiology, prevalence, clinical features, measurement and prevention.

  7. Erosive lichen planus: a therapeutic challenge.

    Science.gov (United States)

    Romero, Williams; Giesen, Laura; Navajas-Galimany, Lucas; Gonzalez, Sergio

    2016-01-01

    Erosive lichen planus is an uncommon variant of lichen planus. Chronic erosions of the soles, accompanied by intense and disabling pain, are some of its most characteristic manifestations. We present the case of a woman who developed oral and plantar erosive lichen planus associated with lichen planus pigmentosus and ungueal lichen planus that were diagnosed after several years. The patient failed to respond to multiple therapies requiring longstanding medication but remained refractory. Knowledge of the treatment options for erosive lichen planus is insufficient. Further research is required to clarify their effectiveness, ideally adopting an evidence-based methodology.

  8. Erosion products in disruption simulation experiments

    Energy Technology Data Exchange (ETDEWEB)

    Safronov, V.; Arkhipov, N.; Bakhtin, V.; Barsuk, V.; Kurkin, S.; Mironova, E.; Toporkov, D.; Vasenin, S.; Zhitlukhin, A. [Troitsk Inst. for Innovation and Fusion Research, Troisk, Moscow region (Russian Federation); Arkhipov, I. [Inst. of Physical Chemistry, Russian Academy of Science, Moscow (Russian Federation); Werle, H.; Wuerz, H. [Forschungszentrum Karlsruhe (Germany)

    1998-07-01

    Erosion of divertor materials under tokamak disruption event presents a serious problem of ITER technology. Erosion restricts the divertor lifetime and leads to production of redeposited layers of the material retaining large amount of tritium, which is a major safety issue for future fusion reactor. Since ITER disruptive heatloads are not achievable in existing tokamaks, material erosion is studied in special simulation experiments. Till now the simulation experiments have focused mainly on investigation of shielding effect and measurement of erosion rate. In the present work the properties of eroded and redeposited graphite are studied under condition typical for hard ITER disruption. (author)

  9. Clinical significance of fibromyalgia syndrome in different rheumatic diseases: Relation to disease activity and quality of life.

    Science.gov (United States)

    El-Rabbat M, Sarah; Mahmoud, Nermeen K; Gheita, Tamer A

    2017-04-11

    To describe the frequencies of fibromyalgia syndrome (FMS) in various rheumatic diseases; rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and Behçets disease (BD) patients and to study the relation to clinical manifestations and quality of life (QoL). 160 patients (50 RA, 50 SLE, 30 SSc and 30 BD) and matched corresponding healthy controls were included. Disease activity was assessed using disease activity score in 28 joints (DAS28) for RA, SLE Disease Activity index (SLEDAI), modified Rodnan skin score for SSc and BD Current Activity Form (BDCAF). The QoL was also recorded. Severity in FMS cases was estimated using the revised Fibromyalgia Impact Questionnaire score. In the RA, SLE, SSc and BD patients, FMS was found in 14%, 18%, 6.67% and 3.33% respectively compared to 2.1%, 3%, 3.3% and 0% in their corresponding controls. In RA patients, DAS28 was significantly higher in those with FMS (p=0.009) and significantly correlated with both Widespread Pain Index (WPI) (p=0.011) and Symptom Severity (SS) scale (p=0.012). The QoL scale in those with FMS was significantly worse (62.3±7.9) compared to those without (71.7±14.4) (p=0.023). In SLE patients, The WPI and SS both significantly correlated with the presence of thrombosis (r=0.28, p=0.049 and r=0.43, p=0.002 respectively). The SS scale tended to correlate with the SLEDAI (r=0.28, p=0.05). In BD patients, BDCAF and WPI significantly correlated (p=0.03). Fibromyalgia syndrome is more frequent in rheumatic diseases, could be related to the disease activity in RA and BD patients and to thrombosis in SLE and affected the QoL in RA. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  10. Magnetic resonance imaging, radiography, and scintigraphy of the finger joints

    DEFF Research Database (Denmark)

    Klarlund, M; Ostergaard, M; Jensen, K E

    2000-01-01

    To evaluate synovial membrane hypertrophy, tenosynovitis, and erosion development of the 2nd to 5th metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints by magnetic resonance imaging in a group of patients with rheumatoid arthritis (RA) or suspected RA followed up for one year...

  11. Coronary artery disease in patients with rheumatic and non-rheumatic valvular heart disease treated at a public hospital in Rio de Janeiro.

    Science.gov (United States)

    Kruczan, Dany David; Silva, Nelson Albuquerque de Souza e; Pereira, Basílio de Bragança; Romão, Vítor André; Correa Filho, Wilson Braz; Morales, Fidel Ernesto Castro

    2008-03-01

    to estimate the prevalence of coronary artery disease (CAD) in valvular heart disease of rheumatic (RVHD) and non-rheumatic (NVHD) etiology, assessing possible predictive factors for the presence of CAD. This is a cross-sectional study of a series of cases obtained from a pre-defined population, wherein 1,412 patients referred for heart surgery of any etiology were evaluated. Of these, 294 primary heart disease patients aged > or =40 submitted to cinecoronary arteriography (CA) were identified and studied. patients with RVHD presented lower prevalence of CAD (4%) when compared to NVHD (33.61%), pTACP), systemic arterial hypertension (SAH), diabetes and dyslipidemia were significantly related to CAD, and that the rheumatic etiology was not a disease determinant. Smoking and gender were clinically important in CAD, although not statistically significant. In the whole group, the Log-linear analysis showed that, regardless of the etiology, gender, age > or =55, SAH, TACP, diabetes and dyslipidemia were all related directly to CAD, with the latter three being the most important variables for the disease. the prevalence of CAD among RVHD patients is low, whereas it is high among NVHD patients; the rheumatic etiology does not seem to have any beneficial effects on the prevalence of CAD; gender, age, SAH, TACP, dyslipidemia and diabetes were identified as being strongly associated with the presence of CAD. It is possible to define the criteria that indicate the need for pre-surgical CA in heart valve replacements, so that the standard indication after the age of 40 years can be avoided.

  12. Erosion controls transpressional wedge kinematics

    Science.gov (United States)

    Leever, K. A.; Oncken, O.

    2012-04-01

    High resolution digital image analysis of analogue tectonic models reveals that erosion strongly influences the kinematics of brittle transpressional wedges. In the basally-driven experimental setup with low-angle transpression (convergence angle of 20 degrees) and a homogeneous brittle rheology, a doubly vergent wedge develops above the linear basal velocity discontinuity. In the erosive case, the experiment is interrupted and the wedge topography fully removed at displacement increments of ~3/4 the model thickness. The experiments are observed by a stereo pair of high resolution CCD cameras and the incremental displacement field calculated by Digital Particle Image Velocimetry (DPIV). From this dataset, fault slip on individual fault segments - magnitude and angle on the horizontal plane relative to the fault trace - is extracted using the method of Leever et al. (2011). In the non-erosive case, after an initial stage of strain localization, the wedge experiences two transient stages of (1) oblique slip and (2) localized strain partitioning. In the second stage, the fault slip angle on the pro-shear(s) rotates by some 30 degrees from oblique to near-orthogonal. Kinematic steady state is attained in the third stage when a through-going central strike-slip zone develops above the basal velocity discontinuity. In this stage, strain is localized on two main faults (or fault zones) and fully partitioned between plate boundary-parallel displacement on the central strike-slip zone and near-orthogonal reverse faulting at the front (pro-side) of the wedge. The fault slip angle on newly formed pro-shears in this stage is stable at 60-65 degrees (see also Leever et al., 2011). In contrast, in the erosive case, slip remains more oblique on the pro-shears throughout the experiment and a separate central strike-slip zone does not form, i.e. strain partitioning does not fully develop. In addition, more faults are active simultaneously. Definition of stages is based on slip on

  13. Anti CD20 (Rituximab therapy in refractory pediatric rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Joel Reis

    2016-01-01

    Full Text Available Objectives: We aim to report the efficacy and safety of rituximab (RTX in patients diagnosed with juvenile systemic lupus erythematosus (JSLE or juvenile idiopathic arthritis (JIA refractory to conventional treatment. Methods: A retrospective review was made of all medical records of patients with JSLE or JIA treated with RTX between January 2009 and January 2015 in the Pediatric Rheumatology Unit of a central hospital. Results: Five patients, 4 with JSLE and 1 with extended oligoarticular JIA, received 10 cycles of RTX (23 infusions. The scheme of RTX frequently used was 750 mg/m2 two weeks apart. The median follow-up time after receiving the first cycle of RTX was 24 months (12 – 70. The four patients with JSLE were female (three caucasian and one black. The patient with JIA was a caucasian male. The median age at diagnosis was 10 years (16 months – 17years. The median evolution time until receiving RTX was 6 years (5 months – 15 years. Refractory class IV lupus nephritis was the most common indication for receiving RTX. Previous treatment to RTX included nonsteroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs, immunosuppressive drugs and corticosteroids in all patients and anti-TNFα (etanercept in the patient with JIA. It was possible to reduce the mean oral corticosteroid dose after RTX, ranging from 23 mg/day (20-25mg/day before RTX to 11 mg/day (0–20 mg/day at the last evaluation. Disease activity before RTX and at last evaluation also improved. The SLEDAI score, for JSLE, decreased from a median of 15, 5 (11 – 18 to 3 (0 – 6, and the JADAS-27 score, for JIA, also diminished from 40.4 to 3.5. Adverse events occurred in 2 patients, including delayed second dose after the diagnosis of cryptococcosis and respiratory tract infection with concomitant hypogammaglobulinemia needing of immunoglobulin replacement and antibiotic therapy. Conclusions: Rituximab might have a role in the treatment of JSLE and JIA

  14. Conventional and anti-erosion fluoride toothpastes: effect on enamel erosion and erosion-abrasion.

    Science.gov (United States)

    Ganss, C; Lussi, A; Grunau, O; Klimek, J; Schlueter, N

    2011-01-01

    New toothpastes with anti-erosion claims are marketed, but little is known about their effectiveness. This study investigates these products in comparison with various conventional NaF toothpastes and tin-containing products with respect to their erosion protection/abrasion prevention properties. In experiment 1, samples were demineralised (10 days, 6 × 2 min/day; citric acid, pH 2.4), exposed to toothpaste slurries (2 × 2 min/day) and intermittently stored in a mineral salt solution. In experiment 2, samples were additionally brushed for 15 s during the slurry immersion time. Study products were 8 conventional NaF toothpastes (1,400-1,490 ppm F), 4 formulations with anti-erosion claims (2 F toothpastes: NaF + KNO(3) and NaF + hydroxyapatite; and 2 F-free toothpastes: zinc-carbonate-hydroxyapatite, and chitosan) and 2 Sn-containing products (toothpaste: 3,436 ppm Sn, 1,450 ppm F as SnF(2)/NaF; gel: 970 ppm F, 3,030 ppm Sn as SnF(2)). A mouth rinse (500 ppm F as AmF/NaF, 800 ppm Sn as SnCl(2)) was the positive control. Tissue loss was quantified profilometrically. In experiment 1, most NaF toothpastes and 1 F-free formulation reduced tissue loss significantly (between 19 and 42%); the Sn-containing formulations were the most effective (toothpaste and gel 55 and 78% reduction, respectively). In experiment 2, only 4 NaF toothpastes revealed significant effects compared to the F-free control (reduction between 29 and 37%); the F-free special preparations and the Sn toothpaste had no significant effect. The Sn gel (reduction 75%) revealed the best result. Conventional NaF toothpastes reduced the erosive tissue loss, but had limited efficacy regarding the prevention of brushing abrasion. The special formulations were not superior, or were even less effective. Copyright © 2011 S. Karger AG, Basel.

  15. Ultrasonography of the first metatarsophalangeal joint in gout

    Directory of Open Access Journals (Sweden)

    Radak-Perović Marija

    2011-01-01

    Full Text Available Introduction. About one half of the first gout attacks occur in the first metatarsophalangeal joint (MTPJ1; in the disease course this joint is practically inevitably affected. Radiographic evidence of bone erosions is the indication for hypouricaemic therapy in order to prevent joint destruction and nephropathy. Advantages of ultrasonography (US comparing to conventional x-ray findings in depicting early bone erosions in various inflammatory arthropathies have been demonstrated by several studies. Objective. The aims of this study were to compare US and x-ray findings in the detection of MTPJ1 erosions in patients with gout, to correlate sonographic and clinical features, and to detect possible characteristic sonographic features of gout. Methods. Thirty patients (60 MTPJ1 with primary gout (ACR and 10 age-matched control subjects (20 MTPJ1 with different inflammatory arthropathies were clinically evaluated. Standard dorsiplantar weight bearing and lateral weight bearing x-ray views of both feet were taken. US was performed and interpreted by an independent sonographer on the presence of bone erosions, synovial fluid, synovial hypertrophy, Doppler signal and hyperechoic spots. Statistical analysis was performed (Spearman and Pearson correlation coefficient, Wilcoxon and χ2 test. Results. Twenty-four studied MTPJ1 had evidence of erosions, 17 only on US and seven both on x-ray and on US (Z=-4.123; p=0.000. US findings showed that hyperechoic spots were the most prominent feature of gouty MTPJ1 (χ2=40.909; p=0.000, followed by erosions and synovial fluid presentation. Conclusion. US of MTPJ1 in gout discovers significantly more erosions than x-ray, which may have therapeutic implications. The evidence of hyperechoic spots (surrogate crystals of the different size, number and orientation is a major sonographic feature of the MTPJ1 in gout, which may be of importance in the diagnosis of certain cases (low serum urate, unavailable synovial fluid

  16. Are rheumatologists adhering to the concepts window of opportunity and treat-to-target? Earlier and more intense disease-modifying anti-rheumatic drug treatment over time in patients with early arthritis in the PEARL study.

    Science.gov (United States)

    Toledano, Esther; Ortiz, Ana M; Ivorra-Cortes, Jose; Montes, Nuria; Beltran, Amada; Rodríguez-Rodriguez, Luis; Carmona, Loreto; González-Álvaro, Isidoro

    2017-11-28

    To analyse changes over time in the treatment with disease modifying anti-rheumatic drugs and biological therapies prescribed to patients from an early arthritis register and whether these changes had an impact on their outcome. This was a longitudinal retrospective 2-year study based on data collected in the PEARL study. The population was clustered in three groups depending on year of symptoms onset (2000-2004, 2005-2009, 2010-2014). Intensity of disease-modifying anti-rheumatic drug treatment was calculated and the percentage of patients receiving biological therapy during the first 2-year follow-up was collected. Disease activity and remission at the end of follow-up, as well as radiological progression were the outcomes analysed. Multivariable analyses were fitted to determine which variables including the three period times were associated with the outcomes. A significant increase in treatment intensity was observed in patients with undifferentiated arthritis, getting closer to that prescribed to patients fulfilling the 1987 RA criteria at the last period studied (2010-2014). This finding was associated with a significantly higher percentage of patients in remission and lower progression of the erosion component of the Sharp van der Heijde score. During the last 15 years, the treatment of patients with early arthritis in our hospital has been progressively increased and it has been associated with significantly better outcomes.

  17. Graffiti for science - erosion painting reveals spatially variable erosivity of sediment-laden flows

    Science.gov (United States)

    Beer, Alexander R.; Kirchner, James W.; Turowski, Jens M.

    2016-12-01

    Spatially distributed detection of bedrock erosion is a long-standing challenge. Here we show how the spatial distribution of surface erosion can be visualized and analysed by observing the erosion of paint from natural bedrock surfaces. If the paint is evenly applied, it creates a surface with relatively uniform erodibility, such that spatial variability in the erosion of the paint reflects variations in the erosivity of the flow and its entrained sediment. In a proof-of-concept study, this approach provided direct visual verification that sediment impacts were focused on upstream-facing surfaces in a natural bedrock gorge. Further, erosion painting demonstrated strong cross-stream variations in bedrock erosion, even in the relatively narrow (5 m wide) gorge that we studied. The left side of the gorge experienced high sediment throughput with abundant lateral erosion on the painted wall up to 80 cm above the bed, but the right side of the gorge only showed a narrow erosion band 15-40 cm above the bed, likely due to deposited sediment shielding the lower part of the wall. This erosion pattern therefore reveals spatial stream bed aggradation that occurs during flood events in this channel. The erosion painting method provides a simple technique for mapping sediment impact intensities and qualitatively observing spatially distributed erosion in bedrock stream reaches. It can potentially find wide application in both laboratory and field studies.

  18. Graffiti for science – erosion painting reveals spatially variable erosivity of sediment-laden flows

    Directory of Open Access Journals (Sweden)

    A. R. Beer

    2016-12-01

    Full Text Available Spatially distributed detection of bedrock erosion is a long-standing challenge. Here we show how the spatial distribution of surface erosion can be visualized and analysed by observing the erosion of paint from natural bedrock surfaces. If the paint is evenly applied, it creates a surface with relatively uniform erodibility, such that spatial variability in the erosion of the paint reflects variations in the erosivity of the flow and its entrained sediment. In a proof-of-concept study, this approach provided direct visual verification that sediment impacts were focused on upstream-facing surfaces in a natural bedrock gorge. Further, erosion painting demonstrated strong cross-stream variations in bedrock erosion, even in the relatively narrow (5 m wide gorge that we studied. The left side of the gorge experienced high sediment throughput with abundant lateral erosion on the painted wall up to 80 cm above the bed, but the right side of the gorge only showed a narrow erosion band 15–40 cm above the bed, likely due to deposited sediment shielding the lower part of the wall. This erosion pattern therefore reveals spatial stream bed aggradation that occurs during flood events in this channel. The erosion painting method provides a simple technique for mapping sediment impact intensities and qualitatively observing spatially distributed erosion in bedrock stream reaches. It can potentially find wide application in both laboratory and field studies.

  19. Quantifying accelerated soil erosion through ecological site-based assessments of wind and water erosion

    Science.gov (United States)

    This work explores how organising soil erosion assessments using established groupings of similar soils (ecological sites) can inform systems for managing accelerated soil erosion. We evaluated aeolian sediment transport and fluvial erosion rates for five ecological sites in southern New Mexico, USA...

  20. Dental erosion in French adolescents.

    Science.gov (United States)

    Muller-Bolla, Michèle; Courson, Frédéric; Smail-Faugeron, Violaine; Bernardin, Thibault; Lupi-Pégurier, Laurence

    2015-11-19

    Since the 2000s, different epidemiological studies focusing on the prevalence or the aetiology of DE in adolescents recognised them as an at-risk population due to their eating behaviours. None was carried out in French adolescents. The primary objective of this study was to assess the prevalence of dental erosion (DE) using the total BEWE score among adolescents in the department of Alpes Maritimes, France. The secondary objectives were to observe changes in prevalence estimates depending on both the cutoffvalue of total BEWE score with different teeth/dental surfaces examined, and to identify the related risk factors. A cross-sectional study in a multistage random sample of 339 14-yr-old schoolchildren was carried out in 2014. The children completed a self-administered questionnaire concerning diet and oral habits. Caries was assessed with ICDAS-II (International Caries Detection and Assessment System-II) criteria and erosion with BEWE (Basic Erosive Wear Examination) index. The total BEWE score was calculated to assess the DE prevalence with two cutoff values (3 and 1). Data were analysed using descriptive statistics and logistic regression models. The 331 children were aged 14.4 ± 0.5 years. The DE prevalence was 39 % using a total BEWE score ≥ 3. With a cutoff total BEWE score of 1 (at least one affected tooth), the prevalence varied from 3.9 to 56.8 % depending on the teeth/surfaces that were used for the analysis. The DE prevalence, assessed with only first molars and maxillary incisors, was about 54 %. The risk factors for DE (total BEWE score ≥ 3) were daily consumption of acidic beverages (OR: 4.0; 95 % CI: 2.1-7.6) and acidic sweets (OR: 3.2; 95 % CI: 1.2-8.0), low socio economic category (OR: 2.4; 95 % CI: 1.1-5.0) and visible dental biofilm (OR: 2.0; 95 % CI: 1.2-3.4). Depending on the method chosen, the prevalence varied from 3.9 to 56.8 % among these adolescents. Thus, a consensus on choice of index, teeth to examine and age at

  1. Low adherence to secondary prophylaxis among clients diagnosed with rheumatic fever, Jamaica.

    Science.gov (United States)

    Thompson, Sheron Boswell; Brown, Cerese Hepburn; Edwards, Ann Marie; Lindo, Jascinth L M

    2014-07-01

    To determine the level of adherence and possible barriers to secondary prophylaxis among clients with rheumatic fever in Kingston, Jamaica. Cross-sectional survey of 39 clients diagnosed with rheumatic fever, receiving penicillin prophylaxis for more than a year using a 22-item self-administered questionnaire on adherence to secondary prophylaxis and knowledge of rheumatic fever. The patients' records were reviewed to determine the number of prophylaxis injections the patients received for the year 2010. The majority of participants (74%) were females and 51% were adults. Only 48·7% had a high level of adherence. The majority (72%) had low knowledge levels regarding their illness, while only 5% had a high knowledge level score. Most clients (70%) strongly agreed that nurses and doctors encouraged them to take their prophylaxis. However, over 60% reported that they travelled long distances and or waited long periods to get their injections. One-third reported that they missed appointments because of fear of injections and having to take time off from work or school. Clients attending the health centers studied had limited knowledge about rheumatic fever. Barriers to adherence included fear of the injections, long commutes, and long waiting periods at the facilities studied.

  2. Toll-like receptors and chronic inflammation in rheumatic diseases: new developments

    NARCIS (Netherlands)

    Joosten, L.A.B.; Abdollahi-Roodsaz, S.; Dinarello, C.A.; O'Neill, L.; Netea, M.G.

    2016-01-01

    In the past few years, new developments have been reported on the role of Toll-like receptors (TLRs) in chronic inflammation in rheumatic diseases. The inhibitory function of TLR10 has been demonstrated. Receptors that enhance the function of TLRs, and several TLR inhibitors, have been identified.

  3. Risk of infections in bronchiectasis during disease-modifying treatment and biologics for rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Geri Guillaume

    2011-11-01

    Full Text Available Abstract Background Bronchiectasis is frequently associated (up to 30% with chronic inflammatory rheumatic diseases and leads to lower respiratory tract infections. Data are lacking on the risk of lower respiratory tract infections in patients treated with biologic agents. Methods Monocenter, retrospective systematic study of all patients with a chronic inflammatory rheumatic disease and concomitant bronchiectasis, seen between 2000 and 2009. Univariate and multivariate analyses were performed to evidence predictive factors of the number of infectious respiratory events. Results 47 patients were included (mean age 64.1 ± 9.1 years, 33 (70.2% women, with a mean follow-up per patient of 4.3 ± 3.1 years. Rheumatoid arthritis was the main rheumatic disease (90.1%. The mean number of infectious events was 0.8 ± 1.0 event per patient-year. The factors predicting infections were the type of treatment (biologic vs. non biologic disease-modifying treatments, with an odds ratio of 8.7 (95% confidence interval: 1.7-43.4 and sputum colonization by any bacteria (odds ratio 7.4, 2.0-26.8. In multivariate analysis, both factors were independently predictive of infections. Conclusion Lower respiratory tract infectious events are frequent among patients receiving biologics for chronic inflammatory rheumatic disease associated with bronchiectasis. Biologic treatment and pre-existing sputum colonization are independent risk factors of infection occurrence.

  4. Rheumatic fever prophylaxis in South Africa - is bicillin 1,2 million ...

    African Journals Online (AJOL)

    Rheumatic fever is a major health problem in South Africa. Although intramuscular benzathine penicillin (bicillin) 1,2 million units (MU) every 4 weeks is widely used for secondary prophylaxis, studies in other countries have shown a recurrence rate of 3 - 8% over 5 - 6 years in patients on this regimen. It has been ...

  5. [Sarcoidosis after adalimumab treatment in inflammatory rheumatic diseases: a report of two cases and literature review].

    Science.gov (United States)

    Scailteux, Lucie-Marie; Guedes, Claudie; Polard, Elisabeth; Perdriger, Aleth

    2015-01-01

    TNF α antagonists (anti-TNF α) are widely used in inflammatory rheumatic diseases: rheumatoid arthritis (RA) and spondylarthropathy (SpA). The efficacy of the anti-TNF α monoclonal antibodies was also observed in unresponsive sarcoidosis to conventional therapy. In contrast, sarcoidosis in patients with inflammatory rheumatic disease treated with anti-TNF α keep on growing, with a suspected role of anti-TNF α in this pathological process. We presented here two cases of sarcoidosis developing while the patient was on adalimumab (ADA) therapy for inflammatory rheumatic disease. In one case, the reintroduction of ADA led to increase in symptomatology. We also analyzed the 16 other cases of sarcoidosis developing under ADA treatment published in literature, mostly in RA patients. These cases show a possible paradoxical effect of ADA in sarcoidosis development in patients treated with anti-TNFα monoclonal antibodies. The iatrogenic mechanism remains unclear. These cases underline the importance of a drug-induced etiology survey facing any symptomatology suggesting the development of sarcoidosis in patients treated with anti-TNF α for an inflammatory rheumatic disease. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  6. Acute rheumatic fever - Carditis is the most common presenting manifestation in South Africa

    NARCIS (Netherlands)

    Muller, E; Huizinga, SJ; Kalis, NN; VanDerMerwe, PL

    Acute rheumatic fever (ARF) is still a major health problem in South Africa. In this retrospective, descriptive study, 100 patients with ARF were analysed to establish whether the clinical profile has changed. Carditis was found in 94% of patients and was therefore the most common of the major

  7. Rheumatic fever prophylaxis in South Africa - is bicillin 1,2 million ...

    African Journals Online (AJOL)

    1993-09-30

    Sep 30, 1993 ... years of sentinel surveillance of acute respiratory infections (1985 - 1990): the benefits of an influenza early warning ... acquired cardiac disease in children worldwide. The prevalence of rheumatic fever and ... (approximately R40 million annually) for valve replacement surgery at six major South African ...

  8. Coping mediates the influence of personality on life satisfaction in patients with rheumatic diseases

    NARCIS (Netherlands)

    Vollmann, M.; Pukrop, Jörg; Salewski, Christel

    2016-01-01

    A rheumatic disease can severely impair a person’s quality of life. The degree of impairment, however, is not closely related to objective indicators of disease severity. This study investigated the influence and the interplay of core psychological factors, i.e., personality and coping, on life

  9. Sub-acute toxicity evaluation of ethanol extract of rheumatic tea ...

    African Journals Online (AJOL)

    Sub-acute toxicity profile of Rheumatic Tea Formula (RTF), a polyherbal tea consisting of Salix alba, Eucalyptus globulus and Albizia chevalieri was investigated in wistar rats of both sexes. Wistar rats were orally administered three different doses of ethanol extract of RTF for 28 days after which the effect on body weight, ...

  10. Rheumatic fever in Ireland: the role of Dr Monica Lea Wilson (1889-1971).

    Science.gov (United States)

    Ward, O Conor

    2013-02-01

    In 1869 William Stokes pointed out that the severity of rheumatic fever in Dublin had declined over recent decades. Similar worldwide decline led to the closure of many internationally famous rheumatic fever centres. The discovery by Robert Collis that rheumatic fever was a sequel to haemolytic streptococcal infection and the subsequent discovery of penicillin accelerated the decline. St Gabriel's Hospital in Dublin opened in 1951 under the clinical direction of Dr Monica Lea Wilson. Contrary to contemporary medical opinion a regimen of very prolonged bed rest was enforced. From 1961 the family doctors became concerned at the adverse psychological effects of the unnecessarily prolonged hospital stay. Twenty-seven of the 56 inpatients were re-assessed. None of them showed any evidence of active rheumatic fever and their parents took them home. The hospital closed in 1968. Dr Lea Wilson distanced herself from mainstream medicine and she is best remembered for having presented an unrecognized Caravaggio painting to the Jesuit Order in recognition of their pastoral support at the time of the controversial assassination in 1920 of her husband Percival, an Inspector in the Royal Irish Constabulary.

  11. A systematic review of the barriers affecting medication adherence in patients with rheumatic diseases.

    Science.gov (United States)

    Goh, Hendra; Kwan, Yu Heng; Seah, Yi; Low, Lian Leng; Fong, Warren; Thumboo, Julian

    2017-10-01

    Medication adherence is a crucial part in the management of rheumatic diseases, especially with many such patients requiring long-term medications. In this paper, we aim to systematically review the literature for the factors associated with medication adherence in the rheumatic patient population. We carried out a systematic literature search using PubMed ® , PsychInfo ® and Embase ® with relevant keywords and employed the PRISMA ® criteria. We included English peer-reviewed articles that studied the factors affecting medication adherence in patients with rheumatic diseases, which were assessed by two independent reviewers. Hand searches were conducted and relevant factors were extracted and classified using the World Health Organization (WHO)'s five dimensions of medication adherence. A simple diagram was drawn to summarise the factors extracted. 1977 articles were identified and reviewed and 90 articles were found to be relevant. A total of 17 factors and 38 sub-factors were identified and categorized based on the WHO's five dimensions of medication adherence. A hand model for medication adherence was developed to succinctly summarise these dimension to remind clinicians the importance of medication adherence in daily practice. We conducted a systematic review on the various factors including patient, therapy, condition, health system and socioeconomic-related factors that affected medication adherence in rheumatic patients. We found 17 factors and 38 sub-factors that affected medication adherence in this population. This systematic review can facilitate future focused research in unexplored dimensions.

  12. Application of the health assessment questionnaire disability index to various rheumatic diseases

    NARCIS (Netherlands)

    van Groen, M.M.; van Groen, Maaike M.; ten Klooster, Peter M.; Taal, Erik; van de Laar, Mart A F J; Glas, Cornelis A.W.

    2010-01-01

    Purpose To investigate whether the Stanford Health Assessment Questionnaire Disability Index (HAQ-DI) can serve as a generic instrument for measuring disability across different rheumatic diseases and to propose a scoring method based on item response theory (IRT) modeling to support this goal.

  13. The epidemiology of rheumatic disorders in a rural area of the ...

    African Journals Online (AJOL)

    Objective: To determine the prevalence of rheumatic diseases in a rural area of DR Congo. Methods: A cross-sectional study was performed in six randomly chosen villages of the health division of Gombe- Matadi, in Kongo-Central province (near Kinshasa), from 15th October to 15th November 2012. Investigators ...

  14. Inflammatory status in patients with rheumatic mitral stenosis: Guilty before and after balloon mitral valvuloplasty

    Directory of Open Access Journals (Sweden)

    Mohamed Ahmed Abdel Rahman

    2016-06-01

    Conclusion: Inflammatory pathogenesis of rheumatic fever, suggested by hsCRP, seems fixed both before, and after BMV. A basal increase in hsCRP before BMV is related to BMV success and an acute increase immediately after BMV seems related to trauma of balloon dilatations.

  15. [RheumaCheck: development and evaluation of a German language screening instrument for rheumatic diseases].

    Science.gov (United States)

    Richter, Jutta G; Wessel, Ewa; Klimt, Ralf; Willers, Reinhardt; Schneider, Matthias

    2008-01-01

    Early diagnosis of inflammatory rheumatic diseases is important for patients' prognosis and outcome. The mean time delay of 1 to 5 years in Germany between the initial symptoms and the first rheumatologist contact should be reduced. Efficiency of patient questionnaires for the identification of inflammatory rheumatic diseases has been demonstrated in other countries. The aim of our study was to develop a patient questionnaire in German identifying inflammatory rheumatic diseases with a high sensitivity and specificity as well as a high positive predictive value. The RheumaCheck questionnaire was developed by adoption of the FDA-approved Connective Tissue Disease Screening Questionnaire. 1448 patients (195 controls, 437 patients suspicious for and 816 patients with known inflammatory rheumatic diseases) recruited by rheumatologists and general practitioners answered the questionnaire that additionally assessed comorbidities and sociodemographic data. A predictive algorithm was calculated. Mean age of the complete group (73.1% female) was 52.5 +/- 15.1 years. 53.1% had no comorbidity. Application of the algorithm yields a high sensitivity (77.6%) and specificity (79.9%). The area under the ROC curve was 0.85 (p < 0.0001). Being aware of a possible high rate of false true results RheumaCheck is a simple, efficient instrument easily filled out by patients. It can identify the group of patients that needs further investigation, care and assessment by a rheumatologist leading to earlier diagnosis and therapy. A web version of RheumaCheck is provided on www.rheuma-check.de .

  16. [Left atrial appendage in rheumatic mitral valve disease: The main source of embolism in atrial fibrillation].

    Science.gov (United States)

    García-Villarreal, Ovidio A; Heredia-Delgado, José A

    To demonstrate that surgical removal of the left atrial appendage in patients with rheumatic mitral valve disease and long standing persistent atrial fibrillation decreases the possibility of stroke. This also removes the need for long-term oral anticoagulation after surgery. A descriptive, prospective, observational study was conducted on 27 adult patients with rheumatic mitral valve disease and long standing persistent atrial fibrillation, who had undergone mitral valve surgery and surgical removal of the left atrial appendage. Oral anticoagulation was stopped in the third month after surgery. The end-point was the absence of embolic stroke. An assessment was also made of postoperative embolism formation in the left atrium using transthoracic echocardiography. None of the patients showed embolic stroke after the third post-operative month. Only one patient exhibited transient ischaemic attack on warfarin therapy within the three postoperative months. Left atrial thrombi were also found in 11 (40.7%) cases during surgery. Of these, 6 (54.5%) had had embolic stroke, with no statistical significance (P=.703). This study suggests there might be signs that the left atrial appendage may be the main source of emboli in rheumatic mitral valve disease, and its resection could eliminate the risk of stroke in patients with rheumatic mitral valve disease and long-standing persistent atrial fibrillation. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  17. Epigenetic Modulation as a Therapeutic Prospect for Treatment of Autoimmune Rheumatic Diseases

    Directory of Open Access Journals (Sweden)

    Marzena Ciechomska

    2016-01-01

    Full Text Available Systemic inflammatory rheumatic diseases are considered as autoimmune diseases, meaning that the balance between recognition of pathogens and avoidance of self-attack is impaired and the immune system attacks and destroys its own healthy tissue. Treatment with conventional Disease Modifying Antirheumatic Drugs (DMARDs and/or Nonsteroidal Anti-Inflammatory Drugs (NSAIDs is often associated with various adverse reactions due to unspecific and toxic properties of those drugs. Although biologic drugs have largely improved the outcome in many patients, such drugs still pose significant problems and fail to provide a solution to all patients. Therefore, development of more effective treatments and improvements in early diagnosis of rheumatic diseases are badly needed in order to increase patient’s functioning and quality of life. The reversible nature of epigenetic mechanisms offers a new class of drugs that modulate the immune system and inflammation. In fact, epigenetic drugs are already in use in some types of cancer or cardiovascular diseases. Therefore, epigenetic-based therapeutics that control autoimmunity and chronic inflammatory process have broad implications for the pathogenesis, diagnosis, and management of rheumatic diseases. This review summarises the latest information about potential therapeutic application of epigenetic modification in targeting immune abnormalities and inflammation of rheumatic diseases.

  18. Perioperative management of a patient with Gilberts syndrome and rheumatic heart disease

    Directory of Open Access Journals (Sweden)

    R V Ranjan

    2012-01-01

    Full Text Available Anaesthetic management of patients with hepatic dysfunction can be quite challenging, as many anaesthetic agents are metabolized by liver. Heart disease on anti coagulation can pose additional challenge. Here we report a case of Gilbert′s syndrome with rheumatic heart disease on anti coagulation posted for elective hernia repair.

  19. Gene polymorphisms of TNF-α and IL-10 related to rheumatic heart ...

    African Journals Online (AJOL)

    disease patients,and IL-10 expression was characterized in heart tissue of RHD patients by immuno-histochemistry. ... rheumatic heart disease (group A) and 10 healthy children as a control group. (Group B). Patients group was classified into ...... morphism is associated with chagas disease cardiomyopathy. J.Infec.Dis.

  20. Physical activity for paediatric rheumatic diseases: standing up against old paradigms.

    Science.gov (United States)

    Gualano, Bruno; Bonfa, Eloisa; Pereira, Rosa M R; Silva, Clovis A

    2017-05-23

    Over the past 50 years it has become clear that physical inactivity is associated with chronic disease risk. For several rheumatic diseases, bed rest was traditionally advocated as the best treatment, but several levels of evidence support the imminent paradigm shift from the prescription of bed rest to physical activity in individuals with paediatric rheumatic diseases, in particular juvenile systemic lupus erythematosus, juvenile idiopathic arthritis, juvenile fibromyalgia, and juvenile dermatomyositis. Increasing levels of physical activity can alleviate several symptoms experienced by patients with paediatric rheumatic diseases, such as low aerobic fitness, pain, fatigue, muscle weakness and poor health-related quality of life. Moreover, the propensity of patients with paediatric rheumatic diseases to be hypoactive - often due to social self-isolation, overprotection, and fear and/or ignorance on the part of parents, teachers and health practitioners - can be detrimental to general disease symptoms and function. In support of this rationale, a growing number of studies have demonstrated that the systemic benefits of exercise training clearly outweigh the risks in these diseases. In this sense, health professionals are advised to assess, track and fight against physical inactivity and sedentary behaviour on a routine basis, as they are invaluable health risk parameters in rheumatology.

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

    DEFF Research Database (Denmark)

    Madsen, Ole Rintek; Egsmose, Charlotte

    2009-01-01

    , there is no evidence that disease-modifying anti-rheumatic (DMARDs) have a therapeutic effect in AS. Clinical evidence that greater TNF-inhibitor effectiveness can be achieved by combining with a DMARD is lacking, but further studies should be performed. More research is needed to clarify the role of DMARDs...

  2. Utility of combined high-resolution bone SPECT and MRI for the identification of rheumatoid arthritis patients with high-risk for erosive progression

    Energy Technology Data Exchange (ETDEWEB)

    Buchbender, Christian, E-mail: christian.buchbender@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Sewerin, Philipp, E-mail: philipp.sewerin@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Rheumatology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Mattes-György, Katalin, E-mail: katalin.mattes@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Nuclear Medicine, Moorenstr. 5, D-40225 Dusseldorf (Germany); Miese, Falk, E-mail: falk.miese@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Wittsack, Hans-Joerg, E-mail: hans-joerg.wittsack@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Specker, Christof, E-mail: c.specker@kliniken-essen-sued.de [Department of Rheumatology and Clinical Immunology, Kliniken Essen-Sud, Propsteistrasse 2, D-45239 Essen (Germany); Antoch, Gerald, E-mail: antoch@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Müller, Hans-Wilhelm, E-mail: HansW.Mueller@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Nuclear Medicine, Moorenstr. 5, D-40225 Dusseldorf (Germany); Schneider, Matthias, E-mail: matthias.schneider@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Rheumatology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Scherer, Axel, E-mail: scherer@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Ostendorf, Benedikt, E-mail: ostendorf@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Rheumatology, Moorenstr. 5, D-40225 Dusseldorf (Germany)

    2013-02-15

    Objectives: To evaluate the utility of sequentially acquired, post hoc fused, magnetic resonance imaging (MRI) and multi-pinhole single photon emission computed tomography (MPH-SPECT) with technetium-99m-labeled disphosphonates (Tc99m-DPD) for the identification of finger joints with later erosive progression in early rheumatoid arthritis (ERA) patients. Methods: Ten consecutive ERA patients prospectively underwent MPH-SPECT and MRI of metacarpophalangeal (MCP) joints prior to and after 6 months methotrexate therapy. Tc99m-DPD uptake was measured at proximal and distal MCP sites using regional analysis. The course of joint pathologies was scored according to the Rheumatoid Arthritis MRI Score (RAMRIS) criteria. Results: The frequency of increased Tc99m-DPD uptake, synovitis and bone marrow edemadecreased under MTX therapy; but the number of bone erosions increased. Joints with progressive and new erosions on follow-up had a higher baseline Tc99m-DPD uptake (2.64 ± 1.23 vs. 1.43 ± 0.91) (p = 0.02). Conclusions: Joints with erosive progression are characterized by an early increased Tc99m-DPD uptake, even in absence of MRI bone pathologies. Tc99m-DPD MPH-SPECT might thus be of additional value to morphological MRI for the identification of RA patients with a high risk for erosive progression.

  3. Rainfall erosivity in Brazil: A Review

    Science.gov (United States)

    In this paper, we review the erosivity studies conducted in Brazil to verify the quality and representativeness of the results generated and to provide a greater understanding of the rainfall erosivity (R-factor) in Brazil. We searched the ISI Web of Science, Scopus, SciELO, and Google Scholar datab...

  4. Backward erosion piping : Initiation and progression

    NARCIS (Netherlands)

    Van Beek, V.M.

    2015-01-01

    Backward erosion piping is an internal erosion mechanism during which shallow pipes are formed in the direction opposite to the flow underneath water-retaining structures as a result of the gradual removal of sandy material by the action of water. It is an important failure mechanism in both dikes

  5. EVALUATION OF RAINFALL EROSIVIT OF RAINFALL EROSIVITY ...

    African Journals Online (AJOL)

    eobe

    climate change [19]. Vegetation intercepts rain, reducing its energy and preventing splash erosion. It also slows runoff, reduces sheet erosion, and anchors and reinforces the soil ... hydro geological significance in terms of groundwater yield and exploitation ..... Australia's Tropics”, Australian Journal of Soil. Research. Vol.

  6. Saliva Parameters and Erosive Wear in Adolescents

    NARCIS (Netherlands)

    Zwier, N.; Huysmans, M. C. D. N. J. M.; Jager, D. H. J.; Ruben, J.; Bronkhorst, E. M.; Truin, G. J.

    2013-01-01

    The aim of this study was to investigate the relationship between several parameters of saliva and erosive wear in adolescents. (Un-)stimulated saliva was collected from 88 adolescents with erosion and 49 controls (age 16 +/- 1 years). Flow rate, pH and buffer capacity were determined immediately.

  7. Interrill soil erosion processes on steep slopes

    Science.gov (United States)

    To date interrill erosion processes and regimes are not fully understood. The objectives are to 1) identify the erosion regimes and limiting processes between detachment and transport on steep slopes, 2) characterize the interactive effects between rainfall intensity and flow depth on sediment trans...

  8. Soil erosion dynamics response to landscape pattern

    NARCIS (Netherlands)

    Ouyang, W.; Skidmore, A.K.; Hao, F.; Wang, T.

    2010-01-01

    Simulating soil erosion variation with a temporal land use database reveals long-term fluctuations in landscape patterns, as well as priority needs for soil erosion conservation. The application of a multi-year land use database in support of a Soil Water Assessment Tool (SWAT) led to an accurate

  9. Past, Present, Future Erosion at Locke Island

    Energy Technology Data Exchange (ETDEWEB)

    Bjornstad, Bruce N.

    2006-08-08

    This report describes and documents the erosion that has occurred along the northeast side of Locke Island over the last 10 to 20 years. The principal cause of this erosion is the massive Locke Island landslide complex opposite the Columbia River along the White Bluffs, which constricts the flow of the river and deflects the river's thalweg southward against the island.

  10. Hydrogeological And Geotechnical Investigations Of Gully Erosion ...

    African Journals Online (AJOL)

    For many years, gully erosion and landslides are posing a serious threat to human existence, agricultural land, infrastructure and socio-economic activities in Calabar and its environs. Consequently, hydrogeological and geotechnical studies of gully erosion sites were carried out in order to provide information on the ...

  11. EPro Non-contact erosion profiling

    DEFF Research Database (Denmark)

    Meinert, Palle

    EPro is a profiler controlled by software, which is constructed to measure the same surface or work piece multiple times and track changes due to erosion.......EPro is a profiler controlled by software, which is constructed to measure the same surface or work piece multiple times and track changes due to erosion....

  12. Evaluation of soil factors controlling gully erosion

    Science.gov (United States)

    Ollobarren, Paul; Giménez, Rafael; Ángel Campo, Miguel; Casalí, Javier

    2015-04-01

    Current models for prediction of (ephemeral) gully erosion rely mainly on topographic factors while soil conditions are almost neglected. However, soil erodibility is essential for analyzing and properly modeling gully erosion. But, despite the wealth of studies to characterize soil vulnerability to gully erosion, a universal approach is still lacking. Moreover, a useful and feasible soil characterization for gully erosion prediction at large scale should be based on simple, quick, repeatable and relatively inexpensive tests to perform. In this work an experimental approach to quantify soil contribution on gully erosion is proposed. From simple methodologies and techniques found in the literature for assessing physical-chemical properties of the soil, a large pool of variables -that presumably underpin gully erosion- were defined. These methodologies includes the use of vane shear apparatus, penetrometers and a mini-rain simulator as well as some current (modified) laboratory tests for assessing soil crustability and erodibility. Thirteen ephemeral gullies developed under different soil condition in agricultural fields of Navarre (Spain) were selected for experiments. Then, the aforementioned variables were calculated for each of the gullies through field and lab experiments. Furthermore, the most relevant variables were detected by means of multivariate analysis and their contribution to gully erosion was finally quantified by using multiple regression analysis. In addition, gully erosion rates of typical agricultural fields are given.

  13. Reduction of soil erosion on forest roads

    Science.gov (United States)

    Edward R. Burroughs; John G. King

    1989-01-01

    Presents the expected reduction in surface erosion from selected treatments applied to forest road traveledways, cutslopes, fillslopes, and ditches. Estimated erosion reduction is expressed as functions of ground cover, slope gradient, and soil properties whenever possible. A procedure is provided to select rock riprap size for protection of the road ditch.

  14. FORECAST THE SOIL EROSION THROUGH THE CARTOGRAMS

    Directory of Open Access Journals (Sweden)

    Mădălina - Cristina Marian

    2014-06-01

    Full Text Available Soil erosion in Arges County affects a high percentage of agricultural land. Most agricultural lands are located on slopes undergoing erosion, excess humidity temporarily or permanently, landslides. The importance lies in the need to know theme addressed erosion, the erosive potential of the land, the causes and factors that led to the onset of erosion and its deployment at a accelerated rate and now, because the based on this knowledge to determine the effective measures to prevent and combat this phenomenon of soil degradation. The importance of knowing this erosion is related both to protect land and diminishing rates of clogging existing accumulation lakes in the river basin. Erosion mapping was carried out in recent years with the use of means modern cadastral- topographical. So not provided with sufficient precision to determine the areas affected by erosion. This paper presents methods using modern maps using satellite images, topographical precision instrumentation, cartograms results can be easily integrated into a GIS system monitoring. The information is graphically and containing a database solid. Cartograms accuracy depends on the quality of engineerings survey carried out in the field.

  15. Rethinking erosion on Java: a reaction

    NARCIS (Netherlands)

    Graaff, de J.; Wiersum, K.F.

    1992-01-01

    In a recent article (Diemont et al., 1991) about erosion on Java, it has been postulated that low inputs, not surface erosion, is the main cause of low productivity of upland food crops on this island. In this article it is argued that this hypothesis is too simple. An analysis of empirical field

  16. Weld overlay coatings for erosion control

    Energy Technology Data Exchange (ETDEWEB)

    Levin, B.; DuPont, J.N.; Marder, A.R.

    1993-03-03

    A literature review was made. In spite of similarities between abrasive wear and solid particle erosion, weld overlay hardfacing alloys that exhibit high abrasion resistance may not necessarily have good erosion resistance. The performance of weld overlay hardfacing alloys in erosive environments has not been studied in detail. It is believed that primary-solidified hard phases such as carbides and intermetallic compounds have a strong influence on erosion resistance of weld overlay hardfacing alloys. However, relationships between size, shape, and volume fraction of hard phases in a hardfacing alloys and erosion resistance were not established. Almost all hardfacing alloys can be separated into two major groups based upon chemical compositions of the primary solidified hard phases: (a) carbide hardening alloys (Co-base/carbide, WC-Co and some Fe base superalloys); and (b) intermetallic hardening alloys (Ni-base alloys, austenitic steels, iron-aluminides).

  17. Dietary assessment and counseling for dental erosion.

    Science.gov (United States)

    Marshall, Teresa A

    2018-02-01

    Dental erosion occurs after exposure to intrinsic or extrinsic acids. Exposure to intrinsic gastrointestinal acids is associated with anorexia nervosa, bulimia nervosa, rumination syndrome, or gastroesophageal reflux. Extrinsic dietary acids from foods or beverages also can cause erosion, particularly when exposure is prolonged by holding or swishing behaviors. Clinicians should screen patients exhibiting dental erosion for anorexia nervosa, bulimia nervosa, rumination syndrome, and gastroesophageal reflux disease. Clinicians should screen patients without a medical explanation for their erosion for exposure to acidic foods and beverages, particularly for habits that prolong exposure. Identification of intrinsic and extrinsic acid exposures and recommendations to minimize exposures are important to prevent erosion and maintain oral health. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.

  18. Erosion Pressure on the Danish Coasts

    DEFF Research Database (Denmark)

    Sørensen, Carlo Sass; Sørensen, Per; Kroon, Aart

    Coastlines around the world are receding due to coastal erosion.With rising sea levels and a potential climatic deterioration due to climate change, erosion rates are likely to increase at many locations in the future.Together with the current preference of people to settle near or directly...... by the ocean, coastal erosion issues become increasingly more important to the human values at risk. Along many Danish coastlines, hard structures already act as coastal protection in the form of groins, breakwaters, revetments etc. These eroding coasts however still lack sand and where the public, in general......, neglects the need for sand replenishment i.e. in the form of repeated sand nourishments. Here we present a conceptual model and method for dividing coastal erosion into acute and chronic erosion pressure, respectively. We focus on the model use for management and climate change adaptation purposes...

  19. [Central regulation of pain in patients with joint disease and approaches to therapy].

    Science.gov (United States)

    Filatova, E S; Erdes, Sh F; Filatova, E G

    2016-01-01

    The paper reviews investigations studies that have demonstrated that chronic pain syndrome is mixed in rheumatic diseases. The nervous system is involved in its pathogenesis with different frequency and different mechanisms. Under the influence of afferent pain impulses from damaged joints, there are changes in the excitability of spinal cord neurons, which is called central sensitization (CS). A number of patients have enhanced CS and clinical manifestations as neuropathic sensitive phenomena. The mixed model of the development of chronic pain in joint diseases and its presence along with nociceptive (inflammatory) and neuropathic pain components may explain the discrepancy between joint inflammatory and structural changes and pain intensity, the presence of distant pain and sensitive disorders in the areas outside the joint, and sometimes the efficiency of anti-inflammatory therapy. The presence of the neuropathic pain component serves as a rationale for combined therapy by adding centrally acting drugs, such as anticonvulsants.

  20. Which is the dominant factor for perception of rheumatic pain: meteorology or psychology?

    Science.gov (United States)

    Cay, Hasan Fatih; Sezer, Ilhan; Firat, Mehmet Z; Kaçar, Cahit

    2011-03-01

    It is believed that there is an association between the weather and rheumatic symptoms. We aimed to investigate what kind of association is present and what are the factors which determine the nature of this association. Fifty-six subjects with rheumatic disease (31 RA, 15 SpA, 10 OA) who live in Antalya were followed between December 2005 and July 2006. Patients were asked to fill diaries which contain questions regarding the symptoms of their rheumatic diseases everyday. In every monthly visit, disease activity measurement, laboratory assessment and Beck depression inventory assessment were recorded. The symptomatic and psychological measurements were matched with the meteorological data of Antalya Regional Directorate of Meteorological Service of Turkish State. Correlation of symptoms with weather variables was investigated. Contributory effect of weather and of psychologic factors on symptom scores were evaluated by stepwise multiple regression analysis. Eighty-four percent of subjects belive in an association between weather and rheumatism, while 57% claimed to have ability to forecast weather. The maximum correlation coefficient between weather and arthritis symptoms was -0.451 and the maximum contribution of weather on symptoms was 17.1%. Arthritis symptoms were significantly contributed by Beck depression score. The belief about presence of weather-arthritis association was found to be stronger than its statistical power. Our results did not prove or rule out the presence of weather-rheumatism association. As long as the scientific attempts result in failure, the intuitive support in favour of the presence of weather-arthritis association will go on forever.

  1. Differences in selected medical care parameters in rheumatic disease ward patients of different ages of life.

    Science.gov (United States)

    Pobrotyn, Piotr; Susło, Robert; Witczak, Izabela; Milczanowski, Piotr; Drobnik, Jarosław

    2016-01-01

    Rheumatic diseases are becoming more and more common in Poland with the ageing of the population. Nearly 18% of the total hospital admissions in Poland result from rheumatic diseases, which was equivalent to 350 thousand cases in the year 2008. These diseases tend to last for many decades, decreasing both the quality of life and income of the patients as well as increasing the medical institutions' workload and society's financial burden. The aim of the study was to determine whether the medical care parameters in a rheumatic disease hospital ward show any significant differences among different patient age groups - especially such that would support taking them into account as a basis for adjusting the financial coverage level of medical services. Data on hospitalizations at the Rheumatic Diseases Ward of Wroclaw University Hospital in Wroclaw in the years 2009-2015 were analyzed, taking into account the age groups, number of hospital admissions, their duration and causes. Relevant statistical data analysis was performed. The study revealed that the number of old patients hospitalized at the rheumatic diseases ward increased over the last 6 years and that such statistically significant differences do exist: on average the old patients not only tend to stay much longer at the hospital, but also suffer from a different and more diverse spectrum of diseases in comparison to their younger counterparts. The detected differences in medical care parameters support the need for more individualized medical care and increased cost of the hospital stay in the case of older patients. Consequently, those factors justify the necessity to increase the value of medical services in the case of old patients, possibly also taking into account the variation between age subgroups.

  2. USING OF BENZATIN-PENICILLIN FOR SECONDARY RHEUMATISM PREVENTION: PROBLEMS AND APPROACHES

    Directory of Open Access Journals (Sweden)

    S.V.Sidorenko. A.S. Tikhonova

    2000-01-01

    Full Text Available Aim: To study the efficacy and lolerability of new benzatin-penicitlin (Extencillin, A VENTIS, France, Germany as a means of prevention of A-streptococcal tonsillites and following repeated rheumatic attacks and also the data of comparative pharmacokinetics assessment for three therapeutical forms of benzatin-penicillin (Extencillin powder for injections 2.4 tnln U.; Bicillin-5 powder for injections 1.5 mln U, SYNTHESIS. Kurgan, Russia. Results: On prescribing Extencillin in dosage of 2.4 mln U i.m. once per three weeks to 60 pts with reliable rheumatism for 3 years the stable normalization of titers of antistreptolysin-0 was noticed in 8S.2% pts, absence of hemolytic streptococci in fauces - in 86.7%. There were no repeated rheumatic attacks in any patient. In 6.67% cases side effects were noticed (eosinophilia, skin itching which were short-termed, reversible, and did not require cancellation of the drug. In comparative study off pharmacokinetics it was determined that after Extencillin administration in dosage of 2.4 mln U. concentration of benzyl-penicillin was enough for inhibition of 13-hemolytic A-streptococci (> 0.025 mkg/ml was preserved for 3-weeks term in 83.3% of cases. After injection of Extencillin 1.2 mln U of Bicillin-5 1.5 mln U this level of benzyl-penicillin was noticed on 21 day’ in 30 and 0% cases cotrespondingly Conclusion: High and prolonged antistreptococcal activity> and good tolerability of Extencillin 2.4 mln U. allow us to recommend it as an effective remedy for secondary prevention of rheumatism. Due to discrepancy to pharmacokinetic requirements to preventive drugs, medical forms of benzatin-penicillin such as Extencillin 1. 2 mln U and Bicillin-5 1.5 mln U. are not acceptable for adequate rheumatism prevention in adult patients.

  3. Involvement of the multidisciplinary team and outcomes in inpatient rehabilitation among patients with inflammatory rheumatic disease.

    Science.gov (United States)

    Uhlig, Till; Bjørneboe, Olav; Krøll, Frode; Palm, Øyvind; Olsen, Inge Christoffer; Grotle, Margreth

    2016-01-13

    The last decades have for patients with inflammatory rheumatic diseases seen a shift towards more physically active rehabilitation programs, often provided as out-patients with less use of inpatient facilities. There is little research on which effect the multidisciplinary team has on health outcomes for patients with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and connective tissue disease. This study examined patient reported outcomes for patients with inflammatory rheumatic diseases receiving rehabilitation care as inpatients in departments of rheumatology, and studied how number of consultations with the multidisciplinary team affected these clinical outcomes. Patients with inflammatory rheumatic diseases were included in a multi-center prospective observational study if rehabilitation was considered a focus during an inpatient stay at four departments of rheumatology. At admission, discharge, and after 3 and 6 months, 317 patients were assessed with patients reported outcomes (PRO) including health assessment questionnaire (HAQ), short-form 36 (SF-36), pain, fatigue, patient global assessment of disease activity, self-efficacy scales, rheumatoid arthritis disease activity index (RADAI), and SF-6D utility. Patients stated consultations with the multidisciplinary team. Improvements were short-lived, and at 6 months follow-up period only mental health, pain and utility remained improved with small effect sizes. Extensive involvement of health professionals was not associated with improved outcomes. Patients with inflammatory rheumatic disease receiving inpatient multidisciplinary rehabilitation had small and mainly short-term improvements in most PROs. High use of the multidisciplinary team did not enhance or preserve rehabilitation outcomes in inflammatory rheumatic conditions when admitted as inpatients.

  4. Rainfall erosivity index for the Ghana Atomic Energy Commission site

    National Research Council Canada - National Science Library

    Paul Essel; Eric T Glover; Serwaa Yeboah; Yaw Adjei-Kyereme; Israel Nutifafa Doyi Yawo; Mawutoli Nyarku; Godfred S Asumadu-Sakyi; Gustav Kudjoe Gbeddy; Yvette Agyiriba Agyiri; Evans Mawuli Ameho; Emmanuel Atule Aberikae

    2016-01-01

      Rainfall erosivity is the potential ability for rainfall to cause soil loss. The purpose of this study was to estimate the Rainfall erosivity index for the Ghana Atomic Energy Commission site in order to compute the surface erosion rate...

  5. Rainfall erosivity index for the Ghana Atomic Energy Commission site

    National Research Council Canada - National Science Library

    Essel, Paul; Glover, Eric T; Yeboah, Serwaa; Adjei-Kyereme, Yaw; Yawo, Israel Nutifafa Doyi; Nyarku, Mawutoli; Asumadu-Sakyi, Godfred S; Gbeddy, Gustav Kudjoe; Agyiri, Yvette Agyiriba; Ameho, Evans Mawuli; Aberikae, Emmanuel Atule

    2016-01-01

    Rainfall erosivity is the potential ability for rainfall to cause soil loss. The purpose of this study was to estimate the rainfall erosivity index for the Ghana Atomic Energy Commission site in order to compute the surface erosion rate...

  6. Wrist and finger joint MR imaging in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Klarlund, Mette; Østergaard, Mikkel; Gideon, P

    1999-01-01

    -FLASH, fat-saturated-T1-SE, STIR and 3D-DESS. RESULTS: Bone erosions were found by MR compared to radiography in 261 versus 85 bones of the wrist (ratio 3.1) and 59 versus 21 MCP joint quadrants (ratio 2.81). MR and radiography interobserver agreements were both approximately 90%. Likewise, MR scored......PURPOSE: To elaborate the best MR imaging protocol for studies in rheumatoid arthritis (RA) and to evaluate the sensitivity and interobserver agreement with respect to detection of bone erosions (MR and radiography) and grading of synovial membrane hypertrophy (MR imaging only). MATERIAL...... synovial membrane hypertrophy in wrist and MCP joints with a high interobserver agreement. The most informative MR sequence appeared to be contrast-enhanced T1-SE MR, preferably with fat saturation. A STIR sequence or T2-weighted fat saturation sequence was useful in screening for joint disease. CONCLUSION...

  7. Joint mobilization.

    Science.gov (United States)

    Saunders, Deborah Gross; Walker, J Randy; Levine, David

    2005-11-01

    Therapeutic touch has been used in human beings to soothe aches and pains. Most dogs also seem to enjoy being touched. Manual therapy techniques are skilled hand movements intended to improve tissue extensibility; increase range of motion; induce relaxation; mobilize or manipulate soft tissue and joints; modulate pain; and reduce soft tissue swelling, inflammation, or restriction. The intent of this article is to provide an overview of the principles of manual therapy, followed by selected treatment techniques for the hip, stifle, elbow, shoulder, carpus.and thoracic and lumbar spine. The techniques of G.D. Maitland, an Australian physical therapist who developed a clinically based approach in the 1960s and 1970s, are emphasized.

  8. Relationship of focal erosions, bone mineral density, and parathyroid hormone in rheumatoid arthritis.

    Science.gov (United States)

    Rossini, Maurizio; Bagnato, Gianfilippo; Frediani, Bruno; Iagnocco, Annamaria; LA Montagna, Giovanni; Minisola, Giovanni; Caminiti, Maurizio; Varenna, Massimo; Adami, Silvano

    2011-06-01

    To investigate the relationship among focal bone erosions and bone mineral density (BMD), 25(OH) vitamin D (25OHD), and parathyroid hormone (PTH) values in patients with rheumatoid arthritis (RA). The study included 1191 RA patients (1014 women, 177 men, mean age 58.9 ± 11.1 yrs) participating in a multicenter, cross-sectional study. Radiographic evidence of typical bony erosions on hands or forefeet was found in 64.1% of patients. In those with bone erosions as compared to those without, mean BMD Z score values were significantly lower at both the spine (-0.74 ± 1.19 vs -0.46 ± 1.31; p = 0.05) and the hip (-0.72 ± 1.07 vs -0.15 ± 1.23; p mineral metabolism factors (i.e., age, sex, menopause, disease duration, Disease Activity Score 28-joint count, Health Assessment Questionnaire, activities of daily living, Steinbrocker functional state, glucocorticoid therapy, body weight, and bisphosphonate treatment). Our results suggest that the presence of bone erosions in RA correlates with low BMD levels and high PTH levels, and that these associations are independent of the degree of functional impairment and other common determinants of bone mass and mineral metabolism in adults with RA. These findings suggest that treatments to prevent bone loss or suppress PTH levels might positively affect the progression of bone erosions in RA.

  9. Wound healing in total joint arthroplasty.

    Science.gov (United States)

    Jones, Richard E

    2010-09-07

    Obtaining primary wound healing in total joint arthroplasty is essential to a good result. Wound healing problems can occur and the consequences can be devastating. Determination of the host healing capacity can be useful in predicting complications. Cierney and Mader classified patients as type A, no healing compromises; and type B, systemic or local healing compromising factors present. Local factors include traumatic arthritis, multiple previous incisions, extensive scarring, lymphedema, poor vascular perfusion. Systemic compromising factors include diabetes, rheumatic diseases, renal or liver disease, immunocompromise, steroids, smoking, and poor nutrition. In high-risk patients, the surgeon should encourage positive choices such as smoking cessation and nutritional supplementation to elevate the total lymphocyte count and total albumin. Careful planning of incisions, particularly in patients with scarring or multiple previous operations, is productive. Around the knee the vascular viability is better in the medial flap. Thus, use the most lateral previous incision, do minimal undermining, and handle tissue meticulously. We perform all potentially complicated total knee arthroplasties without tourniquet to enhance blood flow and tissue viability. The use of perioperative anticoagulation will increase wound problems. If wound drainage or healing problems occur, immediate action is required. Deep sepsis can be ruled out with a joint aspiration and cell count (>2000), differential (>50% polys), and negative culture and sensitivity. All hematomas should be evacuated and necrosis or dehiscence should be managed by debridement to obtain a live wound. Copyright 2010, SLACK Incorporated.

  10. Soil erosion and the global carbon budget.

    Science.gov (United States)

    Lal, R

    2003-07-01

    Soil erosion is the most widespread form of soil degradation. Land area globally affected by erosion is 1094 million ha (Mha) by water erosion, of which 751 Mha is severely affected, and 549 Mha by wind erosion, of which 296 Mha is severely affected. Whereas the effects of erosion on productivity and non-point source pollution are widely recognized, those on the C dynamics and attendant emission of greenhouse gases (GHGs) are not. Despite its global significance, erosion-induced carbon (C) emission into the atmosphere remains misunderstood and an unquantified component of the global carbon budget. Soil erosion is a four-stage process involving detachment, breakdown, transport/redistribution and deposition of sediments. The soil organic carbon (SOC) pool is influenced during all four stages. Being a selective process, erosion preferentially removes the light organic fraction of a low density of erosion causes a severe depletion of the SOC pool on eroded compared with uneroded or slightly eroded soils. In addition, the SOC redistributed over the landscape or deposited in depressional sites may be prone to mineralization because of breakdown of aggregates leading to exposure of hitherto encapsulated C to microbial processes among other reasons. Depending on the delivery ratio or the fraction of the sediment delivered to the river system, gross erosion by water may be 75 billion Mg, of which 15-20 billion Mg are transported by the rivers into the aquatic ecosystems and eventually into the ocean. The amount of total C displaced by erosion on the earth, assuming a delivery ratio of 10% and SOC content of 2-3%, may be 4.0-6.0 Pg/year. With 20% emission due to mineralization of the displaced C, erosion-induced emission may be 0.8-1.2 Pg C/year on the earth. Thus, soil erosion has a strong impact on the global C cycle and this component must be considered while assessing the global C budget. Adoption of conservation-effective measures may reduce the risks of C emission and

  11. Mapping monthly rainfall erosivity in Europe.

    Science.gov (United States)

    Ballabio, Cristiano; Borrelli, Pasquale; Spinoni, Jonathan; Meusburger, Katrin; Michaelides, Silas; Beguería, Santiago; Klik, Andreas; Petan, Sašo; Janeček, Miloslav; Olsen, Preben; Aalto, Juha; Lakatos, Mónika; Rymszewicz, Anna; Dumitrescu, Alexandru; Tadić, Melita Perčec; Diodato, Nazzareno; Kostalova, Julia; Rousseva, Svetla; Banasik, Kazimierz; Alewell, Christine; Panagos, Panos

    2017-02-01

    Rainfall erosivity as a dynamic factor of soil loss by water erosion is modelled intra-annually for the first time at European scale. The development of Rainfall Erosivity Database at European Scale (REDES) and its 2015 update with the extension to monthly component allowed to develop monthly and seasonal R-factor maps and assess rainfall erosivity both spatially and temporally. During winter months, significant rainfall erosivity is present only in part of the Mediterranean countries. A sudden increase of erosivity occurs in major part of European Union (except Mediterranean basin, western part of Britain and Ireland) in May and the highest values are registered during summer months. Starting from September, R-factor has a decreasing trend. The mean rainfall erosivity in summer is almost 4 times higher (315MJmmha-1h-1) compared to winter (87MJmmha-1h-1). The Cubist model has been selected among various statistical models to perform the spatial interpolation due to its excellent performance, ability to model non-linearity and interpretability. The monthly prediction is an order more difficult than the annual one as it is limited by the number of covariates and, for consistency, the sum of all months has to be close to annual erosivity. The performance of the Cubist models proved to be generally high, resulting in R2 values between 0.40 and 0.64 in cross-validation. The obtained months show an increasing trend of erosivity occurring from winter to summer starting from western to Eastern Europe. The maps also show a clear delineation of areas with different erosivity seasonal patterns, whose spatial outline was evidenced by cluster analysis. The monthly erosivity maps can be used to develop composite indicators that map both intra-annual variability and concentration of erosive events. Consequently, spatio-temporal mapping of rainfall erosivity permits to identify the months and the areas with highest risk of soil loss where conservation measures should be applied in

  12. Reliability of Tubular Joints

    DEFF Research Database (Denmark)

    Sørensen, John Dalsgaard; Thoft-Christensen, Palle

    In this paper the preliminary results obtained by tests on tubular joints are presented. The joints are T-joints and the loading is static. It is the intention in continuation of these tests to perform tests on other types of joints (e.g. Y-joints) and also with dynamic loading. The purpose of th...

  13. Cartilage damage and bone erosion are more prominent determinants of functional impairment in longstanding experimental arthritis than synovial inflammation

    Directory of Open Access Journals (Sweden)

    Silvia Hayer

    2016-11-01

    Full Text Available Chronic inflammation of articular joints causing bone and cartilage destruction consequently leads to functional impairment or loss of mobility in affected joints from individuals affected by rheumatoid arthritis (RA. Even successful treatment with complete resolution of synovial inflammatory processes does not lead to full reversal of joint functionality, pointing to the crucial contribution of irreversibly damaged structural components, such as bone and cartilage, to restricted joint mobility. In this context, we investigated the impact of the distinct components, including synovial inflammation, bone erosion or cartilage damage, as well as the effect of blocking tumor necrosis factor (TNF on functional impairment in human-TNF transgenic (hTNFtg mice, a chronic inflammatory erosive animal model of RA. We determined CatWalk-assisted gait profiles as objective quantitative measurements of functional impairment. We first determined body-weight-independent gait parameters, including maximum intensity, print length, print width and print area in wild-type mice. We observed early changes in those gait parameters in hTNFtg mice at week 5 – the first clinical signs of arthritis. Moreover, we found further gait changes during chronic disease development, indicating progressive functional impairment in hTNFtg mice. By investigating the association of gait parameters with inflammation-mediated joint pathologies at different time points of the disease course, we found a relationship between gait parameters and the extent of cartilage damage and bone erosions, but not with the extent of synovitis in this chronic model. Next, we observed a significant improvement of functional impairment upon blocking TNF, even at progressed stages of disease. However, blocking TNF did not restore full functionality owing to remaining subclinical inflammation and structural microdamage. In conclusion, CatWalk gait analysis provides a useful tool for quantitative

  14. Soft drinks and in vitro dental erosion.

    Science.gov (United States)

    Gravelle, Brent L; Hagen Ii, Ted W; Mayhew, Susan L; Crumpton, Brooks; Sanders, Tyler; Horne, Victoria

    2015-01-01

    The purpose of this investigation was to determine to what extent the in vitro exposure of healthy teeth to various commonly consumed carbonated soft drinks may precipitate dental erosion. Forty-two healthy, extracted, previously unerupted human molars were weighed prior to, during, and after suspension in various sugared and diet or zero-calorie carbonated beverages for 20 days; the specimens were stored at room temperature while being stirred at 275 rpm. The percentage decrease in tooth weight from before to after exposure represented the weight loss due to enamel erosion; values in the experimental groups varied from 3.22% to 44.52% after 20 days' exposure. Data were subjected to analysis of variance and post hoc Scheffe testing at a level of α = 0.05. Nonsugared drinks (diet and zero-calorie) as a whole were more erosive than sugared beverages. A significant positive correlation was found between the amount of titratable acid and percentage of tooth erosion, while a significant negative correlation was revealed between the beverage pH and percentage of tooth erosion. No significant correlations were found between calcium or phosphate ion concentrations and the amount of erosion. It appears that enamel erosion is dependent on not only the beverage flow rate, pH, and amount of titratable acid, but also whether the soft drink is of the diet or zero-calorie variety, which reflects the type of artificial sweetener present.

  15. Coupled wellbore erosion and stability analysis

    Science.gov (United States)

    Stavropoulou, M.; Papanastasiou, P.; Vardoulakis, I.

    1998-09-01

    This paper extends earlier work on sand erosion and presents an attempt to couple sand erosion to mechanical damage of rock around a wellbore. Porosity which evolves in time and space as surface erosion progresses, is chosen as the coupling parameter. Both rock elasticity and strength (cohesion) are assumed to depend on porosity in such a way that the material becomes weaker with increasing porosity. The mathematical model, consists of erosion equations, mixture flow equations and stress equilibrium equations, is solved numerically by Galerkin finite element method. Numerical results suggest that erosion, resulting in sand production, is high close to the free surface. Erosion is accompained by changes in porosity and a significant permeability increase. Erosion in the vicinity of the wellbore induces alterations in the mechanical behaviour of the medium. Weakening of rock stiffness leads to severe alteration of both effective stresses and pore pressure near the cavity. Since cohesion decreases with increasing porosity, one can also identify the time instant at which rock mechanical failure starts.

  16. Comparative long-term results of mitral valve repair in adults with chronic rheumatic disease and degenerative disease: is repair for "burnt-out" rheumatic disease still inferior to repair for degenerative disease in the current era?

    Science.gov (United States)

    Dillon, Jeswant; Yakub, Mohd Azhari; Kong, Pau Kiew; Ramli, Mohd Faizal; Jaffar, Norfazlina; Gaffar, Intan Fariza

    2015-03-01

    Mitral valve repair is perceived to be of limited durability for advanced rheumatic disease in adults. We aim to examine the long-term outcomes of repair for rheumatic disease, identify predictors of durability, and compare with repair for degenerative disease. Rheumatic and degenerative mitral valve repairs in patients aged 40 years or more were prospectively analyzed. The primary outcomes investigated were mortality, freedom from reoperation, and valve failure. Logistic regression analysis was performed to define predictors of poor outcome. Between 1997 and 2011, 253 rheumatic and 148 degenerative mitral valves were repaired. The age of patients in both groups was similar, with a mean of 54.1 ± 8.4 years versus 55.6 ± 7.3 years (P = .49). Freedom from reoperation for rheumatic valves at 5 and 10 years was 98.4%, comparable to 95.3% (P = .12) for degenerative valves. Freedom from valve failure at 5 and 10 years was 91.4% and 81.5% for rheumatic repairs and 82.5% and 75.4% for degenerative repairs, respectively (P = .15). The presence of residual mitral regurgitation greater than 2+ before discharge was the only significant independent predictor of reoperation, whereas residual mitral regurgitation greater than 2+ and leaflet procedures were significant risk factors for valve failure. The durability of rheumatic mitral valve repair in the current era has improved and is comparable to the outstanding durability of repairs for degenerative disease, even in the adult rheumatic population. Modifications of standard repair techniques, adherence to the importance of good leaflet coaptation, and strict quality control with stringent use of intraoperative transesophageal echocardiography have all contributed to the improved long-term results. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  17. Increasing erosion risk due to the climate change in a small forested catchment of Sopron Hills

    Science.gov (United States)

    Csáfordi, Péter; Gálos, Borbála; Kalicz, Péter; Gribovszki, Zoltán

    2013-04-01

    expected increase of the probability of intense rainfall events can also influence the soil loss due to water erosion and the sediment rate available in the stream of the forested catchment. Land cover changes driven by climatic and anthropogenic effects can increase the severity of the consequences. Therefore the improvement of our methods and the adaptation of the results for further catchments can provide an important basis to the adaptation and mitigation strategies. Acknowledgements: The research was financially supported by the TÁMOP-4.2.2.A-11/1/KONV-2012-0013 joint EU-national research project and the 'Deutsche Bundesstiftung Umwelt' scholarship. Keywords: soil loss, erosion modelling, climate change, frequency of extremes

  18. Joint Replacement (Finger and Wrist Joints)

    Science.gov (United States)

    ... artificial joint Damage to vessels, nerves or other structures in the region of the surgery Alternatives Some alternate procedures for treating arthritis include: Joint injections Oral medications such as aspirin or anti-inflammatory medicines Hand therapy exercises and ...

  19. Interventions for treating patients with chikungunya virus infection-related rheumatic and musculoskeletal disorders: A systematic review

    National Research Council Canada - National Science Library

    Arturo Martí-Carvajal; Pilar Ramon-Pardo; Emilie Javelle; Fabrice Simon; Sylvain Aldighieri; Hacsi Horvath; Julia Rodriguez-Abreu; Ludovic Reveiz

    2017-01-01

    .... CHIKV causes high fever and painful rheumatic disorders that may persist for years. Because little is known about interventions for treating CHIKV-related illness, we conducted a systematic review...

  20. Joint x-ray

    Science.gov (United States)

    X-ray - joint; Arthrography; Arthrogram ... x-ray technologist will help you position the joint to be x-rayed on the table. Once in place, pictures are taken. The joint may be moved into other positions for more ...

  1. Simulation of chemical erosion in rough fractures.

    Science.gov (United States)

    Verberg, R; Ladd, A J C

    2002-05-01

    We report on numerical simulations of acid erosion in a fractured specimen of Carrara marble. The simulations combine two recent advances in lattice-Boltzmann methodology to accurately and efficiently calculate the velocity field in the pore space. A tracer diffusion algorithm was then used to calculate the distribution of reactants in the fracture, and the local erosion rate was obtained from the flux of tracer particles across the surfaces. Our results show that at large length scales, erosion leads to increased heterogeneity via channel formation, whereas at small length scales it tends to smooth out the roughness in the local aperture.

  2. Vasculite na hanseníase mimetizando doenças reumáticas Vasculitis in leprosy mimicking rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Sandra Lúcia Euzébio Ribeiro

    2007-04-01

    Full Text Available Os autores alertam para o múltiplo espectro de apresentação clínica da hanseníase, destacando as lesões cutâneas necrosantes e manifestações articulares simulando doenças reumáticas, confundindo o diagnóstico e o tratamento correto. Nesses aspectos, são relatados dois casos do sexo feminino com hanseníase virchowiana e dimorfa cujas manifestações iniciais foram de lesões eritêmato-violáceas, necróticas e ulceradas, livedo reticular, oligoartrite, poliartralgias, mialgias e edema de membros inferiores, que mimetizaram algumas doenças reumáticas como o lúpus eritematoso sistêmico e a vasculite sistêmica (poliarterite nodosa.Leprosy has a large spectrum of clinical manifestations, including necrotizing skin lesions and joint complaints that sometimes mimic a primary rheumatic disease, confounding the correct diagnosis and treatment. Herein, the authors report two cases of women with leprosy, respectively virchowian and dimorphic forms, presenting initially with purple-reddish skin lesions, evolving with necrosis and ulceration, livedo reticularis, joint pain, oligoarthritis, myalgia, and leg edema. The differential diagnosis with systemic lupus erythematosus (SLE and systemic vasculitis such as polyarteritis nodosa (PAN is discussed.

  3. Medical care expenditures and earnings losses among persons with arthritis and other rheumatic conditions in 2003, and comparisons with 1997.

    Science.gov (United States)

    Yelin, Edward; Murphy, Louise; Cisternas, Miriam G; Foreman, Aimee J; Pasta, David J; Helmick, Charles G

    2007-05-01

    To obtain estimates of medical care expenditures and earnings losses associated with arthritis and other rheumatic conditions and the increment in such costs attributable to arthritis and other rheumatic conditions in the US in 2003, and to compare these estimates with those from 1997. Estimates for 2003 were derived from the Medical Expenditures Panel Survey (MEPS), a national probability sample of households. We tabulated medical care expenditures of adult MEPS respondents, stratified by arthritis and comorbidity status, and used regression techniques to estimate the increment of medical care expenditures attributable to arthritis and other rheumatic conditions. We also estimated the earnings losses sustained by working-age adults with arthritis and other rheumatic conditions. Estimates for 2003 were compared with those from 1997, inflated to 2003 terms. In 2003, there were 46.1 million adults with arthritis and other rheumatic conditions (versus 36.8 million in 1997). Adults with arthritis and other rheumatic conditions incurred mean medical care expenditures of $6,978 in 2003 (versus $6,346 in 1997), of which $1,635 was for prescriptions ($899 in 1997). Expenditures for adults with arthritis and other rheumatic conditions totaled $321.8 billion in 2003 ($233.5 billion in 1997). In 2003, the mean increment in medical care expenditures attributable to arthritis and other rheumatic conditions was $1,752 ($1,762 in 1997), for a total of $80.8 billion ($64.8 billion in 1997). Persons with arthritis and other rheumatic conditions ages 18-64 years earned $3,613 less than other persons (versus $4,551 in 1997), for a total of $108.0 billion (versus $99.0 billion). Of this amount, $1,590 was attributable to arthritis and other rheumatic conditions (versus $1,946 in 1997), for a total of $47.0 billion ($43.3 billion in 1997). Our findings indicate that the increase in medical care expenditures and earnings losses between 1997 and 2003 is due more to an increase in the

  4. Culture-sensitive adaptation and validation of the community-oriented program for the control of rheumatic diseases methodology for rheumatic disease in Latin American indigenous populations.

    Science.gov (United States)

    Peláez-Ballestas, Ingris; Granados, Ysabel; Silvestre, Adriana; Alvarez-Nemegyei, José; Valls, Evart; Quintana, Rosana; Figuera, Yemina; Santiago, Flor Julian; Goñi, Mario; González, Rosa; Santana, Natalia; Nieto, Romina; Brito, Irais; García, Imelda; Barrios, Maria Cecilia; Marcano, Manuel; Loyola-Sánchez, Adalberto; Stekman, Ivan; Jorfen, Marisa; Goycochea-Robles, Maria Victoria; Midauar, Fadua; Chacón, Rosa; Martin, Maria Celeste; Pons-Estel, Bernardo A

    2014-09-01

    The purpose of the study is to validate a culturally sensitive adaptation of the community-oriented program for the control of rheumatic diseases (COPCORD) methodology in several Latin American indigenous populations. The COPCORD Spanish questionnaire was translated and back-translated into seven indigenous languages: Warao, Kariña and Chaima (Venezuela), Mixteco, Maya-Yucateco and Raramuri (Mexico) and Qom (Argentina). The questionnaire was administered to almost 100 subjects in each community with the assistance of bilingual translators. Individuals with pain, stiffness or swelling in any part of the body in the previous 7 days and/or at any point in life were evaluated by physicians to confirm a diagnosis according to criteria for rheumatic diseases. Overall, individuals did not understand the use of a 0-10 visual analog scale for pain intensity and severity grading and preferred a Likert scale comprising four items for pain intensity (no pain, minimal pain, strong pain, and intense pain). They were unable to discriminate between pain intensity and pain severity, so only pain intensity was included. For validation, 702 subjects (286 male, 416 female, mean age 42.7 ± 18.3 years) were interviewed in their own language. In the last 7 days, 198 (28.2 %) subjects reported having musculoskeletal pain, and 90 (45.4 %) of these had intense pain. Compared with the physician-confirmed diagnosis, the COPCORD questionnaire had 73.8 % sensitivity, 72.9 % specificity, a positive likelihood ratio of 2.7 and area under the receiver operating characteristic curve of 0.73. The COPCORD questionnaire is a valid screening tool for rheumatic diseases in indigenous Latin American populations.

  5. [Gastric band erosion: Alternative management].

    Science.gov (United States)

    Echaverry-Navarrete, Denis José; Maldonado-Vázquez, Angélica; Cortes-Romano, Pablo; Cabrera-Jardines, Ricardo; Mondragón-Pinzón, Erwin Eduardo; Castillo-González, Federico Armando

    2015-01-01

    Obesity is a public health problem, for which the prevalence has increased worldwide at an alarming rate, affecting 1.7 billion people in the world. To describe the technique employed in incomplete penetration of gastric band where endoscopic management and/or primary closure is not feasible. Laparoscopic removal of gastric band was performed in five patients with incomplete penetrance using Foley catheterization in the perforation site that could lead to the development of a gastro-cutaneous fistula. The cases presented include a leak that required surgical lavage with satisfactory outcome, and one patient developed stenosis 3 years after surgical management, which was resolved endoscopically. In all cases, the penetration site closed spontaneously. Gastric band erosion has been reported in 3.4% of cases. The reason for inserting a catheter is to create a controlled gastro-cutaneous fistula, allowing spontaneous closure. Various techniques have been described: the totally endoscopic, hybrid techniques (endoscopic/laparoscopic) and completely laparoscopic. A technique is described here that is useful and successful in cases where the above-described treatments are not viable. Copyright © 2015. Published by Masson Doyma México S.A.

  6. Chikungunya fever. Rheumatic manifestations of an emerging disease in Europe.

    Science.gov (United States)

    Horcada, M Loreto; Díaz-Calderón, Carlos; Garrido, Laura

    2015-01-01

    Chikungunya fever is a viral disease caused by an alphavirus belonging to the Togaviridae family, transmitted by several species of Aedes mosquitoes: Aedes aegypti and Aedes albopictus (A. albopictus). It is endemic in Africa and Asia with recurrent outbreaks. It is an emerging disease and cases in Europe transmitted by A. albopictus have been established in Mediterranean areas. The first autochthonous cases detected on the Caribbean islands suppose a serious threat of spreading disease to America, which so far has been disease free. Clinical symptoms begin abruptly with fever, skin rash and polyarthritis. Although mortality is low, a high percentage of patients develop a chronic phase defined by persistent arthritis for months or even years. A severe immune response is responsible for joint inflammation. The absence of specific treatment and lack of vaccine requires detailed studies about its immunopathogenesis in order to determine the most appropriate target. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  7. Nuclear factor-κB activity in T cells from patients with rheumatic diseases: A preliminary report

    Science.gov (United States)

    Collantes, E.; Blazquez, M; Mazorra, V.; Macho, A.; Aranda, E.; Munoz, E.

    1998-01-01

    OBJECTIVE—The NF-κB/Rel family of transcription factors regulates the expression of many genes involved in the immune or inflammatory response at the transcriptional level. The aim of this study was to determine whether distinctive patterns of NF-kB activation are seen in different forms of joint disease.
METHODS—The DNA binding activity of these nucleoproteins was examined in purified synovial and peripheral T cells from patients with various chronic rheumatic diseases (12: four with rheumatoid arthritis; five with spondyloarthropathies; and three with osteoarthritis).
RESULTS—Electrophoretic mobility shift assays disclosed two specific complexes bound to a NF-κB specific 32P-labelled oligonucleotide in nucleoproteins extracted from purified T cells isolated from synovial fluid and peripheral blood of patients with rheumatoid arthritis. The complexes consisted of p50/p50 homodimers and p50/p65 heterodimers. Increased NF-kB binding to DNA in synovial T cells was observed relative to peripheral T cells. In non-rheumatoid arthritis, binding of NF-κB in synovial T cells was exclusively mediated by p50/p50 homodimers.
CONCLUSION—Overall, the results suggest that NF-κB may play a central part in the activation of infiltrating T cells in chronic rheumatoid arthritis. The activation of this nuclear factor is qualitatively different in rheumatoid synovial T cells to that in other forms of non-rheumatoid arthritis (for example, osteoarthritis, spondyloarthropathies).

 Keywords: NF-κB; synovial T cells; rheumatoid arthritis; spondyloarthropathy; osteoarthritis PMID:10070274

  8. Emission Facilities - Erosion & Sediment Control Facilities

    Data.gov (United States)

    NSGIC Education | GIS Inventory — An Erosion and Sediment Control Facility is a DEP primary facility type related to the Water Pollution Control program. The following sub-facility types related to...

  9. Puerto Rico Relative Erosion Potential (REP) - 1990

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The relative erosion potential is an indicator of sediment and pollution runoff from land based on slope, soil type, land cover (circa 1990) and (maximum monthly)...

  10. RAINFALL EROSIVITY IN SOUTHEASTERN NIGERIA *Ezemonye ...

    African Journals Online (AJOL)

    Osondu

    2011-10-13

    Oct 13, 2011 ... Ethiopian Journal of Environmental Studies and Management EJESM Vol. 5 No. 2 2012 ..... a rainfall erosivity model for the Mediterranean region, Journal of Hydrology ... Journal of Applied. Social Sciences, vol 1 no 1 pp 5-14.

  11. Puerto Rico Relative Erosion Potential (REP) - 2000

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The relative erosion potential is an indicator of sediment and pollution runoff from land based on slope, soil type, land cover (circa 2000) and (maximum monthly)...

  12. Sand transport, erosion and granular electrification

    DEFF Research Database (Denmark)

    Merrison, J.P.

    2012-01-01

    The transport of granular materials by wind has a major impact on our environment through sand/soil erosion and the generation and transport of atmospheric dust aerosols. Terrestrially the transport of dust involves billions of tons of material every year, influencing the global climate...... can affect grain transport through the generation of intense electric fields and processes of electrostatic assembly. Importantly the transport of sand is characterized by saltation, which is known to be an active process for erosion and therefore a source for dust and sand formation. Using novel...... erosion simulation techniques the link between grain transport rates and erosion rates has been quantified. Furthermore this can be linked to production rates for dust and has been associated with chemical and mineral alteration through a process of mechanical activation of fractured surfaces. This work...

  13. Vegetated Reinforced Soil Slope Streambank Erosion Control

    National Research Council Canada - National Science Library

    Sotir, Robbin B; Fischenich, J. C

    2003-01-01

    ...). The VRSS system is useful for the immediate repair or prevention of deeper failures providing a structurally sound system with soil reinforcement, drainage and erosion control typically on steepened...

  14. Regulated Environmental Activity Sites - CriticalErosion

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — Created based on the Critical Erosion Report for 2005. Indicates the condition of shoreline, determined by our staff of Coastal Engineers, for the year 2005. This...

  15. Rain Erosion/Measurement Impact Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The FARM Rain Erosion/Impact Measurement Lab develops solutions for deficiencies in the ability of materials, coatings and designs to withstand a severe operational...

  16. Puerto Rico Relative Vulnerability to Erosion

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Physical factors, such as the slope of the land, the texture of the soil, and the precipitation regime influence erosion in an area. Parts of Puerto Rico are very...

  17. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations.

    Science.gov (United States)

    Cömert Kiliç, S; Kiliç, N; Sümbüllü, M A

    2015-10-01

    The aim of this study was to determine the prevalence of and associations between clinical signs and symptoms and cone beam computed tomography (CBCT) findings of temporomandibular joint osteoarthritis (TMJ-OA). Seventy-six patients (total 117 TMJ) with osteoarthritis were included in this study. Clinical signs and symptoms and CBCT findings were reviewed retrospectively. A considerable decrease in mandibular motions and mastication efficiency, and considerable increase in joint sounds and general pain complaints were observed. The most frequent condylar bony changes were erosion (110 joints, 94.0%), followed by flattening (108 joints, 92.3%), osteophytes (93 joints, 79.5%), hypoplasia (22 joints, 18.8%), sclerosis (14 joints, 12.0%), and subchondral cyst (four joints, 3.4%). Flattening of the articular eminence and pneumatization were each observed in five joints. Forty-one patients had bilateral degeneration and 35 had unilateral degeneration. Hypermobility was detected in 47 degenerative joints. Masticatory efficiency was negatively correlated with both condylar flattening and sclerosis, and general pain complaints was positively correlated with condylar flattening. Condylar erosion, flattening, osteophytes, pain, joint sounds, reduced jaw movements, and worsened mastication were common findings in TMJ-OA in the present study. Poor correlations were found between osseous changes and clinical signs and symptoms of TMJ-OA. CBCT is a powerful diagnostic tool for the diagnosis of TMJ-OA. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. A comparative study of renal dysfunction in patients with inflammatory arthropathies: strong association with cardiovascular diseases and not with anti-rheumatic therapies, inflammatory markers or duration of arthritis.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2012-02-01

    AIMS: The aim of this study was to investigate the prevalence of chronic kidney disease (CKD) among comparable patients with rheumatoid arthritis (RA) and seronegative inflammatory arthritis, and to explore any predictive factors for renal impairment. METHODS: Consecutive patients with peripheral joint disease (oligo and polyarthritis) were recruited from our inflammatory arthritis clinics. We divided patients in two groups: RA group and seronegative inflammatory arthritis group. The cohort consisted of 183 patients (RA = 107, seronegative arthritis = 76 [psoriatic arthritis = 69, undifferentiated oligoarthritis = 7]). Estimated glomerular filtration rate (eGFR) was calculated using the established Modification of Diet in Renal Disease equation. Demographic details, disease-specific characteristics, anti-rheumatic drugs and the presence of cardiovascular diseases were recorded. RESULTS: In total, 17.48% (n = 32) of the cohort had CKD. There was no statistically significant variation between the two groups as regards baseline demographics, disease characteristics, use of anti-rheumatic drugs and the presence of individual cardiovascular diseases. We found that eGFR and the presence of CKD were similar among these groups. Among patients with CKD, 72% had undiagnosed CKD. No association of statistical significance was noted between CKD and the use of corticosteroids, disease-modifying antirheumatic drugs and anti-tumor necrosis factor agents. The association of cardiovascular diseases with CKD remained significant after adjusting for confounders (age, gender, duration of arthritis, high C-reactive protein, use of anti-rheumatic drugs). CONCLUSIONS: Patients with inflammatory arthritis are more prone to have CKD. This could have serious implications, as the majority of rheumatology patients use non-steroidal anti-inflammatory drugs and different immunosuppressives, such as methotrexate. No association of kidney dysfunction was noted with inflammatory disease

  19. Soil erosion - a local and national problem

    Science.gov (United States)

    C.G. Bates; O.R. Zeasman

    1930-01-01

    The erosion of soils through the action of rain water and that from melting snow is almost universal in its occurrence. The gradual erosion and levelling of any country is inevitable, being a process which has gone on as long as there has been free water on the face of the earth. Nevertheless, this process is an extremely slow one where the landscape is naturally well...

  20. DENTAL EROSION IN PRIMARY DENTITION- A REVIEW

    OpenAIRE

    Rafi Shaik

    2017-01-01

    BACKGROUND The pattern of oral diseases has been influenced by ever changing human lifestyle. Tooth wear especially dental erosion has drawn increasing attention as risk factor for tooth damage or loss in recent years. It is a common condition in primary dentition compared to permanent dentition due to thinner and less mineralised enamel. However, it is more worrying, when this condition is being found in an alarming proportion among children. The presence of dental erosion in c...