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Sample records for spondylitis functional index

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

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    W. Grassi

    2011-09-01

    Full Text Available Objectives: The Bath Ankylosing Spondylitis Functional Index (BASFI and the Dougados Functional Index (DFI are the most commonly used instruments to measure functioning in ankylosing spondylitis (AS. The aim of this study was to translate, adapt and validate these instruments into the Italian language. Methods: The BASFI and DFI questionnaires were translated into Italian by two independent bilingual physicians who were familiar with the medical aspects of AS and by one professional translator. Two rheumatologists familiar with instrument validation, and who were aware of the purpose of the study, examined semantic, idiomatic and conceptual issues and produced by consensus unified versions of each instrument. English back-translations from the Italian were done by a professional translator unaware of the original version. Both English versions were compared, and where needed, modifications to the Italian versions were made. Results: A total of 95 patients were included: 77 males, age (mean±SD 47.9±9.3years, and disease duration 12.4±6.6 years, and 18 females, age 45.9±8.7 years, and disease duration 11.3±8.2 years. Reliability, measured in 23 patients participating a physiotherapy program, showed an acceptable one-week test-retest intraclass correlation coefficient (ICC - BASFI ICC: 0.91, 95% CI: 0,87-0.94 and DFI ICC: 0.86, 95% CI: 0.83-0.90. The internal consistency was 0.90 (Cronbach’s alpha for the BASFI and 0.87 for the DFI. For validity the functional indices were correlated with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, Bath Ankylosing Spondylitis Metrology Index (BASMI, Bath Ankylosing Spondylitis Patient Global Score (BAS-G, modified Health Assesment Questionnaire (HAQ-S, SF-36 physical component summary (SF-36 PCS, stiffness, pain, physician’s assessment of disease activity, Bath AS Radiology Index-total (BASRI-t, erythrocyte sedimentation rate (ESR, and C-reactive protein (CRP. The functional indices

  2. Stability of fatigue, pain, patient global assessment and the Bath Ankylosing Spondylitis Functional Index (BASFI) in spondyloarthropathy patients with stable disease according to the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)

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    Madsen, Ole Rintek

    2018-01-01

    The study objective was to examine natural variation of the patient-reported outcome measures fatigue, pain, patient global assessment (PaGl) and the Bath Ankylosing Spondylitis Functional Index (BASFI) in patients with stable axial spondyloarthropathy (ax-SpA) defined on the basis of the Bath...... Spondylitis Ankylosing Disease Activity Index (BASDAI). 107 TNF-inhibitor treated stable ax-SpA patients were identified in the Danish rheumatology registry (DANBIO). According to the Assessment of SpondyloArthritis international Society (ASAS) response criteria, stable disease was defined as a change...

  3. Adaptation of the Bath measures on disease activity and function in ankylosing spondylitis into Danish

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    Pedersen, Ole Birger; Hansen, G O; Svendsen, Anders Jørgen

    2007-01-01

    in Denmark. METHODS: The BASDAI, BASFI, and BASG were translated into Danish and subsequently field-tested among 17 AS patients for relevance, face, and content validity. Reliability and validity were assessed by administering the new measures and a comparator instrument to 113 AS patients on two occasions....... RESULTS: Test-retest reliability was high (>0.90) and the random measurement error was within+/-2.0 for the BASG and within approximately+/-1.5 for BASDAI and BASFI, which is acceptable for most clinical settings. The measures have good internal consistency and are able to discriminate between functional......OBJECTIVE: Adaptation of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Global Score (BASG), and the Bath Ankylosing Spondylitis Functional Index (BASFI) for defining disease status in ankylosing spondylitis (AS) and related diseases for use...

  4. The Impact of Body Mass Index on Disease Progression in Ankylosing Spondylitis

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    Zepa Jūlija

    2018-02-01

    Full Text Available Obesity can be a factor that affects the course of chronic systemic inflammatory arthritis. The objective of this study was to characterise patients with ankylosing spondylitis (AS according to an evaluation of their body mass index (BMI and by exploring the link between the overweightness and obesity with routinely measured disease-specific variables, including disease activity (Bath Ankylosing Spondylitis Disease Activity Index BASDAI; Ankylosing Spondylitis Disease Activity Score, using CRP, ASDAScrp, spinal mobility (Bath Ankylosing Spondylitis Metrology Index, BASMI, functional capacity (BASFI, extraspinal manifestations like fatigue, uveitis, and peripheral arthritis present during the course of the disease. A total of 107 patients were included in the cross-sectional study fulfilling the modified New York criteria for AS. Patients were divided into three groups: with the evaluation of BMI ≤ 24.9, 25.0–29.9 (overweight and ≥ 30.0 (obesity. The mean BMI was 25.13 (SD 4.07. 33% of patients were overweight and 15% were obese. The mean values of age, duration of AS, ASDAScrp, BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI, BASMI, pain in spine, and fatigue in the group with BMI ≤ 24.9 were lower than in the other groups (p < 0.05. There was no difference between groups in age of AS onset, uveitis and peripheral arthritis. AS patients who were overweight or obese had a higher level of the disease activity, pain, fatigue, functional disability and spinal mobility impairment with worse values in the case of obesity.

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

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

    2010-01-01

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

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

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    Schefte, David B; Hetland, Merete L

    2010-01-01

    The Danish DANBIO registry has developed open-source software for touch screens in the waiting room. The objective was to assess the validity of outcomes from self-explanatory patient questionnaires on touch screen in comparison with the traditional paper form in routine clinical care. Fifty-two AS patients and 59 RA patients completed Visual Analogue Scales (VASs) for pain, fatigue and global health, and Bath measures on Ankylosing Spondylitis Disease Activity Index (BASDAI) and Function Index (BASFI) (AS patients) or HAQs (RA patients) on touch screen and paper form in random order with a 1-h interval. Intra-class correlation coefficients (ICCs), 95% CIs and smallest detectable differences (SDDs) were calculated. ICC ranged from 0.922 to 0.988 (P touch screens based on the DANBIO open-source system generates valid results in AS and RA patients on completion of BASDAI, BASFI, HAQ and VAS scores for pain, fatigue and global health when compared with the traditional paper form. Implementation of touch screens in clinical practice is feasible and patients need no instruction.

  7. Association of cytokine and matrix metalloproteinase profiles with disease activity and function in ankylosing spondylitis

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    2012-01-01

    Introduction The pathology of ankylosing spondylitis (AS) suggests that certain cytokines and matrix metalloproteinases (MMPs) might provide useful markers of disease activity. Serum levels of some cytokines and MMPs have been found to be elevated in active disease, but there is a general lack of information about biomarker profiles in AS and how these are related to disease activity and function. The purpose of this study was to investigate whether clinical measures of disease activity and function in AS are associated with particular profiles of circulating cytokines and MMPs. Methods Measurement of 30 cytokines, five MMPs and four tissue inhibitors of metalloproteinases was carried out using Luminex® technology on a well-characterised population of AS patients (n = 157). The relationship between biomarker levels and measures of disease activity (Bath ankylosing spondylitis disease activity index (BASDAI)), function (Bath ankylosing spondylitis functional index) and global health (Bath ankylosing spondylitis global health) was investigated. Principal component analysis was used to reduce the large number of biomarkers to a smaller set of independent components, which were investigated for their association with clinical measures. Further analyses were carried out using hierarchical clustering, multiple regression or multivariate logistic regression. Results Principal component analysis identified eight clusters consisting of various combinations of cytokines and MMPs. The strongest association with the BASDAI was found with a component consisting of MMP-8, MMP-9, hepatocyte growth factor and CXCL8, and was independent of C-reactive protein levels. This component was also associated with current smoking. Hierarchical clustering revealed two distinct patient clusters that could be separated on the basis of MMP levels. The high MMP cluster was associated with increased C-reactive protein, the BASDAI and the Bath ankylosing spondylitis functional index. Conclusions

  8. Functional limitation and associated factors in outpatients with ankylosing spondylitis in Southwest China.

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    Song, Yuqing; Wang, Chen; Chen, Hong

    2017-04-01

    Functional limitation is often complained by patients with ankylosing spondylitis (AS). With a rising number of patients suffering from AS, there are a limited number of reports focusing on functional limitation of AS in Chinese patients. This study was conducted to investigate the level of functional limitation and explore its associations with demographic, disease-related factors. A total of 303 AS outpatients were recruited in this cross-sectional study from a tertiary general hospital in Southwest China. Functional limitation was measured by the Bath Ankylosing Spondylitis Functional Index (BASFI). Other data were collected by the following questionnaires: the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Patient Global Score (BAS-G), and the Pittsburgh Sleep Quality Index Questionnaire (PSQI). Finally, 295 outpatients with AS completed this survey. The median BASFI was 0.80. Worse function limitation was found in outpatients with extra-spinal manifestation, older age, lower household income, more back pain, higher disease activity and morning stiffness, poorer sleep, and worse patient's well-being (all P < 0.05). Multivariate regression analysis indicated that patient's well-being (P < 0.001), disease activity (P < 0.001), and disease duration (P < 0.05) were the positive predictors of functional limitation. AS outpatients in Southwest China had a mild level of functional limitation. The factors associated with functional limitation included disease duration, disease activity, and patients' well-being, which should be taken into consideration when assessing functional limitation of AS outpatients. Besides, more comprehensive and targeted interventions should be conducted for AS patients as early as possible, which will be effective to improve functional outcome.

  9. Analysis of clinical indexes and RUNX3, TBKBP1, PPARGC1B polymorphisms in Chinese Han patients with ankylosing spondylitis.

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    Liu, Jun; Lian, Zijian; Xiao, Yu; Shi, Lewis L; Chai, Wei; Wang, Yan

    2015-01-01

    Ankylosing spondylitis (AS) is a genetically determined disease. Runt-related transcription factor 3 (RUNX3), tumor necrosis factor family member-associated NF-κB activator binding kinase 1 binding protein (TBKBP1), and peroxisome proliferator-activated receptor-gamma coactivator 1 beta (PPARGC1B) have recently been found to be associated with susceptibility to AS in patients of Western European descent. We hypothesize that these three genes may be related to clinical outcomes of Chinese Han AS patients. Blood samples were drawn from 396 HLA-B27-positive Chinese Han AS patients. Clinical indexes were scored for each patient, including the Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), which measure patients' function of daily life and severity of AS. Twelve tagSNPs were selected from these three genes and genotyped. We analyzed the clinical indexes in different genotyped patients to investigate the relationship between severity of AS and different genotypes. The rs11249215 SNP in RUNX3 and the rs7379457 and rs32579 SNPs in PPARGC1B significantly affect the BASFI score in patients. The rs11249215, rs7551188, and rs1395621 SNPs in RUNX3 significantly affect the BASDAI scores. The two selected single nucleotide polymorphisms (SNPs) in TBKBP1 show no relationship with the clinical outcomes. None of the 12 SNPs is related to mSASSS. In conclusion, RUNX3 is related to both the severity of AS and the function of daily life. PPARGC1B is related to the function of daily life.

  10. Assessment of serum asymmetric dimethylarginine levels and left ventricular diastolic function in patients with ankylosing spondylitis.

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    Inci, Umit; Yildiz, Abdulkadir; Batmaz, Ibrahim; Tekbas, Ebru

    2017-02-01

    To assess left ventricular diastolic functions and serum dimethylarginine (ADMA) concentrations, as well as the effect of different treatment strategies on ADMA concentrations and diastolic function parameters, in patients with ankylosing spondylitis (AS). Sixty AS patients and 40 control subjects without classical cardiovascular (CV) risk factors were included in the study. Baseline clinical and echocardiographic variables were obtained. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and ADMA levels were measured. Spinal mobility, disease activity and functional status were assessed using Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index. CRP, ESR and ADMA levels were significantly higher in the AS group as compared to the control group. Two (5%) control subjects and six (10%) AS patients met the criteria for left ventricular diastolic dysfunction (DD) on conventional Doppler echocardiography, but the difference was not statistically significant (P = 0.36). However, using tissue Doppler imaging, 12 (20%) patients in the AS group and three (8%) subjects in the control group were diagnosed with left ventricular DD (P = 0.08). The anti-tumor necrosis factor (TNF)-α group, conventional therapy group and control group were compared in terms of ADMA, CRP, ESR levels and echocardiographic parameters. ADMA levels were significantly lower in anti-TNF-α group as compared to the conventional therapy group (P < 0.001). In the control group, ADMA levels were significantly lower than both treatment groups (P < 0.001). Increased ADMA levels reveal impaired nitric oxide metabolism in a relatively young group of patients with AS, who have no classical CV risk factors. Anti-TNF-α may have beneficial effect on endothelial function in AS patients by reducing ADMA levels. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Function Index (BASFI) and the Bath Ankylosing Spondylitis Global Score (BAS-G) (ranges 0-10) have gained widespread in use as self-reported measures of disease activity, functional impairment...... and overall well-being in patients with ankylosing spondylitis and other spondyloarthropathies (SpA). In Denmark, BASDAI, BASFI and BAS-G are systematically used to monitor treatment response in patients treated with tumour necrosis factor (TNF) inhibitors. The purpose of the present study was to examine...

  12. Determining the relationship of kinesiophobia with respiratory functions and functional capacity in ankylosing spondylitis.

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    Er, Göktuğ; AngIn, Ender

    2017-07-01

    Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease that affects the axial skeleton, causes inflammatory lower back pain, and structural and functional disorders, which affect quality of life negatively.The purpose of this study is to investigate the effects of kinesiophobia in AS on pulmonary function tests (PFTs) and functional performance.Thirty-one individuals with AS (n = 19 male, n = 12 female) who were suitable on the basis of the Modified New York (MNY) criteria were included in the study. The participants were given the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Metrology Index (BASMI), in addition to the Tampa Scale for Kinesiophobia (TKS), PFTs, respiratory muscle strength, pain evaluation, and 6-minute walking test (6MWT).The mean values were found as the following: TKS, 41.65 ± 7.59; pain visual analog scale (VAS) score, 6.23 ± 2.86; forced vital capacity (%) (FVC), 75.35% ± 17.92%; forced expiratory volume in first second (%) (FEV1), 73.45% ± 17.20%; FEV1/FVC (%), 75.58% ± 15.99%; peak expiratory flow (%) (PEF), 54,90% ± 20.21%; forced expiratory flow at 25% to 75% (FEF25-75), 77.71% ± 27.05%; maximal inspiratory pressure (MIP), 62.06 ± 31.68; maximal expiratory pressure (MEP), 95.94 ± 36.60; 6MWT, 445.88 ± 99.48. The scores obtained in TKS were found related to the values of FVC (%), FEV1 (%), chest expansion, BASFI, modified Schober test, lumbar lateral flexion, cervical rotation, and total BASMI score (r = -0.43, -0.36, -0.41, 0.42, -0.49, -0.56, -0.52, 0.56, respectively; P < .05).Kinesiophobia is a condition that may arise in individuals with AS, which has negative effects. Physiotherapists have a responsibility to eliminate kinesiophobia beliefs and prefer therapy method in line with this responsibility.

  13. Determining the relationship of kinesiophobia with respiratory functions and functional capacity in ankylosing spondylitis

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    Er, Göktuğ; AngIn, Ender

    2017-01-01

    Abstract Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease that affects the axial skeleton, causes inflammatory lower back pain, and structural and functional disorders, which affect quality of life negatively. The purpose of this study is to investigate the effects of kinesiophobia in AS on pulmonary function tests (PFTs) and functional performance. Thirty-one individuals with AS (n = 19 male, n = 12 female) who were suitable on the basis of the Modified New York (MNY) criteria were included in the study. The participants were given the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Metrology Index (BASMI), in addition to the Tampa Scale for Kinesiophobia (TKS), PFTs, respiratory muscle strength, pain evaluation, and 6-minute walking test (6MWT). The mean values were found as the following: TKS, 41.65 ± 7.59; pain visual analog scale (VAS) score, 6.23 ± 2.86; forced vital capacity (%) (FVC), 75.35% ± 17.92%; forced expiratory volume in first second (%) (FEV1), 73.45% ± 17.20%; FEV1/FVC (%), 75.58% ± 15.99%; peak expiratory flow (%) (PEF), 54,90% ± 20.21%; forced expiratory flow at 25% to 75% (FEF25–75), 77.71% ± 27.05%; maximal inspiratory pressure (MIP), 62.06 ± 31.68; maximal expiratory pressure (MEP), 95.94 ± 36.60; 6MWT, 445.88 ± 99.48. The scores obtained in TKS were found related to the values of FVC (%), FEV1 (%), chest expansion, BASFI, modified Schober test, lumbar lateral flexion, cervical rotation, and total BASMI score (r = −0.43, −0.36, −0.41, 0.42, −0.49, −0.56, −0.52, 0.56, respectively; P < .05). Kinesiophobia is a condition that may arise in individuals with AS, which has negative effects. Physiotherapists have a responsibility to eliminate kinesiophobia beliefs and prefer therapy method in line with this responsibility. PMID:28723759

  14. Relationship between kinesiophobia and pain, quality of life, functional status, disease activity, mobility, and depression in patients with ankylosing spondylitis

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    Oskay, Deran; Tuna, Zeynep; Düzgün, İrem; Elbasan, Bülent; Yakut, Yavuz; Tufan, Abdurrahman

    2017-11-13

    Background/aim: Our aim was to investigate the association of kinesiophobia with pain, quality of life, clinical measures, and depression in patients with ankylosing spondylitis (AS). Materials and methods: Patients with AS (n: 163) were enrolled in the study. Kinesiophobia was evaluated with the Tampa Scale of Kinesiophobia (TSK), pain with a visual analog scale (VAS), mobility with Bath Ankylosing Spondylitis Metrology Index (BASMI), disease activity with the Bath AS Disease Activity Index (BASDAI), functional status with the Bath AS Functional Index (BASFI), depression level with Beck's Depression Inventory (BDI), and quality of life with the AS Quality of Life Questionnaire (ASQoL). Besides correlation analysis, outcome measures were compared between patients with (TSK ? 37) and without (TSK 0.05). Patients with kinesiophobia had more pain and poorer BASFI, ASQoL, and BDI scores than patients without kinesiophobia (P quality of life.

  15. Spondyloarthritis Research Consortium of Canada (SPARCC) enthesitis index in Turkish patients with ankylosing spondylitis: relationship with disease activity and quality of life.

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    Zahiroglu, Yeliz; Ulus, Yasemin; Akyol, Yesim; Tander, Berna; Durmus, Dilek; Bilgici, Ayhan; Kuru, Omer

    2014-02-01

    The aim of this study was to investigate the relationship between Spondyloarthritis Research Consortium of Canada (SPARCC) enthesitis index and disease activity and health-related quality of life in patients with ankylosing spondylitis (AS). Eighty-six AS patients not receiving antitumour necrosis factor (TNF) therapy were included in the study. Spinal pain by visual analogue scale (pain VAS rest and activity), disease activity by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional capacity by Bath Ankylosing Spondylitis Functional Index (BASFI), enthesitis severity by SPARCC index, quality of life by Short Form-36 (SF-36), and Bath Ankylosing Spondylitis Metrology Index (BASMI) were assessed in patients. In the laboratory evaluations, the erythrocyte sedimentation rates and serum C-reactive protein levels of the patients were determined. All participants were aged between 18 and 65 years, with a mean age of 36.9 ± 11.13 years. The most frequent region of enthesitis was Achilles tendon insertion into calcaneum (55.8%). Pain VAS rest and activity, BASFI and all parameters of SF-36 were significantly different in AS patients with and without enthesitis. SPARCC index was significantly correlated with pain VAS activity (P  0.05). The clinical assessment of enthesitis in AS is an important outcome measure, and enthesitis indexes such as SPARCC enthesitis index can be valuable tools in the evaluation of disease activity in AS patients not receiving anti-TNF therapy. © 2013 The Authors International Journal of Rheumatic Diseases © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  16. [Interdisciplinary rehabilitation in patients with ankylosing spondylitis].

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    Hegedűs, Béla; Varga, János; Somfay, Attila

    2016-07-01

    Complex pulmonary assessment related to respiratory manifestation in patients with ankylosing spondylitis may contribute to adaptation of an appropriate rehabilitation program. To examine the relationship between lung function, exercise physiological variables and change in quality of life after rehabilitation in patients with ankylosing spondylitis. 5 patients in Seyfried's Stage 2 and 11 patients in Stage 3 underwent spinal physiotherapy, ultrasound, massage and paraffin Pack, 15 times each, followed by a high-intensity cycling 3 times a week for 8 weeks. The Bath Ankylosing Spondylitis Disease Activity and Bath Ankylosing Spondylitis Functional Indexes were recorded before and after rehabilitation. Lung function with exercise physiological variables were examined after rehabilitation. Both indexes showed a post-treatment significant improvement compared to the initial scores (pankylosing spondylitis. Orv. Hetil., 2016, 157(28), 1126-1132.

  17. The effectiveness of specific exercise types on cardiopulmonary functions in patients with ankylosing spondylitis: a systematic review.

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    Saracoglu, Ismail; Kurt, Gamze; Okur, Eda Ozge; Afsar, Emrah; Seyyar, Gulce Kallem; Calik, Bilge Basakci; Taspinar, Ferruh

    2017-03-01

    The aim of this review was to assess the effectiveness of specific exercise types on pulmonary functions, aerobic and functional capacity in patients with ankylosing spondylitis (AS). A systematic search of Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, AMED, EMBASE (OVID) was conducted in January 2016. The outcome measures were spirometric measurements, chest expansion, 6 minute walk distance (6MWD), pVO 2 , Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The search strategy was applied with limitation of date and language and this initial electronic search resulted in 143 relevant studies. After duplicates were removed, the titles and abstracts of 52 articles were screened. Of these, 14 full-text articles met initial criteria and were retrieved for review, with eight studies meeting final inclusion criteria. Both specific and conventional exercise groups showed significant improvements in BASDAI and BASFI scores (p  0.05). Specific exercises are an effective adjuvant therapy to enhance cardiopulmonary functions in patients with AS; therefore, it is assumed that in addition to the medical treatments, specific exercise therapy might reduce the cardiopulmonary complications related with AS.

  18. Spinal mobility, vertebral squaring, pulmonary function, pain, fatigue, and quality of life in patients with ankylosing spondylitis.

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    Cho, Hyungpil; Kim, Taikon; Kim, Tae-Hwan; Lee, Seunghun; Lee, Kyu Hoon

    2013-10-01

    To investigate the relationships between spinal mobility, pulmonary function, structural change of the spine, pain, fatigue, and quality of life (QOL) in patients with ankylosing spondylitis (AS). Thirty-six patients with AS were recruited. Their spinal mobility was examined through seven physical tests: modified Schober test, lateral bending, chest expansion, occiput to wall, finger to ground, bimalleolar distance, and range of motion (ROM) of the spine. Pulmonary Function Test (PFT) was performed using a spirometer, and vertebral squaring was evaluated through the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). QOL, disease activity, functional capacity, and fatigue were evaluated by SF-36 Health Survey (SF-36), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), and the Multidimensional Assessment of Fatigue (MAF) scale, respectively. Perceived physical condition and degree of pain were assessed using 10 cm visual analogue scale. Participants showed reduced spinal mobility, which was negatively correlated with mSASSS. PFT results showed reduced forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) and increased FEV1/FVC. Reduced FEV1 and FVC showed positive correlations with reduced spinal mobility and a negative relationship with mSASSS. Perceived physical condition and degree of pain were both significantly related to the SF-36, BASDAI, BASFI, and MAF scores. This study shows that both reduced spinal mobility and radiographic changes in the vertebral body may have a predictive value for pulmonary impairment in patients with AS. Likewise, pain and perceived physical condition may play an important role in the QOL, functional capacity, and fatigue level of these patients.

  19. Proposal of a linear definition of the Bath Ankylosing Spondylitis Metrology Index (BASMI) and comparison with the 2-step and 10-step definitions

    NARCIS (Netherlands)

    van der Heijde, D.; Landewé, R.; Feldtkeller, E.

    2008-01-01

    The Bath Ankylosing Spondylitis Metrology Index (BASMI) characterises the spinal mobility of patients with ankylosing spondylitis. Two versions have been published using categorical scores with either scores 0-2 for each of the five assessments, or scores 0-10. For metric purposes, we recently

  20. Erectile dysfunction in ankylosing spondylitis patients.

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    Santana, Thiago; Skare, Thelma; Delboni, Vitor Steil; Simione, Juliana; Campos, Ana Paula B; Nisihara, Renato

    2017-01-01

    Rheumatic diseases such as ankylosing spondylitis (AS) may be associated with sexual dysfunction. To study erectile function of a group of Brazilian AS patients comparing them with controls. This was a cross sectional study approved by the local Committee of Ethics in Research. The questionnaire IIEF (International Index of Erectile Function) was applied to 40 AS patients and 40 healthy controls. AS patients had determination of disease activity (through BASDAI or Bath Ankylosing Spondylitis Disease activity index), ASDAS (Ankylosing Spondylitis Disease Activity Score, MASES or Maastricht Ankylosing Spondylitis Score and SPARCC or Spondyloarthritis Research Consortium of Canada), function (through BASFI or Bath Ankylosing Spondylitis Functional Index and HAQ or Health Assessment Questionnaire) and BASMI (Bath Ankylosing Spondylitis Metrological Index). AS patients had a median score on IIEF of 22.0 (IQR=18-25) while controls had 29 (IQR=27-30) with p<0.0001 Only 17.5% of the AS patients had no erectile dysfunction, in opposite to 87.5% of controls (p<0.0001). IIEF scores had a negative association with BASDAI (p<0.0001), HAQ (p=0.05), body mass index (P=0.03), MASES (P=0.02) and SPARCC (P=0.02) in a univariate analysis. Multiple regression showed that BASDAI was the only variable independently associated with IIEF. There is a high prevalence of erectile dysfunction among AS patients that is associated with disease activity measured by BASDAI. Copyright® by the International Brazilian Journal of Urology.

  1. The impact of ankylosing spondylitis on audiovestibular functions.

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

    2014-09-01

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

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

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    Luo Michelle P

    2011-05-01

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

  3. Plantar pressure distribution in patients with ankylosing spondylitis.

    Science.gov (United States)

    Aydin, Elif; Turan, Yasemin; Tastaban, Engin; Kurt Omurlu, Imran; Sendur, Omer Faruk

    2015-03-01

    Ankylosing spondylitis is one of the most common inflammatory rheumatic diseases and is associated with alterations in posture. The aim of this study was to investigate the pedobarographic changes among ankylosing spondylitis patients, in an attempt to understand whether the alterations in the posture affect the plantar pressure distribution. The study population consisted of 38 patients with ankylosing spondylitis and 33 healthy volunteers. The static and dynamic pedobarographic measurements were performed to determine the plantar pressure distribution. Moreover, the Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life Questionnaire and Bath Ankylosing Spondylitis Metrology Index were used to assess the clinical state of the patients. The static pedobarographic measurements did not reveal any intergroup difference. There were differences between the groups in the results of dynamic peak pressure measurements under the metatarsal areas and under the midfoot region. The percentage of the midfoot in the dynamic plantar contact area was higher in ankylosing spondylitis patients in comparison to the controls. No clinically significant correlation was found between the clinical scores and static pedobarographic measurements. The plantar pressures under the metatarsal heads, medial and lateral heel regions declined with increasing disease activity according to the Bath Ankylosing Spondylitis Disease Activity Index scores. The lower peak pressures on the forefoot and rearfoot, were associated with the higher Bath Ankylosing Spondylitis Metrology Index scores of the patients. The alterations in the posture may have effects on the plantar pressures in patients with ankylosing spondylitis, especially during dynamic activities. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. The effect of infliximab on depressive symptoms in patients with ankylosing spondylitis.

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    Ersözlü-Bozkırlı, E D; Keşkek, S O; Bozkırlı, E; Yücel, A E

    2015-01-01

    Ankylosing spondylitis is a chronic inflammatory disease which physically, psychologically, and socially affects the patient's life. Previous studies have reported a correlation between ankylosing spondylitis and depression. In this study we investigated the effect of infliximab on depression in ankylosing spondylitis patients. A total of 29 patients with ankylosing spondylitis were enrolled in this prospective study. Infliximab was administered intravenously at a dose of 5 mg/kg at baseline, weeks 2 and 6. The measurements of morning stiffness, modified Schober's test, chest expansion, erythrocyte sedimentation rate, C-reactive protein, Bath ankylosing spondylitis disease activity index, Bath ankylosing spondylitis functional index and Beck depression inventory scores were compared with baseline and 12th week. The modified Schober's test and chest expansion increased, the morning stiffness duration, erythrocyte sedimentation rate and C-reactive protein levels decreased after infliximab treatment (p ankylosing spondylitis disease activity index, Bath ankylosing spondylitis functional index and Beck depression invantory scores of patients after 12 weeks (p ankylosing spondylitis..

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

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    Osman Kuloglu

    2012-05-01

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

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

    Science.gov (United States)

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

    2014-04-01

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

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

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

    2012-12-01

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

  8. REGIONAL RADIOGRAPHIC DAMAGE AND FUNCTIONAL LIMITATIONS IN PATIENTS WITH ANKYLOSING SPONDYLITIS: DIFFERENCES IN EARLY AND LATE DISEASE

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    Ward, Michael M.; Learch, Thomas J.; Gensler, Lianne S.; Davis, John C.; Reveille, John D.; Weisman, Michael H.

    2012-01-01

    Objective Radiographic damage and functional limitations both increase with the duration of ankylosing spondylitis (AS). We examined whether radiographic damage contributed more to functional limitations in late AS than in early AS, and if the strength of association varied with the anatomic region of damage. Methods In this cross-sectional study of 801 patients with AS, we examined associations of the lumbar modified Stoke AS Spine Score (mSASSS), cervical mSASSS, lumbar posterior fusion, cervical posterior fusion, and hip arthritis with the Bath AS Functional Index (BASFI) and the Health Assessment Questionnaire (HAQ-S). Results Higher lumbar and cervical mSASSS were associated with more functional limitations, but there was an interaction between mSASSS and the duration of AS such that the strength of their association with functional limitations decreased with increasing duration of AS. Cervical posterior fusion was associated with worse functioning independent of mSASSS. Hip arthritis was significantly associated with functional limitations independent of measures of spinal damage. Among patients with AS ≥ 40 years, the number of comorbid conditions accounted for most of the variation in functioning. Results were similar for both the BASFI and HAQ-S. Conclusions Although both radiographic damage and functional limitations increase over time in AS, the relative contribution of radiographic damage to functional limitations is lower among patients with longstanding AS than early AS, suggesting patients may accommodate to limited flexibility. Damage in different skeletal regions impacts functioning over the duration of AS. Functional limitations due to comorbidity supervene in late AS. PMID:23042639

  9. Corneal biomechanical features in patients with ankylosing spondylitis.

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    Cabuk, Kubra Serefoglu; Üstün, Emine Isil; Atalay, Kursat; Kirgiz, Ahmet; Aydin, Rukiye

    2017-01-01

    To evaluate the corneal biomechanical features and central corneal thickness in ankylosing spondylitis patients and to evaluate correlations of these parameters with disease activity. The study included 51 patients diagnosed with ankylosing spondylitis (mean age, 40.80 ± 13.15 years; range, 18-72 years) and 34 age- and sex-matched healthy controls (mean age, 42.00 ± 12.32 years; range, 18-60 years). All underwent a complete ophthalmological and physical examination, including visual acuity testing and biomicroscopic anterior and posterior segment examinations. Corneal hysteresis, corneal resistance factor, Goldmann-correlated intraocular pressure, and corneal compensated intraocular pressure were evaluated with an ocular response analyzer, and the central corneal thickness was measured with Sirius® corneal tomography. The Bath Ankylosing Spondylitis Disease Activity Index, Functional Index, and Metrology Index scores were recorded. In the ankylosing spondylitis patients, the mean disease duration was 7.73 ± 6.05 (range, 1-30) years. There was no statistically significant difference between the patients and controls in the corneal biomechanical features. The Goldmann-correlated intraocular pressure and corneal compensated intraocular pressure both showed positive correlations with age (p=0.003 and p=0.001, res-pectively). There was a negative correlation between corneal hysteresis and disease duration (p=0.002), and between central corneal thickness and the Bath Ankylosing Spondylitis Metrology Index score (p=0.003). This study demonstrated a significant negative correlation between corneal hysteresis and disease duration in ankylosing spondylitis patients. Furthermore, the central corneal thickness value decreased with an increase in Bath Ankylosing Spondylitis Metrology Index score, which may result in an underestimate of intraocular pressure readings and thus an inaccurate risk assessment of glaucoma.

  10. Development of a health index in patients with ankylosing spondylitis (ASAS HI): final result of a global initiative based on the ICF guided by ASAS

    Science.gov (United States)

    Kiltz, U; van der Heijde, D; Boonen, A; Cieza, A; Stucki, G; Khan, M A; Maksymowych, W P; Marzo-Ortega, H; Reveille, J; Stebbings, S; Bostan, C; Braun, J

    2015-01-01

    Objectives The burden of disease in patients with ankylosing spondylitis (AS) can be considerable. However, no agreement has been reached among expert members of Assessment of SpondyloArthritis International Society (ASAS) to define severity of AS. Based on the International Classification of Functioning, Disability and Health (ICF), a core set of items for AS has been selected to represent the entire spectrum of possible problems in functioning. Based on this, the objective of this study was to develop a tool to quantify health in AS, the ASAS Health Index. Methods First, based on a literature search, experts’ and patients’ opinion, a large item pool covering the categories of the ICF core set was generated. In several steps this item pool was reduced based on reliability, Rasch analysis and consensus building after two cross-sectional surveys to come up with the best fitting items representing most categories of the ICF core set for AS. Results After the first survey with 1754 patients, the item pool of 251 items was reduced to 82. After selection by an expert committee, 50 items remained which were tested in a second cross-sectional survey. The results were used to reduce the number of items to a final set of 17 items. This selection showed the best reliability and fit to the Rasch model, no residual correlation, and absence of consistent differential item function and a Person Separation Index of 0.82. Conclusions In this long sequential study, 17 items which cover most of the ICF core set were identified that showed the best representation of the health status of patients with AS. The ASAS Health Index is a linear composite measure which differs from other measures in the public domain. PMID:24399232

  11. Treatment of ankylosing spondylitis with biologics and targeted physical therapy: positive effect on chest pain, diminished chest mobility, and respiratory function.

    Science.gov (United States)

    Gyurcsik, Z; Bodnár, N; Szekanecz, Z; Szántó, S

    2013-12-01

    Biologics are highly effective in ankylosing spondylitis (AS). In this self-controlled study, we assessed the additive value of complex physiotherapy in decreasing chest pain and tenderness and improving respiratory function in AS patients treated with tumor necrosis factor α (TNF-α) inhibitors. The trial consisted of 2 parts. In study I, clinical data of AS patients with (n=55) or without biological therapy (n=20) were retrospectively analyzed and compared. Anthropometrical data, duration since diagnosis and patient assessment of disease activity, pain intensity, tender points, sacroiliac joint involvement determined by X-ray, functional condition, and physical activity level were recorded. Subjective, functional, and physical tests were performed. In study II, 10 voluntary patients (6 men and 4 women, age 52.4 ± 13.6 years) with definite AS and receiving anti-TNF therapy were recruited. It was a prospective, non-randomized physiotherapeutic trial. BASFI (Bath Ankylosing Spondylitis Functional Index), BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), modified Schober Index, occiput-to-wall distance, and fingertip-to-floor distance were evaluated. Forced vital capacity, forced 1-s expiratory volume, peak expiratory flow, and maximum voluntary ventilation were recorded. Furthermore, typical tender points were recorded. A targeted physiotherapy program was conducted twice a week for 12 weeks and all above parameters were recorded at baseline and after 12 weeks. Differences in patient assessment of disease activity (p=0.019) and pain intensity (p=0.017) were found in study I. Pain and tenderness of the thoracic spine were observed in both groups. Back pain without biologic therapy was slightly higher than other group. In study II, we found that patient assessment of disease activity and pain intensity significantly improved after the physical therapy program (p=0.002 and prespiratory functional parameters showed a tendency towards improvement. AS

  12. [Clinical-functional evolution of patients with ankylosing spondylitis following physio-kinetotheraphy].

    Science.gov (United States)

    Roşu, Mihaela Oana; Ancuţa, Codrina; Chirieac, Rodica

    2012-01-01

    Ankylosing spondylitis enigmatic from the etiologic point of view, appears with subjects who are still in school or involved in a productive activity. If detected in its early stages, under complex, constant and long-term treatment, patients have a good evolution. The objectives of the study are to describe the clinical and functional profile of patients with AS, sacroiliitis stage, and the evol ution of physical and functional parameters under traditional physio-kinetotherapy. This retrospective study was performed on 40 patients with ankylosing spondylitis (AS), who were hospitalized in the Clinic of Rheumatology Iaşi, during 2008-1010, who satisfied the amended New York criteria for this. Subjects underwent an initial evaluation (first admission) and another one at the end of the study (second admission), after approximately 6 months. The demographic characteristics, the clinical and functional elements of the study sample have indicated: the average age of 24.83 +/- 3.948, predominantly male (82.5%) and 62.5% were from rural areas. Most cases occurred at the age of 19-25 (57.5%), beginning at 18-25 (77.5%), with an average of 19.60 +/- 2.318. Following the radiological changes in the various stages of sacroiliitis, stage II prevailed (40%), then stage III (32.5%) and IV (15%). The evaluation of ASAS (Assessment of Spondylo Arthritis International Society) parameters and the respiratory system showed significant improvements of: BASDAI score with 31.53%, BASFI with 37.62%, BASMI with 20.66%, DIE % with 27.53 and of CV with 5.08% as well as a decrease in pain perception measured by VAS scale (p = 0.017). In the early stages of the disease, as far as the sample involved in the study is concerned, when the spine and vertebrae joints were not blocked by the evolution of the disease, corrective gymnastics and respiratory exercises, stretching and a good posture are very important, along with other therapies used to prevent axial ankylosis.

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

    Science.gov (United States)

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

    2014-01-01

    The endoplasmic reticulum aminopeptidase 1 (ERAP1) is a multifunctional enzyme involved in the final processing of Major Histocompatibility Complex class I (MHC-I) ligands and with a significant influence in the stability and immunological properties of MHC-I proteins. ERAP1 polymorphism is associated with ankylosing spondylitis among HLA-B27-positive individuals and the altered enzymatic activity of natural variants has significant effects on the HLA-B27 peptidome, suggesting a critical pathogenetic role of peptides in this disease. Likewise, the association of ERAP1 with other MHC-I associated disorders and its epistasis with their susceptibility MHC alleles point out to a general role of the MHC-I peptidome in these diseases. The functional interaction between ERAP1 and HLA-B27 or other MHC-I molecules may be related to the processing of specific epitopes, or to a more general peptide-dependent influence on other biological features of the MHC-I proteins. In addition, from a consideration of the reported functions of ERAP1, including its involvement in angiogenesis and macrophage activation, a more complex and multi-level influence in the inflammatory and immune pathways operating in these diseases cannot be ruled out. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Spondylitis - spondylodiscitis

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    Adler, C.P.

    1985-07-01

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

  15. [The relationship between pulmonary function and exercise capacity and quality of life in patients with ankylosing spondylitis].

    Science.gov (United States)

    Akyol, Gonca; Özalevli, Sevgi; Uçan, Eyüp Sabri

    2013-01-01

    Ankylosing spondylitis causes restrictive respiratory disorder by limiting the expansion of the chest because of the costosternal and costovertebral joints. Our study is planned to evaluate the respiratory functions of the ankylosing spondylitis patients who have a high rate of pulmonary involvement, and to compare the results with the exercise capacity and life quality of these patients. There were 27 (18 male, 9 female) Norvegian patients who came to Turkey and had ankylosing spondylitis diagnose according to Modified New York criterias, to have a routine physical therapy and rehabilitation programme with an average age of 50.6 ± 6.6 years. The patients' clinical histories were taken. Pulmonary function tests were performed with spirometry and pulmonary muscle strength was measured with mouth pressure measure. 6 minute walk test was performed to determine exercise capacity and Short Form-36 Life Quality Questionairre was used to evaluate life quality of the patients. The patients had 18.85 ± 10.64 average diagnose duration and the expected FEV1 value of the patients was 3.75 ± 0.88 L/sec, FEV1/FVC ratio was 80.44 ± 6.42, MIP was 62.96 ± 20.61 and MEP was 80.22 ± 21.12. 40.7% of the patients had positive smoking history while 14.8 % had dyspnea and 11.1% had symptoms of caughing-sputum. Walking distance was 595.50 ± 83.20 metre. Life quality category scores were 42.82 ± 16.78 minimally, 83.58 ± 23.06 maximally. Pulmonary function and pulmonary muscle strength values were similar in smoking and non-smoking patients. But in smoking patients, physical function and social function categories of quality of life survey scores were found lower than non-smoking patients. Respiratory and other parameters were high related to high standarts in treatment and following and exercise habit of the patients in Norway. Accordingly, it is thought that an appropriate medical treatment and exercise as a lifestyle habits of the patients reduce the negative effects of

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

    Science.gov (United States)

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

    2016-05-01

    To evaluate aerobic capacity in patients with ankylosing spondylitis (AS) and determine possible relationships between aerobic capacity, pulmonary function, and disease-related variables. Forty-two patients with AS and 42 healthy controls were recruited in the study. Descriptive data, disease-related variables (grip strength, lumbosacral mobility, occiput-to-wall distance, chest expansion, finger-to-floor distance, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Global Score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and hemoglobin), and chest and thoracic spine x-rays were collected in each patient with AS. All subjects took standard pulmonary function and exercise tolerance tests, and forced vital capacity (FVC) and aerobic capacity were recorded. Both aerobic capacity and FVC in patients with AS were significantly lower than those in normal subjects (P < 0.05). AS patients with BASFI scores of < 3 or BASDI scores of < 4 had a higher aerobic capacity. There was significant correlation between aerobic capacity, vital capacity, chest expansion, Schober's test, cervical range of motion, and BASFI in patients with AS. Neither aerobic capacity nor vital capacity correlated with disease duration, ESR, CRP, and hemoglobin. Significantly reduced aerobic capacity and FVC were observed in patients with AS, and there was significant correlation between aerobic capacity, vital capacity, chest expansion, and BASFI. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  17. A Single Nucleotide Polymorphism in the Il17ra Promoter Is Associated with Functional Severity of Ankylosing Spondylitis

    Science.gov (United States)

    Vidal-Castiñeira, Jose Ramón; López-Vázquez, Antonio; Diaz-Peña, Roberto; Diaz-Bulnes, Paula; Martinez-Camblor, Pablo; Coto, Eliecer; Coto-Segura, Pablo; Bruges-Armas, Jacome; Pinto, Jose Antonio; Blanco, Francisco Jose; Sánchez, Alejandra; Mulero, Juan; Queiro, Ruben; Lopez-Larrea, Carlos

    2016-01-01

    The aim of this study was to identify new genetic variants associated with the severity of ankylosing spondylitis (AS). We sequenced the exome of eight patients diagnosed with AS, selected on the basis of the severity of their clinical parameters. We identified 27 variants in exons and regulatory regions. The contribution of candidate variants found to AS severity was validated by genotyping two Spanish cohorts consisting of 180 cases/300 controls and 419 cases/656 controls. Relationships of SNPs and clinical variables with the Bath Ankylosing Spondylitis Disease Activity and Functional Indices BASDAI and BASFI were analyzed. BASFI was standardized by adjusting for the duration of the disease since the appearance of the first symptoms. Refining the analysis of SNPs in the two cohorts, we found that the rs4819554 minor allele G in the promoter of the IL17RA gene was associated with AS (p<0.005). This variant was also associated with the BASFI score. Classifying AS patients by the severity of their functional status with respect to BASFI/disease duration of the 60th, 65th, 70th and 75th percentiles, we found the association increased from p60 to p75 (cohort 1: p<0.05 to p<0.01; cohort 2: p<0.01 to p<0.005). Our findings indicate a genetic role for the IL17/ILRA axis in the development of severe forms of AS. PMID:27415816

  18. A Single Nucleotide Polymorphism in the Il17ra Promoter Is Associated with Functional Severity of Ankylosing Spondylitis.

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    Jose Ramón Vidal-Castiñeira

    Full Text Available The aim of this study was to identify new genetic variants associated with the severity of ankylosing spondylitis (AS. We sequenced the exome of eight patients diagnosed with AS, selected on the basis of the severity of their clinical parameters. We identified 27 variants in exons and regulatory regions. The contribution of candidate variants found to AS severity was validated by genotyping two Spanish cohorts consisting of 180 cases/300 controls and 419 cases/656 controls. Relationships of SNPs and clinical variables with the Bath Ankylosing Spondylitis Disease Activity and Functional Indices BASDAI and BASFI were analyzed. BASFI was standardized by adjusting for the duration of the disease since the appearance of the first symptoms. Refining the analysis of SNPs in the two cohorts, we found that the rs4819554 minor allele G in the promoter of the IL17RA gene was associated with AS (p<0.005. This variant was also associated with the BASFI score. Classifying AS patients by the severity of their functional status with respect to BASFI/disease duration of the 60th, 65th, 70th and 75th percentiles, we found the association increased from p60 to p75 (cohort 1: p<0.05 to p<0.01; cohort 2: p<0.01 to p<0.005. Our findings indicate a genetic role for the IL17/ILRA axis in the development of severe forms of AS.

  19. Five Potentially Modifiable Factors Predict Poor Quality of Life in Ankylosing Spondylitis: Results from the Scotland Registry for Ankylosing Spondylitis.

    Science.gov (United States)

    Dean, Linda E; Macfarlane, Gary J; Jones, Gareth T

    2018-01-01

    A chronic inflammatory condition manifesting in young adulthood, ankylosing spondylitis (AS) affects both physical and emotional quality of life (QOL). To inform future intervention strategies, this study aimed to (1) assess the QOL of patients with AS, and (2) identify potentially modifiable factors associated with reporting poor QOL. The Scotland Registry for Ankylosing Spondylitis collects clinical and patient-reported data on clinically diagnosed patients with AS across Scotland. QOL is measured using the ASQoL questionnaire [range: 0 (high) to 18 (poor)]. Potentially modifiable factors associated with reporting poor QOL (score 12-18) were examined using Poisson regression models, adjusted for a variety of demographic characteristics, plus various nonmodifiable factors. Results are given as risk ratios (RR) with 95% CI. Data were available on 959 patients: 74% male, mean age 52 years (SD 13), median ASQoL 7.0 (interquartile range 2-12). Although many factors were univariately associated with poor QOL, 5 were identified as independent predictors: reporting moderate/severe fatigue (RR 1.60, 95% CI 1.13-2.28), poor physical function [Bath Ankylosing Spondylitis Functional Index (BASFI) ≥ 4: 3.46, 1.76-6.82], chronic widespread pain (CWP; 1.92, 1.33-2.75), high disease activity [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥ 4: 1.52, 1.09-2.12], and poor spinal mobility [Bath Ankylosing Spondylitis Metrology Index (BASMI) ≥ 4: 1.52, 0.93-2.50]. For these factors, population-attributable risks ranged between 20% (disease activity) and 56% (physical function). We have identified 5 potentially modifiable factors independently associated with poor QOL. These findings provide evidence that in addition to traditional clinical targets (BASDAI, BASFI, and BASMI), focus on nonspecific symptoms (CWP and fatigue), perhaps with nonpharmacological therapies, may yield important improvements in QOL.

  20. Exercise and ankylosing spondylitis with New York modified criteria: a systematic review of controlled trials with meta-analysis.

    Science.gov (United States)

    Martins, N A; Furtado, Guilherme Eustáquio; Campos, Maria João; Leitão, José Carlos; Filaire, Edith; Ferreira, José Pedro

    2014-01-01

    Ankylosing spondylitis is a systemic rheumatic disease that affects the axial skeleton, causing inflammatory back pain, structural and functional changes which decrease quality of life. Several treatments for ankylosing spondylitis have been proposed and among them the use of exercise. The present study aims to synthesize information from the literature and identify the results of controlled clinical trials on exercise in patients with ankylosing spondylitis with the New York modified diagnostic criteria and to assess whether exercise is more effective than physical activity to reduce functional impairment. The sources of studies used were: LILACS, Pubmed, EBSCOhost, B-on, personal communication, manual research and lists of references. The criteria used for the studies selection was controlled clinical trials, participants with New York modified diagnostic criteria for ankylosing spondylitis, and with interventions through exercise. The variables studied were related to primary outcomes such as BASFI (Bath Ankylosing Spondylitis Functional Index) as a functional index, BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) as an index of intensity of disease activity and BASMI (Bath Ankylosing Spondylitis Metrology Index) as a metrological index assessing patient's limitation on movement. From the 603 studies identified after screening only 37 articles were selected for eligibility, from which 18 studies were included. The methodological quality was assessed to select those with an high methodological expressiveness using the PEDro scale. A cumulative meta-analysis was subsequently performed to compare exercise versus usual level of physical activity. Exercise shows significant statistical outcomes for the BASFI, BASDAI and BASMI, higher than those found for usual level of physical activity.

  1. Ankylosing Spondylitis

    OpenAIRE

    McGregor, Marion

    1982-01-01

    Ankylosing spondylitis belongs to a group of rheumatic diseases known as the spondyloarthropathies (SpA), which show a strong association with the genetic marker HLA-B27. Inflammatory back pain and stiffness are prominent early in the disease, whereas chronic, aggressive disease may produce pain and marked axial immobility or deformity. Modern medicine has no established treatment for it. From the Ayurvedic perspective, the disease can fall under amavata, which may be effectively managed when...

  2. Effectiveness of ultrasound treatment applied with exercise therapy on patients with ankylosing spondylitis: a double-blind, randomized, placebo-controlled trial.

    Science.gov (United States)

    Şilte Karamanlioğlu, Duygu; Aktas, Ilknur; Ozkan, Feyza Unlu; Kaysin, Meryem; Girgin, Nuray

    2016-05-01

    The aim of our study was to evaluate effectiveness of ultrasound treatment applied with exercise therapy in patients with ankylosing spondylitis. Fifty-two patients, who were diagnosed according to modified New York criteria, were aged 25-60, and have spine pain, were randomly assigned to two groups. Ultrasound (US) and exercise therapy were applied to treatment group (27); placebo US treatment and exercise therapy were applied to control group (25). Patients were evaluated before treatment, at the end of treatment, and 4 weeks after the treatment. Daily and night pain, morning stiffness, patient global assessment (PGA), doctor global assessment (DGA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, Ankylosing Spondylitis Disease Activity Score (ASDAS) erythrocyte sedimentation rate (ESR), and ASDAS C-reactive protein (CRP) were used as clinical parameters. In US group, all parameters showed significant improvements at 2 and 6 weeks, in comparison with the baseline. In placebo US group, significant improvement was obtained for all parameters (except tragus-to-wall distance and modified Schober test at 2 weeks and lumbar side flexion and modified Schober test at 6 weeks). Comparison of the groups showed significantly superior results of US group for parameters of BASMI (p treatment increases the effect of exercise in patients with ankylosing spondylitis.

  3. Inspiratory muscle training improves aerobic capacity and pulmonary function in patients with ankylosing spondylitis: a randomized controlled study.

    Science.gov (United States)

    Drăgoi, Răzvan-Gabriel; Amaricai, Elena; Drăgoi, Mihai; Popoviciu, Horatiu; Avram, Claudiu

    2016-04-01

    To evaluate the impact of inspiratory muscle training on aerobic capacity and pulmonary function in patients with ankylosing spondylitis. Randomized controlled study. Rheumatic Rehabilitation Centre. A total of 54 ankylosing spondylitis patients, all males, were randomized to a conventional exercise training associated with an inspiratory muscle training group, or to a conventional exercise training group. Group 1 (27 patients) performed eight weeks of conventional exercise training (supervised weekly group sessions followed by a home-based exercise programme) associated with inspiratory muscle training sessions. Group 2 (27 patients) received eight weeks of conventional exercise training only. Resting pulmonary function (forced vital capacity - FVC, forced expiratory volume in one second - FEV1); effort ventilatory efficiency (lowest ventilatory equivalent ratio for oxygen and carbon dioxide - VE/VO2 and VE/VCO2) and aerobic capacity (peak oxygen uptake - VO2peak) were assessed at baseline and after eight weeks of exercise-based intervention. After eight weeks follow-up, patients in Group 1 had a significant increased chest expansion and VO2peak compared with Group 2 (3.6 ±0.8 cm vs. 3.2 ±0.5 cm, P = 0.032; 2.0 ±0.5 l/min vs. 1.8 ±0.3 l/min, P = 0.033). There were no significant differences of spirometric measurements, except FVC which significantly improved in patients who performed inspiratory muscle training (82.7 ±5.1% vs. 79.5 ±3.5%, P = 0.014). VE/VCO2 also improved significantly in Group 1 (26.6 ±3.6 vs. 29.2 ±4.7, P = 0.040). Ankylosing spondylitis patients who performed eight weeks of inspiratory muscle training associated to conventional exercise training had an increased chest expansion, a better aerobic capacity, resting pulmonary function and ventilatory efficiency than those who performed conventional exercise training only. © The Author(s) 2015.

  4. Favorable effect of rehabilitation on balance in ankylosing spondylitis: a quasi-randomized controlled clinical trial.

    Science.gov (United States)

    Demontis, Alessandra; Trainito, Sabina; Del Felice, Alessandra; Masiero, Stefano

    2016-03-01

    Balance impairment is a frequent and undertreated manifestation in ankylosing spondylitis, leading to increased risk of falls and lower quality of life. Our aim was to assess supervised training and home-based rehabilitation efficacy on balance improvement in ankylosing spondylitis subjects on biologic agents. This was a single-blinded, quasi-randomized parallel study in a single outpatient Rehabilitation Clinic of a tertiary referral center. Subjects with ankylosing spondylitis on biologic agents were assigned either to supervised training and home-based rehabilitation program (rehabilitation group) plus educational-behavioral therapy, or to educational-behavioral therapy alone (educational groups). The same therapist provided therapy. Outcome measures were assessed at baseline (T0), end of treatment (T1) and at 7-month follow-up (T2). Rheumatologic outcomes were Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index and Bath Ankylosing Spondylitis Disease Activity Index. Balance parameters (anterior-posterior oscillation, latero-lateral oscillation, sway area, sway density and sway path) were evaluated by stabilometry in a condition of open and closed eyes. Forty-six subjects (36 M, 10 F) were enrolled. Demographic data and clinical status at baseline were comparable between the two groups (22 rehabilitation group, 20 educational group). Primary outcome was sway density that improved both at T1 (SDy: open eyes p = 0.003, closed eyes p = 0.004) and at T2 (SDx: open eyes p = 0.0015, closed eyes p = 0.032). A trend toward improvement in the rehabilitation group rather than in the educational group emerged for balance parameters, especially those measured with closed eyes (0.004 ankylosing spondylitis. Eyes-closed trials show a more marked trend toward improvement, and this may suggest a positive effect of rehabilitation on proprioception.

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

    Directory of Open Access Journals (Sweden)

    Xu X

    2016-05-01

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

  6. Translation, cultural adaptation, and validation of the Bath questionnaires and HAQ-S in Hindi for Indian patients with ankylosing spondylitis.

    Science.gov (United States)

    Dhir, Varun; Kulkarni, Sujay; Adgaonkar, Ashish; Dhobe, Poornima; Aggarwal, Amita

    2012-10-01

    The disease activity and functional impact of ankylosing spondylitis (AS) is currently measured through various questionnaire instruments, the most popular of which are the Bath indices. However, Hindi versions for use in Indian patients are not available. This study aimed to fill this lacuna. Translation and cross-cultural adaptation of the instruments--Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitits Metrology Index (BASMI), Bath Ankylosing Spondylitis Patient Global Score (BAS-G), and Health Assessment Questionnaire-Spondyloarthropathy (HAQ-S)--were done using standard guidelines. These were then self-administered to patients. The BASMI measurements, occiput-to-wall distance, chest expansion (in centimeters), total enthesis count, ESR, and C reactive protein (CRP) were measured. To assess reliability, the patient was called back on day 14, and the questionnaires were again self-administered, and the intra-class correlation coefficient was calculated to assess reliability. Correlation of questionnaire scores with acute phase reactants, measurements, and enthesitis index were used to assess for construct validity. Some modifications were done in the Bath indices and HAQ-S for cross-cultural adaptation. For validation, 41 patients of ankylosing spondylitis with a mean age of 34 years (±10.2) and disease duration of 5.8 years (±6.2) were included. The Bath Ankylosing Spondylitis Functional Index (BASFI), BASDAI, and HAQ-S showed good correlation among themselves (r = 0.69 to 0.84, p Indian patients with ankylosing spondylitis.

  7. Endothelial progenitor cell biology in ankylosing spondylitis.

    Science.gov (United States)

    Verma, Inderjeet; Syngle, Ashit; Krishan, Pawan

    2015-03-01

    Endothelial progenitor cells (EPCs) are unique populations which have reparative potential in overcoming endothelial damage and reducing cardiovascular risk. Patients with ankylosing spondylitis (AS) have increased risk of cardiovascular morbidity and mortality. The aim of this study was to investigate the endothelial progenitor cell population in AS patients and its potential relationships with disease variables. Endothelial progenitor cells were measured in peripheral blood samples from 20 AS and 20 healthy controls by flow cytometry on the basis of CD34 and CD133 expression. Disease activity was evaluated by using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Functional ability was monitored by using Bath Ankylosing Spondylitis Functional Index (BASFI). EPCs were depleted in AS patients as compared to healthy controls (CD34(+) /CD133(+) : 0.027 ± 0.010% vs. 0.044 ± 0.011%, P < 0.001). EPC depletions were significantly associated with disease duration (r = -0.52, P = 0.01), BASDAI (r = -0.45, P = 0.04) and C-reactive protein (r = -0.5, P = 0.01). This is the first study to demonstrate endothelial progenitor cell depletion in AS patients. EPC depletions inversely correlate with disease duration, disease activity and inflammation, suggesting the pivotal role of inflammation in depletion of EPCs. EPC would possibly also serve as a therapeutic target for preventing cardiovascular disease in AS. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  8. Treatment efficacy of etanercept and MTX combination therapy for ankylosing spondylitis hip joint lesion in Chinese population.

    Science.gov (United States)

    Lian, Fan; Yang, Xiuyan; Liang, Liuqin; Xu, Hanshi; Zhan, Zhongping; Qiu, Qian; Ye, Yujin

    2012-06-01

    To investigate the efficacy of etanercept and MTX (methotrexate) combination therapy in Chinese patients with ankylosing spondylitis hip joint lesion, the possible courses and maintenance protocol, altogether 97 ankylosing spondylitis patients fulfilling the modified New York criteria with hip joint lesion were enrolled in a 12-month trial treated with combined etanercept and MTX. All these patients were required to be poor responders to SSZ (Sulfasalazine) or MTX therapy for 6 consecutive months or the longer. Etanercept was administered subcutaneously twice a week at a fixed dosage of 25 mg for the first six months, followed by 25 mg once a week in patients with good control of both symptoms and radiological progression, or twice a week for another six months in patients with BASDAI > or = 4. Combined MTX was administered intravenously once a week at the dosage of 15 mg. Demographics, clinical and laboratory features, physical function and quality of life using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), Harris hip score, and radiological assessment using the BASRI-hip index were recorded. Most patients achieved pain release at the end point of assessment. Significant improvement in Bath AS Disease Activity Index (BASDAI) (P ankylosing spondylitis patients with hip joint lesion, and staged dosage deduction in the long term proved to be effective as well as adverse event preventing.

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

    Science.gov (United States)

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

    2009-01-01

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

  10. Prevalence of fibromyalgia in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Aref Hosseinian Amiri

    2014-01-01

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

  11. Ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Mukesh Edavalath

    2010-01-01

    Full Text Available Ankylosing spondylitis belongs to a group of rheumatic diseases known as the spondyloarthropathies (SpA, which show a strong association with the genetic marker HLA-B27. Inflammatory back pain and stiffness are prominent early in the disease, whereas chronic, aggressive disease may produce pain and marked axial immobility or deformity. Modern medicine has no established treatment for it. From the Ayurvedic perspective, the disease can fall under amavata, which may be effectively managed when intervention is started in its early stages. Niruha basthi with Balaguduchyadi yoga, combined by Shamana treatment with Rasnerandadi kwatha and Simhanada guggulu have been found effective in curbing its progression. This article presents a single case report in which these treatments achieved considerable success.

  12. Spinal instability in ankylosing spondylitis

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    Badve Siddharth

    2010-01-01

    grading improved from C to E in 31.25% (n=5 patients, D to E in 12.5% (n=2 and B to D in 12.5% (n=2, while it remained unchanged in the remaining - E in 31.25% (n=5, B in 6.25% (n=1 and D in 6.25% (n=1. Fusion occurred in 11 (68.7% patients, while 12.5% (n=2 had pseudoarthrosis and 12.5% (n=2 patients had evidence of inadequate fusion. 68.7% (n=11 patients regained their pre-injury functional status, with no spine related complaints and 25% (n=4 patients had complaints like chronic back pain and deformity progression. In one patient (6.2% who died of medical complications a week following surgery, the neurological function remained unchanged (Frankel grade D. Persistent back pain attributed to inadequate fusion/ pseudoarthrosis could be managed conservatively in 12.5% (n=2 patients. Progression of deformity and pain secondary to pseudoarthrosis, requiring revision surgery was noted in one patient (6.2%. One patient (6.2% had no neurological recovery following the surgery and continued to have nonfunctional neurological status. Conclusion: In ankylosing spondylitis, the diagnosis of unstable spinal lesions needs high index of suspicion and extensive radiological evaluation Surgery is indicated if neurological deficit, two/three column injury, significant pain and progressive deformity are present. Long segment instrumentation and fusion is ideal.

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

    Science.gov (United States)

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

    2013-03-01

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

  14. Opioid Analgesic Use in Patients with Ankylosing Spondylitis: An Analysis of the Prospective Study of Outcomes in an Ankylosing Spondylitis Cohort.

    Science.gov (United States)

    Dau, Jonathan D; Lee, MinJae; Ward, Michael M; Gensler, Lianne S; Brown, Matthew A; Learch, Thomas J; Diekman, Laura A; Tahanan, Amirali; Rahbar, Mohammad H; Weisman, Michael H; Reveille, John D

    2018-02-01

    Opioid analgesics may be prescribed to ankylosing spondylitis (AS) patients with pain that is unresponsive to antirheumatic treatment. Our study assessed factors associated with opioid usage in AS. A prospective cohort of 706 patients with AS meeting modified New York criteria followed at least 2 years underwent comprehensive clinical evaluation of disease activity and functional impairment. These were assessed by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI). Radiographic severity was assessed by the Bath Ankylosing Spondylitis Radiology Index and modified Stokes Ankylosing Spondylitis Scoring System. Medications taken concurrently with opioids, as well as C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR), were determined at each study visit, performed every 6 months. Analyses were carried out at baseline, and longitudinal multivariable models were developed to identify factors independently associated with chronic and intermittent opioid usage over time. Factors significantly associated with opioid usage, especially chronic opioid use, included longer disease duration, smoking, lack of exercise, higher disease activity (BASDAI) and functional impairment (BASFI), depression, radiographic severity, and cardiovascular disease. Patients taking opioids were more likely to be using anxiolytic, hypnotic, antidepressant, and muscle relaxant medications. Multivariable analysis underscored the association with smoking, older age, antitumor necrosis factor agent use, and psychoactive drugs, as well as with subjective but not objective determinants of disease activity. Opioid usage was more likely to be associated with subjective measures (depression, BASDAI, BASFI) than objective measures (CRP, ESR), suggesting that pain in AS may derive from sources other than spinal inflammation alone.

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

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    F.M. Perrotta

    2013-07-01

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

  16. Atlantoaxial instability: An exceptional complication of ankylosing spondylitis

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    Zeineb Alaya

    2018-04-01

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

  17. Supervised training and home-based rehabilitation in patients with stabilized ankylosing spondylitis on TNF inhibitor treatment: a controlled clinical trial with a 12-month follow-up.

    Science.gov (United States)

    Masiero, Stefano; Poli, Patrizia; Bonaldo, Lara; Pigatto, Maurizia; Ramonda, Roberta; Lubrano, Ennio; Punzi, Leonardo; Maffulli, Nicola

    2014-06-01

    To assess the 12-month's follow-up effects on pain, mobility, and physical function outcomes of a supervised training and home-based rehabilitation for ankylosing spondylitis patients stabilized with TNF-inhibitor therapy. Controlled clinical trial (sequentially determined allocation) with 12-months' follow-up. Patients' homes. A total of 69 subjects were allocated to either a rehabilitation programme (rehabilitation group, n = 22), an educational-behavioural programme (educational group, n = 24), and to neither programme (control group, n = 23). Rehabilitation programme included supervised training and home exercises (stretching, strengthening, aerobic, chest, and spine/hip joint flexibility exercises); educational-behavioural programme included information on ankylosing spondylitis, pain and stress mechanisms, and control. Spinal pain intensity, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, chest expansion, and cervical and lumbar spine active range of motion measured by a pocket goniometer. At baseline, the three groups exhibited comparable demographic characteristics and basal evaluations. Intra-group changes in the rehabilitation group from baseline to 12 months yielded statistically significant gains (p Ankylosing Spondylitis Disease Activity Index (p = 0.012 and p = 0.050), and in some goniometric measurements as cervical rotation (p = 0.007 and p = 0.014), toraco-lumbar rotation (p = 0.009 and p = 0.050), and total cervical movements (p = 0.009 and p = 0.001). In comparison with the educational-behavioural programme or no intervention, supervised training and home exercises improved long-term outcome in patients with ankylosing spondylitis. © The Author(s) 2013.

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

    Directory of Open Access Journals (Sweden)

    Andrea Lopes Gallinaro

    2012-12-01

    Full Text Available OBJETIVO: Analisar a atividade sexual em pacientes com espondilite anquilosante, correlacionando com índices funcionais e de atividade da doença. PACIENTES E MÉTODOS: Foram analisados quanto a dor, fadiga, questionários de atividade de doença (Bath Ankylosing Spondylitis Disease Activity Index - BASDAI, funcionalidade (Bath Ankylosing Spondylitis Functional Index - BASFI e atividade sexual (utilizando imagens de sete posições sexuais 32 pacientes com diagnóstico de espondilite anquilosante e 32 controles saudáveis. Após a entrevista, os pacientes foram divididos em dois grupos: grupo A (com atividade sexual e grupo B (sem atividade sexual. RESULTADOS: O grupo B apresentou associação estatística com maior duração da doença (P = 0,01, pior funcionalidade (P = 0,0007 e maior atividade de doença (P = 0,03. Não houve correlação entre idade e capacidade funcional. O homem deitado de costas e a mulher sobre ele foi a posição mais frequente, agradável e menos dolorosa. A figura com a mulher de costas e o homem deitado sobre ela foi a posição menos escolhida. Indivíduos-controle relataram maior frequência e duração mais longa das relações sexuais, menos fadiga e dor, embora a frequência de orgasmos tenha sido semelhante nos dois grupos. CONCLUSÃO: A natureza crônica da espondilite anquilosante, com pior capacidade funcional e maior atividade da doença, interferiu no comportamento sexual dos pacientes. Quando o sexo se tornou possível, orgasmo e satisfação sexual não diferiram dos controles saudáveis.OBJECTIVE: To assess the sexual activity of patients with ankylosing spondylitis, correlating it with disease activity and functional indices. PATIENTS AND METHODS: Thirty-two patients with ankylosing spondylitis and 32 healthy controls were assessed regarding pain, fatigue, sexual activity (by use of pictures of seven sexual positions, disease activity (by use of Bath Ankylosing Spondylitis Disease Activity Index

  19. The Effectiveness of Exergames in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial.

    Science.gov (United States)

    Karahan, Ali Yavuz; Tok, Fatih; Yildirim, Pelin; Ordahan, Banu; Turkoglu, Gozde; Sahin, Nilay

    2016-01-01

    Exergames are a well-known type of game based on a virtual avatar's body movements. This hightech approach promotes an active lifestyle. The aim of this randomized controlled trial was to evaluate the effects of exergames on pain, disease activity, functional capacity and quality of life in patients with ankylosing spondylitis (AS). The study involved 60 patients, who were randomized into either the exergame group (EG) or the control group (CG). The EG patients engaged in exergaming, and CG patients did not engage in any exercises. The exergaming sessions were performed five times a week for eight weeks (40 sessions in total). The patients were assessed before and after the eight-week program on a visual analog scale (VAS), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire. A statistically significant improvement was observed in VAS, BASFI, BASDAI and ASQoL scores in the EG group after completion of the exercise program (p < 0.05). This study is a first step in investigating the possibilities of using an exergame platform to help patients with spondyloarthropathies to adopt a more physically active lifestyle. The results of this study suggest that exergames increase physical activity and decrease the pain scores in AS patients and also could, therefore, be feasible and safe.

  20. The relationship between C-reactive protein rs3091244 polymorphism and ankylosing spondylitis.

    Science.gov (United States)

    Akbal, Ayla; Reşorlu, Hatice; Gökmen, Ferhat; Savaş, Yılmaz; Zateri, Çoşkun; Sargin, Betül; Bozkurt, Emre; Sılan, Fatma; Özdemir, Öztürk

    2016-01-01

    Previous studies have shown that C-reactive protein (CRP) gene polymorphism can be related to inflammatory changes. The present study aimed to examine the association between CRP gene polymorphism and clinical and laboratory findings in ankylosing spondylitis (AS) patients. A total of 80 patients, 40 with AS and 40 controls, were included in the study. Diagnosis of AS was made according to Assessment in AS International Working Group criteria. Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index and Bath Ankylosing Spondylitis Radiology Index scores were evaluated. CRP gene C, A and T alleles were evaluated and were determined using the analysis of melting curves after real time polymerase chain reaction. The odds ratios were calculated for all alleles and haploids of the CRP gene. We investigated the relationship between the CRP polymorphism and clinical and laboratory findings. A, C, T allele frequencies in the control group were 15%, 57.5% and 27.5%. The allele frequencies in the AS group were 38%, 68.8% and 26.2%. While C and T allele frequencies were shown to be similar in the two groups, A allele frequency was higher in the AS group compared to the control group. The CC wild allele was 42.5% in the control group and 47.5% in the AS group (P = 1.0). Odds ratios for the C allele were 1.6, for the CC haploid 1.2 and for the CT haploid 3.7. Chest expansion and finger-to-ground distance was better in the CRP gene polymorphism group compared to the no polymorphism group. The presence of the CRP gene CC wild haploid and C allele in patients may indicate an increased risk for AS. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  1. Elevated Serum Levels of Soluble CD30 in Ankylosing Spondylitis Patients and Its Association with Disease Severity-Related Parameters

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    Rongfen Gao

    2015-01-01

    Full Text Available Soluble CD30 (sCD30, a transmembrane glycoprotein that belongs to the tumor necrosis factor receptor (TNFR superfamily, has been shown to be associated with various pathological conditions. This study was designed to measure the levels of serum sCD30 in patients with ankylosing spondylitis (AS and to evaluate the relationships between serum sCD30 levels and other disease severity-related indexes, including bath ankylosing spondylitis disease activity index (BASDAI, ankylosing spondylitis disease activity score (ASDAS, and bath ankylosing spondylitis functional index (BASFI. Our results demonstrated significantly elevated sCD30 levels in AS patients compared to healthy controls (HCs with mean values of 32.0±12.2 and 24.9±8.0 ng/mL, respectively (P**=0.007, suggesting a potential role of sCD30 in the pathogenesis of AS. However, no significant correlations of sCD30 with BASDAI, ASDAS, or BASFI were detected in our study (P>0.05. Therefore, sCD30 cannot be used as a reliable marker for reflecting disease activity and functional ability of AS patients.

  2. Ankylosing Spondylitis versus Nonradiographic Axial Spondyloarthritis

    DEFF Research Database (Denmark)

    Glintborg, Bente; Sørensen, Inge J; Østergaard, Mikkel

    2017-01-01

    OBJECTIVE: To compare baseline disease activity and treatment effectiveness in biologic-naive patients with nonradiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) who initiate tumor necrosis factor inhibitor (TNFi) treatment and to study the role of potential confounders....../disease duration/TNFi-type/smoking/baseline disease activity) on TNFi adherence and response [e.g., Bath Ankylosing Spondylitis Activity Index (BASDAI) 50%/20 mm]. RESULTS: The study included 1250 TNFi-naive patients with axSpA (29% nr-axSpA, 50% AS, 21% lacked radiographs of sacroiliac joints). Patients...

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

    Science.gov (United States)

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

    2014-03-01

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

  4. Indirect and direct costs of treating patients with ankylosing spondylitis in the Brazilian public health system.

    Science.gov (United States)

    Azevedo, Valderilio Feijó; Rossetto, Chayanne N; Lorencetti, Pedro G; Tramontin, Mariana Y; Fornazari, Bruna; Araújo, Denizar V

    2016-01-01

    Patients with ankylosing spondylitis require a team approach from multiple professionals, various treatment modalities for continuous periods of time, and can lead to the loss of labour capacity in a young population. So, it is necessary to measure its socio-economic impact. To describe the use of public resources to treat AS in a tertiary hospital after the use of biological medications was approved for treating spondyloarthritis in the Health Public System, establishing approximate values for the direct and indirect costs of treating this illness in Brazil. 93 patients selected from the ambulatory spondyloarthritis clinic at the Hospital de Clínicas of the Federal University of Paraná between September 2011 and September 2012 had their direct costs indirect treatment costs estimation. 70 patients (75.28%) were male and 23 (24.72%) female. The mean age was 43.95 years. The disease duration was calculated based on the age of diagnosis and the mean was 8.92 years (standard deviation: 7.32); 63.44% were using anti-tumour necrotic factor drugs. Comparing male and female patients the mean Bath Ankylosing Spondylitis Disease Activity Index was 4.64 and 5.49 while the mean Bath Ankylosing Spondylitis Functional Index was 5.03 and 6.35 respectively. The Brazilian public health system's spending related to ankylosing spondylitis has increased in recent years. An important part of these costs is due to the introduction of new, more expensive health technologies, as in the case of nuclear magnetic resonance and, mainly, the incorporation of anti-tumour necrotic factor therapy into the therapeutic arsenal. The mean annual direct and indirect cost to the Brazilian public health system to treat a patient with ankylosing spondylitis, according to our findings, is US$ 23,183.56. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  5. Outcome of active disease in ankylosing spondylitis: a prospective study.

    Science.gov (United States)

    Martindale, J; Smith, J; Grennan, D; Goodacre, L; Goodacre, J A

    2010-03-01

    People with ankylosing spondylitis (AS) typically experience episodic exacerbations, but the extent to which they subsequently experience a sustained reduction in disease markers below recognized thresholds for active disease is unclear. To investigate changes in, and associations between, disease markers over 18 months in people with active AS. Within a cohort of 89 participants with AS, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores of 4 or higher were used to identify those with active disease. Standard assessment tools were used to monitor participants prospectively at four consecutive six-monthly intervals. Participants received standard treatments but none received anti-tumor necrosis factor-alpha (TNFalpha) medication during the study. The median age of the cohort was 50 years (inter-quartile range [IQR] 38.5-55.5), the median age of disease onset was 25 years (IQR 18-33) and the median disease duration was 18 years (IQR 13-27). Forty-seven (53%) participants had a BASDAI score of 4 or higher on the first assessment, of whom 45 (51%) scored 4 or higher on all subsequent assessments. Furthermore, 38 (43%) and 16 (18%) participants scored BASDAI 5 or 6, respectively, or higher, throughout. BASDAI scores correlated strongly with Bath Ankylosing Spondylitis Functional Index (BASFI) scores. Compared with 19 (21%) participants whose BASDAI scores were consistently below 4 throughout, participants with persistently high BASDAI scores showed higher scores for anxiety and depression, and some evidence of functional deterioration during the study period. In this cohort, disease markers in most people with active AS were sustained above the standard threshold for active disease. This has important implications for planning care pathways and for optimal utilization of anti-TNFalpha treatment.

  6. Bone Mineral Density in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Bahar Çakmak

    2003-12-01

    Full Text Available Ankylosing Spondylitis (AS, a chronic inflammatory rheumatic disease. One of the most frequent and important complications in these patients is osteoporosis. There are controversial studies on the correlation of osteoporosis and disease duration, activity and functional status. Twenty-one male and five female patients diagnosed as AS according to Modified New York, ESSG( European Spondyloartropaties Study Group and Amor criteria were included in this study. Disease duration and age-sex of the patients was assessed. Patients with ankylosed lumbar spine in late stages of the disease were excluded. Bone mineral density (BMD was measured by DEXA( Hologic at lumbar and femoral neck regions. BASDAI was used for evaluation of disease activity and BASFI index for functional status evaluation.Correlation of BMD with disease duration, BASDAI and BASFI indexes was assessed. BMD at lumbar spine and femoral neck regions was found to be osteoporotic in 11,5 % of the patients. In the lumbar region there was no correlation between BMD and disease duration, BASFI and BASDAI indexes. BMD values of femoral neck showed a weak inverse correlation with disease duration, while no correlation was found between BMD and BASFI and BASDAI. As a conclusion in AS patients osteoporosis besides the disease itself many secondarily influence disease prognosis and complications. Therefore osteoporosis should be evaluated in the management and follow-up of AS patients.

  7. Spondylitis/spondylodiscitis; Spondylitis/Spondylodiszitis

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-06-15

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

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

    Science.gov (United States)

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

    2018-02-02

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

  9. Overview of Ankylosing Spondylitis

    Science.gov (United States)

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

  10. Predicting the outcome of ankylosing spondylitis therapy

    Science.gov (United States)

    Vastesaeger, Nathan; van der Heijde, Désirée; Inman, Robert D; Wang, Yanxin; Deodhar, Atul; Hsu, Benjamin; Rahman, Mahboob U; Dijkmans, Ben; Geusens, Piet; Vander Cruyssen, Bert; Collantes, Eduardo; Sieper, Joachim; Braun, Jürgen

    2011-01-01

    Objectives To create a model that provides a potential basis for candidate selection for anti-tumour necrosis factor (TNF) treatment by predicting future outcomes relative to the current disease profile of individual patients with ankylosing spondylitis (AS). Methods ASSERT and GO–RAISE trial data (n=635) were analysed to identify baseline predictors for various disease-state and disease-activity outcome instruments in AS. Univariate, multivariate, receiver operator characteristic and correlation analyses were performed to select final predictors. Their associations with outcomes were explored. Matrix and algorithm-based prediction models were created using logistic and linear regression, and their accuracies were compared. Numbers needed to treat were calculated to compare the effect size of anti-TNF therapy between the AS matrix subpopulations. Data from registry populations were applied to study how a daily practice AS population is distributed over the prediction model. Results Age, Bath ankylosing spondylitis functional index (BASFI) score, enthesitis, therapy, C-reactive protein (CRP) and HLA-B27 genotype were identified as predictors. Their associations with each outcome instrument varied. However, the combination of these factors enabled adequate prediction of each outcome studied. The matrix model predicted outcomes as well as algorithm-based models and enabled direct comparison of the effect size of anti-TNF treatment outcome in various subpopulations. The trial populations reflected the daily practice AS population. Conclusion Age, BASFI, enthesitis, therapy, CRP and HLA-B27 were associated with outcomes in AS. Their combined use enables adequate prediction of outcome resulting from anti-TNF and conventional therapy in various AS subpopulations. This may help guide clinicians in making treatment decisions in daily practice. PMID:21402563

  11. The role of land and aquatic exercise in ankylosing spondylitis: a systematic review.

    Science.gov (United States)

    Zão, Ana; Cantista, Pedro

    2017-12-01

    Ankylosing spondylitis (AS) is a chronic and inflammatory rheumatic disease, characterized by pain and structural and functional impairments, such as reduced mobility and axial deformity, which lead to diminished quality of life. Its treatment includes not only drugs, but also nonpharmacological therapy. Exercise appears to be a promising modality. The aim of this study is to review the current evidence and evaluate the role of exercise either on land or in water for the management of patients with AS in the biological era. Systematic review of the literature published until November 2016 in Medline, Embase, Cochrane Library, Web of Science and Scopus databases. Thirty-five studies were included for further analysis (30 concerning land exercise and 5 concerning water exercise; combined or not with biological drugs), comprising a total of 2515 patients. Most studies showed a positive effect of exercise on Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, pain, mobility, function and quality of life. The benefit was statistically significant in randomized controlled trials. Results support a multimodal approach, including educational sessions and maintaining home-based program. This study highlights the important role of exercise in management of AS, therefore it should be encouraged and individually prescribed. More studies with good methodological quality are needed to strengthen the results and to define the specific characteristics of exercise programs that determine better results.

  12. Functional Genomics and Its Bench-to-Bedside Translation Pertaining to the Identified Susceptibility Alleles and Loci in Ankylosing Spondylitis.

    Science.gov (United States)

    Kenna, Tony J; Hanson, Aimee; Costello, Mary-Ellen; Brown, Matthew A

    2016-10-01

    Ankylosing spondylitis (AS) is a highly heritable disease for which there is a great unmet need for improved therapies. Genetics research has identified several major pathways involved in the disease, from which treatments have either now entered clinical practice or are in development. In particular, therapies targeting the IL-23 pathway were repositioned for use in AS following the discovery of multiple genes in the pathway as determinants of AS risk. Discovery of the association of aminopeptidase genes with AS, and subsequently with psoriasis, inflammatory bowel disease and other conditions, has triggered research into therapies targeting this pathway. The AS-genetic associations point to involvement of gut mucosal immunity in driving disease, and metagenomic studies have provided strong support that AS is a disease driven by interaction between the gut microbiome and host immune system, providing a rationale for the exploration of gut-targeted therapies for the disease.

  13. Adherence to treatment in patients with ankylosing spondylitis.

    Science.gov (United States)

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

    2013-07-01

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

  14. A long-term, observational cohort study on the safety of low-dose glucocorticoids in ankylosing spondylitis: adverse events and effects on bone mineral density, blood lipid and glucose levels and body mass index.

    Science.gov (United States)

    Zhang, Yu-Ping; Gong, Yao; Zeng, Qing Yu; Hou, Zhi-Duo; Xiao, Zheng-Yu

    2015-06-03

    This study aimed to investigate the risk of adverse events and effects on bone mineral density (BMD), blood lipid and glucose levels and body mass index (BMI) of low-dose glucocorticoid (GC) treatment in ankylosing spondylitis. We performed a retrospective, observational cohort study. Adverse effects were compared between GC users and non-GC users, and we analysed differences in the duration of GC exposure (no GC exposure, 2 years). Outpatient clinic in a tertiary general hospital in China, rheumatology follow-up visits over the past 30 years. We included 830 patients with ankylosing spondylitis who were followed up for at least 6 months without a previous history or current complications of active gastrointestinal problems, hypertension, psychiatric or mental problems, diabetes mellitus, tuberculosis and hepatitis. The median follow-up time was 1.6 years (range 0.5-15 years, a total of 1801 patient-years). A total of 555 (66.9%) patients were treated with low-dose GCs, and the median cumulative duration of GC therapy was 1.3 years (range 0.1-8.5 years). Dermatological incidents, including acne, bruisability and cutaneous infections, were the most common adverse events, with a cumulative incidence rate of 5.4% (22.2 events per 1000 patient-years), followed by a puffy and rounded face (1.6%), symptoms of weight gain (1.1%) and serious infections (1.0%). The rates of all other types of adverse events were less than 1%. The GC groups (GC users and non-GC users) and the duration of GC therapy were not associated with the frequency of low BMD, dyslipidaemia, hyperglycaemia or obesity (peffect on BMD, blood lipid and glucose levels and BMI. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Patellar Tendon Properties and Lower Limb Function in Rheumatoid Arthritis and Ankylosing Spondylitis versus Healthy Controls: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Verena Matschke

    2013-01-01

    Full Text Available Objective. Rheumatoid arthritis (RA and ankylosing spondylitis (AS lead to inflammation in tendons and peritendinous tissues, but effects on biomechanical tendon function are unknown. This study investigated patellar tendon (PT properties in stable, established RA and AS patients. Methods. We compared 18 RA patients (13 women, 59.0 ± 2.8 years, mean ± SEM with 18 age- and sex-matched healthy controls (58.2 ± 3.2 years, and 12 AS patients (4 women, 52.9 ± 3.4 years with 12 matched controls (54.5 ± 4.7 years. Assessments with electromyography, isokinetic dynamometry, and ultrasound included quadriceps muscle force and cross-sectional area (CSA, PT stiffness, and PT CSA. Additionally, measures of physical function and disease activity were performed. Results. PT stiffness and physical function were lower in RA and AS patients compared to healthy controls, without a significant difference in force production. PT CSA was significantly larger leading to reduction in Young’s modulus (YM in AS, but not in RA. Conclusion. The adverse changes in PT properties in RA and AS may contribute to their impaired physical function. AS, but not RA, leads to PT thickening without increasing PT stiffness, suggesting that PT thickening in AS is a disorganised repair process. Longitudinal studies need to investigate the time course of these changes and their response to exercise training.

  16. Regulatory T cells in ankylosing spondylitis and the response after adalimumab treatment.

    Science.gov (United States)

    Liao, Hsien-Tzung; Lin, Yuh-Feng; Tsai, Chang-Youh; Chou, Chung-Tei

    2015-12-01

    The aim of this study was to investigate the role of regulatory T cells (Tregs) in ankylosing spondylitis (AS). We included 69 AS patients (15 of them received anti-tumor necrosis factor-apha agent-adalimumab) in the study and used a questionnaire to record the demographic data, disease activity index, functional index, human leukocyte antigen-B27, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Thirty healthy subjects were used as controls. The peripheral blood mononuclear cells (PMBCs) were stained with anti-CD4, anti-CD25 and anti-Forkhead/winged helix transcription factor P3 (anti-FoxP3) antibodies and flow-cytometry was used to determine cell populations. The percentages of Tregs in PMBCs were significantly higher in AS patients than in healthy controls. In AS patients who had poor disease functional index with higher levels of ESR and CRP were positively and significantly correlated with Tregs percentages in PMBCs. After adalimumab treatment in 15 patients, the percentages of Tregs, the ESR/CRP levels and the Bath Ankylosing Spondylitis Disease Activity Index/Bath Ankylosing Spondylitis Functional Index were significantly and gradually decreased over time. The high expression of FoxP3 and CD25 on CD4(+) T cells in PBMCs in AS patients was noted, and could be reversed by adalimumab therapy. These findings suggest that Tregs may play a role in modulating the inflammatory process in AS. Whether Tregs can be taken as a predictor for disease activity or treatment outcome is unclear and requires further study. Copyright © 2015 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  17. Ankylosing Spondylitis patients with Type D personality have worse clinical status.

    Science.gov (United States)

    Erkol İnal, Esra; Demirci, Kadir; Doğru, Atalay; Şahin, Mehmet

    2016-01-01

    Type D personality was identified as an important factor that can explain the differences in clinical outcomes in various diseases. The aim of this study is to clarify the relationships between Type D personality and clinical status of patients with Ankylosing Spondylitis (AS). The scores of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS)-C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), the Bath Ankylosing Spondylitis Functional Index (BASFI), the 36-Item Short-Form Health Survey (SF-36), and 14-item Type D Scale (DS-14) were noted. We found significantly higher levels of the BASDAI, the BASFI, and the SF-36 mental subscale scores in patients with Type D personalities compared to those who were Non-Type D (p < 0.05). The total DS-14 scores were found to be correlated with the scores of physical and mental subscales of SF-36, the BASDAI, the BASFI, ASDAS-CRP, and ESR (p < 0.05). In logistic regression analysis, the occurrence of Type D personality was found to be an independent predictor for disease activity of AS due to BASDAI and ASDAS-ESR (p = 0.016, OR, 95% CI = 2.98,1.23-7.22; p = 0.022, OR, 95% CI = 2.78,1.16-6.63 respectively). Patients may over-rate self-reported measurements such as the BASDAI, BASFI, and SF-36 related to their interpersonal characteristics. Therefore, including the Type D personality, which is a stable construct in evaluating AS patients with brief and valid DS-14, may be noteworthy.

  18. Absence of radiographic progression of hip arthritis during infliximab treatment for ankylosing spondylitis.

    Science.gov (United States)

    Konsta, M; Sfikakis, P P; Bournia, V K; Karras, D; Iliopoulos, A

    2013-08-01

    This study aims to examine the impact of long-term treatment with the anti-TNF antibody infliximab on radiographic progression of hip arthritis in ankylosing spondylitis. Anteroposterior X-rays of the pelvis obtained at baseline from consecutive patients with ankylosing spondylitis and bilateral hip arthritis were compared with X-rays obtained after 6 ± 2.5 years (mean ± SD) of continuous infliximab treatment. Analysis was performed by the Bath Ankylosing Spondylitis Radiology Hip Index (BASRI-h) scoring system (min 0, max 4). Hip joint space width was also assessed by the average of measurements at three distinct sites between the acetabulum and femoral head. In 23 patients with active disease (21 men, mean age and disease duration of 45 and 16 years, respectively), the BASRI-h score at baseline was 1 in 7, 2 in 16, 3 in 16, and 4 in 7 hips (including two arthroplasties). Individual BASRI-h scores at baseline (2.50 ± 0.86, mean ± SD) remained unchanged in all patients at end of follow-up. At baseline, the average width of the whole joint space (3.56 ± 0.70 mm, n = 44) was not associated with disease activity measurements but negatively correlated with BAS functional index (Spearman r = -0.5, P = 0.007). After 2-10 years of infliximab treatment, the average width of the whole joint space in these patients (3.59 ± 0.79 mm) was not reduced. These results suggest that radiographic progression of hip arthritis in ankylosing spondylitis may be arrested during infliximab treatment.

  19. Andersson lesions of whole spine magnetic resonance imaging compared with plain radiography in ankylosing spondylitis.

    Science.gov (United States)

    Kim, Seong-Kyu; Shin, Kichul; Song, Yoonah; Lee, Seunghun; Kim, Tae-Hwan

    2016-12-01

    The objective of this study was to identify the characteristics of Andersson lesions using whole spine magnetic resonance imaging (MRI) compared with plain radiography in ankylosing spondylitis (AS). A total of 62 patients with AS who had undergone whole spine MRI and plain radiography were retrospectively enrolled in this study. We compared the number of discovertebral units (DVUs) with Andersson lesions with clinical and radiographic indices such as erythrocyte sediment rate (ESR), C-reactive protein (CRP), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), and modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Fifty-three patients (85.5 %) by whole spine MRI and 23 patients (37.1 %) by plain radiography had at least one Andersson lesion. We found 129 DVUs with Andersson lesions (11.1 %) by MRI and 35 DVUs by plain radiography over all the spine levels. Andersson lesions by MRI were most commonly detected at the lower thoracic spine (from T7-8 to T12-L1). Among the 151 total Andersson lesions by whole spine MRI, 41 were identified as central disc type, 26 as anterior peripheral disc type, 44 as posterior peripheral disc type, and 40 as diffuse disc type. However, the number of Andersson lesions did not correlate with ESR, CRP, BASDAI, BASFI, or mSASSS (p > 0.05 for all). Our study indicates that the presence of Andersson lesions in patients with AS is clearly underestimated. MRI is a superior technique for detecting early Andersson lesions compared with plain radiography.

  20. Imaging in spondylitis

    NARCIS (Netherlands)

    van der Heijde, Désirée; Landewé, Robert

    2005-01-01

    The purpose of this review is to describe and evaluate recent findings with respect to imaging in ankylosing spondylitis. The review includes articles from the literature that were published in 2004. Three types of articles are described: methodological studies aimed at validating scoring methods

  1. Imaging in ankylosing spondylitis

    NARCIS (Netherlands)

    Maksymowych, Walter P.; Landewé, Robert

    2006-01-01

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

  2. Investigating the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis.

    Science.gov (United States)

    Kisacik, Pinar; Unal, Edibe; Akman, Umit; Yapali, Gokmen; Karabulut, Erdem; Akdogan, Ali

    2016-02-01

    The purpose of this study is to investigate the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis (AS). The BATH Indexes, Dougados Functional Index (DFI), Health Assessment Questionnaire in Spondyloarthopathies (HAQ-S), Ankylosing Spondylitis Quality of Life (ASQoL) and Beck Depression Inventory (BDI) were used to evaluate twenty-four female AS patients. ESR, CRP, TNF-α and IL-6 were also analyzed. All patients were assessed at baseline and with 3 weeks intervals till 12 week. A multidimensional exercise program was applied for three times a week. There were significant differences in Bath Ankylosing Spondylitis Global Index (BAS-G) and Disease Activity Index (BASDAI), HAQ-S, ASQoL and BDI scores (p < 0.05). The level of the ESR, CRP and IL-6 fluctuated slightly. There was only significant difference at 3 and 12 weeks as compared to baseline levels in TNF-α values (p = 0.048, p < 0.001). We concluded that multidimensional exercise program should be taken into consideration for AS patients due to its positive effects on symptoms and antiinflammatory effects. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2014-06-01

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

  4. T lymphocyte subset imbalances in patients contribute to ankylosing spondylitis

    Science.gov (United States)

    WANG, CHENGGONG; LIAO, QIANDE; HU, YIHE; ZHONG, DA

    2015-01-01

    Ankylosing spondylitis is a chronic inflammatory rheumatic disease, which is characterized by inflammation of the spine and the sacroiliac joints. To date, the disease etiology remains unclear. In the present study, the correlation of T lymphocyte subset changes with the progression of ankylosing spondylitis was investigated. A total of 55 patients with ankylosing spondylitis (22 severe and 23 mild cases) and 20 healthy individuals were selected. Firstly, the punctured cells in the lesions and the serum were collected, and the lymphocytes and the peripheral blood mononuclear cells were prepared. Secondly, quantitative PCR, ELISA and flow cytometry analyses were carried out to detect the levels of a series of immunoglobulins, complements, helper T cells, cytotoxic T cells, regulatory cells and cytokines. The expression levels of α-globulin, γ-globulin, immunoglobulin (Ig)G, IgA, IgM, serum complement C3, and complement C4 were found to be significantly increased in ankylosing spondylitis patients. In addition, the percentage of Th1 and Th17 cells was found to be significantly higher in the ankylosing spondylitis groups (mild and severe) compared with the healthy individuals. As a result, the Th1/Th2 and Th17/Treg ratios were significantly higher in patients with ankylosing spondylitis. In addition, T lymphocyte subset ratio imbalances contributed to an increased expression of immune mediators, including interferon (IFN)-γ and interleukin (IL)-17A. The mRNA and protein expression levels of IFN-γ and IL-17A were found to be higher in the ankylosing spondylitis groups compared with the control group. The present study provided further evidence on the function and underlying mechanism of T lymphocyte subsets, which may be useful in the diagnosis and treatment of ankylosing spondylitis. PMID:25452811

  5. T lymphocyte subset imbalances in patients contribute to ankylosing spondylitis.

    Science.gov (United States)

    Wang, Chenggong; Liao, Qiande; Hu, Yihe; Zhong, DA

    2015-01-01

    Ankylosing spondylitis is a chronic inflammatory rheumatic disease, which is characterized by inflammation of the spine and the sacroiliac joints. To date, the disease etiology remains unclear. In the present study, the correlation of T lymphocyte subset changes with the progression of ankylosing spondylitis was investigated. A total of 55 patients with ankylosing spondylitis (22 severe and 23 mild cases) and 20 healthy individuals were selected. Firstly, the punctured cells in the lesions and the serum were collected, and the lymphocytes and the peripheral blood mononuclear cells were prepared. Secondly, quantitative PCR, ELISA and flow cytometry analyses were carried out to detect the levels of a series of immunoglobulins, complements, helper T cells, cytotoxic T cells, regulatory cells and cytokines. The expression levels of α-globulin, γ-globulin, immunoglobulin (Ig)G, IgA, IgM, serum complement C3, and complement C4 were found to be significantly increased in ankylosing spondylitis patients. In addition, the percentage of Th1 and Th17 cells was found to be significantly higher in the ankylosing spondylitis groups (mild and severe) compared with the healthy individuals. As a result, the Th1/Th2 and Th17/Treg ratios were significantly higher in patients with ankylosing spondylitis. In addition, T lymphocyte subset ratio imbalances contributed to an increased expression of immune mediators, including interferon (IFN)-γ and interleukin (IL)-17A. The mRNA and protein expression levels of IFN-γ and IL-17A were found to be higher in the ankylosing spondylitis groups compared with the control group. The present study provided further evidence on the function and underlying mechanism of T lymphocyte subsets, which may be useful in the diagnosis and treatment of ankylosing spondylitis.

  6. Effects of tumor necrosis factor-α inhibitors in mothers and daughters concordant for HLA-B27-positive ankylosing spondylitis.

    Science.gov (United States)

    Caso, Francesco; Costa, Luisa; Del Puente, Antonio; Rigante, Donato; Selmi, Carlo; Fabbroni, Marta; Scarpa, Raffaele; Galeazzi, Mauro; Frediani, Bruno; Cantarini, Luca

    2015-01-01

    Pharmacogenomics is considered as the new frontier to predict the response to treatments and it can also be based on the comparison of family members being treated for the same condition. No data are available on the impact of anti-tumour necrosis factor (TNF)-α therapies in members of the same family with ankylosing spondylitis (AS). We describe three mother-daughter couples concordant for AS and HLA-B27, both treated with TNF-α inhibitors, for whom the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP were evaluated during a follow-up of 24 months. All patients manifested improvements of all scores, but the daughters had a more prominent effect achieving faster complete disease remission. We hypothesise that longer standing chronic inflammation and older age may cause a less prompt and effective response to treatment in SA when compared with their genetically related controls.

  7. Assessment of relation between neutrophil lympocyte, platelet lympocyte ratios and epicardial fat thickness in patients with ankylosing spondylitis.

    Science.gov (United States)

    Boyraz, Ismail; Onur Caglar, Sabri; Erdem, Fatma; Yazici, Mehmet; Yazici, Selma; Koc, Bunyamin; Gunduz, Ramazan; Karakoyun, Ahmet

    2016-02-01

    To investigate whether there is a relation between neutrophillymphocyte (N/L) and platelet- lymphocyte (P/L) ratios and epicardial adipose tissue (EAT) thickness in patients with ankylosing spondylitis (AS). Thirty patients diagnosed with ankylosing spondylitis and 25 healthy people (controls) were included in the study. Age, gender, body mass index (BMI), height, hemogram, sedimentation, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, CRP, hepatic and renal function tests, lipid profile of the all patients were recorded. Data related to duration of the disease, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) values of the cases in the patient group were obtained. A cardiologist measured EAT thickness by ECHO in both patient and control groups. In the patient group, mean BASDAI and BASFI scores were 2.48±2.21 and 1.5±2.07, respectively. Age, gender, BMI values did not show statistically significant difference between the patient and the control groups. N/L and P/L ratios did not change significantly in the patient group having higher EAT, BASFI values and taking anti-TNF compared to the control group. In patients with AS, EAT measurements, which are related to inflammatory response increase, can be used for monitoring of the risk of development of cardiac disease. We could not find the relation between EAT and N/L, P/L ratios in terms of evaluation of inflammatory response. Copyright© by the Medical Assotiation of Zenica-Doboj Canton.

  8. Association of GSTM1, GSTT1, GSTP1-ILE105VAL and ACE I/D polymorphisms with ankylosing spondylitis.

    Science.gov (United States)

    İnal, Esra Erkol; Görükmez, Orhan; Eroğlu, Selma; Görükmez, Özlem; Solak, Özlem; Topak, Ali; Yakut, Tahsin

    2016-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown origin. The aim of this study is to clarify the relationships between susceptibility and severity of AS and GST-mu1 (GSTM1), GST-theta1 (GSTT1), GST-pi1 (GSTP1)-Ile105Val and angiotensin-converting enzyme (ACE) I/D polymorphisms in AS patients. One hundred thirty-eight AS patients and seventy-one healthy controls were enrolled in this study. Erythrocyte sedimentation rate and C-reactive protein (CRP) levels of the AS patients were recorded. The scores of the numeric rating scale (NRS) pain, the Bath Ankylosing Spondylitis Activity Index, the Bath Ankylosing Spondylitis Metrology Index and the Bath Ankylosing Spondylitis Functional Index were calculated. The genotypes distributions and allele frequencies of GSTM1, GSTT1, GSTP1-Ile105Val and ACE I/D polymorphisms were compared between patients and healthy controls. The Multiplex polymerase chain reaction (PCR) and the PCR-restriction fragment length polymorphism methods were used to detect the polymorphisms of ACE I/D, the GSTT1 and GSTM1 genes and the GSTP1-Ile105Val polymorphism, respectively. There were significantly higher levels of the GSTT1 null and the ACE II genotypes in AS patients compared to those in healthy controls (p = 0.002 and 0.005, respectively). We found significantly higher levels of CRP and the NRS pain scores in the patients with ACE ID or DD genotypes compared to those in the patients with ACE II genotypes (p = 0.005 and 0.035, respectively). The present results showed that genes involved in protection from oxidative stress and ACE gene may influence disease development and course in AS.

  9. Relationship of serum osteoprotegerin with arterial stiffness, preclinical atherosclerosis, and disease activity in patients with ankylosing spondylitis.

    Science.gov (United States)

    Serdaroğlu Beyazal, Münevver; Erdoğan, Turan; Türkyılmaz, Aysegül Kücükali; Devrimsel, Gül; Cüre, Medine Cumhur; Beyazal, Mehmet; Sahin, Ismail

    2016-09-01

    Patients with ankylosing spondylitis (AS) reportedly have a higher mortality and morbidity risk. Osteoprotegerin (OPG) was recently defined as an important cardiovascular (CV) marker in the general population. We aimed to assess the relationship of serum OPG levels with arterial stiffness, carotid intima media thickness (CIMT), and clinical and laboratory data in AS patients. We examined 60 AS patients without CV disease or risk factors and 50 healthy controls. Disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS), whereas functional capacity was evaluated using the Bath Ankylosing Spondylitis Functional Index (BASFI). Serum OPG levels were measured with the enzyme-linked immunosorbent assay. Carotid-femoral pulse wave velocity (PWV) was used as an indicator of arterial stiffness, whereas CIMT (examined via carotid ultrasonography) was used to evaluate preclinical atherosclerosis. The mean serum OPG level, PWV, and CIMT were significantly higher in AS patients than in controls (106.7 ± 50.9 vs. 58.1 ± 12.7 pg/mL; 7.4 ± 1.8 vs. 6.2 ± 1.2 m/s; 0.72 ± 0.13 vs. 0.57 ± 0.07 mm, respectively; P < 0.001 for all). In AS patients, the serum OPG levels were not significantly correlated with PWV and CIMT but were significantly correlated with erthrocyte sedimentation rate, BASFI, and ASDAS. AS patients without CV disease or risk exhibited high OPG levels and increased PWV and CIMT values. Although OPG levels were not significantly correlated with PWV or CIMT, future long-term follow-up studies will help define the predictive value of OPG in these patients.

  10. Imaging in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Lambert, Robert G W

    2012-01-01

    Imaging is an integral part of the management of patients with ankylosing spondylitis and axial spondyloarthritis. Characteristic radiographic and/or magnetic resonance imaging (MRI) findings are key in the diagnosis. Radiography and MRI are also useful in monitoring the disease. Radiography...... and sensitivity to change, become a new standard method for assessment of structural damage. Ultrasonography allows visualization of peripheral arthritis and enthesitis, but has no role in the assessment of axial manifestations. Computed tomography is a sensitive method for assessment of structural changes...

  11. Two exercise interventions for the management of patients with ankylosing spondylitis: a randomized controlled trial.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Alonso-Blanco, Cristina; Morales-Cabezas, Matilde; Miangolarra-Page, Juan Carlos

    2005-06-01

    The purpose of this clinical trial was to evaluate the impact of a 4-month comprehensive protocol of strengthening and flexibility exercises developed by our research group versus conventional exercises for patients with Ankylosing Spondylitis (AS) on functional and mobility outcomes. Randomized controlled trial. Forty-five patients diagnosed with AS according to the modified criteria of New York were allocated to control or experimental groups using a random numbers table. The control group was treated with a conventional protocol of physical therapy in AS, whereas the experimental group was treated with the protocol suggested by our research group. The conventional intervention consisted of 20 exercises: motion and flexibility exercises of the cervical, thoracic, and lumbar spine; stretching of the shortened muscles; and chest expansion exercises. The experimental protocol is based on the postural affectation of the AS and the treatment of the shortened muscle chains in these patients according to the Global Posture Reeducation (GPR) method. This intervention employs specific strengthening and flexibility exercises in which the shortened muscle chains are stretched and strengthened. The study lasted 4 mos. During this period, patients received a weekly group session managed by an experienced physiotherapist. Each session lasted an hour, and there were 15 total sessions. Changes in activity, mobility, and functional capacity were evaluated by an assessor blinded to the intervention, using the following previously validated scores from the Bath group: BASMI (tragus to wall distance, modified Schober test, cervical rotation, lumbar side flexion, and intermalleolar distance), BASDAI (The Bath Ankylosing Spondylitis Disease Activity Index), and BASFI (The Bath Ankylosing Spondylitis Functional Index). Both groups showed an improvement (prepost scores) in all the outcome measures, mobility measures of the BASMI index, as well as in BASFI and BASDAI indexes. In the

  12. Development of a prognostic score for work disability in Romanian patients with ankylosing spondylitis.

    Science.gov (United States)

    Oancea, Corina; Mihai, Carina; Gherman, Despina; Milicescu, Mihaela; Ancuta, Ioan; Martin, Andrei; Bojinca, Mihai; Stoica, Victor; Ciuvica, Maria Magdalena

    2015-01-01

    To develop a prognostic score for predicting work disability (WD) in patients with ankylosing spondylitis (AS) as strong indicator for poor vocational rehabilitation. A cross-sectional study was performed in a group of 170 patients with AS, 120 work disabled and 50 still employed. The variables strongly associated with WD were quantified (scored 0-30) - abnormalities of: anterior-posterior radiograph of pelvis, lateral cervical spine radiograph and lung function tests, certain work factors (occupation, physical strain and microclimate), Bath Ankylosing Spondylitis Mobility Index and Bath Ankylosing Spondylitis Functional Index tests. The eight-item score identifies WD with sensitivity of 91.7% and specificity of 85.7%. The scaling properties were fulfilled: internal consistency - Chronbach's alpha 0.73; reliability - intraclass correlation coefficient 0.73; redundancy weak-moderate, with coefficients ranging from 0.032 to 0.797; the discriminative capacity by the significant variations of the score according to the statute (employed or work disabled) and the degree of WD. The score is a reliable method for assessing the WD risk in patients with AS. It allows a complex evaluation by performing minimal investigations and it is easy to perform. Work disability is an important outcome in AS, determined by numerous variables but highly dependent on the national characteristics of economy, social security and healthcare system. The prognostic score for work disability in AS not only contains medical but also socio-demographic and work-related factors and is expected to be a useful tool for specialists to guide the tertiary prevention-oriented rehabilitation measures. Our study suggests the prognostic score to be comprehensive, useful and a reliable method to assess the risk of work disability in AS.

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

    Directory of Open Access Journals (Sweden)

    Nedović Jovan

    2009-01-01

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

  14. The Effectiveness of Structured Group Education on Ankylosing Spondylitis Patients.

    Science.gov (United States)

    Kasapoglu Aksoy, Meliha; Birtane, Murat; Taştekin, Nurettin; Ekuklu, Galip

    2017-04-01

    Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease that affects the axial skeleton which can lead to structural and functional impairments. It has a negative impact on the person's daily life activities. Early diagnosis, exercise and patient education are factors playing a major role on prognosis. The purpose of the study was to compare the structured theoretical and exercise educational program with routine clinic educational efforts on the parameters of the disorder over a 3 month follow up. This randomized, educational intervention study was performed on 41 AS patients. A 5 day structured education and exercise program was applied to the first group of patients (Group 1) in subgroups consisting 4-5 patients each. Patients had group exercises throughout the education program. The second group followed routine clinical care. The effectiveness of the treatment was assessed by Bath ankylosing spondylitis functional (BASFI), Bath ankylosing spondylitis disease activity (BASDAI), Bath ankylosing spondylitis global (BAS-G), Bath ankylosing spondylitis metrology indices (BASMI), chest expansion, short form-36 (SF-36), ankylosing spondylitis quality of life scale (ASQoL) and laboratory parameters in all patients. Patients were evaluated on initiation and after 3 months. Significant improvements in BASFI, BASDAI and BAS-G, chest expansion, SF-36 and ASQoL indices were observed in Group 1 No difference could be found in BASMI and chest expansion. A structured educational and exercise intervention had a positive effect on the functional status,disease activity, and general well-being and quality of life. It also, shows that education programs should be within the routine treatment program for AS.

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

    Science.gov (United States)

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

    2015-06-01

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

  16. Neutrophil-Lymphocyte Ratio Connected to Treatment Options and Inflammation Markers of Ankylosing Spondylitis.

    Science.gov (United States)

    Gökmen, Ferhat; Akbal, Ayla; Reşorlu, Hatice; Gökmen, Esra; Güven, Mustafa; Aras, Adem Bozkurt; Erbağ, Gökhan; Kömürcü, Erkam; Akbal, Erdem; Coşar, Murat

    2015-07-01

    In recent years, white blood cells (WBCs) and their subtypes have been studied in relation to inflammation. The aim of our study was to assess the relationship between neutrophil-lymphocyte ratio (NLR) and ankylosing spondylitis (AS). We enrolled a total of 177 patients, 96 AS and 81 healthy controls. Complete blood count, WBC, neutrophil and lymphocyte levels were measured, and the NLR was calculated. In the assessment of AS, we used the erythrocyte sedimentation rate, C-reactive protein (CRP), the Bath Ankylosing Spondylitis Disease Activity Index, and the Bath Ankylosing Spondylitis Functional Index. In the present study, 96 AS and 81 healthy individuals were enrolled. The mean age was 43.8 ± 12.9 and 46.5 ± 11.2 years, respectively. Mean disease duration of AS patients was 6.9 ± 5.6 years (median = 5, min-max = 1-25). The patients with AS had a higher NLR than the control individuals (mean NLR, 2.24 ± 1.23 and 1.73 ± 0.70, respectively, P < 0.001). A statistically significant positive correlation was observed between NLR and CRP (r = 0.322, P = 0.01). The patients receiving antitumor necrosis factor α therapy had a lower NLR than the patients receiving nonsteroidal anti-inflammatory drug therapy (mean NLR, 1.71 ± 0.62 and 2.41 ± 1.33, respectively, P = 0.02). NLR may be seen as a useful marker for demonstrating inflammation together with acute phase reactants such as CRP and in evaluating the effectiveness of anti-TNF-α therapy. © 2014 Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2015-06-01

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

  18. Mortality in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Exarchou, Sofia; Lie, Elisabeth; Lindström, Ulf

    2016-01-01

    OBJECTIVES: Information on mortality in ankylosing spondylitis (AS) is scarce. Our study therefore aimed to assess: (1) mortality in AS versus the general population, and (2) predictors of death in the AS population. METHODS: Nationwide cohorts of patients with AS diagnosed at rheumatology...... mortality and predictors for death in the AS cohort. RESULTS: There were 496 deaths in the AS cohort and 1533 deaths in the control cohort resulting in an age-adjusted and sex-adjusted HR of 1.60 (95% CI 1.44 to 1.77), with increased mortality for men (age-adjusted HR=1.53, 95% CI 1.36 to 1.72) and women...... (age-adjusted HR=1.83, 95% CI 1.50 to 2.22). Within the AS cohort, statistically significant predictors for death were a lower level of education, general comorbidities (diabetes, infections, cardiovascular, pulmonary and malignant diseases) and previous hip replacement surgery. CONCLUSIONS: Mortality...

  19. Variance Function Partially Linear Single-Index Models1.

    Science.gov (United States)

    Lian, Heng; Liang, Hua; Carroll, Raymond J

    2015-01-01

    We consider heteroscedastic regression models where the mean function is a partially linear single index model and the variance function depends upon a generalized partially linear single index model. We do not insist that the variance function depend only upon the mean function, as happens in the classical generalized partially linear single index model. We develop efficient and practical estimation methods for the variance function and for the mean function. Asymptotic theory for the parametric and nonparametric parts of the model is developed. Simulations illustrate the results. An empirical example involving ozone levels is used to further illustrate the results, and is shown to be a case where the variance function does not depend upon the mean function.

  20. Kunxian capsules in the treatment of patients with ankylosing spondylitis: a randomized placebo-controlled clinical trial.

    Science.gov (United States)

    Li, Qiuxia; Li, Li; Bi, Liqi; Xiao, Changhong; Lin, Zhiming; Cao, Shuangyan; Liao, Zetao; Gu, Jieruo

    2016-07-22

    Ankylosing spondylitis (AS) is a chronic inflammatory autoimmune disease. Kunxian capsule, a Chinese patent medicine which has been used in the treatment of immunologic diseases for many years in China, has anti-inflammatory and immunoregulatory effects. This study investigates the efficacy and safety of Kunxian capsules in the treatment of AS. This was a randomized, double-blind, parallel control clinical trial involving 80 patients with AS who fulfilled the modified New York criteria (1984) and had active disease defined by a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥40 mm under background stable nonsteroidal anti-inflammatory drugs (NSAIDs) for more than 4 weeks. Patients were randomly divided into two groups, the Kunxian group and the placebo group, and Kunxian (0.6 g, three times per day) and the placebo were provided for 12 weeks. The primary endpoint was the Assessment of SpondyloArthritis international Society (ASAS) 20 response rate at week 12. The secondary endpoints were ASAS 40, BASDAI 50, the Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), and Ankylosing Spondylitis Disease Activity Score on the basis of C-reactive protein level (ASDAS-CRP) at weeks 2, 6, and 12. The primary endpoint of ASAS 20 at week 12 was achieved in 13 of 35 patients (37.1 %) among the Kunxian group, compared with 4 of 33 (12.1 %) in the placebo group (p < 0.05). Significant improvement (BASDAI 50) was also observed between the Kunxian group and the placebo group at week 6 (14 (40 %) and 5 (15.5 %), respectively, p < 0.05). At weeks 2, 6, and 12, the ASDAS-CRP level of the Kunxian group was significantly lower than that of the placebo group, especially at week 6 (p < 0.01). Kunxian obviously reduced CRP levels compared to placebo at weeks 2, 6, and 12 (p < 0.05). Compared with the placebo, Kunxian was associated with greater improvements in signs and symptoms of patients with AS

  1. The Maslov index in weak symplectic functional analysis

    DEFF Research Database (Denmark)

    Booss-Bavnbek, Bernhelm; Zhu, Chaofeng

    2013-01-01

    We recall the Chernoff-Marsden definition of weak symplectic structure and give a rigorous treatment of the functional analysis and geometry of weak symplectic Banach spaces. We define the Maslov index of a continuous path of Fredholm pairs of Lagrangian subspaces in continuously varying Banach...... spaces. We derive basic properties of this Maslov index and emphasize the new features appearing....

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-06-15

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

  3. [Evaluation of performance of BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) in a Brazilian cohort of 1,492 patients with spondyloarthritis: data from the Brazilian Registry of Spondyloarthritides (RBE)].

    Science.gov (United States)

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

    2015-01-01

    To analyze the results of the application of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in a large series of Brazilian patients with the diagnosis of SpA and establish its correlations with specific variables into the group. A common protocol of investigation was prospectively applied to 1492 Brazilian patients classified as SpA according to the European Spondyoarthropathies Study Group (ESSG), attended at 29 referral centers of Rheumatology in Brazil. Clinical and demographic variables, and disease indices (BASDAI, Basfi, Basri, Mases, ASQol) were applicated. The total values of BASDAI were compared to the presence of the different variables. The mean score of BASDAI was 4.20 ± 2.38. The mean scores of BASDAI were higher in patients with the combined (axial + peripheral + entheseal) (4.54 ± 2.38) clinical presentation, compared to the pure axial (3.78 ± 2.27) or pure peripheral (4.00 ± 2.38) clinical presentations (p<0.001). BASDAI also presented higher scores associated with the female gender (p<0.001) and patients who did not practice exercises (p < 0.001). Regarding the axial component, higher values of BASDAI were significantly associated with inflammatory low back pain (p<0.049), alternating buttock pain (p<0.001), cervical pain (p<0.001) and hip involvement (p<0.001). There was also statistical association between BASDAI scores and the peripheral involvement, related to the lower (p=0.004) and upper limbs (p=0.025). The presence of enthesitis was also associated to higher scores of BASDAI (p=0.040). Positive HLA-B27 and the presence of cutaneous psoriasis, inflammatory bowel disease, uveitis and urethritis were not correlated with the mean scores of BASDAI. Lower scores of BASDAI were associated with the use of biologic agents (p<0.001). In this heterogeneous Brazilian series of SpA patients, BASDAI was able to demonstrate "disease activity" in patients with axial as well as peripheral disease. Copyright © 2014 Elsevier Editora Ltda

  4. A longitudinal study of fecal calprotectin and the development of inflammatory bowel disease in ankylosing spondylitis.

    Science.gov (United States)

    Klingberg, Eva; Strid, Hans; Ståhl, Arne; Deminger, Anna; Carlsten, Hans; Öhman, Lena; Forsblad-d'Elia, Helena

    2017-02-02

    Patients with ankylosing spondylitis (AS) are at increased risk of developing inflammatory bowel disease (IBD). We aimed to determine the variation in fecal calprotectin in AS over 5 years in relation to disease activity and medication and also to study the incidence of and predictors for development of IBD. Fecal calprotectin was assessed at baseline (n = 204) and at 5-year follow-up (n = 164). The patients answered questionnaires and underwent clinical evaluations. At baseline and at 5-year follow-up, ileocolonoscopy was performed in patients with fecal calprotectin ≥500 mg/kg and ≥200 mg/kg, respectively. The medical records were checked for diagnoses of IBD during the follow-up period. Fecal calprotectin >50 mg/kg was found in two-thirds of the patients at both study visits. In 80% of the patients, fecal calprotectin changed by Ankylosing Spondylitis Disease Activity Score based on C-reactive protein, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, C-reactive protein, erythrocyte sedimentation rate, and fecal calprotectin at 5-year follow-up. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with higher fecal calprotectin, and 3-week cessation of NSAIDs resulted in a drop of a median 116 mg/kg in fecal calprotectin. The use of tumor necrosis factor (TNF) blockers was associated with lower fecal calprotectin at both visits, but the users of TNF receptor fusion proteins had significantly higher fecal calprotectin than users of anti-TNF antibodies at 5-year follow-up. The 5-year incidence of Crohn's disease (CD) was 1.5% and was predicted by high fecal calprotectin. Fecal calprotectin was elevated in a majority of the patients and was associated with disease activity and medication at both visits. CD developed in 1.5% of the patients with AS, and a high fecal calprotectin was the main predictor thereof. The results support a link between inflammation in the gut and the

  5. Medical Treatment of Ankylosing Spondylitis

    Science.gov (United States)

    Kim, Young-Tae

    2014-01-01

    The diagnosis of ankylosing spondylitis is often delayed due to ambiguous clinical manifestations and strict diagnostic criteria. However, imaging techniques such as magnetic resonance imaging have been found effective for the early diagnosis of non-radiographic sacroiliitis. New tumor necrosis factor alpha (TNF-α) inhibitors have good efficacy for patients with persistently high disease activity despite conventional nonsteroidal anti-inflammatory drug treatment. Thus, early diagnosis and aggressive treatments are essential for ankylosing spondylitis patients. Because many patients complain of musculoskeletal pains, especially around the sacroiliac joint area, hip specialists should be informed of up-to-date knowledge. In this review, we discuss new diagnostic criteria for ankylosing spondylitis, administration methods of TNF-α inhibitors, and the long-term follow-up results for patients treated with TNF-α inhibitors. PMID:27536570

  6. The Role of MicroRNAS in Ankylosing Spondylitis

    Science.gov (United States)

    Li, Zheng; Wong, Sunny H.; Shen, Jianxiong; Chan, Matthew T.V.; Wu, William Ka Kei

    2016-01-01

    Abstract Ankylosing spondylitis (AS) is a common and genetically heterozygous inflammatory rheumatic disease characterized by new bone formation, ankylosis and inflammation of hip, sacroiliac joints and spine. Until now, there is no method for early diagnosis of AS and the effective treatment available for AS patients remain largely undefined. We searched articles indexed in PubMed (MEDLINE) database using Medical Subject Heading (MeSH) or Title/Abstract words (“microRNA” and “ankylosing spondylitis”) from inception up to November 2015. Genetic polymorphisms of miRNAs and their targets might alter the risk of AS development whereas certain miRNAs exhibit correlation with inflammatory index. Let-7i and miR-124 were upregulated whereas miR-130a was downregulated in circulating immune cells of AS patients. These deregulated miRNAs could modulate key immune cell functions, such as cytokine response and T-cell survival. miRNA deregulation is key to AS pathogenesis. However, clinical utilization of miRNAs for management of AS patients requires further support from future translational studies. PMID:27057910

  7. Evaluation of the effects of Global Postural Reeducation in patients with ankylosing spondylitis.

    Science.gov (United States)

    Silva, Eliane Maria; Andrade, Sandra C; Vilar, Maria J

    2012-07-01

    The objective of this study is to assess the effects of Global Postural Reeducation (GPR) in patients with ankylosing spondylitis and compare GPR with group conventional segmental self-stretching and breathing exercises. This is a controlled interventional study of 38 patients divided into 2 groups: a GPR group (n = 22) and a control group (n = 16). Both groups were treated for more than 4 months. With the GPR group patients, positions that stretched the shortened muscle chains were used. With the control group patients, conventional segmental self-stretching and breathing exercises were performed. The variables analyzed were pain intensity, morning stiffness, spine mobility, chest expansion, functional capacity (Health Assessment Questionnaire-Spondyloarthropathies-HAQ-S), quality of life (Medical Outcome Study Short Form 36 Healthy Survey-SF-36), and disease activity (Bath Ankylosing Spondylitis Disease Activity Index-BASDAI). Statistical analysis was used with a significance level of P < 0.05. There was a statistically significant improvement for all the parameters analyzed between pre-and post-treatment in both groups. In the intergroup comparison, the GPR group showed a significantly greater improvement in morning stiffness (P = 0.013), spine mobility parameters, except finger-floor distance (P = 0.118), in chest expansion (P = 0.028), and in the physical aspect component of the SF-36 (P = 0.001). The results of this study showed that individual treatment with GPR (overall stretching) seems to have better clinical outcomes than group treatment with conventional segmental self-stretching and breathing exercises for patients with ankylosing spondylitis.

  8. Evolution of Juvenile Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Ye.V. Prohorov

    2013-02-01

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

  9. Body mass index, pain and function in individuals with knee ...

    African Journals Online (AJOL)

    Background: Obesity is a risk factor for progression of knee osteoarthritis (OA), and high body mass index (BMI) may interfere with treatment effectiveness on pain and function in individuals with knee OA. This study investigated the effects of BMI on pain and function during a four‑week exercise programme in patients with ...

  10. A review of the foot function index and the foot function index – revised

    Science.gov (United States)

    2013-01-01

    Background The Foot Function Index (FFI) is a self-report, foot-specific instrument measuring pain and disability and has been widely used to measure foot health for over twenty years. A revised FFI (FFI-R) was developed in response to criticism of the FFI. The purpose of this review was to assess the uses of FFI and FFI-R as were reported in medical and surgical literature and address the suggestions found in the literature to improve the metrics of FFI-R. Methods A systematic literature search of PubMed/Medline and Embase databases from October 1991 through December 2010 comprised the main sources of literature. To enrich the bibliography, the search was extended to BioMedLib and Scopus search engines and manual search methods. Search terms included FFI, FFI scores, FFI-R. Requirements included abstracts/full length articles, English-language publications, and articles containing the term "foot complaints/problems." Articles selected were scrutinized; EBM abstracted data from literature and collected into tables designed for this review. EBM analyzed tables, KJC, JM, RMS reviewed and confirmed table contents. KJC and JM reanalyzed the original database of FFI-R to improve metrics. Results Seventy-eight articles qualified for this review, abstracts were compiled into 12 tables. FFI and FFI-R were used in studies of foot and ankle disorders in 4700 people worldwide. FFI Full scale or the Subscales and FFI-R were used as outcome measures in various studies; new instruments were developed based on FFI subscales. FFI Full scale was adapted/translated into other cultures. FFI and FFI-R psychometric properties are reported in this review. Reanalysis of FFI-R subscales' confirmed unidimensionality, and the FFI-R questionnaires' response categories were edited into four responses for ease of use. Conclusion This review was limited to articles published in English in the past twenty years. FFI is used extensively worldwide; this instrument pioneered a quantifiable measure

  11. MRI characteristics of tuberculous spondylitis

    International Nuclear Information System (INIS)

    Currie, S.; Galea-Soler, S.; Barron, D.; Chandramohan, M.; Groves, C.

    2011-01-01

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

  12. Ankylosing spondylitis and bowel disease

    NARCIS (Netherlands)

    Rudwaleit, Martin; Baeten, Dominique

    2006-01-01

    Between 5 and 10% of cases of ankylosing spondylitis (AS) are associated with inflammatory bowel disease (IBD), either Crohn's disease or ulcerative colitis. A much larger percentage of AS patients have subclinical gut inflammation manifested either by endoscopic findings or by histology. The

  13. Genetics Home Reference: ankylosing spondylitis

    Science.gov (United States)

    ... for making a protein that plays an important role in the immune system. The HLA-B gene is part of a ... with ankylosing spondylitis . Although these genes play critical roles in the immune system, it is unclear how variations in these genes ...

  14. Effects of Body Mass Index on Lung Function Index of Chinese Population

    Science.gov (United States)

    Guo, Qiao; Ye, Jun; Yang, Jian; Zhu, Changan; Sheng, Lei; Zhang, Yongliang

    2018-01-01

    To study the effect of body mass index (BMI) on lung function indexes in Chinese population. A cross-sectional study was performed on 10, 592 participants. The linear relationship between lung function and BMI was evaluated by multivariate linear regression analysis, and the correlation between BMI and lung function was assessed by Pearson correlation analysis. Correlation analysis showed that BMI was positively related with the decreasing of forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and FEV1/FVC (P <0.05), the increasing of FVC% predicted value (FVC%pre) and FEV1% predicted value (FEV1%pre). These suggested that Chinese people can restrain the decline of lung function to prevent the occurrence and development of COPD by the control of BMI.

  15. Genomics of ankylosing spondylitis.

    Science.gov (United States)

    Thomas, Gethin P; Brown, Matthew A

    2010-09-01

    Ankylosing spondylitis (AS) is the prototypic and most prevalent and debilitating spondyloarthropathy, a group of arthritides where the spine and pelvis are specifically targeted. Unlike many other forms of arthritis in which joint damage is mediated through tissue destruction, in AS uncontrolled bone formation occurs, frequently resulting in joint fusion and consequently significant disability. It is estimated that there are 2.4 million spondyloarthritis sufferers in the U.S., twice as many as rheumatoid arthritis. The pathogenesis of AS is very poorly understood and both genetics and gene expression profiling approaches have been utilized to elucidate the underlying mechanisms and pathways that drive the disease. Using powerful genome-wide association study approaches a number of candidate genes have been found to be associated with AS. However, although such approaches can identify genes that can contribute to the disease process, they do not inform us of the actual changes in gene/cell activity at any point in the disease process. Expression profiling allows us to take a "snapshot" of cellular activity and what gene activity changes are underlying those changes. A number of expression profiling studies have been undertaken in AS, looking at both circulating cells and tissues from affected joints. The results to date have been somewhat disappointing with little consensus on gene activity changes due to the low power of the studies undertaken. Some more recent better powered studies have identified diagnostic expression profiles that do point to a possible role for expression profiling in early AS diagnosis. Future studies will require collaborative approaches to target specific disease stages and sites with larger numbers of samples.

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

    Directory of Open Access Journals (Sweden)

    Sawacha Zimi

    2012-08-01

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

  17. Non-Caseating Granulomatous Infective Spondylitis: Melioidotic Spondylitis.

    Science.gov (United States)

    Arockiaraj, Justin; Karthik, Rajiv; Jeyaraj, Veena; Amritanand, Rohit; Krishnan, Venkatesh; David, Kenny Samuel; Sundararaj, Gabriel David

    2016-12-01

    Retrospective clinical analysis. To delineate the clinical presentation of melioidosis in the spine and to create awareness among healthcare professionals, particularly spine surgeons, regarding the diagnosis and treatment of melioidotic spondylitis. Melioidosis is an emerging disease, particularly in developing countries, associated with a high mortality rate. Its causative pathogen, Burkholderia pseudomallei , has been labeled as a bio-terrorism agent. We performed a retrospective analysis of patients who were culture positive for B. pseudomallei . Assessment of patients was performed using clinical, radiological, and blood parameters. Clinical measures included pain, neurological deficit, and return to work. Radiological measures included plain radiography of the spine and magnetic resonance imaging. Blood tests included erythrocyte sedimentation rate and C-reactive protein levels. Four patients having melioidosis with spondylitis were evaluated. All of them had diabetes mellitus; three had multiple abscesses which required incision and drainage. Their clinical spectrum was similar to that of tuberculous spondylitis; all had back pain and radiology revealed infective spondylodiscitis with prevertebral and paravertebral collections with psoas abscess. Three patients underwent ultrasound-guided drainage of the psoas abscess and one had aspiration of the subcutaneous abscess. Bacteriological cultures showed presence of B. pseudomallei , and histopathology showed non-caseating granulomatous inflammation. All patients were treated with intravenous Ceftazidime for 2 weeks, followed by oral bactrim double strength and Doxycycline for 20 weeks. All patients improved with treatment and were healed at follow up. Melioidosis presents with a clinical spectrum similar to that of tuberculosis. A diagnosis of melioidotic spondylitis should be considered, particularly in patients with diabetes with neutrophilic leukocytosis and clinical-radiological features suggestive of

  18. Postural deformities: potential morbidities to cause balance problems in patients with ankylosing spondylitis?

    Science.gov (United States)

    Çınar, Ece; Akkoç, Yeşim; Karapolat, Hale; Durusoy, Raika; Keser, Gökhan

    2016-03-01

    This study aimed to assess the impact of postural deformities caused by ankylosing spondylitis (AS) on balance problems. This study included 29 patients with AS and 21 healthy controls. For assessing exercise capacity and dynamic balance, timed up and go test, five times sit-to-stand test, gait speed, and 6-min walk test were performed. Romberg tests were used to evaluate static balance and proprioception, whereas Dynamic Gait Index (DGI), Functional Gait Assessment (FGA), Berg Balance Scale (BBS), Activity Specific Balance Confidence Scale (ABC), Dizziness Handicap Inventory (DHI), and functional reach test were used to assess dynamic balance and the risk of falling. Using Bath Ankylosing Spondylitis Metrology Index (BASMI) scores, patients with AS were divided into two groups: those with scores 0-4 were assigned to subgroup AS1, and those with scores 5-10 were assigned to subgroup AS2. In the whole group of patients with AS, five times sit-to-stand test, tandem Romberg test with eyes closed, and BBS and ABC scores were significantly worse than the healthy controls (ptest, 6-min walk test, functional reach test, FGA, and DHI scores were also significantly worse than the healthy controls (p<0.05). Comparing the two subgroups with each other, only BBS scores were significantly worse in the AS2 subgroup than in the AS1 subgroup. Although in clinical practice, poor balance is not a common problem in AS, possibly because of compensatory mechanisms, patients with AS have poorer static and dynamic balance than healthy subjects. Significantly worse BBS scores in the AS2 subgroup than in the AS1 subgroup may suggest the presence of more dynamic balance problems in advanced disease; however, future studies comprising larger samples are necessary to confirm this assumption.

  19. Cardiopulmonary Manifestations of Ankylosing Spondylitis

    Science.gov (United States)

    Momeni, Mahnaz; Taylor, Nora; Tehrani, Mahsa

    2011-01-01

    Ankylosing spondylitis is a chronic inflammatory condition that usually affects young men. Cardiac dysfunction and pulmonary disease are well-known and commonly reported extra-articular manifestation, associated with ankylosing spondylitis (AS). AS has also been reported to be specifically associated with aortitis, aortic valve diseases, conduction disturbances, cardiomyopathy and ischemic heart disease. The pulmonary manifestations of the disease include fibrosis of the upper lobes, interstitial lung disease, ventilatory impairment due to chest wall restriction, sleep apnea, and spontaneous pneumothorax. They are many reports detailing pathophysiology, hypothesized mechanisms leading to these derangements, and estimated prevalence of such findings in the AS populations. At this time, there are no clear guidelines regarding a stepwise approach to screen these patients for cardiovascular and pulmonary complications. PMID:21547038

  20. Generalized Functional Linear Models With Semiparametric Single-Index Interactions

    KAUST Repository

    Li, Yehua

    2010-06-01

    We introduce a new class of functional generalized linear models, where the response is a scalar and some of the covariates are functional. We assume that the response depends on multiple covariates, a finite number of latent features in the functional predictor, and interaction between the two. To achieve parsimony, the interaction between the multiple covariates and the functional predictor is modeled semiparametrically with a single-index structure. We propose a two step estimation procedure based on local estimating equations, and investigate two situations: (a) when the basis functions are pre-determined, e.g., Fourier or wavelet basis functions and the functional features of interest are known; and (b) when the basis functions are data driven, such as with functional principal components. Asymptotic properties are developed. Notably, we show that when the functional features are data driven, the parameter estimates have an increased asymptotic variance, due to the estimation error of the basis functions. Our methods are illustrated with a simulation study and applied to an empirical data set, where a previously unknown interaction is detected. Technical proofs of our theoretical results are provided in the online supplemental materials.

  1. Assessing functional status after intensive care unit stay: the Barthel Index and the Katz Index.

    Science.gov (United States)

    Silveira, Leda Tomiko Yamada da; Silva, Janete Maria da; Soler, Júlia Maria Pavan; Sun, Carolina Yea Ling; Tanaka, Clarice; Fu, Carolina

    2018-01-27

    To assess the functional status of post-ICU patients using the Barthel Index (BI) and the Katz Index (KI) and to assess which is more suitable for this population. Retrospective longitudinal study. Public tertiary hospital in São Paulo (Brazil). Patients aged ≥18 years old, admitted to ICU, who were treated with mechanical ventilation (MV) ≥ 24 h and were discharged to ward. Inability to answer the BI and the KI; limiting neurological or orthopaedic conditions; ICU stay ≥90 days. Patients transferred to or from other hospitals or who died in the wards were not analysed. BI and KI were scored pre-ICU and post-ICU and the variation was calculated. BI and KI scores were compared using analysis based on item response theory (IRT), using degree of difficulty and discriminating items as parameters. Median age was 52 years old, median APACHE II score was 15. Median ICU stay was 11 days and median MV duration was 4 days. BI variation was 44% and KI variation was 55%. In IRT analysis, BI considered a larger number of items with different levels of difficulty. Both the BI and the KI revealed significant deterioration of functional status after ICU discharge. The IRT analysis suggested that the Barthel Index might be a better scale than the Katz Index for the assessment of functional status of patients discharged from ICU, since it presented better discrimination of the ability to carry out the tasks. © The Author(s) 2018. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  2. Functional Principal Components Analysis of Shanghai Stock Exchange 50 Index

    Directory of Open Access Journals (Sweden)

    Zhiliang Wang

    2014-01-01

    Full Text Available The main purpose of this paper is to explore the principle components of Shanghai stock exchange 50 index by means of functional principal component analysis (FPCA. Functional data analysis (FDA deals with random variables (or process with realizations in the smooth functional space. One of the most popular FDA techniques is functional principal component analysis, which was introduced for the statistical analysis of a set of financial time series from an explorative point of view. FPCA is the functional analogue of the well-known dimension reduction technique in the multivariate statistical analysis, searching for linear transformations of the random vector with the maximal variance. In this paper, we studied the monthly return volatility of Shanghai stock exchange 50 index (SSE50. Using FPCA to reduce dimension to a finite level, we extracted the most significant components of the data and some relevant statistical features of such related datasets. The calculated results show that regarding the samples as random functions is rational. Compared with the ordinary principle component analysis, FPCA can solve the problem of different dimensions in the samples. And FPCA is a convenient approach to extract the main variance factors.

  3. [Comparison of effectiveness between two surgical methods in treatment of thoracolumbar brucella spondylitis].

    Science.gov (United States)

    Yang, Xinming; Zuo, Xianhong; Jia, Yongli; Chang, Yuefei; Zhang, Peng; Ren, Yixing

    2014-10-01

    To compare the effectiveness between the method of simple posterior debridement combined with bone grafting and fusion and internal fixation and the method of one-stage anterior radical debridement combined with bone grafting and fusion and posterior internal fixation in the treatment of thoracolumbar brucella spondylitis so as to provide the reference for the clinical treatment. A retrospective analysis was made on the clinical data of 148 cases of thoracolumbar brucella spondylitis between January 2002 and January 2012. Simple posterior debridement combined with bone grafting and fusion and internal fixation was used in 78 cases (group A), and one-stage anterior radical debridement combined with bone grafting and fusion and posterior internal fixation in 70 cases (group B). There was no significant difference in gender, age, disease duration, involved vertebral segments, erythrocyte sedimentation rate (ESR), visual analogue scale (VAS) score, neural function grade of America Spinal Injury Association (ASIA), and kyphosis Cobb angle before operation between 2 groups (P > 0.05). The peri operation period indexes (hospitalization time, operation time, and intraoperative blood loss) and the clinical effectiveness indexes (VAS score, ASIA grade, Cobb angle, and ESR) were compared; the bone fusion and the internal fixation were observed. Incision infection and paravertebral and/or psoas abscess occurred in 2 and 3 cases of group A respectively. All incisions healed by first intention and 2 cases had pneumothorax in group B. The operation time and the hospitalization time of group A were significantly shorter than those of group B (P average. The VAS, ESR, and Cobb angle were significantly decreased at each time point after operation when compared with preoperative ones in 2 groups (P 0.05). The neurological function was significantly improved at 3 months after operation; there were 1 case of ASIA grade C, 14 cases of grade D, and 63 cases of grade E in group A, and

  4. Tomato water stress index as a function of irrigation depths

    Directory of Open Access Journals (Sweden)

    Cícero J. da Silva

    Full Text Available ABSTRACT Infrared thermometry allows evaluating plants under water stress, by measuring the canopy temperature, without the need of physical contact with the leaves. The aim of this study was to determine the water stress index of the tomato crop for industrial processing (Hybrid ‘BRS Sena’, as a function of irrigation depths applied by subsurface drip irrigation, in Southern Goiás, Brazil, in 2015 and 2016. The experiment was conducted in a randomized block design, with four replicates. The treatments consisted in five irrigation depths: 50, 75, 100, 125 and 150% of crop evapotranspiration. The water stress index of the tomato crop was evaluated using two methodologies, as a function of the canopy temperature, air temperature and other local meteorological parameters, as well as the relationship between water stress index and crop yield. Theoretical and empirical methods estimate CWSI similarly in tomato. In the hottest hours of the day, even under adequate soil moisture conditions, the ‘BRS Sena’ tomato showed CWSI above 0.2. CWSI is a good indicator to evaluate the water status of the tomato crop for industrial processing and to recommend the moment of irrigation. The higher the CWSI, the lower the yield of ‘BRS Sena’ tomato.

  5. Kidney Function in Obesity-Challenges in Indexing and Estimation.

    Science.gov (United States)

    Chang, Alex R; Zafar, Waleed; Grams, Morgan E

    2018-01-01

    As the prevalence of obesity continues to increase worldwide, an increasing number of people are at risk for kidney disease. Thus, there is a critical need to understand how best to assess kidney function in this population, and several challenges exist. The convention of indexing glomerular filtration rate (GFR) to body surface area (BSA) attempts to normalize exposure to metabolic wastes across populations of differing body size. In obese individuals, this convention results in a significantly lower indexed GFR than unindexed GFR, which has practical implications for drug dosing. Recent data suggest that "unindexing" estimated GFR (multiplying by BSA/1.73 m 2 ) for drug dosing may be acceptable, but pharmocokinetic data to support this practice are lacking. Beyond indexing, biomarkers commonly used for estimating GFR may induce bias. Creatinine is influenced by muscle mass, whereas cystatin C correlates with fat mass, both independent of kidney function. Further research is needed to evaluate the performance of estimating equations and other filtration markers in obesity, and determine whether unindexed GFR might better predict optimal drug dosing and clinical outcomes in patients whose BSA is very different than the conventional normalized value of 1.73 m 2 . Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  6. Current treatment approaches in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Bilal Elbey

    2015-03-01

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

  7. On the functional form of an efficiency index

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Keiding, Hans

    1998-01-01

    An input efficiency index gives a numeric assessment of the degree to which a given input combination falls short of being efficient in producing a fixed amount of output. This paper presents a system of axioms which characterise a certain family of efficiency indices containing the well-known Fa......An input efficiency index gives a numeric assessment of the degree to which a given input combination falls short of being efficient in producing a fixed amount of output. This paper presents a system of axioms which characterise a certain family of efficiency indices containing the well......-known Farrell and Färe-Lovell indices. The family of indices satisfying the axioms can be obtained by minimizing a suitable function, called a performance evaluation, and different choices of performance evaluation will result in different indices...

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

    Science.gov (United States)

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

    2015-03-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  10. Decreased central corneal thickness in ankylosing spondylitis.

    Science.gov (United States)

    Ortak, Huseyin; Inanır, Ahmet; Demir, Selim; Uysal, Alper; Şahin, Şafak; Sağcan, Mustafa; Önder, Yalçın; Alim, Sait; Demir, Ayşe Kevser

    2014-04-01

    Central corneal thickness and dry eye tests were evaluated in a study population consisting of 68 ankylosing spondylitis patients diagnosed according to the modified New York criteria, and 61 age-matched controls without ankylosing spondylitis. A full ophthalmological evaluation was performed on each subject. All subjects were screened for age, gender, HLA-B27, tear break-up time test, Schirmer test, and duration of disease. Central corneal thickness was measured under topical anesthesia with an ultrasonic pachymeter. The mean central corneal thickness was 537.3 ± 30.6 μm, range 462-600 μm, in ankylosing spondylitis patients, whereas it was 551.7 ± 25.2 μm, range 510-620 μm, in controls (p = 0.005). The Schirmer test result was 7.3 ± 5.9 mm for the ankylosing spondylitis patients and 11.7 ± 5.8 mm for the control group (p = 0.002). Tear break-up time was 7.3 ± 3.2 s for the ankylosing spondylitis patients and 14.0 ± 4.5 s for the control group (p ankylosing spondylitis. In addition, attention must be given to lower dry eye tests in surgical interventions such as photorefractive keratectomy and laser in situ keratomileusis in ankylosing spondylitis patients.

  11. Scintigraphic findings in ankylosing spondylitis.

    Science.gov (United States)

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

    1977-06-01

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

  12. Infectious spondylitis and its differential diagnosis

    International Nuclear Information System (INIS)

    Erlemann, Rainer

    2012-01-01

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

  13. Identification of Potential Transcriptomic Markers in Developing Ankylosing Spondylitis: A Meta-Analysis of Gene Expression Profiles

    OpenAIRE

    Fang, Fang; Pan, Jian; Xu, Lixiao; Li, Gang; Wang, Jian

    2015-01-01

    The goal of this study was to identify potential transcriptomic markers in developing ankylosing spondylitis by a meta-analysis of multiple public microarray datasets. Using the INMEX (integrative meta-analysis of expression data) program, we performed the meta-analysis to identify consistently differentially expressed (DE) genes in ankylosing spondylitis and further performed functional interpretation (gene ontology analysis and pathway analysis) of the DE genes identified in the meta-analys...

  14. Executive functioning in college students: Evaluation of the Dutch Executive Function Index (EFI-NL)

    NARCIS (Netherlands)

    Janssen, G.T.L.; Mey, H.R.A. De; Egger, J.I.M.

    2009-01-01

    The Executive Function Index (EFI) is a short self-report questionnaire for the assessment of executive functions (EF) as encountered in daily life. The aim of the present study is to examine the psychometric properties of the Dutch version of the EFI (EFI-NL) in a college student sample (N = 376).

  15. MRI Findings of Brucellar Spondylitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-03-15

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

  16. MRI Findings of Brucellar Spondylitis: A Case Report

    International Nuclear Information System (INIS)

    Kim, Jin Woo; Kim, Myung Soon; Kim, Young Ju

    2013-01-01

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

  17. Ankle-brachial index by automated method and renal function

    Directory of Open Access Journals (Sweden)

    Ricardo Pereira Silva

    2017-05-01

    Full Text Available Background The Ankle-brachial index (ABI is a non-invasive method used for the diagnosis of peripheral arterial occlusive disease (PAOD. Aims To determine the clinical features of patients submitted to ABI measurement by automatic method. To investigate association between ABI and renal function. Methods The present is a cross-sectional study. The study was performed in a private clinic in the city of Fortaleza (Ce- Brazil. For ABI analysis, we utilized automatic methodology using a Microlife device. Data collection took place from March 2012 to January 2016. During this period, ABI was measured in 375 patients aged >50 years, who had a diagnosis of hypertension, diabetes or vascular disease. Results Of the 375 patients, 18 were categorized as having abnormal ABI (4.8 per cent and 357 were normal ABI (95.2 per cent. Patients with abnormal ABI showed older mean age when compared to patients with normal ABI. Among patients with normal renal function, only 0.95 per cent showed abnormal ABI; among patients with abnormal renal function, 6 per cent showed abnormal ABI. Conclusion 1 No differences were observed when comparing the groups regarding gender or the prevalence of hypertension, diabetes, dyslipidaemia or CAD. 2 Group with abnormal ABI had renal function greater impairment.

  18. Disease modification in ankylosing spondylitis.

    Science.gov (United States)

    Maksymowych, Walter P

    2010-02-01

    The concept of disease modification in ankylosing spondylitis (AS) incorporates aspects of inflammation, bone destruction and new bone formation. The degree to which inflammation and new bone formation are linked remains conjectural, but data from MRI studies of spinal inflammation support the concept of such coupling; however, these studies also suggest a role for the involvement of noninflammatory pathways, such as those involving bone morphogenetic proteins, wingless proteins and Dickkopf-1, in the formation of new bone. The main clinical outcome that reflects disease modification is the modified Stoke Ankylosing Spondylitis Spine Score, which assesses abnormalities in the anterior vertebral corners of the cervical and lumbar spine. However, radiographic progression can only be reliably detected using this method after at least 2 years, and this delay precludes the conduct of placebo-controlled trials on ethical grounds. Preliminary data using this scoring tool suggest that cyclooxygenase-2-selective NSAIDs might reduce disease progression if used continuously over 2 years. By contrast, three different anti-tumor necrosis factor therapies have shown no impact on radiographic progression. Therapeutic trials recruiting patients early in their disease course and at high risk of radiographic progression constitute a high priority for clinical research in AS.

  19. Avaliação do equilíbrio funcional e qualidade de vida em pacientes com espondilite anquilosante Assessment of functional balance and quality of life among patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Marcelo Cardoso de Souza

    2008-10-01

    Full Text Available OBJETIVO: Avaliar o equilíbrio funcional e a qualidade de vida em pacientes com espondilite anquilosante. TIPO DE ESTUDO: Corte transversal. MÉTODOS: Foram avaliados 60 indivíduos, sendo 30 com espondilite anquilosante (EA e 30 saudáveis, por meio da versão brasileira da escala de equilíbrio de Berg, questionário SF-36 para avaliação da qualidade de vida e escala visual analógica da dor (EVA. RESULTADOS: O escore da escala de Berg foi, respectivamente, para os grupos EA e controle de 48,83 e 55,5, com diferença estatisticamente significante. Houve correlação positiva entre a escala de Berg e a de EVA (r = 0,469 e entre esta escala e o domínio referente à capacidade funcional do SF-36 (r = 0,648. A EVA teve correlação negativa com o SF-36 nos seguintes domínios: capacidade funcional (r = -0,753, aspecto físico (r = -0,612, estado geral de saúde (r = -0,607, dor (r = -0,827 e vitalidade (r = -0,532. CONCLUSÃO: Os pacientes com EA possuem pior equilíbrio funcional, pior qualidade de vida e mais dor que indivíduos saudáveis. O pior equilíbrio correlacionou-se com pior capacidade funcional e dor.OBJECTIVE: To assess functional balance and quality of life among patients with ankylosing spondylitis. TYPE OF STUDY: Cross-sectional. METHODS: Sixty individuals were evaluated: 30 with ankylosing spondylitis (AS and 30 healthy individuals - using the Brazilian version of the Berg Balance Scale, SF-36 questionnaire for the assessment of quality of life and a visual analogue scale (VAS for pain. RESULTS: The score of the scale of Berg was respectively for groups EA and control of 48.83 and 55.5 with statistically significant difference. There was a positive correlation between the Berg Scale and the VAS (r = 0,469 and between this scale and the functional capacity domain of the SF-36 (r = 0,648. There was a negative correlation between the VAS and following domains of the SF-36: functional capacity (r = -0,753, physical aspects (r

  20. Ankylosing Spondylitis: a Reflection and a Question

    Directory of Open Access Journals (Sweden)

    Annia Deysi Hernández Martín

    2014-07-01

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

  1. Applying the Female Sexual Functioning Index to sexual minority women.

    Science.gov (United States)

    Boehmer, Ulrike; Timm, Alison; Ozonoff, Al; Potter, Jennifer

    2012-04-01

    Available measurements of women's sexual function do not account for different sexual orientations; rather, instruments have been developed using heterosexual samples. The Female Sexual Functioning Index (FSFI) is a widely used instrument, applicable for sexually active or inactive women. We apply the FSFI to a sample of women who have or prefer women as sexual partners, defined as sexual minority women, and who vary with respect to their sexual activity. A modified version of the FSFI was used in a sample of sexual minority women. Statistical analyses focused on examining associations between FSFI responses of no sexual activity and women's characteristics. Partner status and sexual frequency was significantly associated with reporting no sexual activity on the FSFI. A revised scoring of the FSFI allows for the use of this instrument among women who vary on sexual frequency and partner status, without biasing their scores towards sexual dysfunction. The desire subscale is independent of sexual frequency, partner status, and sexual orientation. The modified wording of the FSFI and its revised scoring allow for the use of this instrument among sexual minority women. A separate reporting of the desire subscale will generate reliable and valid assessments of sexual minority women's sexual functioning.

  2. Serum procalcitonin levels in patients with ankylosing spondylitis.

    Science.gov (United States)

    Ozmen, Mustafa; Oktay, Esin; Tarhan, Emine F; Aslan, Ozgur; Oflazoglu, Utku; Koseoglu, Mehmet H

    2016-05-01

    Procalcitonin is a marker of bacterial and fungal infection and sepsis. The present study evaluated the relationship between serum procalcitonin levels and disease activity in patients with ankylosing spondylitis (AS). A total of 61 patients who met the 1984 New York criteria for AS were studied. Twenty-four age- and sex-matched healthy volunteers were recruited to this study as a control group. Disease activity was assessed by the Bath AS Disease Activity Index (BASDAI). The functional status of patients was evaluated by the Bath AS Functional Index (BASFI). Spinal mobility was measured by the Bath AS Metrology Index (BASMI). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum procalcitonin levels were measured. Thirty patients were on anti-tumor necrosis factor-alpha treatment and 31 patients were on conventional treatment. Seventeen (28%) of the AS patients were active (BASDAI > 4) and 44 (72%) of the AS patients were in remission. The median ESR was 14 (34-6) mm/h and 4 (7-2) mm/h (P < 0.001) for the patient and control groups, respectively. The median CRP level was 0.91 (2.72-0.37) mg/dL and 0.15 (0.25-0.07) mg/dL in the patient and control groups, respectively (P < 0.001). Median BASDAI, BASFI and BASMI scores for all AS patients were 3.6 (5.25-2.29), 2.5 (4.22-0.91) and 3 (5-1), respectively. Serum procalcitonin levels were normal (< 0.05 ng/mL) for all patients and controls. Serum procalcitonin levels were not high in AS patients and controls, and the levels were independent of disease activity and medications. If bacterial or fungal infection is suspected in an AS patient, serum procalcitonin level may be useful for diagnosis. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  3. High free testosterone index increases lung function in adult males

    Directory of Open Access Journals (Sweden)

    Martiem Mawi

    2012-08-01

    Full Text Available Background Increasing age and decreased testosterone concentrations in males influence muscle strength and muscle mass, particularly in skeletal muscle. There have been few studies on decreased lung function resulting from reduced mass and strength of respiratory muscles. The aim of the present study was to investigate the existence of an association between free testosterone index (FTI and lung function in males aged between 40 and 80 years. Methods This cross-sectional study involved 167 males aged between 40 and 80 years in Cilandak subdistrict, South Jakarta. Total serum testosterone and sex hormone-binding globulin (SHBG concentrations were determined by electrochemiluminescence immunoassay (ECLIA using Roche Elecsys Reagent Kit Cat 11776061 and Elecsys 2010 reagent (Cobas e601, respectively FTI was calculated using the formula free testosterone/SHBG x 100%. Forced expiratory volume in 1 second (VEP1 was assessed by means of an AS 500 spirometer. Results Mean age of the subjects was 53.32 ± 8.26 years, mean total serum testosterone concentration was 532.59 ± 206.92 ng/dL, mean SHBG concentration 41.26 ± 21.14 nmol/L, mean FTI 48.22 ± 14.34 %, and mean VEP1 was 1.63 ± 0.54 L. There was a significant association between both SHBG and FTI on the one hand and VEP1 on the other, with Pearson correlation coefficients of -0.199 (p=0.010 and 0.271 (p=0.000, respectively. Linear multiple regression analysis indicated that FTI was the most influential variable on lung function (VEP1, higher FTI values indicating higher VEP1 (â=0.008: p=0.004. Conclusion In males aged 40-80 years, higher FTI values indicate better lung function as determined by means of VEP1.

  4. Body Mass Index and Decline of Cognitive Function.

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    Sujin Kim

    Full Text Available The association between body mass index (BMI and cognitive function is a public health issue. This study investigated the relationship between obesity and cognitive impairment which was assessed by the Korean version of the Mini-mental state examination (K-MMSE among mid- and old-aged people in South Korea.A cohort of 5,125 adults, age 45 or older with normal cognitive function (K-MMSE≥24 at baseline (2006, was derived from the Korean Longitudinal Study of Aging (KLoSA 2006~2012. The association between baseline BMI and risk of cognitive impairment was assessed using multiple logistic regression models. We also assessed baseline BMI and change of cognitive function over the 6-year follow-up using multiple linear regressions.During the follow-up, 358 cases of severe cognitive impairment were identified. Those with baseline BMI≥25 kg/m2 than normal-weight (18.5≤BMI<23 kg/m2 were marginally less likely to experience the development of severe cognitive impairment (adjusted odds ratio [aOR] = 0.73, 95% CI = 0.52 to 1.03; Ptrend = 0.03. This relationship was stronger among female (aOR = 0.63, 95% CI = 0.40 to 1.00; Ptrend = 0.01 and participants with low-normal K-MMSE score (MMSE: 24-26 at baseline (aOR = 0.59, 95% CI = 0.35 to 0.98; Ptrend<0.01. In addition, a slower decline of cognitive function was observed in obese individuals than those with normal weight, especially among women and those with low-normal K-MMSE score at baseline.In this nationally representative study, we found that obesity was associated with lower risk of cognitive decline among mid- and old-age population.

  5. Safety and Efficacy of Golimumab Administered Intravenously in Adults with Ankylosing Spondylitis: Results through Week 28 of the GO-ALIVE Study.

    Science.gov (United States)

    Deodhar, Atul; Reveille, John D; Harrison, Diane D; Kim, Lilianne; Lo, Kim Hung; Leu, Jocelyn H; Hsia, Elizabeth C

    2018-03-01

    To evaluate the safety and efficacy of intravenous golimumab (GOL) in patients with active ankylosing spondylitis (AS). In a phase III, randomized, double-blind, placebo (PBO)-controlled trial, 208 patients were randomized (1:1) to intravenous (IV) infusions of GOL 2 mg/kg (n = 105) at weeks 0, 4, 12, and every 8 weeks, or PBO (n = 103) at weeks 0, 4, and 12, with crossover to GOL at Week 16. The primary endpoint was ≥ 20% improvement from baseline in the Assessment of Spondyloarthritis International Society Criteria (ASAS20) at Week 16. Secondary endpoints included ASAS40, ≥ 50% improvement in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI50), and change in the Bath Ankylosing Spondylitis Functional Index (BASFI) at Week 16. Safety was monitored through Week 28. Significantly greater proportions of GOL-treated patients had ASAS20 response at Week 2 (37.1% vs 19.4%; p = 0.005) and at Week 16 (73.3% vs 26.2%; p GOL achieved BASDAI50 compared with 14.6% of those taking PBO (p GOL group had greater mean improvement in BASFI (-2.4 vs -0.5; p GOL group had ≥ 1 adverse event (AE); infections being the commonest type of AE. Through Week 28, two GOL-treated patients had a serious AE. GOL 2 mg/kg administered IV at weeks 0, 4, and every 8 weeks significantly reduced the signs and symptoms of AS in adults. AE were consistent with other antitumor necrosis factor therapies, with no new safety signals (Clinicaltrials.gov: NCT02186873).

  6. Effects of home-based exercise intervention on health-related quality of life for patients with ankylosing spondylitis: a meta-analysis.

    Science.gov (United States)

    Liang, Hui; Zhang, Hua; Ji, Haiyan; Wang, Chunmei

    2015-10-01

    The objective of this paper was to objectively evaluate the effectiveness of home-based exercise interventions for improving health-related quality of life in patients with ankylosing spondylitis (AS). Databases including PubMed, Web of Science, EMBASE, Ovid-Medline, and The Cochrane Library were electronically searched published from inception through October 2014 involving home-based exercise intervention in AS patients. Studies that measured the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), depression and pain as outcomes were included. Studies involving patients with multiple diseases or received combinations of other interventions were excluded. Two independent investigators screened the identified articles, extracted the data, and assessed the methodological quality of the included studies. Qualitative descriptions were conducted, and quantitative analysis was performed with RevMan software (version 5.2). A total of six studies comprising 1098 participants were included in the study. Meta-analyses showed that home-based exercise interventions significantly reduced the BASFI scores (MD = -0.39, 95 % CI -0.57, -0.20, p = 0.001), BASDAI scores (MD = -0.50, 95 % CI -0.99, -0.02, p = 0.04), depression scores (MD = -2.31, 95 % CI -3.33, -1.30, p = 0.001), and for pain scores because of different evaluation methods among these studies; therefore, a subgroup analysis should be conducted for comparison. The results show that home-based exercise interventions can effectively improve the health-related quality of life in patients with AS. The benefit and clinical performance of home-based exercise care requires further investigation by a series of multicenter, large-sample size randomized controlled trails.

  7. The Minimum Clinically Important Improvement and Patient-acceptable Symptom State in the BASDAI and BASFI for Patients with Ankylosing Spondylitis.

    Science.gov (United States)

    Kviatkovsky, Milla Johanna; Ramiro, Sofia; Landewé, Robert; Dougados, Maxime; Tubach, Florence; Bellamy, Nicholas; Hochberg, Marc; Ravaud, Philippe; Martin-Mola, Emilio; Awada, Hassane; Bombardier, Claire; Felson, David; Hajjaj-Hassouni, Najia; Logeart, Isabelle; Matucci-Cerinic, Marco; van de Laar, Mart; van der Heijde, Désirée

    2016-09-01

    To establish cutoffs for the minimum clinically important improvement (MCII) and the patient-acceptable symptom state (PASS) for the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) in patients with ankylosing spondylitis (AS). Patients with AS who started nonsteroidal antiinflammatory drugs were included. After 4 weeks, the PASS and the MCII were defined using external anchor questions (for the PASS, patients considering their condition of AS over the prior 48 h as "acceptable" forever; and for the MCII, those reporting moderate or slightly important improvement). Consistency of the MCII and PASS were tested according to HLA-B27 status, presence/absence of SpA extraarticular manifestations, age, sex, disease duration, and baseline BASDAI/BASFI score. The 75th percentile of the cumulative distribution was used to determine the MCII and PASS. In total, 283 patients from a multinational cohort were included. Overall cutoffs for the PASS were 4.1 in the BASDAI and 3.8 in the BASFI. Cutoffs for the MCII were 0.7 and 0.4 for the BASDAI and BASFI, respectively. Subgroup analyses revealed that disease duration and baseline BASDAI/BASFI were significantly associated with the PASS and MCII. In a subanalysis limited to patients with active disease (baseline BASDAI ≥ 4), the MCII was 1.1 for the BASDAI and 0.6 for the BASFI. The conceptual viability of the PASS for the BASDAI is questionable because levels approach those required for the start of biological therapy. Because the MCII is less variable than the PASS, we propose its exclusive use, with cutoffs of 1.1/0.6 for the BASDAI/BASFI in patients with active disease. Because these values are based on a subset of the study population, we recommend confirmation in larger studies focused on patients with baseline BASDAI ≥ 4.

  8. Body mass index, type 2 diabetes, and left ventricular function

    DEFF Research Database (Denmark)

    Musaeus, Katrine Dina; Pareek, Manan

    2018-01-01

    previous observations of body mass index as a significant predictor of incident diastolic dysfunction and increased left ventricular mass index among subjects without prevalent diabetes. We discuss potential explanations for the observed discrepancies and general difficulties associated with cardiovascular...

  9. Effect of Secukinumab on Patient‐Reported Outcomes in Patients With Active Ankylosing Spondylitis: A Phase III Randomized Trial (MEASURE 1)

    Science.gov (United States)

    Dougados, Maxime; Baeten, Dominique L.; Cheng‐Chung Wei, James; Geusens, Piet; Readie, Aimee; Richards, Hanno B.; Martin, Ruvie; Porter, Brian

    2016-01-01

    Objective To evaluate the effect of secukinumab (interleukin‐17A inhibitor) on patient‐reported outcomes in patients with active ankylosing spondylitis (AS). Methods In this phase III study, 371 patients were randomized (1:1:1) to receive intravenous (IV) secukinumab 10 mg/kg at baseline and weeks 2 and 4 followed by subcutaneous (SC) secukinumab 150 mg every 4 weeks (IV→150 mg group), or SC secukinumab 75 mg every 4 weeks (IV→75 mg group), or placebo. Patient‐reported outcomes included the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), BASDAI criteria for 50% improvement (BASDAI 50), Short Form 36 (SF‐36) physical component summary (PCS) score and mental component summary (MCS) score, Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, Bath Ankylosing Spondylitis Functional Index (BASFI), EuroQol 5‐domain (EQ‐5D) questionnaire, Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT‐F), and Work Productivity and Activity Impairment–General Health questionnaire (WPAI‐GH). Results At week 16, secukinumab IV→150 mg or IV→75 mg was associated with statistically and clinically significant improvements from baseline versus placebo in the BASDAI (−2.3 for both regimens versus −0.6; P < 0.0001 and P < 0.001, respectively), SF‐36 PCS (5.6 for both regimens versus 1.0; P < 0.0001 and P < 0.001, respectively), and ASQoL (−3.6 for both regimens versus −1.0; P < 0.0001 and P < 0.001, respectively). Clinically significant improvements in the SF‐36 MCS, BASFI, EQ‐5D, and BASDAI 50 were observed with both secukinumab groups versus placebo at week 16; improvements were also observed in the FACIT‐F and WPAI‐GH. All improvements were sustained through week 52. Conclusion Our findings indicate that secukinumab provides significant and sustained improvements in patient‐reported disease activity and health‐related quality of life, and reduces functional impairment, fatigue, and

  10. French validation of the Foot Function Index (FFI).

    Science.gov (United States)

    Pourtier-Piotte, C; Pereira, B; Soubrier, M; Thomas, E; Gerbaud, L; Coudeyre, E

    2015-10-01

    French validation of the Foot Function Index (FFI), self-questionnaire designed to evaluate rheumatoid foot according to 3 domains: pain, disability and activity restriction. The first step consisted of translation/back translation and cultural adaptation according to the validated methodology. The second stage was a prospective validation on 53 patients with rheumatoid arthritis who filled out the FFI. The following data were collected: pain (Visual Analog Scale), disability (Health Assessment Questionnaire) and activity restrictions (McMaster Toronto Arthritis questionnaire). A test/retest procedure was performed 15 days later. The statistical analyses focused on acceptability, internal consistency (Cronbach's alpha and Principal Component Analysis), test-retest reproducibility (concordance coefficients), external validity (correlation coefficients) and responsiveness to change. The FFI-F is a culturally acceptable version for French patients with rheumatoid arthritis. The Cronbach's alpha ranged from 0.85 to 0.97. Reproducibility was correct (correlation coefficients>0.56). External validity and responsiveness to change were good. The use of a rigorous methodology allowed the validation of the FFI in the French language (FFI-F). This tool can be used in routine practice and clinical research for evaluating the rheumatoid foot. The FFI-F could be used in other pathologies with foot-related functional impairments. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  11. Brain potentials index executive functions during random number generation.

    Science.gov (United States)

    Joppich, Gregor; Däuper, Jan; Dengler, Reinhard; Johannes, Sönke; Rodriguez-Fornells, Antoni; Münte, Thomas F

    2004-06-01

    The generation of random sequences is considered to tax different executive functions. To explore the involvement of these functions further, brain potentials were recorded in 16 healthy young adults while either engaging in random number generation (RNG) by pressing the number keys on a computer keyboard in a random sequence or in ordered number generation (ONG) necessitating key presses in the canonical order. Key presses were paced by an external auditory stimulus to yield either fast (1 press/800 ms) or slow (1 press/1300 ms) sequences in separate runs. Attentional demands of random and ordered tasks were assessed by the introduction of a secondary task (key-press to a target tone). The P3 amplitude to the target tone of this secondary task was reduced during RNG, reflecting the greater consumption of attentional resources during RNG. Moreover, RNG led to a left frontal negativity peaking 140 ms after the onset of the pacing stimulus, whenever the subjects produced a true random response. This negativity could be attributed to the left dorsolateral prefrontal cortex and was absent when numbers were repeated. This negativity was interpreted as an index for the inhibition of habitual responses. Finally, in response locked ERPs a negative component was apparent peaking about 50 ms after the key-press that was more prominent during RNG. Source localization suggested a medial frontal source. This effect was tentatively interpreted as a reflection of the greater monitoring demands during random sequence generation.

  12. Spinal pseudarthrosis in ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Chan, F.L.; Ho, E.K.W.; Fang, D.; Hsu, L.C.S.; Leong, J.C.Y.; Ngan, H.

    Spinal pseudarthrosis is an important mechanical complication in longstanding ankylosing spondylitis. Thirty-five patients with 40 lesions were studied. Three lesions through vertebral bodies resulted from complete fractures. The rest occured at interspaces, more common at the lower thoracic and upper lumbar segments. Double pseudarthrotic lesions were observed in 5 patients. Progressive osteolysis of the anterior elements was prominent, with variable sclerosis, osteophytes, vacuum phenomenon, subluxation and fragmentation. A posterior element weak link, as a bony break or facet joint non-fusion, was an essential component in every lesion, playing an initiating or perpetuating role in its pathogenesis. Mechanical derangement from trauma, severe round kyphosis, spondylodiscitis, hip disease, spinal operation and unusual activities may be contributing factors. Initial treatment is conservative, but 16 patients required operative stabilisation.

  13. Wnt signaling in ankylosing spondylitis.

    Science.gov (United States)

    Corr, Maripat

    2014-06-01

    The mechanisms that lead to bony fusion in ankylosing spondylitis (AS) are yet to be fully defined. In recent years, there have been several advances in our understanding of this complex disease. Here, the potential impact of the Wnt signaling pathway will be discussed. This pathway is involved in bone morphogenesis and homeostasis. Perturbations in the normal regulation have been implicated in abnormal bone formation (e.g., osteophytes). Levels of Wnt regulatory proteins like Dickkopf have been investigated as potential biomarkers of disease. This pathway might be involved in other aspects of this disease including T cell activation and differentiation, and in bone marrow adipogenesis. The pathways leading to the unique pathology and bony fusion in AS are complex and the Wnt pathway might play a critical contributing role.

  14. Sleep quality and associated factors in ankylosing spondylitis: relationship with disease parameters, psychological status and quality of life.

    Science.gov (United States)

    Batmaz, İbrahim; Sarıyıldız, Mustafa Akif; Dilek, Banu; Bez, Yasin; Karakoç, Mehmet; Çevik, Remzi

    2013-04-01

    The aim of this study is to investigate sleep quality in patients with ankylosing spondylitis (AS) and to evaluate the relationship of the disease parameters with sleep disturbance. Eighty AS patients (60 males and 20 females) fulfilling the modified New York criteria, and 52 age- and gender-matched controls (33 males and 19 females) were enrolled in the study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Pain was measured by visual analogue scale. The disease activity and functional status were assessed by the Bath AS disease Activity Index and the Bath AS Functional Index. The Bath AS Metrology Index was used to evaluate mobility restrictions, and the Bath AS Radiology Index was employed to evaluate the radiological damage. The psychological status and quality of life were assessed with the hospital anxiety-depression scale and AS quality of life scale. The patients with AS had significantly more unfavourable scores in the subjective sleep quality, habitual sleep efficiency domains (p sleep quality (total PSQI score) was positively correlated with increased pain, poor quality of life, higher depressed mood, higher disease activity and mobility restrictions. Pain was also an independent contributor to poorer sleep quality (p = 0.002). The sleep quality is disturbed in patients with AS. The lower quality of sleep is greatly associated with the pain, disease activity, depression, quality of life and increased limitation of mobility.

  15. Disease activity in ankylosing spondylitis and associations to markers of vascular pathology and traditional cardiovascular disease risk factors: a cross-sectional study.

    Science.gov (United States)

    Berg, Inger Jorid; van der Heijde, Désirée; Dagfinrud, Hanne; Seljeflot, Ingebjørg; Olsen, Inge Christoffer; Kvien, Tore K; Semb, Anne Grete; Provan, Sella A

    2015-04-01

    To compare the risk of cardiovascular disease (CVD) in ankylosing spondylitis (AS) and population controls, and to examine the associations between disease activity and CVD risk. A cross-sectional study was done of patients with AS grouped according to Ankylosing Spondylitis Disease Activity Score (ASDAS) into ASDAS-high and ASDAS-low. Markers of vascular pathology, impaired endothelial function [asymmetric dimethylarginine (ADMA)], and arterial stiffness [augmentation index (AIx) and pulse wave velocity (PWV)], and traditional CVD risk factors [blood pressure, lipids, body mass index (BMI), CVD risk scores] were compared between AS and controls as well as across ASDAS-high versus ASDAS-low versus controls using ANCOVA analyses. Altogether, 151 patients with AS and 134 controls participated. Patients had elevated ADMA (µmol/l) and AIx (%) compared to controls: mean difference (95% CI): 0.05 (0.03, 0.07), p risk scores were similar across groups except for Reynolds Risk Score, where the ASDAS-high group had a significantly higher score, compared to both ASDAS-low and controls. Elevated ADMA and AIx in AS support a higher CVD risk in AS. Elevated AIx and BMI in AS with high ASDAS indicate an association between disease activity and CVD risk. Lower total cholesterol in AS may contribute to underestimation of CVD risk.

  16. Integrative Structural Biomechanical Concepts of Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Alfonse T. Masi

    2011-01-01

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

  17. Integrative structural biomechanical concepts of ankylosing spondylitis.

    Science.gov (United States)

    Masi, Alfonse T; Nair, Kalyani; Andonian, Brian J; Prus, Kristina M; Kelly, Joseph; Sanchez, Jose R; Henderson, Jacqueline

    2011-01-01

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

  18. Aquaporin-1 expression as an indicator in evaluating the efficacy of meloxicam in the treatment of ankylosing spondylitis: A comparative study.

    Science.gov (United States)

    Pan, Jie-En; Xiong, Fei-Long; Chen, Gang; Zhang, Zhong-Wei; Xu, You-Jia

    2017-11-01

    The key objective of the study was to investigate the correlation between the expression of aquaporin-1 (AQP1) and the efficacy of meloxicam and expressions of pro-inflammatory cytokines in ankylosing spondylitis (AS). 40 AS patients whom had received meloxicam were recruited and subsequently placed into the experiment, while 40 healthy individuals were recruited as control group. Clinical indicators were detected before treatment (0 week), and at 2, 4, 6, 8, 10 and 12 week intervals after treatment, which included various assessments including Ankylosing Spondylitis 20% (ASAS20) response, Bath ankylosing spondylitis disease activity index (BASDAI), visual analog scale (VAS) for back pain, duration of morning stiffness, Bath ankylosing spondylitis functional index (BASFI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels. Healthy volunteers were examined for ESR and CRP levels. The mRNA and protein expressions of AQP1 and pro-inflammatory cytokines, tumor necrosis factor-α (TNF-α) and interleukin-2 (IL-2), in peripheral blood mononuclear cells (PBMCs) were detected 6 and 12 weeks after treatment using reverse transcription quantitative polymerase chain reaction (RT-qPCR) and Western blotting. Correlation of expressions of AQP1, efficacy of meloxicam and expression of pro-inflammatory cytokines were determined via Pearson correlation analysis. Following 12 weeks of meloxicam treatment, the ASAS20 response reached 93.7±3.61%. 6 weeks after treatment, BASDAI, VAS for back pain, duration of morning stiffness, BASFI, ESR, and CRP levels all exhibited considerably reduced levels compared to the initial levels observed prior to the commencement of treatment. Compared with before treatment, the expressions of TNF-α, IL-2 and AQP1 mRNA and protein all displayed decreases in the experiment group after both 6 and 12-week periods of treatment. Pre and post treatment levels of TNF-α, IL-2 and AQP1 mRNA and protein expressions were higher than those in

  19. Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an iberoamerican spondyloarthritis cohort.

    Science.gov (United States)

    Landi, Margarita; Maldonado-Ficco, Hernán; Perez-Alamino, Rodolfo; Maldonado-Cocco, José A; Citera, Gustavo; Arturi, Pablo; Sampaio-Barros, Percival D; Flores Alvarado, Diana E; Burgos-Vargas, Rubén; Santos, Elena; Palleiro, Daniel; Gutiérrez, Miguel A; Vieira-Sousa, Elsa; Pimentel-Santos, Fernando; Paira, Sergio O; Berman, Alberto; Barrezueta, Claudia Vera; Vazquez-Mellado, Janitzia; Collantes-Estevez, Eduardo

    2016-12-01

    The aim of the study was to compare clinical manifestations, disease activity, functional capacity, spinal mobility, and radiological findings between men and women from a multicenter, multiethnic Ibero-American cohort of patients with Spondyloarthritis (SpA).This observational cross-section study included 1264 consecutive SpA patients who fulfilled the modified New York criteria for ankylosing spondylitis (AS). Demographic, clinical, and radiologic data were evaluated. Categorical data were compared by X or Fisher's exact tests and continuous variables by ANOVA with post-hoc tests.Primary AS was diagnosed in 1072 patients, psoriatic spondylitis in 147, and spondylitis associated to inflammatory bowel disease (IBD) in 45 patients. Overall, male patients were significantly younger, had longer diagnostic delay, lower disease activity, worse spinal mobility, better quality of life, and more severe radiologic damage. Dactylitis and enthesitis, as well as swollen joint count, were significantly more common among women. In primary AS, there was a marked male predominance (76.2%). Among patients with psoriatic spondylitis, male predominance was lower (57.8%), but was also associated with worse spinal mobility and more severe radiologic damage. In the total population, male patients with primary AS referred higher permanent work disability (13.2% vs 6.9%; P spondylitis according to the gender.Among Ibero-American SpA patients, there are some differences in clinical and radiological manifestations, men showing more structural damage, whereas women more active disease. These data suggest that the phenotype of SpA differs between genders. This can influence the subsequent diagnostic approach and therapeutic decisions.

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

    Science.gov (United States)

    Chen, Wei-Chiao; Wei, James Cheng-Chung; Lu, Hsing-Fang; Wong, Henry Sung-Ching; Woon, Peng Yeong; Hsu, Yu-Wen; Huang, Jin-Ding; Chang, Wei-Chiao

    2017-01-01

    Ankylosing spondylitis (AS) is a systemic autoimmune disease mainly affecting the lumbar spine and sacroiliac joints, and exhibits peripheral inflammatory arthropathy. More than 25 loci have been identified as associated with AS. Because both AS and rheumatoid arthritis (RA) are autoimmune diseases that may share some common genetic factors, we therefore examined if the newly identified RA genetic polymorphisms were associated with AS in a Taiwanese population. In this study, we enrolled 475 AS patients and 11,301 healthy subjects from a Taiwanese biobank as controls. Although none of single-nucleotide polymorphisms (SNPs) were associated with the susceptibility to AS, the AS disease index Bath AS Global (BAS-G) clinical phenotype was observed as significantly correlated to the AA genotype of rs657075 (CSF2). The significance remains after gender/age/disease duration adjustment and after group categorization by human leukocyte antigen-B 27 (HLA-B27) genotype. We further investigated the possible functions of rs657075 through bioinformatics approaches. Results revealed that polymorphism of rs657075 is able to influence the expression of acyl-CoA synthetase long-chain family member 6 (ACSL6). In conclusion, our study indicated that rs657075 (CSF2) is strongly associated with the AS disease index Bath AS Global (BAS-G) clinical phenotype. PMID:28054948

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

    Science.gov (United States)

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

    2013-01-01

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

  2. Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome

    Directory of Open Access Journals (Sweden)

    Şenol Kobak

    2013-01-01

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

  3. Tinnitus functional index: validation of the German version for Switzerland.

    Science.gov (United States)

    Peter, Nicole; Kleinjung, Tobias; Jeker, Raphael; Meyer, Martin; Klaghofer, Richard; Weidt, Steffi

    2017-05-05

    Different standardized questionnaires are used to assess tinnitus severity, making comparisons across studies difficult. These questionnaires are also used to measure treatment-related changes in tinnitus although they were not designed for this purpose. To solve these problems, a new questionnaire - the Tinnitus Functional Index (TFI) - has been established. The TFI is highly responsive to treatment-related change and promises to be the new gold standard in tinnitus evaluation. The aim of the current study was to validate a German version of the TFI for a German-speaking population in Switzerland. At the ENT department of the University Hospital Zurich, 264 subjects completed an online survey including the German version for Switzerland of TFI, Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and sociodemographic variables. Internal consistency of the TFI was calculated with Cronbach's alpha coefficient. Pearson correlation coefficients were used for the test-retest reliability of the TFI and to investigate convergent and discriminant validity between the THI and the BDI and BAI, respectively. Factor analysis was assessed using a principal component analysis with oblique rotation. The different factors extracted were then compared with the original questionnaire. The German version of the TFI for Switzerland showed an excellent internal consistency (Cronbach's alpha of 0.97) and an excellent test-retest reliability of 0.91. The convergent validity with THI was high (r = 0.86). The discriminant validity with BAI and BDI showed moderate results (BAI: r = 0.60 and BDI: r = 0.65). In the factor analysis only five factors with one main factor could be extracted instead of eight factors as described in the original version. Nevertheless, relations to the original eight subscales could be demonstrated. The German version of the TFI for Switzerland is a suitable instrument for measuring the impact of tinnitus

  4. Efficiency of adalimumab, etanercept and infliximab in ankylosing spondylitis in clinical practice.

    Science.gov (United States)

    Escudero-Vilaplana, Vicente; Ramírez-Herráiz, Esther; Alañón-Plaza, Estefanía; Trovato-López, Nicolás; García-Vicuña, Rosario; Carreño-Pérez, Luis; Morell-Baladrón, Alberto; Sanjurjo-Sáez, María

    2015-10-01

    Information on the use of ankylosing spondylitis (AS) therapies in clinical practice is a key factor in decision making, as more efficient treatments may involve substantial savings while maintaining the clinical benefits for the patient. To assess the mean annual doses and associated costs of the three main anti-tumour necrosis factor agents used in Spanish daily clinical practice in ankylosing spondylitis patients and to correlate these costs with disease activity. This retrospective, observational study included adult ankylosing spondylitis patients over a 4-year period that had been treated for at least 6 months with adalimumab, etanercept or infliximab at two University Hospitals in Spain. Disease activity was estimated with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores at the start of anti-tumour necrosis factor (anti-TNF) therapy and in the last visit or whenever the drug was switched. Mean costs were estimated for a 52-week horizon from the delivered doses registered by pharmacy records. Outcomes were the doses and costs of anti TNFs administered to each patient, and the BASDAI score. A total of 119 patients (137 cases) were included (28 cases treated with adalimumab, 48 cases with etanercept and 61 with infliximab). Mean doses of adalimumab and etanercept were 92.8 and 88.8% of the initially prescribed doses, respectively, while the mean dose of infliximab administered was 102%. There were no statistical differences among treatments in terms of clinical effectiveness. Associated mean patient-year costs were significantly higher in the infliximab group (€14,235), compared to the other treatments [adalimumab €11,934; etanercept €10,516; (P ankylosing spondylitis patients, doses and associated costs of biological therapies can be reduced while controlling disease activity. Mean doses used in our clinical practice vary from the recommended doses and are significantly lower for adalimumab and etanercept than for infliximab. These

  5. Maintenance of improvement in spinal mobility, physical function and quality of life in patients with ankylosing spondylitis after 5 years in a clinical trial of adalimumab.

    Science.gov (United States)

    van der Heijde, Désirée; Breban, Maxime; Halter, Dale; DiVittorio, Gino; Bratt, Johan; Cantini, Fabrizio; Kary, Sonja; Pangan, Aileen L; Kupper, Hartmut; Rathmann, Suchitrita S; Sieper, Joachim; Mease, Phillip J

    2015-07-01

    Chronic pain and progressive loss of physical function with AS may adversely affect health-related quality of life (HRQoL). The objective of this study was to assess the 5-year data regarding spinal mobility, physical function and HRQoL in patients with AS who participated in the Adalimumab Trial Evaluating Long-term Efficacy and Safety for AS (ATLAS) study. Patients received blinded adalimumab 40 mg or placebo every other week for 24 weeks, then open-label adalimumab for up to 5 years. Spinal mobility was evaluated using linear BASMI (BASMIlin). BASDAI, total back pain, CRP, BASFI, Short Form-36 and AS quality of life (ASQoL) were also assessed. Correlations between BASMIlin and clinical, functional and ASQoL outcomes after 12 weeks and after 5years of adalimumab exposure were evaluated using Spearman's rank correlation. Associations were further analysed using multivariate regression. Three hundred and eleven patients received ≥1 dose of adalimumab; 125 of the 208 patients originally randomized to adalimumab received treatment for 5 years. Improvements in BASMIlin were sustained through 5 years, with a mean change of -0.6 from baseline in the population who completed 5 years of treatment with adalimumab. Improvements in disease activity, physical function and ASQoL were also sustained through 5 years. BASMIlin was significantly correlated with all evaluated clinical outcomes (P mobility, disease activity, physical function and HRQoL in patients with active AS. Spinal mobility was significantly associated with short- and long-term physical function in these patients. Clinicaltrials.gov; https://clinicaltrials.gov/NCT00085644. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology.

  6. Indexed

    CERN Document Server

    Hagy, Jessica

    2008-01-01

    Jessica Hagy is a different kind of thinker. She has an astonishing talent for visualizing relationships, capturing in pictures what is difficult for most of us to express in words. At indexed.blogspot.com, she posts charts, graphs, and Venn diagrams drawn on index cards that reveal in a simple and intuitive way the large and small truths of modern life. Praised throughout the blogosphere as “brilliant,” “incredibly creative,” and “comic genius,” Jessica turns her incisive, deadpan sense of humor on everything from office politics to relationships to religion. With new material along with some of Jessica’s greatest hits, this utterly unique book will thrill readers who demand humor that makes them both laugh and think.

  7. Maximal Inspiratory Pressure: A Lost Point Trying to Explain a S-Index Function Line Index

    Directory of Open Access Journals (Sweden)

    Paulo Eugênio Silva, João Luiz Quaglioti Durigan, Gerson Cipriano

    2015-12-01

    Full Text Available Minahan et al. (2015 recently published a study that examined respiratory strength using a new device, POWERbreathe K5, before and after a strenuous exercise, in comparison with an well-established maneuver to evaluate the maximum inspiratory pressure (MIP. In this study, authors have compared a dynamic evaluation of the inspiratory muscles (S-Index with a quasi-isometric evaluation (MIP including a scientific rational about an isokinetic and isometric limb muscles evaluation, even considering that the S-index is not an isokinetic parameter. The authors did not find respiratory muscle fatigue evaluated by these two different parameters before and after whole body exercise protocol. However, the present results may have been influenced by two confounders: 1 The exercise protocol used to induce respiratory muscle fatigue and 2 The learning effect of the test.

  8. The extremity function index (EFI), a disability severity measure for neuromuscular diseases: psychometric evaluation.

    Science.gov (United States)

    Bos, Isaäc; Wynia, Klaske; Drost, Gea; Almansa, Josué; Kuks, Jan B M

    2018-06-01

    To adapt and to combine the self-report Upper Extremity Functional Index and Lower Extremity Function Scale, for the assessment of disability severity in patients with a neuromuscular disease and to examine its psychometric properties in order to make it suitable for indicating disease severity in neuromuscular diseases. A cross-sectional postal survey study was performed among patients diagnosed with a neuromuscular disease. Patients completed both adapted extremity function scales, questionnaires for psychometric evaluation, and disease-specific questions. Confirmatory factor analysis was performed, and reliability and validity were examined. Response rate was 70% (n = 702). The Extremity Function Index model with a two-factor structure - for upper and lower extremities - showed an acceptable fit. The Extremity Function Index scales showed good internal consistency (alphas: 0.97-0.98). The known-groups validity test confirmed that Extremity Function Index scales discriminate between categories of "Extent of limitations" and "Quality of Life." Convergent and divergent validity tests confirmed that Extremity Function Index scales measure the physical impact of neuromuscular diseases. Relative validity tests showed that the Extremity Function Index scales performed well in discriminating between subgroups of patients with increasing "Extent of limitations" compared to concurrent measurement instruments. The Extremity Function Index proved to be a sound and easy to apply self-report disability severity measurement instrument in neuromuscular diseases. Implications for rehabilitation The Extremity Function Index reflects the functioning of all muscles in the upper and lower extremities involved in activities of daily living. The Extremity Function Index is an easy to administer and patient-friendly disability severity measurement instrument that has the ability to evaluate differences in disability severity between relevant neuromuscular disease subgroups. The

  9. Functional ability level development and validation: providing clinical meaning for Spinal Cord Injury Functional Index scores.

    Science.gov (United States)

    Sinha, Richa; Slavin, Mary D; Kisala, Pamela A; Ni, Pengsheng; Tulsky, David S; Jette, Alan M

    2015-08-01

    To develop functional ability levels for the Spinal Cord Injury Functional Index (SCI-FI) and to validate them using calibration and reliability samples. Three-phase strategy involved (1) performing quantitative synthesis of SCI-FI data to create item maps; (2) using a panel of experts to identify functional ability levels after the bookmarking and Delphi consensus-building process; and (3) performing quantitative analyses to examine demographic characteristics across 2 samples, assessing the distribution pattern across functional ability levels, and examining concurrent validity using the self-reported functional measure and the observer-rated FIM. Inpatient and community settings. People 18 years or older with traumatic spinal cord injury (N=1124) were recruited from the Spinal Cord Injury Model Systems programs and stratified by diagnosis, severity, and time since injury (n=855 and n=269 for calibration and reliability samples, respectively). Not applicable. SCI-FI. Five functional ability levels were identified for all SCI-FI domains, except fine motor having 4 functional ability levels. Statistical test results indicated no significant differences in the distribution pattern across the 2 samples across functional ability levels for all domains except for ambulation. Known-group comparisons were able to discern the spinal cord injury population as expected. Basic mobility, self-care, and wheelchair mobility domains had a cluster of persons with paraplegia and incomplete lesions at higher functional ability levels and persons with tetraplegia and complete lesions at lower functional ability levels. For the ambulation domain, the distribution was skewed to the lower end, with a relatively small percentage of persons with incomplete lesions (paraplegia and tetraplegia) at higher functional ability levels. For the fine motor domain, the distribution was skewed to higher functional ability levels, with a high percentage of persons with paraplegia at the highest

  10. Posterior Surgical Approach to Tuberculous Spondylitis | Shehu ...

    African Journals Online (AJOL)

    Objectives: Foraminotomy is a simple posterior surgical approach useful for treatment of radicular (nerve root) pain in TB spondylitis. It doesn't affect the stability of the facet joint, requires neither fusion nor implants. It is therefore cheap and affordable for patients with low income. We describe a simple form of posterior spinal ...

  11. Employment perspectives of patients with ankylosing spondylitis

    NARCIS (Netherlands)

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

    2002-01-01

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

  12. Radon within therapeutic strategies of ankylosing spondylitis

    International Nuclear Information System (INIS)

    Herold, M.; Lind-Albrecht, G.

    2008-01-01

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

  13. Radiation-induced leukemias in ankylosing spondylitis

    International Nuclear Information System (INIS)

    Toolis, F.; Potter, B.; Allan, N.C.; Langlands, A.O.

    1981-01-01

    Three cases of leukemia occurred in patients with ankylosing spondylitis treated by radiotherapy. In each case, the leukemic process exhibited bizarre features suggesting that radiation is likely to induce atypical forms of leukemia possessing unusual attributes not shared by spontaneously developing leukemia. The likely distinctive aspects of radiation-induced leukemia are discussed

  14. Ankylosing spondylitis and bowel disease.

    Science.gov (United States)

    Rudwaleit, Martin; Baeten, Dominique

    2006-06-01

    Between 5 and 10% of cases of ankylosing spondylitis (AS) are associated with inflammatory bowel disease (IBD), either Crohn's disease or ulcerative colitis. A much larger percentage of AS patients have subclinical gut inflammation manifested either by endoscopic findings or by histology. The association with HLA-B27 is less strong in IBD-associated AS than in idiopathic AS, and there is evidence for an association between gut inflammation in AS with the Crohn's-disease-related CARD15 mutations. Despite the different genetics, the immunopathology suggests common inflammatory pathways in gut and joint inflammation in AS, and in gut inflammation in AS and IBD. Although this observation is of interest to unravel the pathophysiology of the disease, systematic screening of AS patients by ileocolonoscopy is not indicated in the absence of gut symptomatology as only a small proportion of AS patients with subclinical gut inflammation will develop overt IBD over time. Treatment of AS associated with IBD with non-steroidal anti-inflammatory drugs (NSAIDs) is problematic because of concerns of potential re-activation of IBD by NSAIDs. Major advances have been made in recent years with the establishment of anti-tumour necrosis factor (TNF) therapy in AS, the other spondyloarthritides and IBD. Anti-TNF agents are of particular relevance to AS patients with concomitant IBD who are at risk of exacerbation of the underlying bowel disease when treated with NSAIDs. In IBD, infliximab, unlike etanercept, is effective in treating clinical symptoms, inducing and maintaining remission, and mucosal healing. Adalimumab appears to be effective in treating both AS and IBD; however, official approval is pending. Currently, infliximab is the drug of choice for the treatment of patients with active AS associated with IBD.

  15. Assessment of sexual function in patients undergoing vasectomy using the international index of erectile function

    Directory of Open Access Journals (Sweden)

    Eduardo Bertero

    2005-10-01

    Full Text Available INTRODUCTION: The present study aims to prospectively compare the sexual function in males before and after vasectomy surgery using the international index of erectile function (IIEF. MATERIALS AND METHODS: From October to December 2002, sixty-four patients who were candidates for male sterilization in the vasectomy program of the Urology Section at the General Hospital of the University of São Paulo were included. The same investigator applied the IIEF before and 90 days after the surgery. The mean scores obtained on pre and postoperative visits for all domains of sexual function were analyzed and compared with the Wilcoxon test. RESULTS: The mean patient age was 35 years (range from 25 to 48 years and the mean number of children per man was 3. The total mean score of the IIEF was 64.06 before surgery and 65.64 after the procedure, with this difference considered statistically significant (p < 0.001. Sixty-seven per cent of the patients improved their scores, versus 17% and 16% who showed worsening or no change at all in IIEF scores following surgery, respectively. Of the 5 sexual function domains, desire and sexual satisfaction presented statistically significant improvement. CONCLUSION: This study showed that vasectomy caused a positive impact on sexual function, especially on desire and sexual satisfaction, in the majority of men undergoing surgery. There was no case of surgery-related erectile dysfunction.

  16. Relations among several nuclear and electronic density functional reactivity indexes

    Science.gov (United States)

    Torrent-Sucarrat, Miquel; Luis, Josep M.; Duran, Miquel; Toro-Labbé, Alejandro; Solà, Miquel

    2003-11-01

    An expansion of the energy functional in terms of the total number of electrons and the normal coordinates within the canonical ensemble is presented. A comparison of this expansion with the expansion of the energy in terms of the total number of electrons and the external potential leads to new relations among common density functional reactivity descriptors. The formulas obtained provide explicit links between important quantities related to the chemical reactivity of a system. In particular, the relation between the nuclear and the electronic Fukui functions is recovered. The connection between the derivatives of the electronic energy and the nuclear repulsion energy with respect to the external potential offers a proof for the "Quantum Chemical le Chatelier Principle." Finally, the nuclear linear response function is defined and the relation of this function with the electronic linear response function is given.

  17. Identification of Potential Transcriptomic Markers in Developing Ankylosing Spondylitis: A Meta-Analysis of Gene Expression Profiles

    Science.gov (United States)

    Fang, Fang; Pan, Jian; Xu, Lixiao; Li, Gang; Wang, Jian

    2015-01-01

    The goal of this study was to identify potential transcriptomic markers in developing ankylosing spondylitis by a meta-analysis of multiple public microarray datasets. Using the INMEX (integrative meta-analysis of expression data) program, we performed the meta-analysis to identify consistently differentially expressed (DE) genes in ankylosing spondylitis and further performed functional interpretation (gene ontology analysis and pathway analysis) of the DE genes identified in the meta-analysis. Three microarray datasets (26 cases and 29 controls in total) were collected for meta-analysis. 905 consistently DE genes were identified in ankylosing spondylitis, among which 482 genes were upregulated and 423 genes were downregulated. The upregulated gene with the smallest combined rank product (RP) was GNG11 (combined RP = 299.64). The downregulated gene with the smallest combined RP was S100P (combined RP = 335.94). In the gene ontology (GO) analysis, the most significantly enriched GO term was “immune system process” (P = 3.46 × 10−26). The most significant pathway identified in the pathway analysis was antigen processing and presentation (P = 8.40 × 10−5). The consistently DE genes in ankylosing spondylitis and biological pathways associated with those DE genes identified provide valuable information for studying the pathophysiology of ankylosing spondylitis. PMID:25688367

  18. Identification of Potential Transcriptomic Markers in Developing Ankylosing Spondylitis: A Meta-Analysis of Gene Expression Profiles

    Directory of Open Access Journals (Sweden)

    Fang Fang

    2015-01-01

    Full Text Available The goal of this study was to identify potential transcriptomic markers in developing ankylosing spondylitis by a meta-analysis of multiple public microarray datasets. Using the INMEX (integrative meta-analysis of expression data program, we performed the meta-analysis to identify consistently differentially expressed (DE genes in ankylosing spondylitis and further performed functional interpretation (gene ontology analysis and pathway analysis of the DE genes identified in the meta-analysis. Three microarray datasets (26 cases and 29 controls in total were collected for meta-analysis. 905 consistently DE genes were identified in ankylosing spondylitis, among which 482 genes were upregulated and 423 genes were downregulated. The upregulated gene with the smallest combined rank product (RP was GNG11 (combined RP=299.64. The downregulated gene with the smallest combined RP was S100P (combined RP=335.94. In the gene ontology (GO analysis, the most significantly enriched GO term was “immune system process” (P=3.46×10-26. The most significant pathway identified in the pathway analysis was antigen processing and presentation (P=8.40×10-5. The consistently DE genes in ankylosing spondylitis and biological pathways associated with those DE genes identified provide valuable information for studying the pathophysiology of ankylosing spondylitis.

  19. Identification of potential transcriptomic markers in developing ankylosing spondylitis: a meta-analysis of gene expression profiles.

    Science.gov (United States)

    Fang, Fang; Pan, Jian; Xu, Lixiao; Li, Gang; Wang, Jian

    2015-01-01

    The goal of this study was to identify potential transcriptomic markers in developing ankylosing spondylitis by a meta-analysis of multiple public microarray datasets. Using the INMEX (integrative meta-analysis of expression data) program, we performed the meta-analysis to identify consistently differentially expressed (DE) genes in ankylosing spondylitis and further performed functional interpretation (gene ontology analysis and pathway analysis) of the DE genes identified in the meta-analysis. Three microarray datasets (26 cases and 29 controls in total) were collected for meta-analysis. 905 consistently DE genes were identified in ankylosing spondylitis, among which 482 genes were upregulated and 423 genes were downregulated. The upregulated gene with the smallest combined rank product (RP) was GNG11 (combined RP=299.64). The downregulated gene with the smallest combined RP was S100P (combined RP=335.94). In the gene ontology (GO) analysis, the most significantly enriched GO term was "immune system process" (P=3.46×10(-26)). The most significant pathway identified in the pathway analysis was antigen processing and presentation (P=8.40×10(-5)). The consistently DE genes in ankylosing spondylitis and biological pathways associated with those DE genes identified provide valuable information for studying the pathophysiology of ankylosing spondylitis.

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

    OpenAIRE

    Le Chatelier, Emmanuelle; He, Zhixing; Zhong, Wendi; Fan, Yongsheng; Zhang, Linshuang; Li, Haichang; Wu, Chunyan; Hu, Changfeng; Xu, Qian; Zhou, Jia; Cai, Shunfeng; Wang, Dawei; Huang, Yun; Breban, Maxime; Qin, Nan

    2017-01-01

    Background The assessment and characterization of the gut microbiome has become a focus of research in the area of human autoimmune diseases. Ankylosing spondylitis is an inflammatory autoimmune disease and evidence showed that ankylosing spondylitis may be a microbiome-driven disease. Results To investigate the relationship between the gut microbiome and ankylosing spondylitis, a quantitative metagenomics study based on deep shotgun sequencing was performed, using gut microbial DNA from 211 ...

  1. Entire Functions of Bounded L-Index: Its Zeros and Behavior of Partial Logarithmic Derivatives

    Directory of Open Access Journals (Sweden)

    Andriy Bandura

    2017-01-01

    Full Text Available In this paper, we obtain new sufficient conditions of boundedness of L-index in joint variables for entire function in Cn functions. They give an estimate of maximum modulus of an entire function by its minimum modulus on a skeleton in a polydisc and describe the behavior of all partial logarithmic derivatives and the distribution of zeros. In some sense, the obtained results are new for entire functions of bounded index and l-index in C too. They generalize known results of Fricke, Sheremeta, and Kuzyk.

  2. Evaluating the cardiac function of duchenne muscular dystrophy with Doppler Tei index

    International Nuclear Information System (INIS)

    Yao Fengjuan; Zheng Ju; Lu Kun; Liu Donghong; Wu Miaoling; Lin Hong; Zhang Cheng; Yu Hongkui

    2007-01-01

    Objective: To evaluate the cardiac function of early Duchenne muscular dystrophy (DMD) by left ventricular ejection fraction (LVEF) and pulse Doppler Tei index. Methods: Twenty-eight DMD patients and fifteen normal people were studied. LVEF, E/A and Tei index were measured and calculated by M-mode and Pulse wave Doppler respectively. Results: Compared with control group, Tei index and IRT were significantly high, and there were not significant difference in LVEF(%) and E/A. Conclusion: Tei index was valuable in assessing cardiac function of early DMD. (authors)

  3. The role of Vitamin D in immuno-inflammatory responses in Ankylosing Spondylitis patients with and without Acute Anterior Uveitis.

    Science.gov (United States)

    Mitulescu, T C; Stavaru, C; Voinea, L M; Banica, L M; Matache, C; Predeteanu, D

    2016-01-01

    Hypothesis: Abnormal Vitamin D (Vit D) level could have consequences on the immuno-inflammatory processes in Ankylosing Spondylitis (AS). Aim: The purpose of this study was to analyze the role of Vitamin D in the interplay between immune and inflammation effectors in AS associated-Acute Anterior Uveitis (AAU). Methods and Results: 25-hydroxyvitamin D (Vit D), LL-37 peptide, IL-8 and Serum Amyloid A (SAA) were identified and quantified in the serum/ plasma of thirty-four AS patients [eleven AS patients presenting AAU (AAU AS patients) and twenty-three AS patients without AAU (wAAU AS patients)] and eighteen healthy individuals (Control) using enzyme-linked immunosorbent assay. Acute-phase SAA level was significantly higher in AS patients compared to Controls. Contrary with wAAU AS patients, significantly elevated levels of IL-8, and diminished levels of Vit D characterized AAU AS patients. Regarding LL-37, its level decreased concomitantly with the level of Vit D. When AS patients were subgrouped based on AAU presence or on Vit D level, important associations between immuno-inflammatory assessed markers and AS features were noticed. Generally, Vit D levels were associated indirectly with leukocytes/ neutrophils number or with ESR, CRP, and Fibrinogen levels. The levels of SAA and IL-8 associated directly with AAU or with AAU relapses, especially in AS patients with Vit D insufficiency, while SAA associated directly with infection/ inflammatory markers and with disease activity indexes or with the degree of functional limitation. Discussion: Altered levels of Vit D affect the balance between LL-37, IL-8 and SAA, suggesting an association with AAU, an extra-articular manifestation of AS. Abbreviations: Vit D = Vitamin D, AS = Ankylosing Spondylitis, AAU = Acute Anterior Uveitis, AAU AS = AS patients with AAU, wAAU AS = AS patients without AAU, SSZ = Sulphasalazine, Leu = Leukocytes, Neu = Neutrophils.

  4. Investigation of integrated quality index of desserts and functional beverages

    OpenAIRE

    Свідло, Карина Володимирівна; Жулінська, Оксана Володимирівна

    2015-01-01

    Implementation of the strategic directions of the development of food functional production in Ukraine is aimed at growth in production of healthy food. Among dietary factors relevant to maintaining health, working capacity and active longevity a decisive role belongs to the regular supply of the body's functional complex of macro- and micronutrients contained in dietary supplements and physiologically active materials. Permanent deficit of such nutrients leads to the fact that the physical c...

  5. Body Mass Index (BMI) and Cognitive Functions in Later Life.

    Science.gov (United States)

    Momtaz, Yadollah A; Haron, Sharifah A; Hamid, Tengku A; Ibrahim, Rahimah; Tanjani, Parisa T

    2018-01-01

    The findings from previous studies exploring the association between BMI and cognitive function in the elderly are conflicting. The purpose of the present study is twofold; to verify the association between BMI and cognitive functions and examine whether this association is impacted by height, when adjusted for possible covariates. The data for this study, consisted of 2287 older adults aged 60 years and above, drawn from a nationally representative population-based survey entitled "Determinants of Wellness among Older Malaysians: A Health Promotion Perspective" conducted in 2009. The mean age of the respondents was 68.7 (SD=6.6) years. The average score of cognitive function, measured by MMSE was 24.5 (SD=5.6). About 40% of the respondents were classified as overweight. Results of the multiple linear regression analysis revealed a significant association between BMI and cognitive function (Beta=.10, pFactorial ANCOVA revealed significant interaction effect between BMI and height on cognitive function (F= 10.8, p<.001), after adjusting for possible covariates. The findings from the current study indicating the positive association between BMI and cognitive function depends on height, therefore it is suggested that short people might be targeted for dementia prevention. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  6. Role of Th1/Th2 cytokines in the diagnosis and prognostic evaluation of ankylosing spondylitis.

    Science.gov (United States)

    Wen, J T; Zhang, D H; Fang, P F; Li, M H; Wang, R J; Li, S H

    2017-03-16

    Ankylosing spondylitis (AS), a progressive disease of the spine, manifests as peripheral arthritis with tendon and ligament inflammation that restricts activity. AS is a rheumatoid autoimmune disease although the rheumatoid factor is absent in patients with AS. It is characterized by inflammatory changes such as elevated levels of serum inflammatory factors. The roles of Th1 and Th2 cytokines in autoimmune diseases are well known. However, the roles of these cytokines in the diagnosis and prognosis of AS is poorly understood. The aim of this study was to investigate the roles of Th1/Th2 cytokines in the diagnosis and prognosis of AS. The BASDAI activity, BASFI functional index, BASMI measurement score, and the levels of CRP and ESR were measured during the treatment of patients with active AS. The levels of IFN-γ and TNF-α (Th1 cytokines) and IL-4 and IL-10 (Th2 cytokines) were quantified. The levels of IL-4 and IL-10 were significantly low in the serum of patients with active AS, who also had high IFN-γ and TNF-α levels compared to those in the control individuals (P cytokines in patients with AS may reflect disease activity and prognosis.

  7. [Comparison of clinical manifestations according to HLA-B(27) genotype in ankylosing spondylitis patients: real-world evidence from smart management system for spondyloarthritis].

    Science.gov (United States)

    Ji, X J; Sun, K; Hu, Z Y; Zhang, Y; Ma, Y P; Sun, Z; Li, K P; Zhu, J; Zhang, J L; Huang, F

    2018-03-01

    Objective: The aim of this study was to set up a large, longitudinal and prospective database to compare the clinical manifestations in human leucocyte antigen (HLA)-B(27) positive and negative patients with ankylosing spondylitis(AS) based on real-world evidence in Chinese population. Methods: A total of 897 outpatients with confirmed AS were recruited consecutively by smart management system for spondyloarthritis (SMSP) from April 13, 2016 to June 6, 2017 in Chinese PLA General Hospital from 30 provinces and autonomous regions. 801 patients with HLA-B(27) data were included in the analysis. Demographic and clinical parameters including Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), ankylosing spondylitis disease activity score (ASDAS), arthritis, enthesitis, Bath ankylosing spondylitis metrology index (BASMI), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were compared between HLA-B(27) positive and negative groups. Results: A total of 801 patients were included in the analysis with an average age of (30.7±8.8) years. There were 659 males and 142 females and HLA-B(27) was present in 88.0%(705/801). Males were significantly more in HLA-B(27) positive patients [83.3%(587/705) vs. 75.0%(72/96); P= 0.047].The average age at disease onset was (22.3±7.6)years in HLA-B(27) positive patients and (24.4±8.7) years in HLA-B(2)7 negative ones ( P= 0.028).There was significant difference in diagnose delay between two groups [14.3(2.5,43.6)months in HLA-B(27) positive patients vs. 20.3(5.0,67.4) months in HLA-B(27) negative ones, P= 0.041]. Anterior uveitis was found to be significantly more common in HLA-B(27) positive patients [18.9% (133/705)vs.7.3%(7/96), P= 0.005], and knee involvement less common in HLA-B(27) positive patients [4.0%(27/682) vs.10.0%(9/90), P= 0.010], conversely. CRP[6.5(3.0, 16.4)mg/L vs. 3.5(1.6, 12.3)mg/L] and ESR[11.0(4.0, 24.0)mm/1h vs. 7.0(3.0, 16.0)mm/1h

  8. Indexes of physical development, physical preparedness and functional state of polish students

    Directory of Open Access Journals (Sweden)

    Prusik Krzysztof.

    2012-12-01

    Full Text Available The purpose of work - determination of level of physical development, physical preparedness and functional state of the Polish students. In research took part 50 students of Higher School of Sciences about a Health from Bydgoshch (14 boys and 36 girls, aged 18-29 years. It is exposed, that the indexes of flexibility correspond the middle indexes of flexibility of spine for people, not going in for sports. The indexes of Index of Kettle correspond a normosthenic build, there are separate cases of failing and surplus of mass of body. It is set that the index of Index Rufe corresponds the satisfactory estimation of capacity. The indexes of test of Romberga testify to the low functional state of vestibular analyzer and low level of static co-ordination. More high indexes of force of the left brush are got as compared to right. It is exposed, that indexes simple a reaction on a sound above average level, indexes of reaction of choice are at satisfactory level, and indexes simple a reaction on light - below the average level. A change of frequency of heart-throbs in an orthostatic test is within the limits of norm. In the system of physical education it is necessary to spare the special attention development of the cardiovascular system and vestibular stability, and also instrumental in the change of appearance life of students toward the increase of their motive activity.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2014-11-01

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

  11. Efficacy of certolizumab pegol on signs and symptoms of axial spondyloarthritis including ankylosing spondylitis: 24-week results of a double-blind randomised placebo-controlled Phase 3 study

    Science.gov (United States)

    Landewé, R; Braun, J; Deodhar, A; Dougados, M; Maksymowych, W P; Mease, P J; Reveille, J D; Rudwaleit, M; van der Heijde, D; Stach, C; Hoepken, B; Fichtner, A; Coteur, G; de Longueville, M; Sieper, J

    2014-01-01

    Objectives To evaluate the efficacy and safety of certolizumab pegol (CZP) after 24 weeks in RAPID-axSpA (NCT01087762), an ongoing Phase 3 trial in patients with axial spondyloarthritis (axSpA), including patients with ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA). Methods Patients with active axSpA were randomised 1:1:1 to placebo, CZP 200 mg every 2 weeks (Q2W) or CZP 400 mg every 4 weeks (Q4W). In total 325 patients were randomised. Primary endpoint was ASAS20 (Assessment of SpondyloArthritis international Society 20) response at week 12. Secondary outcomes included change from baseline in Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Metrology Index (BASMI) linear. Results Baseline disease activity was similar between AS and nr-axSpA. At week 12, ASAS20 response rates were significantly higher in CZP 200 mg Q2W and CZP 400 mg Q4W arms versus placebo (57.7 and 63.6 vs 38.3, p≤0.004). At week 24, combined CZP arms showed significant (p<0.001) differences in change from baseline versus placebo in BASFI (−2.28 vs −0.40), BASDAI (−3.05 vs −1.05), and BASMI (−0.52 vs −0.07). Improvements were observed as early as week 1. Similar improvements were reported with CZP versus placebo in both AS and nr-axSpA subpopulations. Adverse events were reported in 70.4% vs 62.6%, and serious adverse events in 4.7% vs 4.7% of All CZP versus placebo groups. No deaths or malignancies were reported. Conclusions CZP rapidly reduced the signs and symptoms of axSpA, with no new safety signals observed compared to the safety profile of CZP in RA. Similar improvements were observed across CZP dosing regimens, and in AS and nr-axSpA patients. PMID:24013647

  12. An Index for Measuring Functional Diversity in Plant Communities Based on Neural Network Theory

    Directory of Open Access Journals (Sweden)

    Naiqi Song

    2013-01-01

    Full Text Available Functional diversity in plant communities is a key driver of ecosystem processes. The effective methods for measuring functional diversity are important in ecological studies. A new method based on neural network, self-organizing feature map (SOFM index, was put forward and described. A case application to the study of functional diversity of Phellodendron amurense communities in Xiaolongmen Forest Park of Beijing was carried out in this paper. The results showed that SOFM index was an effective method in the evaluation of functional diversity and its change in plant communities. Significant nonlinear correlations of SOFM index with the common used methods, FAD, MFAD, FDp, FDc, FRic, and FDiv indices, also proved that SOFM index is useful in the studies of functional diversity.

  13. Evaluation of periostin and factors associated with new bone formation in ankylosing spondylitis: Periostin may be associated with the Wnt pathway.

    Science.gov (United States)

    Solmaz, Dilek; Uslu, Sadettin; Kozacı, Didem; Karaca, Neslihan; Bulbul, Hale; Tarhan, Emine Figen; Ozmen, Mustafa; Can, Gercek; Akar, Servet

    2018-02-01

    Periostin has been shown to be involved in bone anabolism through the regulation of Wnt-β-catenin signaling. It may be one of the pathogenic mechanisms in syndesmophyte formation in ankylosing spondylitis (AS). The aim of this study was to evaluate serum periostin levels in patients with AS and to assess relationships among biomarkers of bone formation and periostin in disease outcomes, particularly radiographic changes. Ninety-seven consecutive AS patients (78% male) and 48 healthy controls (75% male) were included in the study. Serum periostin, dickkopf-1 (DKK-1), sclerostin and vascular endothelial growth factor (VEGF) levels were measured using commercially available enzyme-linked immunosorbent assay kits. Disease-related characteristics of patients were assessed using Ankylosing spondylitis disease activity score - C-reactive protein (ASDAS-CRP), Bath AS Disease Activity Index, Bath AS Functional Index and Bath AS metrology index. Radiographs were scored using the modified New York criteria and modified Stokes AS spinal score (mSASSS). Compared with control subjects, patients with AS had significantly lower serum levels of periostin (P < 0.001) and sclerostin (P < 0.001), but higher serum levels of VEGF (P < 0.001) and high-sensitivity CRP (P < 0.001). Serum periostin (P = 0.005) and sclerostin levels (P = 0.016) were significantly lower in patients with very high disease activity according to ASDAS-CRP. Current age (P = 0.009), age at symptom onset (P = 0.021) and hip joint involvement (P = 0.012) were independently associated with the development of syndesmophyte, in contrast to biomarkers of bone metabolism that we evaluated. Our results suggest that periostin is down-regulated in AS patients with highly active disease and may contribute to disease pathogenesis through an interaction with Wnt signaling. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  14. Vitamin D in ankylosing spondylitis: review and meta-analysis.

    Science.gov (United States)

    Cai, Guoqi; Wang, Li; Fan, Dazhi; Xin, Lihong; Liu, Li; Hu, Yanting; Ding, Ning; Xu, Shengqian; Xia, Guo; Jin, Xingzhong; Xu, Jianhua; Zou, Yanfeng; Pan, Faming

    2015-01-01

    The role of vitamin D in ankylosing spondylitis (AS) is largely unknown. This paper aims to examine the association between serum vitamin D levels and susceptibility and disease activity of AS. We searched the relevant literatures in PubMed, Elsevier Science Direct, Chinese Biomedical Database (CBM), Chinese National Knowledge Infrastructure (CNKI) and Wanfang (Chinese) Database published before June 2014. Eight independent case-control studies with a total of 533 AS patients and 478 matching controls were selected into this meta-analysis. Standard mean differences (SMDs) with 95% confidence intervals (CIs) were used to assess the levels of serum vitamin D, parathyroid hormone (PTH), serum calcium and alkaline phosphatase (ALP) in cases and controls, respectively. Correlation coefficients (CORs) have been performed to value the correlationship between vitamin D and disease activity (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)) of AS patients. Meta-analysis results suggested that vitamin D may play a protective role in AS (for total vitamin D: SMD=-0.71, P<0.001; for 25OHD: SMD=-0.66, P=0.002; for 1,25OHD: SMD=-0.72, P=0.19). Differences in PTH and serum calcium levels were not significant in AS (SMD=-0.10, P=0.67; SMD=0.12, P=0.17 respectively), while ALP was associated with AS susceptibility (SMD=0.20, P=0.04). The relationship between serum vitamin D levels and disease activity was statistically significant except for 25OHD versus (vs.) CRP or BASDAI (for CRP vs. 25OHD: COR=-0.22, P=0.08; for BASDAI vs. 25OHD: COR=-0.20, P=0.06, respectively). The higher levels of serum vitamin D were associated with a decreased risk of AS, and showed an inverse relationship with AS activity. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Integrative Structural Biomechanical Concepts of Ankylosing Spondylitis

    OpenAIRE

    Alfonse T. Masi; Kalyani Nair; Brian J. Andonian; Kristina M. Prus; Joseph Kelly; Jose R. Sanchez; Jacqueline Henderson

    2011-01-01

    Ankylosing spondylitis (AS) is not fully explained by inflammatory processes. Clinical, epidemiological, genetic, and course of disease features indicate additional host-related risk processes and predispositions. Collectively, the pattern of predisposition to onset in adolescent and young adult ages, male preponderance, and widely varied severity of AS is unique among rheumatic diseases. However, this pattern could reflect biomechanical and structural differences between the sexes, naturally...

  16. The genomics and genetics of ankylosing spondylitis

    OpenAIRE

    Thomas GP; Kenna TJ; Davidson SI

    2011-01-01

    Tony J Kenna, Stuart I Davidson, Gethin P ThomasUniversity of Queensland Diamantina Institute, Brisbane, AustraliaAbstract: The spondyloarthropathies are a group of arthritides which specifically target the spine and pelvis with ankylosing spondylitis (AS) being the most prevalent and debilitating of these conditions. Unique to AS is the progression to excessive uncontrolled bone formation following an initial inflammatory phase that can result in joint fusion and significant disability. Spon...

  17. Development of multi-functional streetscape green infrastructure using a performance index approach

    Czech Academy of Sciences Publication Activity Database

    Tiwary, A.; Williams, L. D.; Heidrich, O.; Namdeo, A.; Bandaru, V.; Calfapietra, Carlo

    2016-01-01

    Roč. 208, jan (2016), s. 209-220 ISSN 0269-7491 Institutional support: RVO:67179843 Keywords : Green infrastructure * Multi-functional * Pollution * Performance index * Streetscape Subject RIV: EH - Ecology, Behaviour Impact factor: 5.099, year: 2016

  18. Influence of methotrexate on infliximab pharmacokinetics and pharmacodynamics in ankylosing spondylitis

    Science.gov (United States)

    Ternant, David; Mulleman, Denis; Lauféron, Francine; Vignault, Céline; Ducourau, Emilie; Wendling, Daniel; Goupille, Philippe; Paintaud, Gilles

    2012-01-01

    AIMS Infliximab, an anti-tumour necrosis factor α monoclonal antibody, has profoundly modified the treatment of several inflammatory diseases. The objective was to assess the influence of methotrexate on the variability of infliximab pharmacokinetics and concentration–effect relationship in axial ankylosing spondylitis (AAS) patients. METHODS Twenty-six patients with AAS were included in a prospective study. They were treated by infliximab 5 mg kg−1 infusions at weeks 0, 2, 6, 12 and 18. Infliximab concentrations were measured before, and 2 and 4 h after each infusion, and at each intermediate visit (weeks 1, 3, 4, 5, 8, 10 and 14). Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was measured at each visit. Infliximab pharmacokinetics was described using a two-compartment model with first-order distribution and elimination constants. A population approach was used. Infliximab pharmacodynamics was described using the area under the BASDAI curve. RESULTS A total of 507 blood samples and 329 BASDAI measurements were collected. The following pharmacokinetic parameters were obtained (interindividual coefficient of variation): volumes of distribution for the central compartment = 2.4 l (9.6%) and peripheral compartment = 1.8 l (26%), systemic clearance = 0.23 l day−1 (22%) and intercompartment clearance = 2.3 l day−1. Methotrexate influenced neither pharmacokinetic nor BASDAI variability. CONCLUSIONS Using the present dosage, the clinical efficacy of infliximab is only weakly influenced by its serum concentrations. The results do not support the combination of methotrexate with infliximab in ankylosing spondylitis. PMID:21692827

  19. Secukinumab, an Interleukin-17A Inhibitor, in Ankylosing Spondylitis

    NARCIS (Netherlands)

    Baeten, Dominique; Sieper, Joachim; Braun, Jürgen; Baraliakos, Xenofon; Dougados, Maxime; Emery, Paul; Deodhar, Atul; Porter, Brian; Martin, Ruvie; Andersson, Mats; Mpofu, Shephard; Richards, Hanno B.; van den Bosch, Filip; Nzeusseu, Adrien; de Vlam, Kurt; Geusens, Piet; Oparanov, Boycho; Rashkov, Rasho; Batalov, Anastas; Goranov, Ivan; Kazmin, Ivan; McCarthy, Tim; Inman, Robert; Rahman, Proton; Schaeverbeke, Thierry; N'Guyen, Minh; Bertin, Philippe; Frediani, Bruno; Adami, Silvano; Foti, Rosario; Triolo, Giovanni; Fusaro, Enrico; Franceschini, Franco; Zazueta, Beatriz; Maradiaga, Marco; Avila, Hilario; Garza, Mario; Bijlsma, Hans; Berrocal, Alfredo; Garro, Boris; Gamboa, Rocio; Castaneda, Oswaldo; Becerra, Felipe; Stanislav, Marina; Salnikova, Tatyana; Maslyanskiy, Alexey; Ershova, Olga; Izmozherova, Nadezda; Lesniak, Olga; Tseng, Jui-Cheng; Wei, Cheng-Chung; Ozdogan, Huri; Kisacik, Bunyamin; Onen, Fatos; Tahir, Hasan; Ostor, Andrew; Barkham, Nick; Kay, Lesley; Braun, Juergen; Dahmen, Georg; Rubbert-Roth, Andrea; Wassenberg, Siegfried; Oelzner, Peter; Nuesslein, Hubert; Moericke, Ruediger; Rech, Juergen; Kivitz, Alan; Aelion, Jacob; Kohen, Michael; Knibbe, William; LaSalle, Sean; Zang, Song; Cohen, Stanley; Brooks, Michael; Graninger, Winfried; Jorg, Rieger; Zamani, Omid; Bessette, Louis; Cohen, Martin; Beaulieu, Andre; Pavelka, Karel; Galatikova, Dagmar; Dokoupilova, Eva; Leirisalo-Repo, Marjatta; Paimela, Leena; Järvinen, Pentti; Sokka-Isler, Tuulikki; Rouhe, Esa; keskussairaala, Seinäjoen; Pellerito, Raffaele; Trofimov, Vasiliy; Vezikova, Natalia; Zotkin, Eugeny; Mosesova, Nino; Lee, Lui Nai; Cheung, Peter; Balsa, Alejandro; Blanco, Ricardo; Blanco, Francisco J.; Gonzalez, Carlos; Bannert, Bettina; Daniela, Benz; Dudler, Jean; Ciurea, Adrian; Marzo-Ortega, Helena; Gaffney, Karl; Mackay, Kirsten; Codding, Christine; Dorman, Walter; Legerton, Clarence; Khan, Mohamed; Lee, Eric; Caldron, Paul; Wolfe, J. Frederick; Swarup, Areena; Singhal, Atul; Tony, Hans-Peter

    2015-01-01

    BACKGROUND Secukinumab is an anti-interleukin-17A monoclonal antibody that has been shown to control the symptoms of ankylosing spondylitis in a phase 2 trial. We conducted two phase 3 trials of secukinumab in patients with active ankylosing spondylitis. METHODS In two double-blind trials, we

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

    Science.gov (United States)

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

    2017-07-27

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

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

    OpenAIRE

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

    2017-01-01

    Given that the pathogenesis of ankylosing spondylitis (AS) remains unclear, the aim of this study was to detect the potentially functional pathway cross-talk in AS to further reveal the pathogenesis of this disease. Using microarray profile of AS and biological pathways as study objects, Monte Carlo cross-validation method was used to identify the significant pathway cross-talks. In the process of Monte Carlo cross-validation, all steps were iterated 50 times. For each run, detection of diffe...

  2. Does HLA-B27 Status Influence Ankylosing Spondylitis Phenotype?

    Directory of Open Access Journals (Sweden)

    Amal Akassou

    2018-01-01

    Full Text Available The association of HLA-B27 with ankylosing spondylitis (AS remains as one of the intriguing models that could exist between a molecule and human disease in medicine. Although it was reported in 1973, its contribution to AS and related spondyloarthritis continues to be a major challenge for scientific community. It is important to understand its etiopathogenic mechanism and its functions in these diseases. Although the diagnostic and prognostic roles of HLA-B27 in AS are still debated, there is an increasing interest for HLA-B27–based effects especially in HLA-B27(+ patients with AS. This review will focus in the examination of published reports regarding the influence of HLA-B27 status on the demographic and clinical features in AS, with specific interest to its role on AS severity.

  3. Does HLA-B27 Status Influence Ankylosing Spondylitis Phenotype?

    Science.gov (United States)

    Akassou, Amal; Bakri, Youssef

    2018-01-01

    The association of HLA-B27 with ankylosing spondylitis (AS) remains as one of the intriguing models that could exist between a molecule and human disease in medicine. Although it was reported in 1973, its contribution to AS and related spondyloarthritis continues to be a major challenge for scientific community. It is important to understand its etiopathogenic mechanism and its functions in these diseases. Although the diagnostic and prognostic roles of HLA-B27 in AS are still debated, there is an increasing interest for HLA-B27–based effects especially in HLA-B27(+) patients with AS. This review will focus in the examination of published reports regarding the influence of HLA-B27 status on the demographic and clinical features in AS, with specific interest to its role on AS severity. PMID:29343996

  4. Pathogenesis of ankylosing spondylitis - recent advances and future directions.

    Science.gov (United States)

    Ranganathan, Vidya; Gracey, Eric; Brown, Matthew A; Inman, Robert D; Haroon, Nigil

    2017-06-01

    Over the past 5 years, advances in high-throughput techniques and studies involving large cohorts of patients have led to considerable advances in the identification of novel genetic associations and immune pathways involved in ankylosing spondylitis (AS). These discoveries include genes encoding cytokine receptors, transcription factors, signalling molecules and transport proteins. Although progress has been made in understanding the functions and potential pathogenic roles of some of these molecules, much work remains to be done to comprehend their complex interactions and therapeutic potential in AS. In this Review, we outline the current knowledge of AS pathogenesis, including genetic risk associations, HLA-B27-mediated pathology, perturbations in antigen-presentation pathways and the contribution of the type 3 immune response.

  5. Spectral Intensity Variation by the Correlation Function of Refractive Index Fluctuations of the Liquid Medium

    Directory of Open Access Journals (Sweden)

    Nageshwar Singh

    2013-01-01

    Full Text Available It is proposed that a macroscopic theory of propagation and scattering of light through random media can be functional for the dye liquid flowing media in the microscopic levels too, with modest approximations. Maxwell’s equation for a random refractive index medium is approximated and solved for the electric field. An analytical expression for the spectral intensity of the field scattered by the refractive index fluctuations inside a medium has been derived which was valid within the first Born approximation. Far field spectral intensity variation of the radiation propagating through the liquid medium is a consequence of variation in correlation function of the refractive index inhomogeneities. The strength of radiation scattered in a particular direction depends on the spatial correlation function of the refractive index fluctuations of the medium. An attempt is made to explain some of the experimentally observed spectral intensity variations, particularly dye emission propagation through liquid flowing medium, in the presence of thermal and flow field.

  6. Biomarkers of bone metabolism in ankylosing spondylitis in relation to osteoproliferation and osteoporosis.

    Science.gov (United States)

    Klingberg, Eva; Nurkkala, Merja; Carlsten, Hans; Forsblad-d'Elia, Helena

    2014-07-01

    To identify biomarkers for bone metabolism in patients with ankylosing spondylitis (AS) and to determine the relationship between these biomarkers and disease activity, back mobility, osteoproliferation, and bone mineral density (BMD). Serum levels of Wingless protein (Wnt-3a), Dickkopf-1 (DKK-1), sclerostin, soluble receptor activator of nuclear factor-κB ligand (sRANKL), and osteoprotegerin were assessed using ELISA. Ankylosing Spondylitis Disease Activity Score-C reactive protein, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis patient global score, and C-reactive protein (CRP) were used as disease activity measures, and Bath Ankylosing Spondylitis Metrology Index (BASMI) as a measure of spinal mobility. Lateral spine radiographs were scored for chronic AS-related changes (mSASSS). BMD was measured with dual-energy x-ray absorptiometry. Two hundred four patients with AS (NY criteria; 57% men), with a mean age of 50 ± 13 years and disease duration 15 ± 11 years, and 80 age and sex-matched controls were included. The patients with AS had significantly higher serum levels of Wnt-3a (p < 0.001) and lower levels of sclerostin (p = 0.014) and sRANKL (p = 0.047) compared with the controls. High CRP was associated with low sclerostin (r(S) = -0.21, p = 0.003) and DKK-1 (r(S) = -0.14, p = 0.045). In multiple linear regression analyses, increasing BASMI and mSASSS were independently associated with older age, male sex, high CRP, and elevated serum levels of Wnt-3a. In addition, mSASSS remained associated with a high number of smoking pack-years after adjusting for age. Low BMD of femoral neck was associated with high mSASSS after adjusting for age. Serum levels of Wnt-3a are elevated in AS and associated with increased BASMI and mSASSS, independent of age, indicating that Wnt-3a could be a biomarker for the osteoproliferative process.

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

    Science.gov (United States)

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

    2015-01-01

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

  8. Surgical management of contiguous multilevel thoracolumbar tuberculous spondylitis.

    Science.gov (United States)

    Qureshi, Muhammad Asad; Khalique, Ahmed Bilal; Afzal, Waseem; Pasha, Ibrahim Farooq; Aebi, Max

    2013-06-01

    Tuberculous spondylitis (TBS) is the most common form of extra-pulmonary tuberculosis. The mainstay of TBS management is anti-tuberculous chemotherapy. Most of the patients with TBS are treated conservatively; however in some patients surgery is indicated. Most common indications for surgery include neurological deficit, deformity, instability, large abscesses and necrotic tissue mass or inadequate response to anti-tuberculous chemotherapy. The most common form of TBS involves a single motion segment of spine (two adjoining vertebrae and their intervening disc). Sometimes TBS involves more than two adjoining vertebrae, when it is called multilevel TBS. Indications for correct surgical management of multilevel TBS is not clear from literature. We have retrospectively reviewed 87 patients operated in 10 years for multilevel TBS involving the thoracolumbar spine at our spine unit. Two types of surgeries were performed on these patients. In 57 patients, modified Hong Kong operation was performed with radical debridement, strut grafting and anterior instrumentation. In 30 patients this operation was combined with pedicle screw fixation with or without correction of kyphosis by osteotomy. Patients were followed up for correction of kyphosis, improvement in neurological deficit, pain and function. Complications were noted. On long-term follow-up (average 64 months), there was 9.34 % improvement in kyphosis angle in the modified Hong Kong group and 47.58 % improvement in the group with pedicle screw fixation and osteotomy in addition to anterior surgery (p multilevel thoracolumbar tuberculous spondylitis undergoing radical debridement and anterior column reconstruction.

  9. Renal function decline predicted by left atrial expansion index in non-diabetic cohort with preserved systolic heart function.

    Science.gov (United States)

    Hsiao, Shih-Hung; Chiou, Kuan-Rau

    2017-05-01

    Since natriuretic peptide and troponin are associated with renal prognosis and left atrial (LA) parameters are indicators of subclinical cardiovascular abnormalities, this study investigated whether LA expansion index can predict renal decline. This study analysed 733 (69% male) non-diabetic patients with sinus rhythm, preserved systolic function, and estimated glomerular filtration rate (eGFR) higher than 60 mL/min/1.73 m2. In all patients, echocardiograms were performed and LA expansion index was calculated. Renal function was evaluated annually. The endpoint was a downhill trend in renal function with a final eGFR of renal decline was defined as an annual decline in eGFR >3 mL/min/1.73 m2. The median follow-up time was 5.2 years, and 57 patients (7.8%) had renal function declines (19 had rapid renal declines, and 38 had incidental renal dysfunction). Events were associated with left ventricular mass index, LA expansion index, and heart failure during the follow-up period. The hazard ratio was 1.426 (95% confidence interval, 1.276-1.671; P renal function decline in the unadjusted model and a 6.9-fold risk after adjusting for left ventricular mass index and heart failure during the follow-up period. Left atrial expansion index is a useful early indicator of renal function decline and may enable the possibility of early intervention to prevent renal function from worsening. NCT01171040. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  10. Weak convergence of the function-indexed integrated periodogram for infinite variance processes

    DEFF Research Database (Denmark)

    Can, Umut; Mikosch, Thomas Valentin; Samorodnitsky, Gennady

    2010-01-01

    ), entropy conditions are needed for α ∈ [1, 2) to ensure the tightness of the sequence of integrated periodograms indexed by functions. The results of this paper are of additional interest since they provide limit results for infinite mean random quadratic forms with particular Toeplitz coefficient matrices.......In this paper, we study the weak convergence of the integrated periodogram indexed by classes of functions for linear processes with symmetric α-stable innovations. Under suitable summability conditions on the series of the Fourier coefficients of the index functions, we show that the weak limits...... constitute α-stable processes which have representations as infinite Fourier series with i.i.d. α-stable coefficients. The cases α ∈ (0, 1) and α ∈ [1, 2) are dealt with by rather different methods and under different assumptions on the classes of functions. For example, in contrast to the case α ∈ (0, 1...

  11. Correlation of PROMIS Physical Function and Pain CAT Instruments With Oswestry Disability Index and Neck Disability Index in Spine Patients.

    Science.gov (United States)

    Papuga, Mark O; Mesfin, Addisu; Molinari, Robert; Rubery, Paul T

    2016-07-15

    A prospective and retrospective cross-sectional cohort analysis. The aim of this study was to show that Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive testing (CAT) assessments for physical function and pain interference can be efficiently collected in a standard office visit and to evaluate these scores with scores from previously validated Oswestry Disability Index (ODI) and Neck Disability Index (NDI) providing evidence of convergent validity for use in patients with spine pathology. Spinal surgery outcomes are highly variable, and substantial debate continues regarding the role and value of spine surgery. The routine collection of patient-based outcomes instruments in spine surgery patients may inform this debate. Traditionally, the inefficiency associated with collecting standard validated instruments has been a barrier to routine use in outpatient clinics. We utilized several CAT instruments available through PROMIS and correlated these with the results obtained using "gold standard" legacy outcomes measurement instruments. All measurements were collected at a routine clinical visit. The ODI and the NDI assessments were used as "gold standard" comparisons for patient-reported outcomes. PROMIS CAT instruments required 4.5 ± 1.8 questions and took 35 ± 16 seconds to complete, compared with ODI/NDI requiring 10 questions and taking 188 ± 85 seconds when administered electronically. Linear regression analysis of retrospective scores involving a primary back complaint revealed moderate to strong correlations between ODI and PROMIS physical function with r values ranging from 0.5846 to 0.8907 depending on the specific assessment and patient subsets examined. Routine collection of physical function outcome measures in clinical practice offers the ability to inform and improve patient care. We have shown that several PROMIS CAT instruments can be efficiently administered during routine clinical visits. The

  12. Scintigraphic evaluation of the sacroiliac joints in anklylosing spondylitis

    International Nuclear Information System (INIS)

    Schoerner, W.

    1980-01-01

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

  13. Genetics and the Causes of Ankylosing Spondylitis.

    Science.gov (United States)

    Hanson, Aimee; Brown, Matthew A

    2017-08-01

    Ankylosing spondylitis (AS) is a common inflammatory arthritis in which genetic factors are the primary determinants of disease risk and severity. Substantial progress has been made in identifying genetic pathways involved in the disease, and in translating those discoveries to drug discovery programs. Recently discovered novel disease pathways include those involved in control of DNA methylation, bacterial sensing, and mucosal immunity. Additional pathways are likely to be identified as a higher proportion of the genetic risk of AS is determined. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. On the integration of products of Whittaker functions with respect to the second index

    International Nuclear Information System (INIS)

    Becker, Peter A.

    2004-01-01

    Several new formulas are developed that enable the evaluation of a family of definite integrals containing the product of two Whittaker W κ,μ (x)-functions. The integration is performed with respect to the second index μ, and the first index κ is permitted to have any complex value, within certain restrictions required for convergence. The method utilizes complex contour integration along with various symmetry relations satisfied by the Whittaker functions. The new results derived in this article are complementary to the previously known integrals of products of Whittaker functions, which generally treat integration with respect to either the first index κ or the primary argument x. A physical application involving radiative transport is discussed

  15. Celecoxib versus diclofenac for the treatment of ankylosing spondylitis: 12-week randomized study in Norwegian patients.

    Science.gov (United States)

    Walker, Chris; Essex, Margaret N; Li, Chunming; Park, Peter W

    2016-06-01

    To compare the efficacy and safety of two different doses of celecoxib and diclofenac in the treatment of Norwegian patients with ankylosing spondylitis. In this 12-week, double-blind, non-inferiority trial patients were randomized to 200 mg once daily (qd) celecoxib, 400 mg qd celecoxib, or 50 mg three times daily (tid) diclofenac. The primary objective compared patients' assessments of Global Pain Intensity, measured on a visual analogue scale. A total of 330 patients were randomized (200 mg celecoxib, n = 107; 400 mg celecoxib, n = 108; diclofenac, n = 115). Least squares mean changes in Global Pain Intensity at 12 weeks were -25.8 mm, -30.6 mm and -28.2 mm, respectively. Both celecoxib treatment groups were non-inferior to diclofenac. More patients in the 400 mg celecoxib group met the Assessments in Ankylosing Spondylitis 20 responder criteria at Week 12 (60.2%) than in the celecoxib 200 mg (51.4%) and the diclofenac 50 mg (57.4%) groups. Adverse events were mild-to-moderate in severity, with dyspepsia and diarrhoea the most commonly reported. Celecoxib and diclofenac both provided pain reduction, in addition to improvements in disease activity and functional capacity, in patients with ankylosing spondylitis. © The Author(s) 2016.

  16. The index of ADOH: concept of measuring oral self-care functioning in the elderly.

    Science.gov (United States)

    Bauer, J G

    2001-01-01

    Measures of ability, or function, are used in the health field to determine the level of performance of a specific task, assess the loss of function, and to measure the return to function as a result of rehabilitation or interventions. While these measures are important to all age groups, it is the elderly and chronically ill who are at most risk for adverse changes in their health and functional status. The Index of the Activities of Daily Oral Hygiene (ADOH) is an instrument to assess and monitor functional dependency in manipulating aids used in oral self-care. It is part of the overall concept of oral self-care which subsumes function, education and training, and compliance in achieving and maintaining oral health. The purpose of the Index of ADOH is two-fold: to assess a subject for the progressive loss of the physical ability to manipulate the aids used in oral self-care, and to measure the return to function in response to care intervention and rehabilitative services. These manipulative tasks are associated with flossing, brushing, topical fluoride application, and the use of oral rinses. Aside from changes in function, the Index of ADOH can be used by health care providers and administrators to project the need for services or support for home care.

  17. Noncontiguous multifocal brucellar spondylitis involving the cervical, thoracic, and lumbar spine: A case report

    Directory of Open Access Journals (Sweden)

    Rong Wang

    2017-06-01

    Full Text Available Brucellosis is a zoonosis infectious disease, brucellar spondylitis primarily infects the lumbar, the cervical is uncommon. Multiple-level involvement is extremely rare. This report describes a 46-year-old man with noncontiguous multifocal brucellar spondylitis involving the cervical, thoracic, and lumbar spine. Brucellar spondylitis is difficult to diagnose. Routine laboratory findings for the disease have little diagnostic value. Manifestations and radiological features are usually nonspecific. Radiological features of brucellar spondylitis are similar to tuberculous spondylitis and pyogenic spondylitis. MRI findings have diagnostic value. Suspicious patients with unexplained fever, musculoskeletal complaints at risk of infection should be considered.

  18. Determination of distribution function of refraction index and anion diffusion depth in porous alumina photonic crystals

    Directory of Open Access Journals (Sweden)

    H. Kaviani

    2007-09-01

    Full Text Available   Band structure of porous alumina photonic crystal in the Γ X direction was calculated using order-N method . In a comparison of calculated results with experimental data of reflective and absorptive index, the variation of refractive index of alumina in the external region of oxide layer, around the pores were studied. A Gaussian distribution function was adopted for phosphate anions in the external oxide layer and the variation of refractive index and diffusion depth were determined. The structure of the first four bands was calculated using the obtained distribution of refractive index in the external oxide layer for both TE and TM mode. This results show a narrow full band gap in the TM mode.

  19. A Novel Integrated Score Index of Echocardiographic Indices for the Evaluation of Left Ventricular Diastolic Function.

    Directory of Open Access Journals (Sweden)

    Sheng-Nan Chang

    Full Text Available We propose a novel integrated score index, which could be used to quantify and grade left ventricular (LV diastolic function.We enrolled 629 participants [393 healthy subjects, 145 with hypertension (HTN, 24 with hypertrophic cardiomyopathy (HCM, and 67 with coronary artery disease (CAD]. This score index was with a score of 1 for an E/A ratio 240 ms. The sum of each score was considered as the final value in this scoring method (either a septal or a lateral E/e' ratio > 15 was given a total score of 10, regardless of the other measurements.After analysis, the AUROC of this integrated score index for predicting any diastolic dysfunction (discriminated by the American Society of Echocardiography guidelines was 0.962, and the AUROC of the method from the logistic regression was 0.970. The mean values of the score index for the groups were 3.81 ± 0.12 in healthy, 6.48 ± 0.19 in HTN, 7.35 ± 0.46 in HCM, and 6.62 ± 0.29 in CAD. Using the score index, the healthy subjects obtained lower scores compared with those of HTN (p = 0.00, HCM (p = 0.00, and CAD (p = 0.00. Therefore, this score index could discriminate patients with diseases with impaired diastolic function from the healthy subjects when the total sum of the score was equal to or greater than 4.If the presently used methods cannot allow the clear diagnosis of LV diastolic dysfunction, this integrated score index might be helpful for discriminating diseases with impaired diastolic function.

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

    DEFF Research Database (Denmark)

    Schefte, David B; Hetland, Merete L

    2010-01-01

    The Danish DANBIO registry has developed open-source software for touch screens in the waiting room. The objective was to assess the validity of outcomes from self-explanatory patient questionnaires on touch screen in comparison with the traditional paper form in routine clinical care....

  1. [Evaluation of functional adaptation level in air specialists according to biochemical indexes of saliva secretion].

    Science.gov (United States)

    Soldatov, S K; Malysheva, E V; Zasiad'ko, K I; Abashev, V Iu; Gulin, A V; Ermakova, N V

    2009-09-01

    It was examined a capability of evaluation of functional condition of air staff by indexes of natrium, kalium, cortisol and glucose in saliva. There were realized 5 series of examinations with participations of 71 airplane pilot of the same level in conditions of realizing flies of different difficultness. Saliva sampling was effectuated before and after the flies not later then 10-15 minutes after landing. On pre-flight medical examination and after performance of task of air relay there was registration of systolic, diasystolic blood pressure and cardiac rate. It was posed the correlation of physiological indexes with percentage of examined ingredients in saliva in different flight loads. The results of examinations speak for capability of using of indexes of percentage of natrium, kalium, cortisol and glucose in saliva for evaluation of functional condition of airplane pilots during effectuating the flies and rating of value of flight load with account of individual peculiarities.

  2. Tuberculous spondylitis in Haji Adam Malik hospital, Medan

    Science.gov (United States)

    Dharmajaya, R.

    2018-03-01

    Ankylosing tuberculosis is an infection caused by Mycobacterium tuberculosis in one or more components of the vertebrae; it is Pott disease or tuberculous spondylitis. It might become a potential cause of morbidity, including neurological deficits and permanent deformity of the spine. Management of TB Spondylitis, in general, is chemotherapy with antituberculosis drugs (ATG), immobilization, and spine surgical interventions. A retrospective study was conducted to analyze the patients of TB Spondylitis who had undergone surgery at Haji Adam Malik hospital from June 2015 to June 2017. The most common location is thoracal (10%), lumbal (3%), and thoracolumbal junction (3%). Decompression laminectomy with fusion (18%) is the most suitable option for surgical management. The majority, pre- operation ASIA scale is D (8%), and post operation is E (8%). It means that surgical plays an important role in themanagement of tuberculous spondylitis.

  3. The Relationships among Body Image, Body Mass Index, Exercise, and Sexual Functioning in Heterosexual Women

    Science.gov (United States)

    Weaver, Angela D.; Byers, E. Sandra

    2006-01-01

    Problems related to negative body image are very common among young women. In this study, we examined the relationship between women's body image and their sexual functioning over and above the effects of physical exercise and body mass index (BMI) in a sample of 214 university women. Low situational body image dysphoria and low body…

  4. Validation of a Russian-language version of the Foot Functional Index (FFI) questionnaire

    OpenAIRE

    E. V. Orlova; A. V. Surnov; D. E. Karateev; V. N. Amirdzhanova

    2016-01-01

    The Foot Functional Index (FFI) questionnaire most completely reflects the functional status of patients with joint diseases of the feet.Objective: to study the psychometric properties of a Russian-language version of the FFI questionnaire.Patients and methods. The reliability, sensitivity, and validity of the Russian-language version of the FFI questionnaire were assessed in 55 patients with rheumatoid arthritis (RA). The investigators checked the reliability by assessing the internal consis...

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

    Energy Technology Data Exchange (ETDEWEB)

    Manaster, B.J.

    1988-03-01

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

  6. Arthritis of the middle ear in ankylosing spondylitis.

    OpenAIRE

    Magarò, M; Ceresia, G; Frustaci, A

    1984-01-01

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

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

    International Nuclear Information System (INIS)

    Manaster, B.J.

    1988-01-01

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

  8. Evaluation of the smallest detectable difference in outcome or process variables in ankylosing spondylitis.

    Science.gov (United States)

    Auleley, Guy-Robert; Benbouazza, Karima; Spoorenberg, Anneke; Collantes, Eduardo; Hajjaj-Hassouni, Najia; van der Heijde, Desirée; Dougados, Maxime

    2002-12-15

    To evaluate the smallest detectable difference (SDD) of symptomatic outcome or process variables in ankylosing spondylitis (AS) patients from various countries. Thirty consecutive AS patients with axial involvement were recruited from 1 center in each of 4 countries (Spain, Morocco, France, The Netherlands), for a total of 120 patients. Fourteen variables were studied in 6 domains: pain (3 variables), stiffness (1 variable), function (2 variables), spinal mobility (3 variables), patient global assessment (4 variables), and the domain of enthesiopathy (1 variable). All patients were evaluated twice within a 1-week period during which no clinical or therapeutic change occurred. Intracenter reliability was evaluated using the intraclass correlation coefficient (ICC). The SDD was determined using the Bland-Altman method. Of the 14 variables evaluated in the 120 patients (82% males, 42 +/- 12 years old, with a mean disease duration of 17 +/- 13 years), only the SDD for the variable occiput-to-wall distance showed statistically significant difference among centers. For the entire group, the SDD, expressed as percentage of the range of the variable, varied from 10% (Mander enthesis index) to 39% (spinal pain at night last week). The intraobserver reliability was good (ICC > 0.80) except for the variables morning stiffness and modified Schober test (ICCs of 0.76 and 0.60, respectively). This study suggests that the evaluation of AS patients is homogenous and reliable in different centers of different European and North African countries. Evaluation of the SDD of the symptomatic outcome or process variables is a starting point to determine the minimum clinically important difference, permitting the presentation of results of clinical studies on an individual basis.

  9. Fatigue in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Analysis from a Longitudinal Observation Cohort.

    Science.gov (United States)

    Bedaiwi, Mohamed; Sari, Ismail; Thavaneswaran, Arane; Ayearst, Renise; Haroon, Nigil; Inman, Robert D

    2015-12-01

    In this study, we aimed to address the prevalence of fatigue, its associated factors, and the effect of tumor necrosis factor inhibitors (TNFi) on this subgroup of patients in a large axial spondyloarthritis (axSpA) cohort. The study included 681 patients [ankylosing spondylitis (AS) and nonradiographic axSpA (nr-axSpA)]. The Fatigue Severity Scale (FSS) and the Bath AS Disease Activity Index question 1 (BASDAI Q1) indices were used for fatigue assessment. Severe fatigue was defined as an FSS ≥ 4 or a BASDAI Q1 ≥ 5. Disease activity, function, and quality of life (QoL) measures were recorded. Patients who had been treated with TNFi were identified, and baseline and followup data were analyzed. Of the cohort, 67.3% had severe fatigue, and the prevalence was similar between AS (67.2%) and nr-axSpA (68.2%). Severely fatigued patients tended to have higher disease activity scores, increased acute-phase proteins, and decreased QoL measures. TNFi therapy was associated with improvement in disease activity, and although this treatment led to significantly decreased fatigue scores, this reduction was not optimal in the majority of patients with 80% continuing to have severe fatigue according to their posttreatment scores. Health Assessment Questionnaire, mean scores of BASDAI Q5 and Q6, and BASDAI enthesitis were independent predictors of fatigue severity. Fatigue is a common symptom in axSpA, and the burden of fatigue among patients with nr-axSpA is similar to that seen in AS. While biologics are effective in improving disease activity, their effect on fatigue is more limited. In axSpA, fatigue remains unresponsive to TNFi in nearly 80% of patients.

  10. Brachial index does not reflect upper extremity functionality following surgery for vascular trauma

    Directory of Open Access Journals (Sweden)

    Erdal Simsek

    2014-04-01

    Full Text Available OBJECTIVES: Vascular injuries to the upper extremities requiring surgical repair are common after accidents. However, neither postoperative functionality nor hemodynamic status of the extremity are routinely described. We evaluated the postoperative functional and hemodynamic status of patients with vascular traumas in the upper extremities. METHODS: 26 patients who suffered penetrating vascular traumas in the upper extremities from November 2008 to December 2011 were retrospectively evaluated. Data on first approach, surgical technique employed and early postoperative outcomes were recorded. Further data on the post-discharge period, including clinical functional status of the arm, Doppler ultrasonography and brachial-brachial index were also evaluated. RESULTS: Average follow up was 33.5±10.8 months. Right (1.05±0.09 and left (1.04±0.08 brachial indexes were measured during follow up,. Doppler ultrasonography showed arterial occlusion in 4 patients (15%. Near-normal brachial-brachial indexes was observed in all four of these patients with occlusion of one of the upper extremity arteries, even though they exhibited limited arm function for daily work. CONCLUSIONS: Evaluation of the postoperative outcomes of this small series of patients with penetrating vascular traumas in the upper extremity revealed that 15% of them suffered occlusion of one artery of the upper extremity. Artery occlusion did not correlate with brachial-brachial Doppler index, probably due to rich collateral circulation, but occlusion was associated with an extremity that was dysfunctional for the purposes of daily work. The result of the brachial-brachial index does not therefore correlate with functionality.

  11. Avoiding the 4-index transformation in one-body reduced density matrix functional calculations for separable functionals.

    Science.gov (United States)

    Giesbertz, Klaas J H

    2016-08-03

    One of the major computational bottlenecks in one-body reduced density matrix (1RDM) functional theory is the evaluation of approximate 1RDM functionals and their derivatives. The reason is that more advanced approximate functionals are almost exclusively defined in the natural orbital basis, so a 4-index transformation of the two-electron integrals appears to be unavoidable. I will show that this is not the case and that so-called separable functionals can be evaluated much more efficiently, i.e. only at cubic cost in the basis size. Since most approximate functionals are actually separable, this new algorithm is an important development to make 1RDM functional theory calculations feasible for large electronic systems.

  12. Secukinumab and Sustained Improvement in Signs and Symptoms of Patients With Active Ankylosing Spondylitis Through Two Years: Results From a Phase III Study

    Science.gov (United States)

    Sieper, J.; Kivitz, A.; Blanco, R.; Cohen, M.; Martin, R.; Readie, A.; Richards, H. B.; Porter, B.

    2017-01-01

    Objective Secukinumab improved the signs and symptoms of ankylosing spondylitis (AS) over 52 weeks in the phase III MEASURE 2 study. Here, we report longer‐term (104 weeks) efficacy and safety results. Methods Patients with active AS were randomized to subcutaneous secukinumab 150 mg, 75 mg, or placebo at baseline; weeks 1, 2, and 3; and every 4 weeks from week 4. The primary end point was the Assessment of SpondyloArthritis international Society criteria for 20% improvement (ASAS20) response rate at week 16. Other end points included ASAS40, high‐sensitivity C‐reactive protein, ASAS5/6, Bath Ankylosing Spondylitis Disease Activity Index, Short Form 36 health survey physical component summary, ASAS partial remission, EuroQol 5‐domain measure, and Functional Assessment of Chronic Illness Therapy fatigue subscale. End points were assessed through week 104, with multiple imputation for binary variables and a mixed‐effects model repeated measures for continuous variables. Results Of 219 randomized patients, 60 of 72 (83.3%) and 57 of 73 (78.1%) patients completed 104 weeks of treatment with secukinumab 150 mg and 75 mg, respectively; ASAS20/ASAS40 response rates at week 104 were 71.5% and 47.5% with both secukinumab doses, respectively. Clinical improvements with secukinumab were sustained through week 104 across all secondary end points. Across the entire treatment period (mean secukinumab exposure 735.6 days), exposure‐adjusted incidence rates for serious infections and infestations, Crohn's disease, malignant or unspecified tumors, and major adverse cardiac events with secukinumab were 1.2, 0.7, 0.5, and 0.7 per 100 patient‐years, respectively. No cases of tuberculosis reactivation, opportunistic infections, or suicidal ideation were reported. Conclusion Secukinumab provided sustained improvement through 2 years in the signs and symptoms of AS, with a safety profile consistent with previous reports. PMID:28235249

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    INTRODUCTION: The multinational initiative "3e Initiative in Rheumatology - Multi-national Recommendations for the Management of Ankylosing Spondylitis 2006-7" served the primary purpose of providing specific recommendations for the management of ankylosing spondylitis and spondyloarthritis...

  14. Decreased clinical response to infliximab in ankylosing spondylitis is correlated with anti-infliximab formation

    NARCIS (Netherlands)

    de Vries, Mirjam K.; Wolbink, Gerrit Jan; Stapel, Steven O.; de Vrieze, Henk; van Denderen, J. Christiaan; Dijkmans, Ben A. C.; Aarden, Lucien A.; van der Horst-Bruinsma, Irene E.

    2007-01-01

    OBJECTIVES: Correlation of serum trough infliximab levels and antibodies to infliximab (anti-infliximab) with clinical response in ankylosing spondylitis. METHODS: In accordance with the international ASsessment in Ankylosing Spondylitis (ASAS) consensus statement, patients were treated with

  15. Chronic diseases, cognition, functional decline, and the Charlson index in elderly people with dementia.

    Science.gov (United States)

    Pimenta, Fausto Aloísio Pedrosa; Bicalho, Maria Aparecida Camargos; Romano-Silva, Marco Aurélio; Moraes, Edgar Nunes de; Rezende, Nilton Alves de

    2013-01-01

    To assess the association between chronic degenerative diseases and functional decline, cognition, and mortality prediction. A cross-sectional study was conducted in a geriatrics service in Belo Horizonte, Brazil, involving 424 patients subdivided into two groups: control and dementia. The study analyzed socio-demographic and environmental data, chronic degenerative diseases, the Charlson index, and data on functional and cognitive dementia. After a univariate analysis, there was a greater frequency of cerebrovascular accident (CVA), urinary incontinence, constipation, and sleep disorder in the dementia group, while the multivariate analysis showed a greater number of environmental factors and sleep disorder. Regarding the Mini Mental State Examination (MMSE), patients with chronic obstructive pulmonary disease (COPD), CVA, and heart failure presented lower scores. There was a greater score in the dementia group with regarding the Charlson index. These comorbidities were associated with the functional decline in elderly people with dementia. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

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

    OpenAIRE

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

    2008-01-01

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

  17. Bayesian Nonparametric Mixture Estimation for Time-Indexed Functional Data in R

    Directory of Open Access Journals (Sweden)

    Terrance D. Savitsky

    2016-08-01

    Full Text Available We present growfunctions for R that offers Bayesian nonparametric estimation models for analysis of dependent, noisy time series data indexed by a collection of domains. This data structure arises from combining periodically published government survey statistics, such as are reported in the Current Population Study (CPS. The CPS publishes monthly, by-state estimates of employment levels, where each state expresses a noisy time series. Published state-level estimates from the CPS are composed from household survey responses in a model-free manner and express high levels of volatility due to insufficient sample sizes. Existing software solutions borrow information over a modeled time-based dependence to extract a de-noised time series for each domain. These solutions, however, ignore the dependence among the domains that may be additionally leveraged to improve estimation efficiency. The growfunctions package offers two fully nonparametric mixture models that simultaneously estimate both a time and domain-indexed dependence structure for a collection of time series: (1 A Gaussian process (GP construction, which is parameterized through the covariance matrix, estimates a latent function for each domain. The covariance parameters of the latent functions are indexed by domain under a Dirichlet process prior that permits estimation of the dependence among functions across the domains: (2 An intrinsic Gaussian Markov random field prior construction provides an alternative to the GP that expresses different computation and estimation properties. In addition to performing denoised estimation of latent functions from published domain estimates, growfunctions allows estimation of collections of functions for observation units (e.g., households, rather than aggregated domains, by accounting for an informative sampling design under which the probabilities for inclusion of observation units are related to the response variable. growfunctions includes plot

  18. Ankylosing spondylitis is indigenous to Mesoamerica.

    Science.gov (United States)

    Martínez-Lavín, M; Mansilla, J; Pineda, C; Pijoán, C

    1995-12-01

    Paleopathology helps to define the origin and the migration of diseases. It has been established that genetic and environmental factors play a role in the pathogenesis of ankylosing spondylitis (AS). We investigated whether AS was present in Mesoamerica before contact with the European civilization. We studied the collection of Mesoamerican human skeletal remains preserved at the National Museum of Anthropology of Mexico, searching for features of AS. We found one incomplete specimen of a man of the Postclassic period (900-1521 AD). It showed fusion of the vertebral column from T8 to L5 due to ankylosis of the apophyseal joints and of the spinal processes. The pelvis was not preserved. Radiographs demonstrated ossification of both supraspinous and interspinous ligaments. Our findings suggest AS was present in Mesoamerica before the arrival of Europeans.

  19. Ankylosis in ankylosing spondylitis: current concepts.

    Science.gov (United States)

    Haroon, Nigil

    2015-06-01

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

  20. Relationship between ultrasound bone parameters, lung function, and body mass index in healthy student population.

    Science.gov (United States)

    Cvijetić, Selma; Pipinić, Ivana Sabolić; Varnai, Veda Maria; Macan, Jelena

    2017-03-01

    Low bone mineral density has been reported in paediatric and adult patients with different lung diseases, but limited data are available on the association between lung function and bone density in a healthy young population. We explored the predictors of association between bone mass and pulmonary function in healthy first-year university students, focusing on body mass index (BMI). In this cross-sectional study we measured bone density with ultrasound and lung function with spirometry in 370 university students (271 girls and 99 boys). Information on lifestyle habits, such as physical activity, smoking, and alcohol consumption were obtained with a questionnaire. All lung function and bone parameters were significantly higher in boys than in girls (Pstudents had a significantly lower forced vital capacity (FVC%) (P=0.001 girls; P=0.012 boys), while overweight students had a significantly higher FVC% than normal weight students (P=0.024 girls; P=0.001 boys). BMI significantly correlated with FVC% (P=0.001) and forced expiratory volume in 1 second (FEV1 %) in both genders (P=0.001 girls; P=0.018 boys) and with broadband ultrasound attenuation (BUA) in boys. There were no significant associations between any of the bone and lung function parameters either in boys or girls. The most important determinant of lung function and ultrasound bone parameters in our study population was body mass index, with no direct association between bone density and lung function.

  1. Tei index in determination of fetal cardiac function in pregnant women with gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Guo-Dong Li

    2016-09-01

    Full Text Available Objective: To explore the application value of Tei index in determination of fetal cardiac function in pregnant women with gestational diabetes mellitus (GDM. Methods: A total of 60 gestational diabetes mellitus pregnant women with single birth were included in the study and served as GDM group, while 60 healthy pregnant women with single birth were served as the control group. The fetal echocardiography was performed. The cardiac structure, function, and other related indicators were detected and compared. Results: IVSs, LVWT, RVWT, LVEF, LVFS, and RVFS in GDM group were significantly greater than those in the control group (P<0.05. E/A MV and E/A TV in GDM group were significantly lower than those in the control group (P<0.05. The left and right ventricular Tei index in GDM group was significantly higher than that in the control group (P<0.05. Conclusions: The fetal cardiac structure and function in GDM pregnant women can cause damage to a different degree. Tei index is an important indicator to evaluate the fetal cardiac function in GDM pregnant women, and can be applied in the early diagnosis and treatment; therefore, it deserved to be widely recommended in the clinic.

  2. Magnetic resonance imaging for ankylosing spondylitis

    International Nuclear Information System (INIS)

    Bollow, M.

    2002-01-01

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

  3. Assessment of Differential Item Functioning in the Experiences of Discrimination Index

    Science.gov (United States)

    Cunningham, Timothy J.; Berkman, Lisa F.; Gortmaker, Steven L.; Kiefe, Catarina I.; Jacobs, David R.; Seeman, Teresa E.; Kawachi, Ichiro

    2011-01-01

    The psychometric properties of instruments used to measure self-reported experiences of discrimination in epidemiologic studies are rarely assessed, especially regarding construct validity. The authors used 2000–2001 data from the Coronary Artery Risk Development in Young Adults (CARDIA) Study to examine differential item functioning (DIF) in 2 versions of the Experiences of Discrimination (EOD) Index, an index measuring self-reported experiences of racial/ethnic and gender discrimination. DIF may confound interpretation of subgroup differences. Large DIF was observed for 2 of 7 racial/ethnic discrimination items: White participants reported more racial/ethnic discrimination for the “at school” item, and black participants reported more racial/ethnic discrimination for the “getting housing” item. The large DIF by race/ethnicity in the index for racial/ethnic discrimination probably reflects item impact and is the result of valid group differences between blacks and whites regarding their respective experiences of discrimination. The authors also observed large DIF by race/ethnicity for 3 of 7 gender discrimination items. This is more likely to have been due to item bias. Users of the EOD Index must consider the advantages and disadvantages of DIF adjustment (omitting items, constructing separate measures, and retaining items). The EOD Index has substantial usefulness as an instrument that can assess self-reported experiences of discrimination. PMID:22038104

  4. M2 polarization of monocytes in ankylosing spondylitis and relationship with inflammation and structural damage.

    Science.gov (United States)

    Zhao, Jinzhu; Yuan, Wei; Tao, Chunsheng; Sun, Peifeng; Yang, Zaixing; Xu, Weidong

    2017-12-01

    The aim of this study was to evaluate the polarization of peripheral blood monocytes in the patients with ankylosing spondylitis (AS) and to determine the correlations between monocyte polarization and inflammation and structural damage. A total of 120 AS patients, 50 rheumatoid arthritis (RA) patients and 100 healthy controls were enrolled in the study. M1 (CD68+CD192+) and M2 (CX3CR1+CD163+) monocytes were characterized by flow cytometry. Demographic, clinical, radiographic and laboratory data were collected and analyzed. A large increase in M2 (CX3CR1+CD163+) monocytes was observed in AS, and M2/M1 ratio was 7.18 ± 6.12, 2.54 ± 3.14 and 35.61 ± 20.04 in control, RA and AS, respectively. The M2/M1 ratio correlated with modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) (r = 0.565; p Ankylosing Spondylitis Disease Activity Index (BASDAI) (r = -0.201; p = 0.028). Anti-TNF-α therapy induced a significant reduction in the percentage of M1 monocyte, ESR, CRP and BASDAI in AS patients. The present results demonstrated that M2 type polarized monocytes are predominant in the peripheral blood in AS and the M2/M1 ratio is correlated with structural damage (mSASSS), inflammatory biomarkers (ESR and CRP) and BASDAI. © 2017 APMIS. Published by John Wiley & Sons Ltd.

  5. Results of Corrective Osteotomy and Treatment Strategy for Ankylosing Spondylitis with Kyphotic Deformity.

    Science.gov (United States)

    Kim, Ki-Tack; Park, Dae-Hyun; Lee, Sang-Hun; Lee, Jung-Hee

    2015-09-01

    To report the radiological and clinical results after corrective osteotomy in ankylosing spondylitis patients. Furthermore, this study intended to classify the types of deformity and to suggest appropriate surgical treatment options. We retrospectively analyzed ankylosing spondylitis patients who underwent corrective osteotomy between 1996 and 2009. The radiographic assessments included the sagittal vertical axis (SVA), spinopelvic alignment parameters, correction angle, correction loss, type of deformity related to the location of the apex, and the craniocervical range of motion (CCROM). The clinical outcomes were assessed by the Oswestry Disability Index (ODI) scores. A total of 292 corrective osteotomies were performed in 248 patients with a mean follow-up of 40.1 months (range, 24 to 78 months). There were 183 cases of single pedicle subtraction osteotomy (PSO), 19 cases of multiple Smith-Petersen osteotomy (SPO), 17 cases of PSO + SPO, 14 cases of single SPO, six cases of posterior vertebral column resection (PVCR), five cases of PSO + partial pedicle subtraction osteotomy (PPSO), and four cases of PPSO. The mean correction angles were 31.9° ± 11.7° with PSO, 14.3° ± 8.4° with SPO, 38.3° ± 12.7° with PVCR, and 19.3° ± 7.1° with PPSO. The thoracolumbar type was the most common. The outcome analysis showed a significant improvement in the ODI score (p ankylosing spondylitis, resulting in satisfactory outcomes with acceptable complications. The CCROM and postoperative SVA were important factors in determining the outcome.

  6. Correlations of Egen Klassifikation and Barthel Index scores with pulmonary function parameters in Duchenne muscular dystrophy.

    Science.gov (United States)

    Brunherotti, Marisa Afonso; Sobreira, Claudia; Rodrigues-Júnior, Antônio Luiz; de Assis, Marcos Renato; Terra Filho, João; Baddini Martinez, José Antônio

    2007-01-01

    This study investigated the correlations obtained by using the Egen Klassifikation (EK) and Barthel Index (BI) functional scales and respiratory function parameters in patients with Duchenne muscular dystrophy. Spirometry, maximal respiratory pressures, and arterial blood gases were analyzed and graded according to the EK and BI scales in 26 patients. They were classified as high or low risk for introduction of noninvasive ventilation according to the respiratory function. The EK and BI scales significantly correlated with forced vital capacity, forced expiratory volume in 1 second, and maximal respiratory pressures. The worse the functional performance, the worse the respiratory measurements. The degree of correlation between the functional scales and each respiratory parameter was similar. An EK of 21 or higher predicted high risk for the introduction of noninvasive ventilation. EK and BI scales similarly correlated with the degree of respiratory involvement in Duchenne muscular dystrophy. The EK scale was superior in detecting subjects with a higher risk for introduction of noninvasive ventilation.

  7. The cluster index of regularly varying sequences with applications to limit theory for functions of multivariate Markov chains

    DEFF Research Database (Denmark)

    Mikosch, Thomas Valentin; Wintenberger, Olivier

    2014-01-01

    We introduce the cluster index of a multivariate stationary sequence and characterize the index in terms of the spectral tail process. This index plays a major role in limit theory for partial sums of sequences. We illustrate the use of the cluster index by characterizing infinite variance stable...... limit distributions and precise large deviation results for sums of multivariate functions acting on a stationary Markov chain under a drift condition....

  8. Husimi functions at gradient index cavities designed by conformal transformation optics.

    Science.gov (United States)

    Kim, Inbo; Cho, Jinhang; Kim, Yushin; Min, Bumki; Ryu, Jung-Wan; Rim, Sunghwan; Choi, Muhan

    2018-03-19

    Dielectric cavity systems, which have been studied extensively so far, have uniform refractive indices of their cavities, and Husimi functions, the most widely used phase space representation of optical modes formed in the cavities, accordingly were derived only for these homogeneous index cavities. For the case of the recently proposed gradient index dielectric cavities (called as transformation cavities) designed by optical conformal mapping, we show that the phase space structure of resonant modes can be revealed through the conventional Husimi functions by constructing a reciprocal virtual space. As examples, the Husimi plots were obtained for an anisotropic whispering gallery mode (WGM) and a short-lived mode supported in a limaçon-shaped transformation cavity. The phase space description of the corresponding modes in the reciprocal virtual space is compatible with the far-field directionality of the resonant modes in the physical space.

  9. Brain functional networks. Correlation analysis with clinical indexes in patients with diabetic retinopathy

    Energy Technology Data Exchange (ETDEWEB)

    Dai, Hui; Zhang, Yu; Hu, Su; Wang, Ximing; Li, Yonggang; Hu, Chunhong [The First Affiliated Hospital of Soochow University, Department of Radiology, Suzhou, Jiangsu (China); Lai, Lillian [LAC+USC Medical Center, Department of Neuroradiology, Los Angeles, CA (United States); Shen, Hailin [Suzhou Kowloon Hospital, Shanghai Jiao Tong University Medical School, Department of Radiology, Suzhou, Jiangsu (China)

    2017-11-15

    The relationship between parameters of brain functional networks and clinical indexes is unclear so far in patients with diabetic retinopathy (DR). This paper is to investigate this. Twenty-one patients with different grades of DR and 21 age- and sex-matched healthy controls were enrolled from August 2012 to September 2014. The clinical indexes recorded included DR grade, duration of diabetes, HbA1c, diabetic foot screen, fasting plasma glucose, insulin, Homa-β, Homa-IR, insulin sensitive index (ISI), Mini-Mental State Examination (MMSE), and patient sex and age. Subjects were scanned using 3-T MR with blood-oxygen-level-dependent and 3D-FSPGR sequences. MR data was analyzed via preprocessing and functional network construction, and quantified indexes of network (clustering coefficient, characteristic path length, global efficiency, degree distribution, and small worldness) were evaluated. Statistics consisted of ANOVA and correlation. There were significant differences between patients and controls among clustering coefficient, characteristic path length, degree distribution, and small worldness parameters (P < 0.05). MMSE scores negatively correlated with characteristic path length, and Hb1Ac negatively correlated with small worldness. MMSE, duration of diabetes, diabetic foot screen, fasting plasma glucose, insulin, Homa-β, Homa-IR, ISI, DR grade, and patient age, except from Hb1Ac, correlated with degree distribution in certain brain areas. Brain functional networks are altered, specifically in the areas of visual function and cognition, and these alterations may reflect the severity of visual weakness and cognitive decline in DR patients. Moreover, the brain networks may be affected both by long-standing and instant clinical factors. (orig.)

  10. Brain functional networks. Correlation analysis with clinical indexes in patients with diabetic retinopathy

    International Nuclear Information System (INIS)

    Dai, Hui; Zhang, Yu; Hu, Su; Wang, Ximing; Li, Yonggang; Hu, Chunhong; Lai, Lillian; Shen, Hailin

    2017-01-01

    The relationship between parameters of brain functional networks and clinical indexes is unclear so far in patients with diabetic retinopathy (DR). This paper is to investigate this. Twenty-one patients with different grades of DR and 21 age- and sex-matched healthy controls were enrolled from August 2012 to September 2014. The clinical indexes recorded included DR grade, duration of diabetes, HbA1c, diabetic foot screen, fasting plasma glucose, insulin, Homa-β, Homa-IR, insulin sensitive index (ISI), Mini-Mental State Examination (MMSE), and patient sex and age. Subjects were scanned using 3-T MR with blood-oxygen-level-dependent and 3D-FSPGR sequences. MR data was analyzed via preprocessing and functional network construction, and quantified indexes of network (clustering coefficient, characteristic path length, global efficiency, degree distribution, and small worldness) were evaluated. Statistics consisted of ANOVA and correlation. There were significant differences between patients and controls among clustering coefficient, characteristic path length, degree distribution, and small worldness parameters (P < 0.05). MMSE scores negatively correlated with characteristic path length, and Hb1Ac negatively correlated with small worldness. MMSE, duration of diabetes, diabetic foot screen, fasting plasma glucose, insulin, Homa-β, Homa-IR, ISI, DR grade, and patient age, except from Hb1Ac, correlated with degree distribution in certain brain areas. Brain functional networks are altered, specifically in the areas of visual function and cognition, and these alterations may reflect the severity of visual weakness and cognitive decline in DR patients. Moreover, the brain networks may be affected both by long-standing and instant clinical factors. (orig.)

  11. Adaptation and Validation of the Foot Function Index-Revised Short Form into Polish

    OpenAIRE

    Rutkowski, Radosław; Gałczyńska-Rusin, Małgorzata; Gizińska, Małgorzata; Straburzyński-Lupa, Marcin; Zdanowska, Agata; Romanowski, Mateusz Wojciech; Romanowski, Wojciech; Budiman-Mak, Elly; Straburzyńska-Lupa, Anna

    2017-01-01

    Purpose The aim of the present study was to adapt the Foot Function Index-Revised Short Form (FFI-RS) questionnaire into Polish and verify its reliability and validity in a group of patients with rheumatoid arthritis (RA). Methods The study included 211 patients suffering from RA. The FFI-RS questionnaire underwent standard linguistic adaptation and its psychometric parameters were investigated. The enrolled participants had been recruited for seven months as a convenient sample from the rheu...

  12. Cross-cultural adaptation and validation of the Foot Function Index to Spanish.

    Science.gov (United States)

    Paez-Moguer, Joaquin; Budiman-Mak, Elly; Cuesta-Vargas, Antonio I

    2014-03-01

    The purpose of this study was to adapt and validate the Foot Function Index to the Spanish (FFI-Sp) following the guidelines of the American Academy of Orthopaedic Surgeons. A cross-sectional study 80 participants with some foot pathology. A statistical analysis was made, including a correlation study with other questionnaires (the Foot Health Status Questionnaire, EuroQol 5-D, Visual Analogue Pain Scale, and the Short Form SF-12 Health Survey). Data analysis included reliability, construct and criterion-related validity and factor analyses. The principal components analysis with varimax rotation produced 3 principal factors that explained 80% of the variance. The confirmatory factor analysis showed an acceptable fit with a comparative fit index of 0.78. The FFI-Sp demonstrated excellent internal consistency on the three subscales: pain 0.95; disability 0.96; and activity limitation 0.69, the subscale that scored lowest. The correlation between the FFI-Sp and the other questionnaires was high to moderate. The Spanish version of the Foot Function Index (FFI-Sp) is a tool that is a valid and reliable tool with a very good internal consistency for use in the assessment of pain, disability and limitation of the function of the foot, for use both in clinic and research. Copyright © 2013 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  13. Sex differences in associations of cardio-ankle vascular index with left ventricular function and geometry.

    Science.gov (United States)

    Ye, Zi; Pellikka, Patricia A; Kullo, Iftikhar J

    2017-12-01

    The cardio-ankle vascular index (CAVI) is a measure of global arterial stiffness. We hypothesized that CAVI is associated with left ventricular (LV) function and geometry in individuals without structural heart disease. We measured CAVI in 600 participants (mean age 60.3±14.6 years, 54% men) without history of atherosclerotic cardiovascular disease who were referred for transthoracic echocardiography. Linear regression analysis was used to assess the association of CAVI with LV function (peak mitral annular systolic s' and early diastolic velocity e') and structure (LV mass index (LVMI) and relative wall thickness (RWT)). Older age, male sex, lower body mass index, history of hypertension, diabetes and chronic kidney disease were each associated with a higher CAVI (adjusted R 2 = 0.56, all p 0.1 in men). In conclusion, a higher CAVI, a measure of global arterial stiffness, is associated with worse LV systolic function, worse diastolic relaxation, and greater LV RWT in both men and women, and with LVMI in women.

  14. Immunogenicity, adalimumab levels and clinical response in ankylosing spondylitis patients during 24 weeks of follow-up.

    Science.gov (United States)

    Kneepkens, Eva L; Wei, James Cheng-Chung; Nurmohamed, Michael T; Yeo, Kai-Jieh; Chen, C Y; van der Horst-Bruinsma, Irene E; van der Kleij, Desiree; Rispens, Theo; Wolbink, Gertjan; Krieckaert, Charlotte L M

    2015-02-01

    Immunogenicity influences adalimumab levels and therefore clinical response in patients with rheumatic diseases. To study the relationship between clinical response, adalimumab levels and antidrug antibodies (ADAb) in ankylosing spondylitis (AS). Observational cohort study of 115 consecutive AS patients treated with adalimumab in the Netherlands (n=85) and Taiwan (n=30), monitored during 24 weeks. Adalimumab levels and ADAb titres were determined using an ELISA and an antigen binding test (ABT), respectively, designed by Sanquin Research, Amsterdam. Response to adalimumab treatment was defined as a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) response, and disease activity was measured using the Ankylosing Spondylitis Disease Activity Score using C-reactive protein (CRP) (ASDAS). At baseline, median BASDAI (IQR) was 6.4 (4.5-7.6) and mean ASDAS (SD) was 3.5 (1.0). After 24 weeks, 49 (42.6%) patients were BASDAI50 responders and mean ASDAS (SD) for responders was 1.5 (1.0) vs 2.6 (1.0) for non-responders (p100 AU/mL). In these patients, CRP and erythrocyte sedimentation rate remained elevated during treatment. Adalimumab levels are related to clinical response in AS patients measured with ASDAS and are influenced by ADAb detectable with an ABT. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Serum Prolidase Activity in Ankylosing Spondylitis and Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Demet Uçar

    2013-01-01

    Full Text Available The aim of the present study was to emphasize the collagen turnover in 2 of the most common chronic inflammatory rheumatic diseases by evaluating serum prolidase activity (SPA in ankylosing spondylitis (AS and rheumatoid arthritis (RA. 30 patients who met the modified New York Criteria for the classification of AS, 29 patients who met the 2010 Rheumatoid Arthritis Classification Criteria for the classification of RA, and 31 healthy controls were enrolled in the study. Serum samples of the patients and the controls were collected and SPA was measured by a spectrophotometric method. The comparison of the SPA in these 3 groups was statistically examined. In both patient groups, the SPA was lower than in the control group. SPA in patients with AS was statistically significantly lower than in the control and RA groups ( P < 0.001/ P = 0.002. No statistically significant difference was found between the RA and the control groups ( P = 0.891. In conclusion, lower SPA is presumably associated with decreased collagen turnover and fibrosis, leading to decreased physical functions in both chronic inflammatory musculoskeletal diseases.

  16. Emerging drugs for axial spondyloarthritis including ankylosing spondylitis.

    Science.gov (United States)

    Busquets-Perez, Noemi; Marzo-Ortega, Helena; Emery, Paul

    2013-03-01

    Only non-steroidal anti-inflammatories (NSAIDs) and TNF inhibitors (TNFi) are effective in ankylosing spondylitis (AS). However, not all patients successfully respond to these drugs and a subset may have contraindications to their use. In the last decade, an earlier diagnosis of AS has been achieved due to the increasing availability of MRI. This has led to prompt treatment initiation with improved outcomes. NSAIDs and TNFi are the current treatments for AS which lead to sustained clinical responses in the long term. Recent studies have shown other potential biomarkers in AS, such as the IL-17/IL-23 axis. This has translated into the development of new drugs which interfere with these pathways, such as apremilast and secukinumab, which have shown efficacy in early clinical trials. AS carries considerable short- and long-term disabilities. Anti-TNF-α therapies reduce pain, improve function and decrease inflammation as seen by MRI. New treatment options are being developed which may prove efficacious on those patients not responding to anti-TNF. The ultimate research goal should focus on treatments to prevent and stop new bone formation.

  17. Genetics of ankylosing spondylitis--insights into pathogenesis.

    Science.gov (United States)

    Brown, Matthew A; Kenna, Tony; Wordsworth, B Paul

    2016-02-01

    Ankylosing spondylitis (AS), an immune-mediated arthritis, is the prototypic member of a group of conditions known as spondyloarthropathies that also includes reactive arthritis, psoriatic arthritis and enteropathic arthritis. Patients with these conditions share a clinical predisposition for spinal and pelvic joint dysfunction, as well as genetic associations, notably with HLA-B(*)27. Spondyloarthropathies are characterized by histopathological inflammation in entheses (regions of high mechanical stress where tendons and ligaments insert into bone) and in the subchondral bone marrow, and by abnormal osteoproliferation at involved sites. The association of AS with HLA-B(*)27, first described >40 years ago, led to hope that the cause of the disease would be rapidly established. However, even though many theories have been advanced to explain how HLA-B(*)27 is involved in AS, no consensus about the answers to this question has been reached, and no successful treatments have yet been developed that target HLA-B27 or its functional pathways. Over the past decade, rapid progress has been made in discovering further genetic associations with AS that have shed new light on the aetiopathogenesis of the disease. Some of these discoveries have driven translational ideas, such as the repurposing of therapeutics targeting the cytokines IL-12 and IL-23 and other factors downstream of this pathway. AS provides an excellent example of how hypothesis-free research can lead to major advances in understanding pathogenesis and to the development of innovative therapeutic strategies.

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

    Directory of Open Access Journals (Sweden)

    O. V. Bugrova

    2016-01-01

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

  19. Primary pyogenic spondylitis following kyphoplasty: a case report

    Directory of Open Access Journals (Sweden)

    Heyse Thomas J

    2011-03-01

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

  20. Scoring radiographic progression in ankylosing spondylitis: should we use the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) or the Radiographic Ankylosing Spondylitis Spinal Score (RASSS)?

    NARCIS (Netherlands)

    Ramiro, Sofia; van Tubergen, Astrid; Stolwijk, Carmen; Landewé, Robert; van de Bosch, Filip; Dougados, Maxime; van der Heijde, Désirée

    2013-01-01

    ABSTRACT: INTRODUCTION: Radiographic damage is one of the core outcomes in axial SpA and is usually assessed with the modified Stoke Ankylosing Spondylitis (AS) Spine Score (mSASSS). Alternatively, the Radiographic AS Spinal Score (RASSS) is proposed, which includes the lower thoracic vertebrae,

  1. A numerical method for determining refractive index of a glass sample from its implicit transcendental function

    Science.gov (United States)

    Ince, R.; Sınır, E.; Feeney, M.; Yükselici, M. H.; Ince, A. T.

    2008-07-01

    The refractive index of a glass sample was determined from an implicit function of its optical path within the sample arm of a Michelson interferometer. On rotation of the sample from normal incidence, the light beam suffers increasing refraction, causing the optical path for air to decrease whilst that for the glass sample increases. This is observed as a shift in the number of fringes, which were captured and counted in real time on a computer, as rotation proceeded. The angle of rotation and the fringe shift were entered into an implicit function of optical path versus refractive index written to an Excel worksheet. A refractive index matching the wavelength of the He-Ne laser light source was read-off to three decimal places. A new source of uncertainty has been identified, misalignment on a micrometer scale of the laser normal to the sample surface. Whilst driving the sample to find normal incidence a finite angular region of insensitivity (dead space) occurs due to misalignment of the laser normal to the sample surface by a few micrometers. A linearization technique was employed to compensate for this offset and hence reduce its uncertainty contribution.

  2. Walking recovery after an acute stroke: assessment with a new functional classification and the Barthel Index.

    Science.gov (United States)

    Viosca, Enrique; Lafuente, Rubén; Martínez, José L; Almagro, Pedro L; Gracia, Antonio; González, Carmen

    2005-06-01

    To investigate walking recovery after an acute stroke by using both a new functional classification and the Barthel Index, and to identify factors associated with good recovery. A 1-year inception cohort study. In- and outpatient setting in a district hospital. Twenty-six patients with a prognosis of intermediate walking recovery. Conventional physical rehabilitation under professional supervision. Walking capacity was assessed with a new classification scale and the Barthel Index during 5 patient evolution stages (admission to the hospital, hospital and physiotherapy discharge, clinical review, end of study). We also assessed the severity of the paresis of the affected lower limb, the time lapse between the stroke until the recovery of the weight-bearing capacity of the affected leg, and finally the time until standing balance was regained. We detected improvement in walking capacity throughout the follow-up process with our new classification scale, but not with the Barthel Index. Significant improvements were observed from the initial assessment, from 1 month onward, and from 3 to 12 months. The functional level of the final ambulation correlated negatively and significantly with the initial time to achieve weight-bearing capacity on the affected leg and also with the standing balance. There was also a significant correlation with the severity of lower-extremity paresis. Patients experienced an improvement in walking recovery throughout the first year after their stroke. The early weight-bearing capacity of the affected leg and standing balance were associated with higher walking levels 1 year after the stroke.

  3. Bilaterally Primary Cementless Total Hip Arthroplasty for Severe Hip Ankylosis with Ankylosing Spondylitis.

    Science.gov (United States)

    Feng, Dong-Xu; Zhang, Kun; Zhang, Yu-Min; Nian, Yue-Wen; Zhang, Jun; Kang, Xiao-Min; Wu, Shu-Fang; Zhu, Yang-Jun

    2016-08-01

    Total hip arthroplasty is a reliable therapeutic intervention in patients with ankylosing spondylitis, in whom the aims of surgery are to reduce pain, restore hip function and improve quality of life. The current study is a retrospective analysis of the clinical and radiographic findings in a consecutive series of patients with hip ankylosis associated with severe ankylosing spondylitis who underwent bilateral primary total hip arthroplasty using non-cemented components. From June 2008 to May 2012, total hip arthroplasty was performed on 34 hips in 17 patients with bilateral ankylosis caused by ankylosing spondylitis. The study patients included 13 men and 4 women with a mean age of 24.2 years. The mean duration of disease was 8.3 years and the average duration of hip involvement was 7.6 years. All patients had severe hip pain and dysfunction with bilateral bony ankylosis and no range of motion preoperatively and all underwent bilateral cementless total hip arthroplasty performed by a single surgeon. Joint pain, range of motion (ROM), and Harris hip scores were assessed to evaluate the postoperative results. At a mean follow-up of 31.7 months, all patients had experienced significant clinical improvement in function, ROM, posture and ambulation. At the final follow-up, the mean postoperative flexion ROM was 134.4° compared with 0° preoperatively. Similar improvements were seen in hip abduction, adduction, internal rotation and external rotation. Postoperatively, 23 hips were completely pain-free, six had only occasional discomfort, three mild to moderate pain and two severe pain. The average Harris Hip Score improved from 23.7 preoperatively to 65.8 postoperatively. No stems had loosened at the final follow-up in any patient, nor had any revision surgery been required. Bilateral severe hip ankylosis in patients with ankylosing spondylitis can be treated with cementless bilateral synchronous total hip arthroplasty, which can greatly improve hip joint function and

  4. Functional changes in vascular amputee patients: evaluation by Barthel Index, PULSES profile and ESCROW scale.

    Science.gov (United States)

    O'Toole, D M; Goldberg, R T; Ryan, B

    1985-08-01

    This study evaluated the changes made by 60 peripheral vascular amputees from one month prior to admission to six months after attending a rehabilitation hospital. The Barthel index, PULSES profile, and ESCROW profile were used to measure functional status, social support, and rehabilitation progress. Statistical analysis consisted of t-tests to determine significant differences between the means of scores at varying intervals, and analysis of variance was added to determine interactions between amputation level, age, and sex as related to functional change. Amputees showed significant gains in Barthel scores from admission to discharge; this was attributed to rehabilitation intervention. They showed a significant decrease by the PULSES profile over the study period, indicating a decrease in independence from their premorbid function. Changes in ESCROW scores showed patients to have a greater need for social supports as they moved from admission to discharge. Age was a significant factor in mobility at discharge as measured by the Barthel index. As measured by the PULSES profile, men did better than women at six months follow-up. Unexpected results were that neither amputation level nor the presence or absence of diabetes mellitus had a significant impact on functional status as measured. The lack of significant differences by amputation level may be due to factors of age and sex, as well as to more depression in the below-knee group.

  5. Validation of the International Index of Erectile Function (IIFE) for Use in Brazil

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    Gonzáles, Ana Inês; Sties, Sabrina Weiss; Wittkopf, Priscilla Geraldine, E-mail: sabrinasties@yahoo.com.br; Mara, Lourenço Sampaio de; Ulbrich, Anderson Zampier; Cardoso, Fernando Luiz; Carvalho, Tales de [Universidade do Estado de Santa Catarina, Florianópolis, SC (Brazil)

    2013-08-15

    The International Index of Erectile Function has been proposed as a method for assessing sexual function assisting the diagnosis and classification of erectile dysfunction. However, IIEF was not validated for the Portuguese language. Validate the International Index of Erectile Function in patients with cardiopulmonary and metabolic diseases. The sample consisted of 108 participants of to Cardiopulmonary and Metabolic program Rehabilitation (CPMR) in southern Brazil. The clarity assessment of the instrument was performed using a scale ranging from zero to 10. The construct validity was carried out by confirmatory factor analysis (KMO = 0.85; Barllet p < 0.001), internal consistency by Cronbach's alpha and reproducibility and interrater reliability via the test retest method. The items were considered very clear with averages superior to 9. The internal consistency resulted in 0.89. The majority of items related correctly with their domains, with exception of three questions from sexual satisfaction domain, and one from erectile function. All items showed excellent stability of measure and substantial to almost perfect agreement. The present study showed that the IIEF is valid and reliable for use in participants of a cardiopulmonary and metabolic rehabilitation program.

  6. Implied adjusted volatility functions: Empirical evidence from Australian index option market

    Science.gov (United States)

    Harun, Hanani Farhah; Hafizah, Mimi

    2015-02-01

    This study aims to investigate the implied adjusted volatility functions using the different Leland option pricing models and to assess whether the use of the specified implied adjusted volatility function can lead to an improvement in option valuation accuracy. The implied adjusted volatility is investigated in the context of Standard and Poor/Australian Stock Exchange (S&P/ASX) 200 index options over the course of 2001-2010, which covers the global financial crisis in the mid-2007 until the end of 2008. Both in- and out-of-sample resulted in approximately similar pricing error along the different Leland models. Results indicate that symmetric and asymmetric models of both moneyness ratio and logarithmic transformation of moneyness provide the overall best result in both during and post-crisis periods. We find that in the different period of interval (pre-, during and post-crisis) is subject to a different implied adjusted volatility function which best explains the index options. Hence, it is tremendously important to identify the intervals beforehand in investigating the implied adjusted volatility function.

  7. Association of Serum Vitamin D Levels with Disease Activity in Male Patients with Ankylosing Spondylitis

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    Nilgün Mesci

    2016-12-01

    Full Text Available Objective: To examine the relationship between serum 25-hydroxyvitamin D [25(OHD] level and disease activity in male patients with ankylosing spondylitis (AS. Materials and Methods: The study enrolled 51 male AS patients being followed at our hospital. Patient demographics as well as serum levels of 25(OHD vitamin, C-reactive protein (CRP, calcium, phosphorus, alkaline phosphatase and parathormone, and erythrocyte sedimentation rate (ESR at 1 hour were recorded. Patients were divided into two groups based on their serum 25(OHD vitamin levels; one group consisted of 21 patients with 25(OHD vitamin levels less than 20 ng/mL and the other group comprised 30 patients with 25(OHD levels greater than 20 ng/mL. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI scores were evaluated in order to determine the disease activity. Results: BASDAI scores were statistically significantly higher in the group with serum 25(OHD vitamin levels less than 20 ng/mL compared to the group with 25(OHD levels above 20 ng/mL (p<0.05. There was no statistically significant difference between groups in terms of ESR, serum levels of CRP, parathormone, calcium, phosphorus and alkaline phosphatase. Conclusion: In the present study, an inverse relationship has been found between serum vitamin D levels and disease activity in male AS patients and it was concluded that serum vitamin D levels should also be taken into account while developing a treatment plan.

  8. Hemodynamics, functional state of endothelium and renal function, platelets depending on the body mass index in patients with chronic heart failure and preserved systolic function

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    Kushnir Yu.

    2014-03-01

    Full Text Available The aim of the study was to evaluate hemodynamics, endothelium function of kidneys and platelets depending on the body mass index (BMI in patients with chronic heart failure (CHF and preserved systolic function. 42 patients (mean age - 76,690,83 years with CHF II-III FC NYHA with preserved systolic function (LVEF>45% were enrolled. Echocardiography was performed, endothelial function, serum creatinine levels and microalbuminuria were determined in patients. BMI and glomerulation filtration rate were calculated by formulas. The morphological and functional status of platelets was estimated by electronic microscopy. It was defined that increased BMI in patients with CHF and preserved systolic function determines the structural and functional changes of the myocardium and leads to the endothelial and renal functional changes. An increased risk of thrombogenesis was established in patients with overweight and obesity.

  9. Pre-operative Tei Index does not predict left ventricular function immediately after mitral valve repair

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    Chirojit Mukherjee

    2012-01-01

    Full Text Available Echocardiographic assessment of systolic left ventricular (LV function in patients with severe mitral regurgitation (MR undergoing mitral valve (MV repair can be challenging because the measurement of ejection fraction (EF or fractional area change (FAC in pathological states is of questionable value. The aim of our study was to evaluate the usefulness of the pre-operative Tei Index in predicting left ventricular EF or FAC immediately after MV repair. One hundred and thirty patients undergoing MV repair with sinus rhythm pre- and post-operatively were enrolled in this prospective study. Twenty-six patients were excluded due to absence of sinus rhythm post-operatively. Standard transesophageal examination(IE 33,Philips,Netherlands was performed before and after cardiopulmonary bypass according to the guidelines of the ASE/SCA. FAC was determined in the transgastric midpapillary short-axis view. LV EF was measured in the midesophageal four- and two-chamber view. For calculation of the Tei Index, the deep transgastric and the midesophageal four-chamber view were used. Statistical analysis was performed with SPSS 17.0. values are expressed as mean with standard deviation. LV FAC and EF decreased significantly after MV repair (FAC: 56±12% vs. 50±14%, P<0.001; EF: 58±11 vs. 50±12Έ P<0.001. The Tei Index decreased from 0.66±0.23 before MV repair to 0.41±0.19 afterwards (P<0.001. No relationship between pre-operative Tei Index and post-operative FAC or post-operative EF were found (FAC: r=−0.061, P=0.554; EF: r=−0.29, P=0.771. Conclusion: Pre-operative Tei Index is not a good predictor for post-operative FAC and EF in patients undergoing MV repair.

  10. The genomics and genetics of ankylosing spondylitis

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    Thomas GP

    2011-12-01

    Full Text Available Tony J Kenna, Stuart I Davidson, Gethin P ThomasUniversity of Queensland Diamantina Institute, Brisbane, AustraliaAbstract: The spondyloarthropathies are a group of arthritides which specifically target the spine and pelvis with ankylosing spondylitis (AS being the most prevalent and debilitating of these conditions. Unique to AS is the progression to excessive uncontrolled bone formation following an initial inflammatory phase that can result in joint fusion and significant disability. Spondyloarthritis is estimated to affect 1%–2% of the population, twice as many as rheumatoid arthritis and thus constitutes a significant health problem. Currently AS pathogenesis is very poorly understood but recent large-scale genetics and gene expression profiling studies have identified some of the underlying mechanisms and pathways contributing to the disease. Genome-wide association studies have identified a number of candidate genes associated with AS sharing the same pathways which are now being targeted for therapeutic intervention. However, although such approaches can identify genes contributing to the disease process and are very informative as to disease aetiopathogenesis, they cannot profile the actual changes in gene/cell activity at any point in the disease process or possibly more importantly at specific sites. Such information is generated using expression profiling. A number of expression profiling studies have been undertaken in AS, looking at both circulating cells and tissues from affected joints. Although some common genes/pathways have been identified, overall the results to date have been somewhat disappointing due to differences in experimental design and tissue source as well as the low power of the studies. More recent better powered studies have shown some potential in developing gene expression profiling as a diagnostic tool in AS. True future success will rely on larger genetic and genomic studies and the combination of these

  11. The effect of smoking on clinical and radiographic variables, and acute phase reactants in patients with ankylosing spondylitis.

    Science.gov (United States)

    Sakellariou, Grigorios T; Anastasilakis, Athanasios D; Kenanidis, Eustathios; Potoupnis, Michael; Tsiridis, Eleftherios; Savvidis, Matthaios; Kartalis, Nikolaos; Sayegh, Fares E

    2015-12-01

    To investigate the association between smoking and clinical, inflammatory and radiographic parameters in patients with ankylosing spondylitis (AS). One hundred and six tumour necrosis factor inhibitor naïve patients with AS were included in the study. The erythrocyte sedimentation rate, C-reactive protein, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI) and modified Stroke AS Spine Score (mSASSS) were assessed cross-sectionally for each patient. Smoking history was obtained, and smoking pack years were calculated. Current smokers had significantly higher BASDAI (p < 0.001) and a trend for higher BASFI (p = 0.059). Ever smokers had significantly higher BASFI (p = 0.035) and a trend for higher mSASSS (p = 0.063) compared to never smokers. Pack years (smoking intensity) were positively correlated with duration of inflammatory back pain (r = 0.628, p < 0.001), BASFI (r = 0.443, p < 0.001) and mSASSS (r = 0.683, p < 0.001). Multivariate regression analyses showed that current smoking was independently associated with a higher BASDAI score [regression coefficient (B) = 14.75, p < 0.001] and increasing pack years were independently associated with higher mSASSS (B = 0.26, p = 0.005). In patients with AS, current smoking was strongly and independently associated with higher disease activity, and cumulative smoking exposure with more radiographic spinal damage. In AS smokers, smoking cessation should be strongly recommended.

  12. Comparison of Sexual Dysfunction Using the Female Sexual Function Index following Surgical Treatments for Uterine Fibroids

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    Allison Ryann Louie

    2012-01-01

    Full Text Available Uterine fibroids are a common problem in women. Statistics showing 20–50% of fibroids produce symptoms and consequently patients seek surgical intervention to improve their quality of life. Treatments for fibroids are typically successful in controlling the fibroid disease, yet sexual function following invasive surgical treatments for fibroids can be jeopardized. The Sexual Function Index (FSFI is a valid instrument producing quantifiable reproducible results. In this paper three case reports are evaluated by the FSFI and compared between the following treatment groups: hysterectomy, myomectomy, and uterine embolization. Our goal is to illustrate how each of these treatment outcomes can result in sexual dysfunction and therefore decreased quality of life. Effects of invasive fibroid treatments on sexual functioning would be helpful in guiding patient’s ultimate decisions regarding treatment.

  13. Decreased health-related physical fitness in adults with ankylosing spondylitis: a cross-sectional controlled study.

    Science.gov (United States)

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

    2016-06-01

    (1) Assess the health-related physical fitness of adults with ankylosing spondylitis (AS) and compare these to the general population, and (2) examine the relationships between physical fitness and condition-specific outcomes. Cross-sectional, controlled study. Exercise research laboratory. Thirty-nine adults with AS (32 men, 7 women) and 39 age- and gender-matched controls. Comprehensive physical fitness assessment, and completion of questionnaires assessing disease activity, physical function and quality-of-life. Body composition was assessed by bio-impedance analysis. Flexibility was measured with the Bath AS Metrology Index (BASMI). Cardiorespiratory fitness was assessed by submaximal treadmill test with breath-by-breath gas analysis and heart rate monitoring. Muscular strength and endurance were measured by isokinetic dynamometry of concentric knee flexion/extension. The AS group demonstrated significantly lower cardiorespiratory fitness [mean difference -1.3mLmin(-1)kg(-1) (95% CI -1.1 to -1.4)], flexibility [0.4 BASMI units (0.2 to 0.7)], muscular strength [-31.6 peak torque per body weight dominant knee extension (-56.1 to -7.1)], and increased body fat [0.4% (0.0 to 1.2)] compared to population controls (pfitness component and physical function (pFitness was not significantly associated with disease activity. Adults with AS have significantly reduced health-related physical fitness compared to population controls. Decreased body fat, and higher aerobic capacity, muscular fitness and flexibility are significantly associated with improved function. These findings have implications for clinicians assessing adults with AS, and for targeted-exercise prescription in this cohort. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  14. Exploring differential item functioning in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC

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    Pollard Beth

    2012-12-01

    Full Text Available Abstract Background The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC is a widely used patient reported outcome in osteoarthritis. An important, but frequently overlooked, aspect of validating health outcome measures is to establish if items exhibit differential item functioning (DIF. That is, if respondents have the same underlying level of an attribute, does the item give the same score in different subgroups or is it biased towards one subgroup or another. The aim of the study was to explore DIF in the Likert format WOMAC for the first time in a UK osteoarthritis population with respect to demographic, social, clinical and psychological factors. Methods The sample comprised a community sample of 763 people with osteoarthritis who participated in the Somerset and Avon Survey of Health. The WOMAC was explored for DIF by gender, age, social deprivation, social class, employment status, distress, body mass index and clinical factors. Ordinal regression models were used to identify DIF items. Results After adjusting for age, two items were identified for the physical functioning subscale as having DIF with age identified as the DIF factor for 2 items, gender for 1 item and body mass index for 1 item. For the WOMAC pain subscale, for people with hip osteoarthritis one item was identified with age-related DIF. The impact of the DIF items rarely had a significant effect on the conclusions of group comparisons. Conclusions Overall, the WOMAC performed well with only a small number of DIF items identified. However, as DIF items were identified in for the WOMAC physical functioning subscale it would be advisable to analyse data taking into account the possible impact of the DIF items when weight, gender or especially age effects, are the focus of interest in UK-based osteoarthritis studies. Similarly for the WOMAC pain subscale in people with hip osteoarthritis it would be worthwhile to analyse data taking into account the

  15. Surgical orodental implications in ankylosing spondylitis

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    Mohammad Mehdizadeh

    2012-01-01

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

  16. Spinal fractures in patients with ankylosing spondylitis.

    Science.gov (United States)

    Leone, Antonio; Marino, Marzia; Dell'Atti, Claudia; Zecchi, Viola; Magarelli, Nicola; Colosimo, Cesare

    2016-10-01

    The ankylosed spine is prone to fracture even after minor trauma due to its changed biomechanical properties. The two central features of ankylosing spondylitis (AS) that promote the pathological remodeling of the spine are inflammation and new bone formation. AS is also associated with osteoporosis that is attributed to an uncoupling of the bone formation and bone resorption processes. Therefore, bone resorption occurs and promotes weakening of the spine as well as increased risk of vertebral fractures which can be hugely different in terms of clinical relevance. Even in the presence of symptomatic clinical vertebral fractures, the diagnosis can be overruled by attributing the pain to disease activity. Furthermore, given the highly abnormal structure of the spine, vertebral fracture diagnosis can be difficult on the basis of radiography alone. CT can show the fractures in detail. Magnetic resonance imaging is considered the method of choice for the imaging of spinal cord injuries, and a reasonable option for exclusion of occult fractures undetected by CT. Since it is equally important for radiologists and clinicians to have a common knowledge base rather than a compartmentalized view, the aim of this review article was to provide the required clinical knowledge that radiologists need to know and the relevant radiological semiotics that clinicians require in diagnosing clinically significant injury to the ankylosed spine.

  17. Ankylosing Spondylitis: From Cells to Genes

    Science.gov (United States)

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

    2013-01-01

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

  18. Rosuvastatin improves endothelial dysfunction in ankylosing spondylitis.

    Science.gov (United States)

    Garg, Nidhi; Krishan, Pawan; Syngle, Ashit

    2015-06-01

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

  19. Ankylosing spondylitis and a diagnostic dilemma: coccydynia.

    Science.gov (United States)

    Deniz, R; Ozen, G; Yilmaz-Oner, S; Aydin, S Z; Erzik, C; Gunduz, O H; Inanc, N; Direskeneli, H; Atagunduz, P

    2014-01-01

    Coccydynia is defined as pain in or around the tail bone area. The most common cause of coccydynia is either a trauma such as a fall directly on to the coccyx or repetitive minor trauma. The etiology remains obscure in up to 30% of patients. The literature on the contribution of rheumatic diseases to coccydynia is scarce. Our objective was to investigate the prevalence of coccydynia in ankylosing spondylitis (AS) patients. One hundred and seven consecutive patients with AS were evaluated for coccydynia were enrolled between January and November 2012 for a cross-sectional analysis. Seventy-four consecutive patients were followed for mechanical back pain as controls and the AS patients were interviewed for the presence of coccydynia. The data collected was evaluated on SPSS® version 11.5 and Microsoft Excel® Programmes. Prevalence of coccydynia in AS (38.3%) was significantly higher than the control group (ppain. Our observation may implicate that inflammatory diseases have a role in the etiology of coccydynia, especially in those without a history of recent or past trauma and coccydynia may be a factor associated with the severity of AS as well.

  20. Ankylosing Spondylitis and Pregnancy: A Literature Review.

    Science.gov (United States)

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

    2017-01-01

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

  1. Ankylosing Spondylitis Associated With Bilateral TMJ Ankylosis

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

    2000-09-15

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

  2. Development of multi-functional streetscape green infrastructure using a performance index approach

    International Nuclear Information System (INIS)

    Tiwary, A.; Williams, I.D.; Heidrich, O.; Namdeo, A.; Bandaru, V.; Calfapietra, C.

    2016-01-01

    This paper presents a performance evaluation framework for streetscape vegetation. A performance index (PI) is conceived using the following seven traits, specific to the street environments – Pollution Flux Potential (PFP), Carbon Sequestration Potential (CSP), Thermal Comfort Potential (TCP), Noise Attenuation Potential (NAP), Biomass Energy Potential (BEP), Environmental Stress Tolerance (EST) and Crown Projection Factor (CPF). Its application is demonstrated through a case study using fifteen street vegetation species from the UK, utilising a combination of direct field measurements and inventoried literature data. Our results indicate greater preference to small-to-medium size trees and evergreen shrubs over larger trees for streetscaping. The proposed PI approach can be potentially applied two-fold: one, for evaluation of the performance of the existing street vegetation, facilitating the prospects for further improving them through management strategies and better species selection; two, for planning new streetscapes and multi-functional biomass as part of extending the green urban infrastructure. - Highlights: • A performance evaluation framework for streetscape vegetation is presented. • Seven traits, relevant to street vegetation, are included in a performance index (PI). • The PI approach is applied to quantify and rank fifteen street vegetation species. • Medium size trees and evergreen shrubs are found more favourable for streetscapes. • The PI offers a metric for developing sustainable streetscape green infrastructure. - A performance index is developed and applied to fifteen vegetation species indicating greater preference to medium size trees and evergreen shrubs for streetscaping.

  3. Upper and lower limb functionality and body mass index in physically active older adults

    Directory of Open Access Journals (Sweden)

    Juliana Molinari Tecchio

    Full Text Available Abstract Introduction: Aging leads to sarcopenia and functional capacity decline, compromising upper (UL and lower limb (LL performance of activities. Body mass index (BMI is an important parameter for the assessment of health conditions in older adults, especially with regard to obesity, since it leads to functional limitations in terms of mobility and task performance. Objective: To investigate the potential association between UL and LL functionality and BMI in physically active older adults; and to characterize this population with regard to BMI and UL and LL functionality. Methods: The data were collected between August 2013 and April 2014. The sample comprised 371 physically active older adults. This study used secondary data from the program “PET Saúde IPA/SMS”. The program interviewed older adults living in areas comprised by the Third Family Health Unit of a neighborhood in Porto Alegre/RS. This paper used questions from the “Instrumento de Avaliação Multidimensional Rápida da Pessoa Idosa” (Instrument for Rapid Multidimensional Assessment of Elderly People, in English that had to do with UL and LL functionality, weight, height and BMI. Results and Conclusion: There was no association between UL and LL functionality and BMI in physically active older adults. More than half of the sample was overweight. Most participants had functional UL and LL. While occupation, self-perception of health as “good” and “very good”, and physical activity were found to be associated with LL functionality; regular physical exercise was found to be associated with UL and LL functionality.

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

    Directory of Open Access Journals (Sweden)

    Han-qing HUANG

    2013-07-01

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

  5. Association between functional performance and executive cognitive functions in an elderly population including patients with low ankle–brachial index

    Science.gov (United States)

    Ferreira, Naomi Vidal; Cunha, Paulo Jannuzzi; da Costa, Danielle Irigoyen; dos Santos, Fernando; Costa, Fernando Oliveira; Consolim-Colombo, Fernanda; Irigoyen, Maria Cláudia

    2015-01-01

    Introduction Peripheral arterial disease, as measured by the ankle–brachial index (ABI), is prevalent among the elderly, and is associated with functional performance, assessed by the 6-minute walk test (6MWT). Executive cognitive function (ECF) impairments are also prevalent in this population, but no existing study has investigated the association between ECF and functional performance in an elderly population including individuals with low ABI. Aim To investigate the association between functional performance, as measured by the 6MWT, and loss in ECF, in an elderly sample including individuals with low ABI. Method The ABI group was formed by 26 elderly individuals with low ABI (mean ABI: 0.63±0.19), and the control group was formed by 40 elderly individuals with normal ABI (mean ABI: 1.08±0.07). We analyzed functional performance using the 6MWT, global cognition using the Mini-Mental State Examination (MMSE), and ECF using the Digit Span for assessing attention span and working memory, the Stroop Color Word Test (SCWT) for assessing information processing speed and inhibitory control/impulsivity, and the Controlled Oral Word Association Test (COWAT) for assessing semantic verbal fluency and phonemic verbal fluency. We also used a factor analysis on all of the ECF tests (global ECF). Results Before adjustment, the ABI group performed worse on global cognition, attention span, working memory, inhibitory control/impulsivity, semantic verbal fluency, and phonemic verbal fluency. After adjustment, the ABI group performance remained worse for working memory and semantic verbal fluency. In a simple correlation analysis including all of the subjects, the 6MWT was associated with global cognition, attention span, working memory, information processing speed, inhibitory control/impulsivity, semantic verbal fluency, and global ECF. After adjustment, all the associations remained statistically significant. Conclusion This study found an independent association between

  6. Establishing score equivalence of the Functional Independence Measure motor scale and the Barthel Index, utilising the International Classification of Functioning, Disability and Health and Rasch measurement theory

    OpenAIRE

    Prodinger, B; O'Connor, RJ; Stucki, G; Tennant, A

    2017-01-01

    Introduction: Two widely used outcome measures to assess functioning in neurological rehabilitation are the Functional Independence Measure (FIM™) and the Barthel Index. The current study aims to establish the equivalence of the total score of the FIM™ motor scale and the Barthel Index through the application of the International Classification of Functioning, Disability and Health, and Rasch measurement theory. Methods: Secondary analysis of a large sample of patients with stroke, spinal cor...

  7. Outcome of minimally invasive surgery in the management of tuberculous spondylitis

    Directory of Open Access Journals (Sweden)

    Pankaj Kandwal

    2012-01-01

    Full Text Available Introduction: With the advancement of instrumentation and minimally access techniques in the field of spine surgery, good surgical decompression and instrumentation can be done for tuberculous spondylitis with known advantage of MIS (minimally invasive surgery. The aim of this study was to assess the outcome of the minimally invasive techniques in the surgical treatment of patients with tuberculous spondylodiscitis. Materials and Methods: 23 patients (Group A with a mean age 38.2 years with single-level spondylodiscitis between T4-T11 treated with video-assisted thoracoscopic surgery (VATS involving anterior debridement and fusion and 15 patients (Group B with a mean age of 32.5 years who underwent minimally invasive posterior pedicle screw instrumentation and mini open posterolateral debridement and fusion were included in study. The study was conducted from Mar 2003 to Dec 2009 duration. The indication of surgery was progressive neurological deficit and/or instability. The patients were evaluated for blood loss, duration of surgery, VAS scores, improvement in kyphosis, and fusion status. Improvement in neurology was documented and functional outcome was judged by oswestry disability index (ODI. Results: The mean blood loss in Group A (VATS category was 780 ml (330-1180 ml and the operative time averaged was 228 min (102-330 min. The average preoperative kyphosis in Group A was 38° which was corrected to 30°. Twenty-two patients who underwent VATS had good fusion (Grade I and Grade II with failure of fusion in one. Complications occurred in seven patients who underwent VATS. The mean blood loss was 625 ml (350-800 ml with an average duration of surgery of 255 min (180-345 min in the percutaneous posterior instrumentation group (Group B. The average preoperative segmental (kyphosis Cobb′s angle of three patients with thoracic TB in Group B was 41.25° (28-48°, improved to 14.5°(11°- 21° in the immediate postoperative period (71

  8. Association of Body Mass Index with Asthma Severity and Pulmonary Function among Asthmatic Children

    Directory of Open Access Journals (Sweden)

    Rasuol Nasiri Kalmarzi

    2016-09-01

    Full Text Available Background Asthma is a chronic inflammatory disease in respiratory system and obesity is another inflammatory disease which incidence rate is increasing. Although, many studies have been conducted on severity of asthma and its relationship with obesity, but different results have been obtained. This study aimed to determine a relationship between asthma severity, Body Mass Index (BMI and pulmonary function in Kurdistan province, Iran. Materials and Methods: In this cross sectional study 90 asthmatic patients referred to referral hospital in Kurdistan, North West of Iran, were selected by simple random method. BMI was calculated by dividing weight by height.Pulmonary Function Test (PFT and bronchial-stimulation-test were used for confirmation and investigation of asthma severity. Data were analyzed using SPSS-15 and Chi-square and spearman correlation coefficient tests. Results: Relationship between BMI and severity of asthma (mild, medium and severe was evaluated, there was a relationship and positive relationship between them (P

  9. Detecting genomic regions associated with a disease using variability functions and Adjusted Rand Index

    Directory of Open Access Journals (Sweden)

    Makarenkov Vladimir

    2011-10-01

    Full Text Available Abstract Background The identification of functional regions contained in a given multiple sequence alignment constitutes one of the major challenges of comparative genomics. Several studies have focused on the identification of conserved regions and motifs. However, most of existing methods ignore the relationship between the functional genomic regions and the external evidence associated with the considered group of species (e.g., carcinogenicity of Human Papilloma Virus. In the past, we have proposed a method that takes into account the prior knowledge on an external evidence (e.g., carcinogenicity or invasivity of the considered organisms and identifies genomic regions related to a specific disease. Results and conclusion We present a new algorithm for detecting genomic regions that may be associated with a disease. Two new variability functions and a bipartition optimization procedure are described. We validate and weigh our results using the Adjusted Rand Index (ARI, and thus assess to what extent the selected regions are related to carcinogenicity, invasivity, or any other species classification, given as input. The predictive power of different hit region detection functions was assessed on synthetic and real data. Our simulation results suggest that there is no a single function that provides the best results in all practical situations (e.g., monophyletic or polyphyletic evolution, and positive or negative selection, and that at least three different functions might be useful. The proposed hit region identification functions that do not benefit from the prior knowledge (i.e., carcinogenicity or invasivity of the involved organisms can provide equivalent results than the existing functions that take advantage of such a prior knowledge. Using the new algorithm, we examined the Neisseria meningitidis FrpB gene product for invasivity and immunologic activity, and human papilloma virus (HPV E6 oncoprotein for carcinogenicity, and confirmed

  10. Adaptation and Validation of the Foot Function Index-Revised Short Form into Polish

    Directory of Open Access Journals (Sweden)

    Radosław Rutkowski

    2017-01-01

    Full Text Available Purpose. The aim of the present study was to adapt the Foot Function Index-Revised Short Form (FFI-RS questionnaire into Polish and verify its reliability and validity in a group of patients with rheumatoid arthritis (RA. Methods. The study included 211 patients suffering from RA. The FFI-RS questionnaire underwent standard linguistic adaptation and its psychometric parameters were investigated. The enrolled participants had been recruited for seven months as a convenient sample from the rheumatological hospital in Śrem (Poland. They represented different sociodemographic characteristics and were characterized as rural and city environments residents. Results. The mean age of the patients was 58.9±10.2 years. The majority of patients (85% were female. The average final FFI-RS score was 62.9±15.3. The internal consistency was achieved at a high level of 0.95 in Cronbach’s alpha test, with an interclass correlation coefficient ranging between 0.78 and 0.84. A strong correlation was observed between the FFI-RS and Health Assessment Questionnaire-Disability Index (HAQ-DI questionnaires. Conclusion. The Polish version of FFI-RS-PL indicator is an important tool for evaluating the functional condition of patients’ feet and can be applied in the diagnosis and treatment of Polish-speaking patients suffering from RA.

  11. Adaptation and Validation of the Foot Function Index-Revised Short Form into Polish.

    Science.gov (United States)

    Rutkowski, Radosław; Gałczyńska-Rusin, Małgorzata; Gizińska, Małgorzata; Straburzyński-Lupa, Marcin; Zdanowska, Agata; Romanowski, Mateusz Wojciech; Romanowski, Wojciech; Budiman-Mak, Elly; Straburzyńska-Lupa, Anna

    2017-01-01

    The aim of the present study was to adapt the Foot Function Index-Revised Short Form (FFI-RS) questionnaire into Polish and verify its reliability and validity in a group of patients with rheumatoid arthritis (RA). The study included 211 patients suffering from RA. The FFI-RS questionnaire underwent standard linguistic adaptation and its psychometric parameters were investigated. The enrolled participants had been recruited for seven months as a convenient sample from the rheumatological hospital in Śrem (Poland). They represented different sociodemographic characteristics and were characterized as rural and city environments residents. The mean age of the patients was 58.9 ± 10.2 years. The majority of patients (85%) were female. The average final FFI-RS score was 62.9 ± 15.3. The internal consistency was achieved at a high level of 0.95 in Cronbach's alpha test, with an interclass correlation coefficient ranging between 0.78 and 0.84. A strong correlation was observed between the FFI-RS and Health Assessment Questionnaire-Disability Index (HAQ-DI) questionnaires. The Polish version of FFI-RS-PL indicator is an important tool for evaluating the functional condition of patients' feet and can be applied in the diagnosis and treatment of Polish-speaking patients suffering from RA.

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

    Science.gov (United States)

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

    2013-12-01

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

  13. A QEEG index of level of functional dependence for people sustaining acquired brain injury: the Seville Independence Index (SINDI).

    Science.gov (United States)

    Leon-Carrion, Jose; Martin-Rodriguez, Juan Francisco; Damas-Lopez, Jesus; Martin, Juan Manuel Barroso Y; Dominguez-Morales, Maria Del Rosario

    2008-01-01

    To find an easy-to-use, valid and reliable tool for evaluating the level of functional dependence of an individual with brain damage who seeks a diagnosis of his/her functional dependence in daily activities. Eighty-one patients with acquired brain injury (ABI) in post-acute phase, 40 traumatic brain injury (TBI) and 41 cerebral vascular accident (CVA), were assessed using quantitative electroencephalography (QEEG) and grouped according to the FIM + FAM scale. Discriminant analysis was performed on QEEG variables to obtain a discriminant function with the best discriminative capacity between functionality groups. Discriminant analysis showed classification accuracy of 100% in the training set sample and 75% in an external cross-validation sample; 100% sensitivity and 100% specificity were reached. Coherence measures were the most numerous variables in the function. These results point out that the discriminant function may be a useful tool in objective evaluations of patients seeking a diagnosis of their level of dependence and that it could be included in current functionality assessment protocols.

  14. Idiopathic Pulmonary Fibrosis: Gender-Age-Physiology Index Stage for Predicting Future Lung Function Decline.

    Science.gov (United States)

    Salisbury, Margaret L; Xia, Meng; Zhou, Yueren; Murray, Susan; Tayob, Nabihah; Brown, Kevin K; Wells, Athol U; Schmidt, Shelley L; Martinez, Fernando J; Flaherty, Kevin R

    2016-02-01

    Idiopathic pulmonary fibrosis is a progressive lung disease with variable course. The Gender-Age-Physiology (GAP) Index and staging system uses clinical variables to stage mortality risk. It is unknown whether clinical staging predicts future decline in pulmonary function. We assessed whether the GAP stage predicts future pulmonary function decline and whether interval pulmonary function change predicts mortality after accounting for stage. Patients with idiopathic pulmonary fibrosis (N = 657) were identified retrospectively at three tertiary referral centers, and baseline GAP stages were assessed. Mixed models were used to describe average trajectories of FVC and diffusing capacity of the lung for carbon monoxide (Dlco). Multivariable Cox proportional hazards models were used to assess whether declines in pulmonary function ≥ 10% in 6 months predict mortality after accounting for GAP stage. Over a 2-year period, GAP stage was not associated with differences in yearly lung function decline. After accounting for stage, a 10% decrease in FVC or Dlco over 6 months independently predicted death or transplantation (FVC hazard ratio, 1.37; Dlco hazard ratio, 1.30; both, P ≤ .03). Patients with GAP stage 2 with declining pulmonary function experienced a survival profile similar to patients with GAP stage 3, with 1-year event-free survival of 59.3% (95% CI, 49.4-67.8) vs 56.9% (95% CI, 42.2-69.1). Baseline GAP stage predicted death or lung transplantation but not the rate of future pulmonary function decline. After accounting for GAP stage, a decline of ≥ 10% over 6 months independently predicted death or lung transplantation. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Karin M. Goya

    2009-04-01

    Full Text Available A espondilite anquilosante é uma doença inflamatória que influencia de maneira restritiva a mecânica respiratória por meio do acometimento das articulações da coluna, bem como das alterações posturais decorrentes desse processo como o aumento da cifose torácica. OBJETIVO: O objetivo deste estudo foi avaliar a alteração pulmonar dos pacientes portadores de espondilite anquilosante e relacioná-la à atividade física, verificando a influência na capacidade respiratória. MÉTODOS:Foram recrutados para este estudo 104 pacientes. Apenas 15 preenchiam os critérios de inclusão e exclusão, sendo divididos em dois grupos: grupo I, composto por indivíduos sedentários, e o grupo II, composto por pacientes que praticam uma atividade física regular moderada. RESULTADOS:Os dois grupos não diferiram em relação à média da idade (49,6 ± 11,6 versus 43,3 ± 13,2 anos, p = 0,19, peso (70,9 ± 9,7 versus 74,1 ± 12,1 kg, p = 0,30 e a altura (164,6 ± 3,5 versus 167,6 ± 6,9 cm, p = 0,16. Entretanto, o tempo médio de doença foi significantemente maior no grupo I comparado ao grupo de ativos (20,1 ± 6,9 vs. 9,6 ± 3,4, p = 0,004. Como tema de interesse, observou-se que o volume minuto foi significativamente maior no grupo ativo que no inativo (4,83 ± 1,07 versus 6,1 ± 1,25, p = 0,035. Por outro lado, isso não foi demonstrado em relação à frequência respiratória (14,57 ± 1,76 versus 16,25 ± 3,53 ipm, p = 0,15, ao volume corrente (0,402 ± 0,07 versus 0,342 ± 0,10 L, p = 0,13, bem como às medidas de pressão PI máx (84,29 ± 24,99 versus 93,13 ± 16,76 cmH2O, p = 0,24 e PE máx (102,2 ± 29,26 versus 105 ± 17,32 cmH2O, p = 0,42. CONCLUSÃO:Este estudo pareceu demonstrar que os volumes pulmonares são mantidos em pacientes com espondilite anquilosante que realizam atividade física regular.Ankylosing spondylitis is an inflammatory condition which causes restriction in the lung function due to column joint alterations leading

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  17. Cervical discitis, spondylitis and spondylodiscitis in chronic polyarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Dirheimer, Y.; Bourjat, P.

    1985-07-01

    All inflammatory rheumatoid variants may involve the cervical spine. After progressive destruction and narrowing of the intervertebral disks, spondylitis and spondylodiscitis does result in subluxation and fusion of vertebral bodies, and anterior corners squarring. These variants of the vertebral bodies involvements are here described.

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

    African Journals Online (AJOL)

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

  19. Cost-of-illness of rheumatoid arthritis and ankylosing spondylitis

    NARCIS (Netherlands)

    Franke, A.C.; Ament, A.J.H.A.; Laar, M.A.F.J.; Boonen, A.; Severens, J.L.

    2009-01-01

    Objective. To assess, quantify and summarise the cost of illness of rheumatoid arthritis (RA) and ankylosing spondylitis (AS) from the societal perspective Methods. Original studies reporting costs of RA or AS were searched systematically. Both cost-of-illness studies and economic evaluations of

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  1. Fractures of the dens complicating ankylosing spondylitis with atlantooccipital fusion.

    Science.gov (United States)

    Miller, F H; Rogers, L F

    1991-05-01

    Patients with ankylosing spondylitis are prone to fractures. Fractures tend to occur in the lower cervical spine disc space. We describe 2 patients with odontoid fractures. Both patients had atlantooccipital fusion which may have increased their susceptibility for dens fractures. One patient had Crohn's disease.

  2. Prioritization, clustering and functional annotation of MicroRNAs using latent semantic indexing of MEDLINE abstracts.

    Science.gov (United States)

    Roy, Sujoy; Curry, Brandon C; Madahian, Behrouz; Homayouni, Ramin

    2016-10-06

    The amount of scientific information about MicroRNAs (miRNAs) is growing exponentially, making it difficult for researchers to interpret experimental results. In this study, we present an automated text mining approach using Latent Semantic Indexing (LSI) for prioritization, clustering and functional annotation of miRNAs. For approximately 900 human miRNAs indexed in miRBase, text documents were created by concatenating titles and abstracts of MEDLINE citations which refer to the miRNAs. The documents were parsed and a weighted term-by-miRNA frequency matrix was created, which was subsequently factorized via singular value decomposition to extract pair-wise cosine values between the term (keyword) and miRNA vectors in reduced rank semantic space. LSI enables derivation of both explicit and implicit associations between entities based on word usage patterns. Using miR2Disease as a gold standard, we found that LSI identified keyword-to-miRNA relationships with high accuracy. In addition, we demonstrate that pair-wise associations between miRNAs can be used to group them into categories which are functionally aligned. Finally, term ranking by querying the LSI space with a group of miRNAs enabled annotation of the clusters with functionally related terms. LSI modeling of MEDLINE abstracts provides a robust and automated method for miRNA related knowledge discovery. The latest collection of miRNA abstracts and LSI model can be accessed through the web tool miRNA Literature Network (miRLiN) at http://bioinfo.memphis.edu/mirlin .

  3. The image diagnosis of juvenile ankylosing spondylitis

    International Nuclear Information System (INIS)

    Xian Jianxing; Zhao Jihong

    2005-01-01

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

  4. Evaluation of sexual function in young men with spina bifida and myelomeningocele using the International Index of Erectile Function.

    Science.gov (United States)

    Gamé, Xavier; Moscovici, Jacques; Gamé, Laurence; Sarramon, Jean-Pierre; Rischmann, Pascal; Malavaud, Bernard

    2006-03-01

    To assess sexual function in young men with spina bifida and myelomeningocele. Between November 2003 and February 2004, a cross-sectional study was performed in 55 men older than 18 years of age who had been regularly followed up for myelomeningocele since childhood, between 1961 and 1985, in the Pediatric Internal Surgery Department. The International Index of Erectile Function (IIEF) questionnaire was mailed to each man. The response rate was 72.7%. Of the 40 men who replied, 16 (40%) had had sexual intercourse at least once during the previous month. These were the older men (age 31.9 +/- 5.7 years versus 27.7 +/- 5.5 years, P = 0.027). The IIEF scores for the whole group were erectile function 11.61 +/- 9.44, orgasmic function 3.53 +/- 3.86, sexual desire 6.94 +/- 2.4, intercourse satisfaction 3.7 +/- 4.81, and overall satisfaction 4.7 +/- 3.34. According to the classification of Cappelleri, of the 16 men who had had sexual intercourse during the previous month, 4 had no erectile dysfunction, 3 had mild, 4 mild to moderate, and 5 severe dysfunction. Erectile function was statistically related to the ability to maintain erections (mean IIEF score 4 and 5 for men with no erectile dysfunction versus a mean IIEF score of 4 and 5 for men with erectile dysfunction: 4.75 +/- 0.5 versus 2.00 +/- 1.32, P = 0.011 for IIEF score of 4 and 4.50 +/- 1.5 versus 3 +/- 2, P = 0.040 for IIEF score of 5). Young adult men with spina bifida and myelomeningocele begin sexual activity late. Moreover, 75% have erectile dysfunction that is related to difficulty in maintaining erections.

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

    Science.gov (United States)

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

    2014-09-23

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

  6. Selection of a method for scoring radiographs for ankylosing spondylitis clinical trials, by the Assessment in Ankylosing Spondylitis Working Group and OMERACT

    NARCIS (Netherlands)

    van der Heijde, Désirée; Landewé, Robert

    2005-01-01

    Radiographs are important for assessing structural damage in patients with ankylosing spondylitis (AS); this technology was selected by the international ASsessment in Ankylosing Spondylitis (ASAS) Working Group as an important domain for assessing outcome in clinical trials. The selection of a

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-12-01

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

  8. Airway management in a patient of ankylosing spondylitis with traumatic cervical spine injury

    Directory of Open Access Journals (Sweden)

    Nilesh Kumar

    2015-01-01

    Full Text Available Traumatic cervical lesions compressing the spinal cord pose a significant risk of exacerbating the existing neurological condition during tracheal intubation and subsequent positioning. Preexisting ankylosing spondylitis with spinal column involvement renders the spinal column more rigid and introduces difficulty in airway management of the patient with traumatic cervical spinal cord. To improve ease and success, and reduce cervical spine movement, awake fibreoptic intubation (FOI is considered the gold standard technique for airway management in such cases. Attaining appropriate position for intubation was challenge in this case due to rigid curvature of the ankylosed spinal column. To prevent neurological injury to the spinal cord and preserve spinal cord function, minimizing movement during intubation and attaining appropriate position was of prime concern. Optimal sedation with self-positioning by the patient in a comfortable posture is quite imperative and assures both airway as well as neurological protection in such expected difficult situations. We report the use of dexmedetomidine for self-positioning and awake FOI in a patient with ankylosing spondylitis having traumatic cervical spine who was otherwise neither able to co-operative nor able to give appropriate position for FOI.

  9. Highly sensitive detection of naphthalene in solvent vapor using a functionalized PBG refractive index sensor.

    Science.gov (United States)

    Girschikofsky, Maiko; Rosenberger, Manuel; Belle, Stefan; Brutschy, Malte; Waldvogel, Siegfried R; Hellmann, Ralf

    2012-01-01

    We report an optical refractive index sensor system based on a planar Bragg grating which is functionalized by substituted γ-cyclodextrin to determine low concentrations of naphthalene in solvent vapor. The sensor system exhibits a quasi-instantaneous shift of the Bragg wavelength and is therefore capable for online detection. The overall shift of the Bragg wavelength reveals a linear relationship to the analyte concentration with a gradient of 12.5 ± 1.5 pm/ppm. Due to the spectral resolution and repeatability of the interrogation system, this corresponds to acquisition steps of 80 ppb. Taking into account the experimentally detected signal noise a minimum detection limit of 0.48 ± 0.05 ppm is deduced.

  10. Highly Sensitive Detection of Naphthalene in Solvent Vapor Using a Functionalized PBG Refractive Index Sensor

    Directory of Open Access Journals (Sweden)

    Ralf Hellmann

    2012-02-01

    Full Text Available We report an optical refractive index sensor system based on a planar Bragg grating which is functionalized by substituted γ-cyclodextrin to determine low concentrations of naphthalene in solvent vapor. The sensor system exhibits a quasi-instantaneous shift of the Bragg wavelength and is therefore capable for online detection. The overall shift of the Bragg wavelength reveals a linear relationship to the analyte concentration with a gradient of 12.5 ± 1.5 pm/ppm. Due to the spectral resolution and repeatability of the interrogation system, this corresponds to acquisition steps of 80 ppb. Taking into account the experimentally detected signal noise a minimum detection limit of 0.48 ± 0.05 ppm is deduced.

  11. Translation and validation of the Greek version of the female sexual function index questionnaire.

    Science.gov (United States)

    Zachariou, A; Filiponi, M; Kirana, P S

    2017-07-01

    The clinical evaluation of female sexual dysfunctions should be supplemented by validated questionnaires; however, there is no specific instrument available in Greek language. The study was designed to linguistically validate the Greek version of Female Sexual Function Index (FSFI). Ninety-nine healthy women and eighteen women with a sexual dysfunction were recruited through a survey and were asked to voluntarily complete the FSFI questionnaire in Greek (FSFI-Gr) at baseline and after 2 weeks. We assessed validity, internal consistency reliability and test-retest reliability of the FSFI greek version. Subscales of the FSFI showed good internal consistency reliability (Cronbach's=0.92, PGreek version of the FSFI is a reliable tool for the assessment of female sexual dysfunction. The results show that it is comparable to the outcome of studies in English-speaking countries.

  12. Dietary inflammatory index and memory function: population-based national sample of elderly Americans.

    Science.gov (United States)

    Frith, Emily; Shivappa, Nitin; Mann, Joshua R; Hébert, James R; Wirth, Michael D; Loprinzi, Paul D

    2018-03-01

    The objective of this study was to examine the association between dietary inflammatory potential and memory and cognitive functioning among a representative sample of the US older adult population. Cross-sectional data from the 2011-2012 and 2013-2014 National Health and Nutrition Examination Survey were utilised to identify an aggregate sample of adults 60-85 years of age (n 1723). Dietary inflammatory index (DII®) scores were calculated using 24-h dietary recall interviews. Three memory-related assessments were employed, including the Consortium to Establish a Registry for Alzheimer's disease (CERAD) Word Learning subset, the Animal Fluency test and the Digit Symbol Substitution Test (DSST). Inverse associations were observed between DII scores and the different memory parameters. Episodic memory (CERAD) (b adjusted=-0·39; 95 % CI -0·79, 0·00), semantic-based memory (Animal Fluency Test) (b adjusted=-1·18; 95 % CI -2·17, -0·20) and executive function and working-memory (DSST) (b adjusted=-2·80; 95 % CI -5·58, -0·02) performances were lowest among those with the highest mean DII score. Though inverse relationships were observed between DII scores and memory and cognitive functioning, future work is needed to further explore the neurobiological mechanisms underlying the complex relationship between inflammation-related dietary behaviour and memory and cognition.

  13. Functional cohesion of gene sets determined by latent semantic indexing of PubMed abstracts.

    Directory of Open Access Journals (Sweden)

    Lijing Xu

    2011-04-01

    Full Text Available High-throughput genomic technologies enable researchers to identify genes that are co-regulated with respect to specific experimental conditions. Numerous statistical approaches have been developed to identify differentially expressed genes. Because each approach can produce distinct gene sets, it is difficult for biologists to determine which statistical approach yields biologically relevant gene sets and is appropriate for their study. To address this issue, we implemented Latent Semantic Indexing (LSI to determine the functional coherence of gene sets. An LSI model was built using over 1 million Medline abstracts for over 20,000 mouse and human genes annotated in Entrez Gene. The gene-to-gene LSI-derived similarities were used to calculate a literature cohesion p-value (LPv for a given gene set using a Fisher's exact test. We tested this method against genes in more than 6,000 functional pathways annotated in Gene Ontology (GO and found that approximately 75% of gene sets in GO biological process category and 90% of the gene sets in GO molecular function and cellular component categories were functionally cohesive (LPv<0.05. These results indicate that the LPv methodology is both robust and accurate. Application of this method to previously published microarray datasets demonstrated that LPv can be helpful in selecting the appropriate feature extraction methods. To enable real-time calculation of LPv for mouse or human gene sets, we developed a web tool called Gene-set Cohesion Analysis Tool (GCAT. GCAT can complement other gene set enrichment approaches by determining the overall functional cohesion of data sets, taking into account both explicit and implicit gene interactions reported in the biomedical literature.GCAT is freely available at http://binf1.memphis.edu/gcat.

  14. Functional cohesion of gene sets determined by latent semantic indexing of PubMed abstracts.

    Science.gov (United States)

    Xu, Lijing; Furlotte, Nicholas; Lin, Yunyue; Heinrich, Kevin; Berry, Michael W; George, Ebenezer O; Homayouni, Ramin

    2011-04-14

    High-throughput genomic technologies enable researchers to identify genes that are co-regulated with respect to specific experimental conditions. Numerous statistical approaches have been developed to identify differentially expressed genes. Because each approach can produce distinct gene sets, it is difficult for biologists to determine which statistical approach yields biologically relevant gene sets and is appropriate for their study. To address this issue, we implemented Latent Semantic Indexing (LSI) to determine the functional coherence of gene sets. An LSI model was built using over 1 million Medline abstracts for over 20,000 mouse and human genes annotated in Entrez Gene. The gene-to-gene LSI-derived similarities were used to calculate a literature cohesion p-value (LPv) for a given gene set using a Fisher's exact test. We tested this method against genes in more than 6,000 functional pathways annotated in Gene Ontology (GO) and found that approximately 75% of gene sets in GO biological process category and 90% of the gene sets in GO molecular function and cellular component categories were functionally cohesive (LPvmethod to previously published microarray datasets demonstrated that LPv can be helpful in selecting the appropriate feature extraction methods. To enable real-time calculation of LPv for mouse or human gene sets, we developed a web tool called Gene-set Cohesion Analysis Tool (GCAT). GCAT can complement other gene set enrichment approaches by determining the overall functional cohesion of data sets, taking into account both explicit and implicit gene interactions reported in the biomedical literature. GCAT is freely available at http://binf1.memphis.edu/gcat.

  15. Women with low libido: correlation of decreased androgen levels with female sexual function index.

    Science.gov (United States)

    Turna, B; Apaydin, E; Semerci, B; Altay, B; Cikili, N; Nazli, O

    2005-01-01

    The aim of the present study was to investigate a possible correlation between decreased androgen levels and female sexual function index (FSFI) in women with low libido and compare these findings with normal age-matched subjects. In total, 20 premenopausal women with low libido (mean age 36.7; range 24-51 y) and 20 postmenopausal women with low libido (mean age 54; 45-70 y), and 20 premenopausal healthy women (mean age 32.2; range 21-51 y) and 20 postmenopausal healthy women (mean age 53.5; range 48-60 y) as controls were enrolled in the current study. Women with low libido had symptoms for at least 6 months and were in stable relationships. All premenopausal patients had regular menstrual cycles and all postmenopausal patients and controls were on estrogen replacement therapy. None of the patients were taking birth control pills, corticosteroids or had a history of chronic medical illnesses. All completed the FSFI and Beck's Depression Inventory (BDI) questionnaires. Hormones measured included: cortisol; T3, T4 and TSH; estradiol; total and free testosterone; dehydroepiandrosterone sulfate (DHEA-S); sex hormone binding globulin (SHBG). We performed statistical analysis by parametric and nonparametric comparisons and correlations, as appropriate. We found significant differences between the women with low libido and the controls in total testosterone, free testosterone and DHEA-S levels and full-scale FSFI score for both pre- and postmenopausal women (Plibido have lower androgen levels compared to age-matched normal control groups and their decreased androgen levels correlate positively with female sexual function index domains.

  16. Genome-wide association study of ankylosing spondylitis identifies non-MHC susceptibility loci

    OpenAIRE

    Reveille, John D; Sims, Anne-Marie; Danoy, Patrick; Evans, David M; Leo, Paul; Pointon, Jennifer J; Jin, Rui; Zhou, Xiaodong; Bradbury, Linda A; Appleton, Louise H; Davis, John C; Diekman, Laura; Doan, Tracey; Dowling, Alison; Duan, Ran

    2010-01-01

    To identify susceptibility loci for ankylosing spondylitis, we undertook a genome-wide association study in 2,053 unrelated ankylosing spondylitis cases among people of European descent and 5,140 ethnically matched controls, with replication in an independent cohort of 898 ankylosing spondylitis cases and 1,518 controls. Cases were genotyped with Illumina HumHap370 genotyping chips. In addition to strong association with the major histocompatibility complex (MHC; P < 10−800), we found associa...

  17. Economic evaluation of etoricoxib versus non-selective NSAIDs in the treatment of ankylosing spondylitis in the UK.

    Science.gov (United States)

    Jansen, Jeroen P; Pellissier, James; Choy, Ernest H; Ostor, Andrew; Nash, Julian T; Bacon, Paul; Hunsche, Elke

    2007-12-01

    To evaluate the cost-effectiveness of etoricoxib, a cyclooxygenase (COX)-2 selective inhibitor, versus non-selective nonsteroidal anti-inflammatory drugs (nsNSAIDs) in the treatment of ankylosing spondylitis (AS). The cost-effectiveness of etoricoxib versus nsNSAIDs was evaluated from the UK National Health Service (NHS) and society perspective with a decision-analytic model. Patients stayed on initial therapy throughout 52 weeks unless they experienced an adverse event (AE) or lacked efficacy, in which case they switched to another nsNSAID or a tumor necrosis factor alpha antagonist. Efficacy data were obtained from a 1-year etoricoxib clinical trial in AS. Bath AS Functional Index (BASFI) data were translated into Quality Adjusted Life Year (QALY) weights using a published data on the relation between BASFI and Short-form (SF) 36 Quality of life scores, as well as the relation between SF-36 and utility. Safety data were based on meta-analyses of etoricoxib trials. Information on treatment pathways, resource consumption, and absenteeism from work was obtained from literature and experts. Model outcomes included QALYs, perforations, ulcers, or bleeds, cardiovascular events, and costs. Etoricoxib was cost-effective compared to nsNSAIDs in terms of cost per QALY saved ( pound5611). Probabilistic sensitivity analysis found a 77% probability of the incremental cost per QALY saved being within a threshold for cost-effectiveness of pound20 000. The expected direct costs over the 52-week period were pound1.23 (95% uncertainty distribution pound1.10; pound1.39) and pound1.13 per day ( pound0.78; pound1.55) for patients starting with etoricoxib and nsNSAIDs, respectively. When costs related to absenteeism were taken into account, the cost per QALY saved was pound281. Given the underlying assumptions and data used, this economic evaluation demonstrated that, compared to nsNSAIDs, etoricoxib is a cost-effective therapy for AS patients in the UK.

  18. Assessment of semaphorin 3A and its role in bone remodelling in a group of ankylosing spondylitis patients.

    Science.gov (United States)

    Perrotta, Fabio Massimo; Ceccarelli, Fulvia; Barbati, Cristiana; Colasanti, Tania; Montepaone, Monica; Alessandri, Cristiano; Valesini, Guido; Lubrano, Ennio

    2017-01-01

    Several molecules are involved in the pathogenesis of new bone formation in ankylosing spondylitis (AS). The aim of the present study was to evaluate serum levels of semaphoring 3A in AS and to investigate any correlations with radiographic damage, disease activity, function and treatment. AS patients who fulfilled the modified New York criteria were enrolled for this study. Healthy subjects were also enrolled as control group. BASDAI, ASDAS-CRP, BASMI, BASFI, patients and physician VAS, C-reactive protein and erythrocyte sedimentation rate were evaluated at baseline visit. Radiographs of the spine and pelvis performed within six months from the enrolment in the study were collected in all patients. Spinal damage was assessed using the mSASSS. Serum concentrations of semaphorin3A were assessed at baseline and after four months of therapy in patients who started an anti-TNF. Twenty healthy subjects and forty AS patients were enrolled in the study. Of these patients, 15 started anti-TNF therapy the day of baseline visit. Semaphorin3A serum concentrations [median (25th-75th)] were similar in AS patients [0.26 (0.20-0.31) ng/ml] and controls [0.28 (0.26-0.3) ng/ml; p=ns). No significant correlation was found between semaphorin 3A serum levels and radiographic damage index. Semaphorin 3A serum levels positively correlated with ESR values (rho=0.37, p=0.049) and with disease activity assessed by the physician VAS (rho=0.47, p<0.01). No differences were found in the semaphorin3A serum levels after 4 months, compared to baseline values. The results of the present study could contribute to the intriguing topic of bone remodelling in AS.

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

    DEFF Research Database (Denmark)

    Exarchou, Sofia; Lindström, Ulf; Askling, Johan

    2015-01-01

    INTRODUCTION: Prevalence estimates of ankylosing spondylitis vary considerably, and there are few nationwide estimates. The present study aimed to describe the national prevalence of clinically diagnosed ankylosing spondylitis in Sweden, stratified according to age, sex, geographical, and socio-economic...... factors, and according to subgroups with ankylosing spondylitis-related clinical manifestations and pharmacological treatment. METHODS: All individuals diagnosed with ankylosing spondylitis according to the World Health Organization International Classification of Disease codes, between 1967 and 2009...... arthritis (21.7% versus 15.3%, P oral corticosteroids (14.0% versus 10.4% in 2009, P 

  20. Genome-wide association study of ankylosing spondylitis identifies non-MHC susceptibility loci

    Science.gov (United States)

    Reveille, John D; Sims, Anne-Marie; Danoy, Patrick; Evans, David M; Leo, Paul; Pointon, Jennifer J; Jin, Rui; Zhou, Xiaodong; Bradbury, Linda A; Appleton, Louise H; Davis, John C; Diekman, Laura; Doan, Tracey; Dowling, Alison; Duan, Ran; Duncan, Emma L; Farrar, Claire; Hadler, Johanna; Harvey, David; Karaderi, Tugce; Mogg, Rebecca; Pomeroy, Emma; Pryce, Karena; Taylor, Jacqueline; Savage, Laurie; Deloukas, Panos; Kumanduri, Vasudev; Peltonen, Leena; Ring, Sue M; Whittaker, Pamela; Glazov, Evgeny; Thomas, Gethin P; Maksymowych, Walter P; Inman, Robert D; Ward, Michael M; Stone, Millicent A; Weisman, Michael H; Wordsworth, B Paul; Brown, Matthew A

    2011-01-01

    To identify susceptibility loci for ankylosing spondylitis, we undertook a genome-wide association study in 2,053 unrelated ankylosing spondylitis cases among people of European descent and 5,140 ethnically matched controls, with replication in an independent cohort of 898 ankylosing spondylitis cases and 1,518 controls. Cases were genotyped with Illumina HumHap370 genotyping chips. In addition to strong association with the major histocompatibility complex (MHC; P ankylosing spondylitis risk and identifies a major role for the interleukin (IL)-23 and IL-1 cytokine pathways in disease susceptibility. PMID:20062062

  1. Genome-wide association study of ankylosing spondylitis identifies non-MHC susceptibility loci.

    Science.gov (United States)

    Reveille, John D; Sims, Anne-Marie; Danoy, Patrick; Evans, David M; Leo, Paul; Pointon, Jennifer J; Jin, Rui; Zhou, Xiaodong; Bradbury, Linda A; Appleton, Louise H; Davis, John C; Diekman, Laura; Doan, Tracey; Dowling, Alison; Duan, Ran; Duncan, Emma L; Farrar, Claire; Hadler, Johanna; Harvey, David; Karaderi, Tugce; Mogg, Rebecca; Pomeroy, Emma; Pryce, Karena; Taylor, Jacqueline; Savage, Laurie; Deloukas, Panos; Kumanduri, Vasudev; Peltonen, Leena; Ring, Sue M; Whittaker, Pamela; Glazov, Evgeny; Thomas, Gethin P; Maksymowych, Walter P; Inman, Robert D; Ward, Michael M; Stone, Millicent A; Weisman, Michael H; Wordsworth, B Paul; Brown, Matthew A

    2010-02-01

    To identify susceptibility loci for ankylosing spondylitis, we undertook a genome-wide association study in 2,053 unrelated ankylosing spondylitis cases among people of European descent and 5,140 ethnically matched controls, with replication in an independent cohort of 898 ankylosing spondylitis cases and 1,518 controls. Cases were genotyped with Illumina HumHap370 genotyping chips. In addition to strong association with the major histocompatibility complex (MHC; P ankylosing spondylitis risk and identifies a major role for the interleukin (IL)-23 and IL-1 cytokine pathways in disease susceptibility.

  2. Reliability of the Foot Function Index:: A report of the AOFAS Outcomes Committee..

    Science.gov (United States)

    Agel, Julie; Beskin, James L; Brage, Michael; Guyton, Gregory P; Kadel, Nancy J; Saltzman, Charles L; Sands, Andrew K; Sangeorzan, Bruce J; SooHoo, Nelson F; Stroud, Chris C; Thordarson, David B

    2005-11-01

    There currently is no widely used, validated, self-administered instrument for measuring musculoskeletal functional status in individuals with nonsystemic foot disorders. The purpose of this paper was to report on the assessment of reliability of one of these instruments. We wanted to determine if the Foot Function Index (FFI), which has been validated in rheumatoid patients without fixed foot deformity or prior foot surgery, would be reliable for a population of patients with foot complaints without systemic disease. Patients were recruited from five orthopaedic offices where the physicians were members of the American Orthopaedic Foot and Ankle Society. Patients were asked to complete the FFI at the time of their initial office visit and then were given a second copy to complete and return by mail 1 week after their visit. Ninety-six patients completed the first questionnaire, and 54 patients completed the second. Reliability in this population was acceptable with an average of 23.5% of the patients providing retest values within one point of the initial response and an average of 45.3% of the patients providing the same response, for a total of 68.8% of all respondents answering within one point between their initial and second questionnaire. In two of the three categories, there were frequent nonresponses or no applicable responses. Four questions, two in the pain section and two in the activity limitation section, generated 20% or more of the nonapplicable answers. The FFI appears to be a reasonable tool for low functioning individuals with foot disorders. It may not be appropriate for individuals who function at or above the level of independent activities of daily living.

  3. On the multi-index (3 m-parametric) Mittag-Leffler functions, fractional calculus relations and series convergence

    Science.gov (United States)

    Paneva-Konovska, Jordanka

    2013-10-01

    In this paper we consider a family of 3 m-indices generalizations of the classical Mittag-Leffler function, called multi-index (3 m-parametric) Mittag-Leffler functions. We survey the basic properties of these entire functions, find their order and type, and new representations by means of Mellin-Barnes type contour integrals, Wright p Ψ q -functions and Fox H-functions, asymptotic estimates. Formulas for integer and fractional order integration and differentiations are found, and these are extended also for the operators of the generalized fractional calculus (multiple Erdélyi-Kober operators). Some interesting particular cases of the multi-index Mittag-Leffler functions are discussed. The convergence of series of such type functions in the complex plane is considered, and analogues of the Cauchy-Hadamard, Abel, Tauber and Littlewood theorems are provided.

  4. Dirichlet-to-Neumann maps, abstract Weyl-Titchmarsh M-functions, and a generalized index of unbounded meromorphic operator-valued functions

    Science.gov (United States)

    Behrndt, Jussi; Gesztesy, Fritz; Holden, Helge; Nichols, Roger

    2016-09-01

    We introduce a generalized index for certain meromorphic, unbounded, operator-valued functions. The class of functions is chosen such that energy parameter dependent Dirichlet-to-Neumann maps associated to uniformly elliptic partial differential operators, particularly, non-self-adjoint Schrödinger operators, on bounded Lipschitz domains, and abstract operator-valued Weyl-Titchmarsh M-functions and Donoghue-type M-functions corresponding to closed extensions of symmetric operators belong to it. The principal purpose of this paper is to prove index formulas that relate the difference of the algebraic multiplicities of the discrete eigenvalues of Robin realizations of non-self-adjoint Schrödinger operators, and more abstract pairs of closed operators in Hilbert spaces with the generalized index of the corresponding energy dependent Dirichlet-to-Neumann maps and abstract Weyl-Titchmarsh M-functions, respectively.

  5. Engineering Design Information System (EDIS), Information Management Services (IMS), Index Function, User`s manual. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, R.K. [ed.; Walker, C.T.; Cline, B.E.; Lucas, C.L.

    1995-02-01

    The Engineering Design Information System (EDIS) Information Management Services (IMS) Index Function is an interactive system developed for IMS personnel to perform indexing, maintenance, and retrieval of information about engineering documents. This manual gives an overview of the system structure, data, and functionality, as well as the hardware and security environment within which the system operates. It gives a detailed description of the interactive menus, screens, and prompts that provide access to the system functions and the requirements for data entry. Appendixes are included to display data definitions, modification rules, help screen formats, explanation of system help and informational messages, code translations, and a report format.

  6. FUSED KERNEL-SPLINE SMOOTHING FOR REPEATEDLY MEASURED OUTCOMES IN A GENERALIZED PARTIALLY LINEAR MODEL WITH FUNCTIONAL SINGLE INDEX.

    Science.gov (United States)

    Jiang, Fei; Ma, Yanyuan; Wang, Yuanjia

    We propose a generalized partially linear functional single index risk score model for repeatedly measured outcomes where the index itself is a function of time. We fuse the nonparametric kernel method and regression spline method, and modify the generalized estimating equation to facilitate estimation and inference. We use local smoothing kernel to estimate the unspecified coefficient functions of time, and use B-splines to estimate the unspecified function of the single index component. The covariance structure is taken into account via a working model, which provides valid estimation and inference procedure whether or not it captures the true covariance. The estimation method is applicable to both continuous and discrete outcomes. We derive large sample properties of the estimation procedure and show different convergence rate of each component of the model. The asymptotic properties when the kernel and regression spline methods are combined in a nested fashion has not been studied prior to this work even in the independent data case.

  7. Plasma homocysteine status in patients with ankylosing spondylitis.

    Science.gov (United States)

    Wei, James Cheng-Chung; Jan, Ming-Shiou; Yu, Chen-Tung; Huang, Yi-Chia; Yang, Chi-Chiang; Tsou, Hsi-Kai; Lee, Hong-Shan; Chou, Chang-Tei; Tsay, Gregory; Chou, Ming-Chih

    2007-05-01

    Homocysteine (Hcy), a sulfur-containing amino acid, is eliminated through B vitamins-dependent pathways. Hyperhomocysteinemia has been found to be an independent risk factor for atherosclerotic cardiovascular, cerebrovascular, and peripheral vascular diseases. Recently, psoriasis, lupus, and rheumatoid arthritis were reported to be associated with hyperhomocysteinemia. This study was aimed to evaluate the changes of plasma Hcy level before and after sulfasalazine and MTX therapy in patients with ankylosing spondylitis (AS). One hundred and two patients with AS and ten normal controls were enrolled in the cross-sectional case-control study. Fasting plasma Hcy levels were determined by ELISA kits (IMX, Abbott). Hcy levels were compared to their Bath AS disease activity index (BASDAI) and the usage of sulfasalazine and/or MTX. Active disease was defined by BASDAI as more than 3 in a 10-cm scale with ESR >20 mm/h. For those patients with plasma Hcy >or=15 micromol/l, a perspective trial of daily supplement of vitamin B-12 0.5 mg, B-6 50 mg, and folic acid 5 mg for 2 weeks were also tested for the efficacy. Plasma Hcy level increased significantly in AS patients under sulfasalazine (10.4+/-3.8 micromol/l, p<0.05), MTX (11.9+/-4.7, p<0.05) and sulfasalazine/MTX combination treatment (11.2+/-2.6, p<0.05) compared with normal controls (8.6+/-1.2 micromol/l) and AS patients without DMARD(9.4+/- 2.6 micromol/l). No correlation between disease activity and plasma Hcy level was found. Daily supplement of vitamin B-12 0.5 mg, B-6 50 mg, and folic acid 5 mg can lower Hcy level in 2 weeks (32.3+/-24.0 vs 15.6+/-11.1 micromol/l, p=0.007). Plasma homocysteine level did significantly increase in AS patients under sulfasalazine or MTX treatment. B-vitamins should be considered as a routine supplementation for patients who underwent sulfasalazine and/or MTX treatment. Further longitudinal studies are required to confirm the conclusions.

  8. Changes of thyroid function, autoantibodies, bone mineral density and bone metabolism indexes in patients with hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Yan Wang

    2016-07-01

    Full Text Available Objective: To investigate the changes of thyroid function, autoantibodies, bone mineral density and bone metabolism in patients with hyperthyroidism. Methods: A total of 216 cases of hyperthyroidism in our hospital from December 2015 to January 2015 were selected as the case group, 216 cases of healthy people selected the same period in our hospital physical examination center as the control group, detected thyroid function, autoantibodies, bone mineral density and bone metabolism indexes of all the studied subjects and compared with each other. Results: In this study, it was found that diastolic blood pressure, BMI, triglyceride, total cholesterol, HDL-C, VLDL-C, TSH were all significantly lower than the control group (P<0.05, systolic blood pressure, LDL-C, GLU, T3, T4, FT3, FT4, HTG, TG-Ab, TPO-Ab in case group were significantly higher than the control group (P<0.05. Right calcaneal speed of sound (SOS in case group was significantly lower than the control group (P<0.05, BGP, PTH in case group were significantly higher than the control group (P<0.05. Conclusions: Hyperthyroidism can cause thyroid hormone levels abnormal, abnormal increase autoantibodies, decrease bone density, bone metabolism actively, easy to form osteoporosis, clinical treatment of hyperthyroidism in the same time, should actively prevent the occurrence of osteoporosis

  9. Correlation of a scanning laser derived oedema index and visual function following grid laser treatment for diabetic macular oedema.

    Science.gov (United States)

    Hudson, C; Flanagan, J G; Turner, G S; Chen, H C; Young, L B; McLeod, D

    2003-04-01

    To correlate change of an oedema index derived by scanning laser tomography with change of visual function in patients undergoing grid laser photocoagulation for clinically significant diabetic macular oedema (DMO). The sample comprised 24 diabetic patients with retinal thickening within 500 micro m of the fovea. Inclusion criteria included a logMAR visual acuity of 0.25, or better. Patients were assessed twice before a single session of grid laser treatment and within 1 week of, and at 1, 2, 4, and 12 weeks after, treatment. At each visit, patients underwent logMAR visual acuity, conventional and short wavelength automated perimetry (SWAP), and scanning laser tomography. Each visual function parameter was correlated with the mean oedema index. The mean oedema index represented the z-profile signal width divided by the maximum reflectance intensity (arbitrary units). A Pearson correlation coefficient (Bonferroni corrected) was undertaken on the data set of each patient. 13 patients exhibited significant correlation of the mean oedema index and at least one measure of visual function for the 10 degrees x 10 degrees scan field while 10 patients correlated for the 20 degrees x 20 degrees scan field. Seven patients demonstrated correlation for both scan fields. Laser photocoagulation typically resulted in an immediate loss of perimetric sensitivity whereas the oedema index changed over a period of weeks. Localised oedema did not impact upon visual acuity or letter contrast sensitivity when situated extrafoveally. Correlation of change of the oedema index and of visual function following grid laser photocoagulation was not found in all patients. An absence of correlation can be explained by the localised distribution of DMO in this sample of patients, as well as by differences in the time course of change of the oedema index and visual function. The study has objectively documented change in the magnitude and distribution of DMO following grid laser treatment and has

  10. Limb Symmetry Indexes Can Overestimate Knee Function After Anterior Cruciate Ligament Injury.

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    Wellsandt, Elizabeth; Failla, Mathew J; Snyder-Mackler, Lynn

    2017-05-01

    Study Design Prospective cohort. Background The high risk of second anterior cruciate ligament (ACL) injuries after return to sport highlights the importance of return-to-sport decision making. Objective return-to-sport criteria frequently use limb symmetry indexes (LSIs) to quantify quadriceps strength and hop scores. Whether using the uninvolved limb in LSIs is optimal is unknown. Objectives To evaluate the uninvolved limb as a reference standard for LSIs utilized in return-to-sport testing and its relationship with second ACL injury rates. Methods Seventy athletes completed quadriceps strength and 4 single-leg hop tests before anterior cruciate ligament reconstruction (ACLR) and 6 months after ACLR. Limb symmetry indexes for each test compared involved-limb measures at 6 months to uninvolved-limb measures at 6 months. Estimated preinjury capacity (EPIC) levels for each test compared involved-limb measures at 6 months to uninvolved-limb measures before ACLR. Second ACL injuries were tracked for a minimum follow-up of 2 years after ACLR. Results Forty (57.1%) patients achieved 90% LSIs for quadriceps strength and all hop tests. Only 20 (28.6%) patients met 90% EPIC levels (comparing the involved limb at 6 months after ACLR to the uninvolved limb before ACLR) for quadriceps strength and all hop tests. Twenty-four (34.3%) patients who achieved 90% LSIs for all measures 6 months after ACLR did not achieve 90% EPIC levels for all measures. Estimated preinjury capacity levels were more sensitive than LSIs in predicting second ACL injuries (LSIs, 0.273; 95% confidence interval [CI]: 0.010, 0.566 and EPIC, 0.818; 95% CI: 0.523, 0.949). Conclusion Limb symmetry indexes frequently overestimate knee function after ACLR and may be related to second ACL injury risk. These findings raise concern about whether the variable ACL return-to-sport criteria utilized in current clinical practice are stringent enough to achieve safe and successful return to sport. Level of Evidence

  11. Treatment persistence in patients with rheumatoid arthritis and ankylosing spondylitis

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    Marina Amaral de Ávila Machado

    2016-01-01

    Full Text Available ABSTRACT OBJECTIVE To evaluate treatment persistence in patients with rheumatoid arthritis and ankylosing spondylitis who started therapies with disease-modifying antirheumatic drugs (DMARD and tumor necrosis factor blockers (anti-TNF drugs. METHODS This retrospective cohort study from July 2008 to September 2013 evaluated therapy persistence, which is defined as the period between the start of treatment until it is discontinued, allowing for an interval of up to 30 days between the prescription end and the start of the next prescription. Odds ratio (OR with 95% confidence intervals (95%CI were calculated by logistic regression models to estimate the patients’ chances of persisting in their therapies after the first and after the two first years of follow-up. RESULTS The study included 11,642 patients with rheumatoid arthritis – 2,241 of these started on anti-TNF drugs (+/-DMARD and 9,401 patients started on DMARD – and 1,251 patients with ankylosing spondylitis – 976 of them were started on anti-TNF drugs (+/-DMARD and 275 were started on DMARD. In the first year of follow-up, 63.5% of the patients persisted in their therapies with anti-TNF drugs (+/-DMARD and 54.1% remained using DMARD in the group with rheumatoid arthritis. In regards to ankylosing spondylitis, 79.0% of the subjects in anti-TNF (+/-DMARD group and 41.1% of the subjects in the DMARD group persisted with their treatments. The OR (95%CI for therapy persistence was 1.50 (1.34-1.67 for the anti-TNF (+/-DMARD group as compared with the DMARD group in the first year for the patients with rheumatoid arthritis, and 2.33 (1.74-3.11 for the patients with ankylosing spondylitis. A similar trend was observed at the end of the second year. CONCLUSIONS A general trend of higher rates of therapy persistence with anti-TNF drugs (+/-DMARD was observed as compared to DMARD in the study period. We observed higher persistence rates for anti-TNF drugs (+/-DMARD in patients with ankylosing

  12. Values of functional indexes in assessment of efficacy of osteoarthritis treatment with Chondrolon and Zel T in polyclinic

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    O Y Maiko

    2009-01-01

    Full Text Available Objective. To study change of knee joints functional disability in pts with predominantly I-II stage of knee osteoarthritis (OA with clinical tests and WOMAC index for assessment of efficacy of treatment with Chondrolon and Zel T in polyclinic. Material and methods. 70 pts with I and II stage of OA according to Kellgren-Lawrence aged from 40 to 67 years were included. They were divided in 2 groups (30 pts in group I and40 pts in group II. Group I pts were treated with Chondrolon and group II pts – with Zel T. Treatment efficacy was assessed with WOMAC index, functional Lequesne index, pain on VAS at rest and at movement, knee mobility, time of walking for 30 m and walking stairs. Results. Positive changes of all parameters were revealed in both groups: significant improvement of pain on VAS, functional tests, Lequesne index, WOMAC scales was achieved. During treatment with Zel T improvement of the efficacy measures increased slower, mainly after 12 weeks of treatment (during treatment with Chondrolon – after8 weeks. Both drugs provided functional improvement assessed by WOMAC index butChondrolon was more effective. Conclusion. Chondrolon and Zel T can be used for treatment of OA at I or II stage with moderate knee joints functional disability. Course of treatment with Zel T should be continued not less than 3 months and with Chondrolon – 2 months.

  13. Validation of a Russian-language version of the Foot Functional Index (FFI questionnaire

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    E. V. Orlova

    2016-01-01

    Full Text Available The Foot Functional Index (FFI questionnaire most completely reflects the functional status of patients with joint diseases of the feet.Objective: to study the psychometric properties of a Russian-language version of the FFI questionnaire.Patients and methods. The reliability, sensitivity, and validity of the Russian-language version of the FFI questionnaire were assessed in 55 patients with rheumatoid arthritis (RA. The investigators checked the reliability by assessing the internal consistency (calculating Cronbach's alpha and reproducibility by a test-retest analysis. The criterion validity was evaluated by correlation analysis using HAQ, RAPID3, and pain visual analogue scale (VAS scores. The sensitivity of FFI was studied by comparing its dynamics with RAPID3 changes during treatment.Results. Evaluating the internal consistency yielded a high Cronbach's alpha (0.78. The test-retest analysis demonstrated a significant correlation (0.83 between the results of primary and secondary testing. Assessing the criterion validity showed a high or near-high relationship to the scores of RAPID3 (0.78, HAQ (0.69, and pain VAS (0.76. The group of patients who were observed to have a decrease in disease activity according to RAPID3 from a high (16.2±4.1 to moderate (10.5±5.2 degree displayed a more marked reduction in FFI (ΔFFI = 20.5±2.3 than the group that did not exhibit significant changes in disease activity (ΔFFI = 6.9±3.4.Conclusion. FFI is a reliable, valid, and sensitive tool to evaluate the functional status of patients with foot diseases in RA.

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

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

    2015-07-17

    Axial spondyloarthritis (axSpA) comprises ankylosing spondylitis (radiographic axSpA) and non-radiographic (nr-)axSpA and is associated with psoriasis, uveitis and inflammatory bowel disease. Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as first-line drug treatment. To determine the benefits and harms of NSAIDs in axSpA. We searched CENTRAL, MEDLINE and EMBASE to 18 June 2014. Randomised controlled trials (RCTs) or quasi-RCTs of NSAIDs versus placebo or any comparator in adults with axSpA and observational cohort studies studying the long term effect (≥ six months) of NSAIDs on radiographic progression or adverse events (AEs). The main comparions were traditional or COX-2 NSAIDs versus placebo. The major outcomes were pain, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), radiographic progression, number of withdrawals due to AEs and number of serious AEs Two review authors independently selected trials for inclusion, assessed the risk of bias, extracted data and assessed the quality of evidence for major outcomes using GRADE. We included 39 studies (35 RCTs, two quasi-RCTs and two cohort studies); and 29 RCTs and two quasi-RCTs (n = 4356) in quantitative analyses for the comparisons: traditional NSAIDs versus placebo, cyclo-oxygenase-2 (COX-2) versus placebo, COX-2 versus traditional NSAIDs, NSAIDs versus NSAIDs, naproxen versus other NSAIDs, low versus high dose. Most trials were at unclear risk of selection bias (n = 29), although blinding of participants and personnel was adequate in 24 trials. Twenty-five trials had low risk of attrition bias and 29 trials had low risk of reporting bias. Risk of bias in both cohort studies was high for study participation, and low or unclear for all other criteria. No trials in the meta-analyses assessed patients with nr-axSpA.Traditional NSAIDs were more beneficial than placebo at six

  15. Establishing score equivalence of the Functional Independence Measure motor scale and the Barthel Index, utilising the International Classification of Functioning, Disability and Health and Rasch measurement theory.

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    Prodinger, Birgit; O'Connor, Rory J; Stucki, Gerold; Tennant, Alan

    2017-05-16

    Two widely used outcome measures to assess functioning in neurological rehabilitation are the Functional Independence Measure (FIM™) and the Barthel Index. The current study aims to establish the equivalence of the total score of the FIM™ motor scale and the Barthel Index through the application of the International Classification of Functioning, Disability and Health, and Rasch measurement theory. Secondary analysis of a large sample of patients with stroke, spinal cord injury, and multiple sclerosis, undergoing rehabilitation was conducted. All patients were assessed at the same time on both the FIM™ and the Barthel Index. The International Classification of Functioning, Disability and Health Linking Rules were used to establish conceptual coherency between the 2 scales, and the Rasch measurement model to establish an exchange of the total scores. Using the FIM™ motor scale, items from both scales linked to the International Classification of Functioning, Disability and Health d4 Mobility or d5 Self-care chapters. Their co-calibration satisfied the assumptions of the Rasch model for each of 3 diagnostic groups. A ceiling effect was observed for the Barthel Index when contrasted against the FIM™ motor scale. Having a Rasch interval metric to transform scores between the FIM™ motor scale and Barthel Index is valuable for monitoring functioning, meta-analysis, quality audits and hospital benchmarking.

  16. Serum levels of Dkk-1, sclerostin and VEGF in patients with ankylosing spondylitis and their association with smoking, and clinical, inflammatory and radiographic parameters.

    Science.gov (United States)

    Sakellariou, Grigorios T; Iliopoulos, Alexios; Konsta, Maria; Kenanidis, Eustathios; Potoupnis, Michael; Tsiridis, Eleftherios; Gavana, Elpida; Sayegh, Fares E

    2017-05-01

    To evaluate serum Dickkopf-1 (Dkk-1), sclerostin and vascular endothelial growth factor (VEGF) levels in patients with ankylosing spondylitis (AS) compared to healthy controls as well as their association with smoking, and clinical, inflammatory and radiographic parameters. Serum samples for total Dkk-1, sclerostin and VEGF were obtained from 57 tumour necrosis factor (TNF) inhibitor naïve patients with AS and 34 sex-, age- and body mass index (BMI)-matched controls. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), modified Stroke AS Spine Score (mSASSS) and smoking status were assessed for each patient. There was no significant difference in serum bone metabolism markers between AS patients and controls. Dkk-1 levels were significantly (P<0.05) higher in AS patients with elevated ESR and CRP and no syndesmophytes, and were significantly (P<0.001) correlated with sclerostin levels (r=0.592). VEGF levels were significantly (P<0.05) higher in AS patients with current and ever smoking, elevated ESR and CRP, and high BASDAI and BASFI, and were significantly (P<0.05) correlated with ESR (r=0.284), CRP (r=0.285), BASDAI (r=0.349) and BASFI (r=0.275). In multivariate regression analyses, high Dkk-1 levels were significantly (P≤0.001) associated with elevated ESR and CRP, no syndesmophytes and high sclerostin levels, and high VEGF levels significantly (P<0.05) with ever smoking, and elevated ESR and CRP. In AS, serum Dkk-1 concentrations appear to be related not only to syndesmophyte formation but also to systemic inflammation. Furthermore, high VEGF levels may be associated with smoking exposure. Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

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

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    Nannini C

    2013-01-01

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

  18. Understanding presenteeism in patients with ankylosing spondylitis: contributing factors and association with sick leave.

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    Gordeev, Vladimir S; Maksymowych, Walter P; Schachna, Lionel; Boonen, Annelies

    2014-06-01

    To understand the impact of ankylosing spondylitis (AS) on presenteeism and to explore its relationship to sick leave. AS patients completed a questionnaire consisting of sociodemographics, disease characteristics, and work outcomes, including sick leave and presenteeism, assessed by the Work Limitations Questionnaire (WLQ). Associations between a broad range of explanatory variables with the WLQ and AS-related sick leave were assessed by zero-inflated negative binomial and zero-inflated Poisson regressions. Of 311 employed patients (204 men [65.6%]), 18% had sick leave in the past month. Limitations in meeting time management demands (33.7%), physical demands (30.2%), mental-interpersonal demands (20.2%), and output (19.0%) were noted. With the mean ± SD WLQ index score of 6.7 ± 5.9, the average decrease in work productivity attributable to health was 6.3%; an extra 7.1% of work hours would be needed to compensate for lost productivity. Helplessness, female sex, and impaired health-related quality of life (Ankylosing Spondylitis Quality of Life instrument [ASQoL]) were major contributors to the level of presenteeism (P < 0.01). At-work limitations (WLQ) and lower quality of life (ASQoL) were significantly associated with probability of sick leave, while the length of sick leave was strongly associated with lower educational level and helplessness (P < 0.01), and in some models, also with disease duration and country of residence (P < 0.05). AS hinders patients' work, mainly in time management and physical demand domains. The WLQ and ASQoL are able to identify patients who incur sick leave. Helplessness contributes independently to the level of presenteeism and the length of sick leave. Copyright © 2014 by the American College of Rheumatology.

  19. Circulating levels of Th1 and Th2 chemokines in patients with ankylosing spondylitis.

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    Wang, Jianing; Zhao, Qi; Wang, Gaoya; Yang, Chunshu; Xu, Yong; Li, Yujia; Yang, Pingting

    2016-05-01

    Although chemokines are critical elements for the selective attraction and activation of various leukocyte subsets in the inflammatory process, there are few findings concerning T helper (Th) 1 or Th2 chemokines in ankylosing spondylitis (AS). This study was designed to determine whether serum levels of chemokines that are preferentially chemotactic for Th1 (IFN-gamma-inducible protein-10, IP-10/CXCL10) and Th2 (thymus and activation regulated chemokine, TARC/CCL17) and (macrophage derived chemokine, MDC/CCL22) cells were elevated and whether they correlated with the clinical features in patients with AS. Forty-two patients with axial AS and 25 healthy controls were enrolled into the study. Serum levels of chemokines (IP-10, TARC and MDC) and cytokines (IFN-γ, TNF-α and IL-4) were examined using ELISA. The disease activity was evaluated by Ankylosing Spondylitis Disease Activity Score (ASDAS). Serum levels of IgG, IgA, IgM, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured. Serum chemokine levels of IP-10, TARC and MDC were significantly higher in patients with AS than those in healthy controls. Serum cytokine levels of IFN-γ, TNF-α were also significantly increased, but the levels of IL-4 were not. Furthermore, IP-10 levels in AS patients correlated with ESP, CRP and ASDAS, while the levels of TARC and MDC did not correlate with these clinic indexes. Correlation analysis between the levels of chemokines and cytokines revealed a positive correlation between IP-10 and TNF-α. The levels of both Th1 and Th2 chemokines decreased under blockade of TNF-α. Our results suggest that both a Th1 chemoattractant IP-10 and Th2 chemoattractants, TARC and MDC, cooperatively play a role in the development of AS. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

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    Yasemin Özkan

    2018-04-01

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

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

    Science.gov (United States)

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

    2014-01-01

    Ankylosing spondylitis (AS) is an inflammatory disorder that presents with arthritis of the axial skeleton, including sacroiliac joints. Vitamin D is a secosteroid hormone with a long-established role in calcium and phosphate homeostasis, and in the regulation of bone formation and resorption. It is now known that vitamin D plays an immunosuppressive role in the body, and there is interest of late in the role of vitamin D in autoimmune diseases. Inflammation may be responsible for some of the loss of bone mineral density seen in AS. We reviewed the literature for studies assessing vitamin D level as a marker of AS disease activity and those examining vitamin D levels in AS in comparison to healthy controls. Four of 7 studies found a significant negative correlation between vitamin D levels and Bath Ankylosing Spondylitis Index (BASDAI), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). In a review of 8 case-control studies, the mean level of 25-hydroxyvitamin D3 was 22.8 ± 14.1 ng/mL in 555 AS patients versus 26.6 ± 12.5 ng/mL in 557 healthy controls. When compared with a 2-sample t test, vitamin D levels were significantly higher in healthy controls (p < 0.01). We conclude that patients with AS appear to have lower vitamin D levels versus healthy controls; however, the cause is unclear. Existing studies do not demonstrate a consistent link between vitamin D levels and disease activity in AS. Further studies are in need to determine if a causative link exists between vitamin D deficiency and AS. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  2. Detection of active sacroiliitis with ankylosing spondylitis through intravoxel incoherent motion diffusion-weighted MR imaging

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    Zhao, Ying-hua [Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics, Department of Radiology, Guangzhou (China); Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, Guangzhou (China); Li, Shao-lin; Zhao, Xiang-cheng; Hu, Shao-yong; Liu, Zhen-hua [Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics, Department of Radiology, Guangzhou (China); Liu, Zai-yi; Chen, Xin; Liang, Chang-hong [Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, Guangzhou (China); Mei Ms, Ying-jie [Philips Healthcare, Guangzhou (China); Chan, Queenie [Philips Electronics Hong Kong Ltd, Hong Kong (China)

    2015-09-15

    To confirm feasibility and assess intravoxel incoherent motion (IVIM) to differentiate active sacroiliitis and ankylosing spondylitis. Forty-one patients were divided into two groups, an active group (n = 20) and a chronic group (n = 21), according to the Bath Ankylosing Spondylitis (AS) Disease Activity Index (BASDAI) and laboratory parameters. In addition, 21 healthy volunteers were chosen as the control group. Tissue diffusivity (D{sub slow}), perfusion fraction (f), and pseudo-diffusion coefficient (D{sub fast}) values were obtained for all three groups. One-way analysis of variance and receiver operating characteristic analysis were performed for all parameters. There was good interobserver agreement on the measurements between the two observers. The optimal cut-off values (with respective AUC, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio) between active and chronic groups were D{sub slow} = 0.53 x 10{sup -3} mm{sup 2}/s (0.976, 90 %, 95.2 %, 18.9, 0.10) and f = 0.09 (0.545, 20 %, 95.5 %, 4.2, 0.84), and between chronic and control groups were D{sub slow} = 0.22 x 10{sup -3} mm{sup 2}/s (0.517, 9.52 %, 100 %, no number, 0.9) and f = 0.09 (0.935, 95.24 %, 80.95 %, 5, 0.059). D{sub slow} and f of IVIM diffusion-weighted (DW)-MRI in AS show a significant difference in the values of diffusion of water molecules and fractional perfusion-related volume among the three groups. (orig.)

  3. Application of Intraoperative CT-Guided Navigation in Simultaneous Minimally Invasive Anterior and Posterior Surgery for Infectious Spondylitis

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    Meng-Huang Wu

    2017-01-01

    Full Text Available This study was aimed at evaluating the safety and efficacy of using intraoperative computed tomography- (iCT- guided navigation in simultaneous minimally invasive anterior and posterior surgery for infectious spondylitis. Nine patients with infectious spondylitis were enrolled in this study. The average operative time was 327.6 min (range, 210–490 and intraoperative blood loss was 407 cc (range, 50–1,200. The average duration of hospital stay was 48.9 days (range, 11–76. Out of a total of 54 pedicle screws employed, 53 screws (98.1% were placed accurately. A reduced visual analog scale on back pain (from 8.2 to 2.2 and Oswestry disability index (from 67.1% to 25.6% were found at the 2-year follow-up. All patients had achieved resolution of spinal infection with reduced average erythrocyte sedimentation rate (from 83.9 to 14.1 mm/hr and average C-reactive protein (from 54.4 to 4.8 mg/dL. Average kyphotic angle correction was 10.5° (range, 8.4°–12.6° postoperatively and 8.5° (range, 6.9°–10.1° after 2 years. In conclusion, the current iCT-guided navigation approach has been demonstrated to be an alternative method during simultaneous minimally invasive anterior and posterior surgery for infectious spondylitis. It can provide a good intraoperative orientation and visualization of anatomic structures and also a high pedicle screw placement accuracy in patient’s lateral decubitus position.

  4. Assessment of active and inactive sacroiliitis in patients with ankylosing spondylitis using quantitative dynamic contrast-enhanced MRI.

    Science.gov (United States)

    Zhang, Mengchao; Zhou, Le; Huang, Ning; Zeng, Hong; Liu, Songyan; Liu, Lin

    2017-07-01

    To investigate the feasibility of using quantitative dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) to differentiate the active and inactive stage of sacroiliitis and the correlation between quantitative parameters and disease activity as measured by clinical scores. Forty-two patients with ankylosing spondylitis underwent DCE-MRI on a 3.0T MRI unit. According to the results of the blood sedimentation rate (ESR), C-reactive protein (CRP), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the patients were grouped into inactive and active groups. Pharmacokinetic models were used to generate the semiquantitative and quantitative hemodynamic parameters of DCE-MRI. The between-group differences were analyzed using the Wilcoxon rank sum test, and the correlations between the pharmacokinetic parameters and BASDAI score were analyzed using Spearman's correlation coefficient. The efficacies of different parameters in differentiating the active and inactive phase of sacroiliitis were evaluated and compared using receiver operator characteristics (ROC) curve analysis. K trans , K ep , V e , time to peak (TTP), max concentration (MAX Conc), and area under the curve (AUC) of the active group were significantly higher than those of the inactive stage group (P 0.05), except between AUC and MAX Conc (P = 0.0012). Quantitative DCE-MRI parameters can differentiate between active and inactive ankylosing spondylitis. Among those, K trans had the highest correlation coefficient with the BASDAI score. 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:71-78. © 2016 International Society for Magnetic Resonance in Medicine.

  5. [Effectiveness of the tenoxicam in patients with ankylosing spondylitis].

    Science.gov (United States)

    Gaydukova, I Z; Aparkina, A V; Khondkaryan, E V; Rebrov, A P

    2018-01-01

    To study the changes in pain syndrome and its characteristic in patients with ankylosing spondylitis (AS) who received tenoxicam after non-effective treatment with NSAIDs on the 'on-demand' basis. Forty patients with AS, who had BASDAI ≥4.0 at baseline and after 52 weeks of NSAIDs on the 'on-demand' basis, were randomized into 2 groups: 30 patients were prescribed 20 mg of tenoxicam oraly per day, 10 patients continued previous therapy. The BASDAI, ASDAS indices were calculated in 52 and 56 weeks. BASDAI and ASDAS indices decreased in patients treated with tenoxicam, the AS activity in patients with on-demand NSAID intake did not change. The change of the ineffective long-term NSAID intake in the 'on-demand' basis to permanent drug intake was associated with a rapid (within 4 weeks) decrease in the clinical activity of ankylosing spondylitis.

  6. The ongoing quest for biomarkers in Ankylosing Spondylitis.

    Science.gov (United States)

    Danve, Abhijeet; O'Dell, James

    2015-11-01

    Ankylosing Spondylitis poses significant challenges in terms of early diagnosis, assessment of disease activity, predicting response to the treatment and monitoring radiographic progression. With better understanding of underlying immunopathogenesis, effective targeted therapies are available which improve symptoms, quality of life and possibly slow the radiographic progression. There has been a growing interest in the discovery of biomarkers for defining various aspects of disease assessment and management in Ankylosing Spondylitis. The C-reactive protein and HLA-B27 are most commonly used biomarkers. This review describes many other newer biomarkers which have potential clinical applications in this chronic inflammatory disease. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  7. General functional fitness and body mass index of elderly women engaged in physical activity

    Directory of Open Access Journals (Sweden)

    Ana Paula Moratelli Prado

    2006-12-01

    Full Text Available The aim of the study was to verify the relationship between the General Functional Fitness Index (GFFI and the Body Mass Index (BMI of elderly women engaged in physical activity. The sample consisted of 52 elderly women, with mean age of 68.62 years (s.d. =4.98 yrs engaged in physical activity for at least 6 months. To test functional fi tness, the battery of tests of American Alliance for Health, Physical Education, Recreation & Dance (AAHPERD for the elderly was applied. Body mass and stature were measured with an electronic scale and stadiometer, allowing for body mass index (IMC computation. The results were compared with AAHPERD normative values for elderly women aged 60 to 79 years. Data analyses were performed using descriptive statistics, the Qui-square test, Fisher’s Exact test and binary logistic regression, with a level of significance of p RESUMO O objetivo do estudo foi verifi car a relação entre o Índice de Aptidão Funcional Geral (IAFG e o Índice de Massa Corporal (IMC de mulheres idosas, praticantes de atividade física. A amostra foi constituída por 52 idosas, com média de 68,62 anos idade (DP=4,98, praticantes de atividade física por, no mínimo, 6 meses. O instrumento utilizado para verifi car a aptidão funcional das idosas foi a bateria de testes para idosos da American Alliance for Health, Physical Education, Recreation & Dance (AAHPERD, e a massa corporal foi medida pela balança eletrônica e estadiômetro, e o índice de massa corporal (IMC foi calculado. Os resultados dos testes foram comparados com os valores normativos para a bateria da AAHPERD para mulheres idosas, com idade entre 60 e 79 anos. O tratamento de dados deu-se por estatística descritiva, teste do Qui-quadrado, teste Exato de Fisher e teste de regressão logística binária, com um nível de signifi cância de p<0,05. Observou-se uma tendência de 42,9% das idosas com IAFG bom de terem IMC normal e de 95,6% daquelas com IAFG fraco de terem IMC

  8. The general functional fitness index and symptoms of depression in older adults

    Directory of Open Access Journals (Sweden)

    Grasiely Faccin Borges

    2012-03-01

    Full Text Available Depression is considered the most common mental health disorder in older adults. Studies have shown that physical activity can reduce depressive symptoms in this population with immediate clinical effects. The objective of this study was to analyze the association between symptoms of depression and General Functional Fitness Index (GFFI in elderly physical exercise practitioners. The Geriatric Depression Scale of Yesavage (GDS-15 was used to evaluate the presence of depressive symptoms, and the AAHPERD (American Alliance for Health, Physical Education, Recreation and Dance fitness test battery for assessment of GFFI. We used descriptive statistics and Pearson correlation with 95% confidence intervals. The population consisted of 146 elderly participants of the Floripa Ativa Program - Phase B, with the sample consisting of 77 older adults with a mean age of 67.9 (SD 5.7 years. Among them, 13 exhibited symptoms of depression and 33 were fit, with the GFFI within normal range. We found a negative (r = -0.307 and significant (p = 0.007 correlation between GDS and GFFI. This inversely proportional relationship demonstrates that subjects with a better GFFI had a lower incidence of depressive symptoms. As the GFFI value is obtained through physical tests, it can be suggested that physical exercise supported the reduction of depressive symptoms in the study group.

  9. Estimation of leaf area index in the sunflower as a function of thermal time1

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    Dioneia Daiane Pitol Lucas

    Full Text Available The aim of this study was to obtain a mathematical model for estimating the leaf area index (LAI of a sunflower crop as a function of accumulated thermal time. Generating the models and testing their coefficients was carried out using data obtained from experiments carried out for different sowing dates in the crop years of 2007/08, 2008/09, 2009/10 and 2010/11 with two sunflower hybrids, Aguará 03 and Hélio 358. Linear leaf dimensions were used for the non-destructive measurement of the leaf area, and thermal time was used to quantify the biological time. With the data for accumulated thermal time (TTa and LAI known for any one day after emergence, mathematical models were generated for estimating the LAI. The following models were obtained, as they presented the best fit (lowest rootmean- square error, RMSE: gaussian peak, cubic polynomial, sigmoidal and an adjusted compound model, the modified sigmoidal. The modified sigmoidal model had the best fit to the generation data and the highest value for the coefficient of determination (R2. In testing the models, the lowest values for root-mean-square error, and the highest R2 between the observed and estimated values were obtained with the modified sigmoidal model.

  10. Development of multi-functional streetscape green infrastructure using a performance index approach.

    Science.gov (United States)

    Tiwary, A; Williams, I D; Heidrich, O; Namdeo, A; Bandaru, V; Calfapietra, C

    2016-01-01

    This paper presents a performance evaluation framework for streetscape vegetation. A performance index (PI) is conceived using the following seven traits, specific to the street environments - Pollution Flux Potential (PFP), Carbon Sequestration Potential (CSP), Thermal Comfort Potential (TCP), Noise Attenuation Potential (NAP), Biomass Energy Potential (BEP), Environmental Stress Tolerance (EST) and Crown Projection Factor (CPF). Its application is demonstrated through a case study using fifteen street vegetation species from the UK, utilising a combination of direct field measurements and inventoried literature data. Our results indicate greater preference to small-to-medium size trees and evergreen shrubs over larger trees for streetscaping. The proposed PI approach can be potentially applied two-fold: one, for evaluation of the performance of the existing street vegetation, facilitating the prospects for further improving them through management strategies and better species selection; two, for planning new streetscapes and multi-functional biomass as part of extending the green urban infrastructure. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. A Swedish cross-cultural adaptation and validation of the Tinnitus Functional Index.

    Science.gov (United States)

    Hoff, Maria; Kähäri, Kim

    2017-04-01

    The Tinnitus Functional Index (TFI) is a recent self-report instrument for tinnitus with potential advantages over other existing instruments, including a demonstrated high responsiveness. The objectives of this study were to translate and cross-culturally adapt the TFI into Swedish and to investigate its validity and reliability. The development of the Swedish version (TFI-SE) followed published guidelines on cross-cultural adaptation of health questionnaires. Validity and reliability was investigated by correlating responses on the TFI-SE with other tinnitus measures [Tinnitus Handicap Inventory (THI) and visual analogue scale (VAS)] and a scale measuring anxiety and depression (HADS). Consecutively recruited tinnitus patients (n = 100) from four Swedish clinics completed the questionnaires. The mean age of the sample was 51 years (SD =17). The internal consistency of the TFI-SE was good (α = 0.95) and the test-retest reliability was high (ICC =0.93). Our results supported the eight-factor structure proposed for the original TFI, and a high correlation between the TFI-SE and the THI (r = 0.8; p tinnitus patients.

  12. Association between body mass index and functional independence measure in patients with deconditioning.

    Science.gov (United States)

    Jain, Nitin B; Al-Adawi, Samir; Dorvlo, Atsu S S; Burke, David T

    2008-01-01

    To assess the association of body mass index (BMI) with functional independence measure (FIM) score in patients with deconditioning. We also examined whether the association was different for motor and cognitive subscales of the FIM instrument. A retrospective study of 1077 inpatients admitted to the general medicine service for deconditioning at an acute rehabilitation hospital. Patients were classified into underweight (BMI or = 40). Median gain in FIM scores from admission to discharge was highest in obese class I patients (27 points), followed by obese class II patients (26 points). The most gain in FIM scores was accounted for by the motor subscale. Adjusting for age, gender, and length of in-hospital stay, obese class I patients had a 5.8-point (95% confidence limits = 1.2, 7.0) higher gain in FIM score compared with patients with BMI in the normal range. In an acute rehabilitation setting, obese patients had higher gains in FIM scores as compared with normal-range-BMI patients. Most of the improvements in FIM scores were accounted for by the motor subscale, with little or no improvement on the cognitive scale.

  13. Functional MRI in peripheral arterial disease: arterial peak flow versus ankle-brachial index.

    Directory of Open Access Journals (Sweden)

    Bas Versluis

    Full Text Available OBJECTIVES: The purpose of this study was to compare the success rate of successful arterial peak flow (APF and ankle-brachial index (ABI measurements in patients with suspected or known peripheral arterial disease (PAD. MATERIALS AND METHODS: 183 patients with varying degrees of PAD were included. All subjects underwent ABI measurements and MR imaging of the popliteal artery to determine APF. Proportions of patients with successful APF and ABI measurements were compared and the discriminative capability was evaluated. RESULTS: APF was successfully measured in 91% of the patients, whereas the ABI could be determined in 71% of the patients (p<0.01. Success rates of APF and ABI were significantly higher in patients with intermittent claudication (95% and 80%, respectively than in patients with critical ischemia (87% and 62%, respectively. CONCLUSIONS: Compared to the assessment of PAD severity with ABI, the success rate of MRI-based APF measurements in patients with a clinical indication for MRA is 20% higher, with similar discriminatory capacity for disease severity. Therefore, APF is an especially convenient and valuable measure to assess severity in PAD patients scheduled to undergo MR angiography to obtain additional functional information concerning the vascular status.

  14. A cross-cultural adaptation of the Upper Limb Functional Index in French Canadian.

    Science.gov (United States)

    Hamasaki, Tokiko; Demers, Louise; Filiatrault, Johanne; Aubin, Ginette

    2014-01-01

    Clinical measurement. The Upper Limb Functional Index (ULFI) is a self-report questionnaire assessing activity limitations/participation restrictions resulting from an upper limb musculoskeletal disorder (UL-MSD). It is suitable for use in a rehabilitation context where clinicians have important time constraints due to a heavy caseload. However, no French version was available until now. To perform a cross-cultural adaptation of the ULFI in French Canadian and examine the psychometric properties and clinical applicability of the adapted version (ULFI-FC) among 50 bilingual patients. The ULFI-FC showed high internal consistency (Cronbach α = 0.93), good convergent validity with the original ULFI (r = 0.85) and with the French Canadian version of the Disabilities of the Arm, Shoulder and Hand (r = -0.85) and good applicability. This study supports the suitability of the ULFI-FC for use in a busy rehabilitation setting for French-speaking patients with UL-MSD. N/A. Copyright © 2014 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  15. Exercise capacity in the Bidirectional Glenn physiology: Coupling cardiac index, ventricular function and oxygen extraction ratio.

    Science.gov (United States)

    Vallecilla, Carolina; Khiabani, Reza H; Trusty, Phillip; Sandoval, Néstor; Fogel, Mark; Briceño, Juan Carlos; Yoganathan, Ajit P

    2015-07-16

    In Bi-directional Glenn (BDG) physiology, the superior systemic circulation and pulmonary circulation are in series. Consequently, only blood from the superior vena cava is oxygenated in the lungs. Oxygenated blood then travels to the ventricle where it is mixed with blood returning from the lower body. Therefore, incremental changes in oxygen extraction ratio (OER) could compromise exercise tolerance. In this study, the effect of exercise on the hemodynamic and ventricular performance of BDG physiology was investigated using clinical patient data as inputs for a lumped parameter model coupled with oxygenation equations. Changes in cardiac index, Qp/Qs, systemic pressure, oxygen extraction ratio and ventricular/vascular coupling ratio were calculated for three different exercise levels. The patient cohort (n=29) was sub-grouped by age and pulmonary vascular resistance (PVR) at rest. It was observed that the changes in exercise tolerance are significant in both comparisons, but most significant when sub-grouped by PVR at rest. Results showed that patients over 2 years old with high PVR are above or close to the upper tolerable limit of OER (0.32) at baseline. Patients with high PVR at rest had very poor exercise tolerance while patients with low PVR at rest could tolerate low exercise conditions. In general, ventricular function of SV patients is too poor to increase CI and fulfill exercise requirements. The presented mathematical model provides a framework to estimate the hemodynamic performance of BDG patients at different exercise levels according to patient specific data. Published by Elsevier Ltd.

  16. Modification of the upper limb functional index to a three-point response improves clinimetric properties.

    Science.gov (United States)

    Gabel, Charles Philip; Michener, Lori A; Melloh, Markus; Burkett, Brendan

    2010-01-01

    Observational two-stage. To achieve optimal clinimetric properties for outcome measures, both practical and psychometric, ongoing improvements are required. To evaluate if the Upper Limb Functional Index (ULFI) clinimetric properties are improved by modification to a three-point response option and to verify the factor structure. Stage 1, calibration (n=139) used ULFI dichotomous responses, and stage 2, validation (n=117) used a three-point response option. The clinimetric properties were compared in physical therapy outpatients with the QuickDASH as the reference standard. Repeated measurements were made at two to four weekly intervals. The ULFI three-point response option improved reliability [intraclass correlation coefficient (2,1)=0.98], internal consistency (alpha=0.92), QuickDASH concurrent validity (r=0.86), and responsiveness. Minimal detectable change (90% confidence interval) was 7.9%, and factor structure was unidimensional. Missing responses were modification to a three-point response option. 2c. Crown Copyright (c) 2010. Published by Elsevier Inc. All rights reserved.

  17. TRANSLATION, CULTURAL ADAPTATION AND VALIDATION OF THE FOOT FUNCTION INDEX - REVISED (FFI-R).

    Science.gov (United States)

    Stéfani, Kelly Cristina; Pereira, Miguel Viana; Oliveira, Pedro Rizzi; Wun, Paloma Yan Lam

    2017-01-01

    The aim of this study was to translate, culturally adapt, and validate the "Foot Function Index - Revised" (FFI-R) for use in Brazilian Portuguese. The scale was translated and administered (as recommended by Guillemin, 2000) to 52 patients in the postoperative period after foot and ankle surgery. Seven days after the initial assessment, the scale was readministered by a different interviewer. The data were entered into an Excel spreadsheet and analyzed using SPSS version 23.0 software for Mac. Reproducibility was assessed using intraclass correlation analysis. were considered statistically significant at a type I error rate of 5%. Results: The following random-effects intraclass correlation coefficients (ICC) were obtained for each score on the FFI-R: 0.625 for pain, 0.558 for stiffness, 0.757 for difficulty, 0.718 for activity restrictions, 0.854 for personal concerns, and 0.753 for the total score. The FFI-R was successfully translated to Portuguese and culturally adapted for use in Brazilian patients, demonstrating satisfactory validity and reliability. Level of Evidence I, Testing of Previously Developed Diagnostic Criteria on Consecutive Patients (with universally applied reference "golg" standard).

  18. Reliability and Validity of the Korean Version of the Foot Function Index.

    Science.gov (United States)

    Huh, Jung-Wook; Eun, Il-Soo; Ko, Young-Chul; Park, Man-Jun; Hwang, Keum-Min; Park, Sook-Hyun; Park, Tae-Hong; Park, Joon-Hyung

    2016-01-01

    Although translated versions of the Foot Function Index (FFI) in several languages are available, the absence of a Korean version has precluded comparing the data from Korea with the data from other countries using the FFI. We, therefore, evaluated the reliability and validity of the adapted Korean version of the FFI. We translated the English version of the FFI into Korean and back into English. We mailed the Korean version of the visual analog scale, FFI, and the previously validated Medical Outcomes Study Short-Form 36-item questionnaire (SF-36) to 121 patients with treated foot complaints. To evaluate the test-retest reliability and internal consistency, we used the intraclass correlation coefficient and Cronbach's α, respectively. We also evaluated the concurrent and construct validity of Korean version of the FFI by comparing the visual analog scale and SF-36. Cronbach's α was 0.91 and 0.95 for the pain and disability subscales, respectively. The reproducibility was good, and a strong correlation between the FFI and the SF-36 and visual analog scale with related content was observed, indicating good construct validity.The Korean version of the FFI is a reliable and valid questionnaire for the self-assessment of pain and disability in Korean patients with foot complaints. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Use of the cardiopulmonary flow index to evaluate cardiac function in thoroughbred horses

    International Nuclear Information System (INIS)

    Guthrie, A.J.; Killeen, V.M.; Grosskopf, J.F.W.

    1991-01-01

    The ratio of the cardiopulmonary blood volume to stroke volume is called the cardiopulmonary flow index (CPFI). The CPFI can be determined indirectly from the simultaneous recording of a radiocardiogram and an electrocardiogram. The CPFI and cardiac output were measured simultaneously in horses that were diagnosed as having cardiac disease. The results obtained from these subjects were compared with those from control animals and significant differences were found between the mean CPFI of the control horses and those with macroscopically visible myocardial fibrosis on post mortem examination. No significant differences were found between the means of the cardiac output measured in either of the groups of horses. The effect of pharmacological acceleration of the heart rate on the CPFI was also studied. Significant differences were found between the mean CPFI and the slopes of the regression lines of CPFI on heart rate of the control and principal groups of horses. These differences were greatest at heart rates near to the resting heart rates of the individuals. The CPFI was found to be a more sensitive measure of cardiac function than cardiac output, in the horses. 16 refs., 2 figs., 2 tabs

  20. Polish Translation and Validation of the Tinnitus Handicap Inventory and the Tinnitus Functional Index.

    Science.gov (United States)

    Wrzosek, Małgorzata; Szymiec, Eugeniusz; Klemens, Wiesława; Kotyło, Piotr; Schlee, Winfried; Modrzyńska, Małgorzata; Lang-Małecka, Agnieszka; Preis, Anna; Bulla, Jan

    2016-01-01

    Objective: The need for validated measures enabling clinicians to classify tinnitus patients according to the severity of tinnitus and screen the progress of therapies in our country led us to translate into Polish and to validate two tinnitus questionnaires, namely the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI). Design: The original English versions of the questionnaires were translated into Polish and translated back to English by three independent translators. These versions were then finalized by the authors into a Polish THI (THI-Pl) and a Polish TFI (TFI-Pl). Participants from three laryngological centers in Poland anonymously answered the THI-Pl ( N = 98) and the TFI-Pl ( N = 108) in addition to the Polish versions of the Center for Epidemiologic Studies Depression Scale as a measure of self-perceived level of depression, and the Satisfaction With Life Scale to assess self-perceived quality of life. Both were used to determine discriminant validity. Two Visual Analog Scales were used to measure tinnitus annoyance and tinnitus loudness in order to determine convergent validity. Results: Similar to the original version of the THI, the THI-Pl showed a high internal consistency (Cronbach's α = 0.93). The exploratory factor analysis revealed that the questionnaire has a three-factorial structure that does not correspond to the original division for functional, catastrophic, and emotional subscales. Convergent and discriminant validities were confirmed. The TFI-Pl showed high internal consistency (Cronbach's α = 0.96) with the reliability ranging from 0.82 to 0.95 for its different subscales. Factor analysis confirmed an eight-factorial structure with factors assigning all items to appropriate subscales reported in the original version of the questionnaire. Discriminant and convergent validities were also confirmed for the TFI-Pl. Conclusion: We translated and validated the Polish versions of the THI and the TFI to make them

  1. Validity and reliability of the Foot Function Index (FFI) questionnaire Brazilian-Portuguese version.

    Science.gov (United States)

    Martinez, Bruna Reclusa; Staboli, Isabela Maschk; Kamonseki, Danilo Harudy; Budiman-Mak, Elly; Yi, Liu Chiao

    2016-01-01

    To evaluate the validity and reliability of the Foot Function Index (FFI) in its Brazilian Portuguese version. The validity and reliability of the FFI were tested in 50 volunteers, with plantar fasciitis, metatarsalgia and chronic ankle sprain. The FFI validity process used the Short Form-36 (SF-36) and Foot and Ankle Outcome Score (FAOS) questionnaires. The correlation between FFI, SF-36 and FAOS was done using the Pearson's linear coefficient. The inter and intra-evaluator reliability was ascertained by means of the intraclass correlation coefficient (ICC) and the internal consistency by means of Cronbach's alpha coefficient. The scores were used to assess the standard error measurement (SEM), minimal detectable change (MDC) and ceiling floor and effects. The validity process showed that there were correlations between FFI and the "pain" and "social aspects" subscales of SF-36 and all subscales of FAOS, except for "other symptoms". The Brazilian-Portuguese version of FFI showed excellent intra and interevaluator correlations, with an ICC range of 0.99-0.97 and score reliability that was considered highly satisfactory, with Cronbach's alpha range of 0.80-0.61. The SEMs for inter and intra-evaluator reliability were 1.32 and 1.08, respectively. The MDC was 2.42 (90 % confidence interval). No ceiling and floor effect were detected. The Brazilian-Portuguese version of the FFI questionnaire was found to be a valid and reliable instrument for foot function evaluation, and can be used both in scientific settings and in clinical practice.

  2. A case of retropharyngeal abscess with spondylitis causing tetraplegia

    Directory of Open Access Journals (Sweden)

    Takeshi Kusunoki

    2012-04-01

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

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

    Directory of Open Access Journals (Sweden)

    E. Filippucci

    2011-06-01

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

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

    International Nuclear Information System (INIS)

    Windeyer, B.

    1976-01-01

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

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

    OpenAIRE

    Altun, Idiris; Yuksel, Kas?m Zafer

    2016-01-01

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

  6. Are there new emerging drugs for ankylosing spondylitis or spondyloarthritis?

    Science.gov (United States)

    Wendling, Daniel

    2013-03-01

    New emerging drugs in the treatment of ankylosing spondylitis (AS), and spondyloarthritis in general, should be compared to anti-TNF agents, which provided clear evidence of efficacy in these conditions. To date, other biologic agents used in rheumatoid arthritis failed to demonstrate efficacy in AS, even in anti-TNF naïve patients. Some new potential options may target cytokines such as IL-17, or molecules involved in entheseal ossification or signaling pathways, but need confirmatory evaluation.

  7. Vestibular evoked myogenic potentials in patients with ankylosing spondylitis.

    Science.gov (United States)

    Özgür, Abdulkadir; Serdaroğlu Beyazal, Münevver; Terzi, Suat; Coşkun, Zerrin Özergin; Dursun, Engin

    2016-10-01

    Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease with unknown etiology. Although sacroiliac joint involvement is the classic sign along with the formed immune mediators, it may result in immune-mediated inner ear disease and may cause damage to the audiovestibular system. Vestibular evoked myogenic potentials (VEMP) is a clinical reflex test used in the diagnosis of vestibular diseases and is performed by recording and evaluating the muscle potentials resulting from the stimulation of the vestibular system with different stimuli. The aim of this study is to evaluate the cervical VEMP test results in AS patients without vestibular symptoms. Thirty-three patients with AS and a control group of 30 healthy volunteers with similar demographic characteristics were evaluated in the study. VEMP wave latency, P13-N23 wave amplitude, and VEMP asymmetry ratio (VAR) values were compared between the groups. The relationship between clinical and laboratory findings of the AS patients and VEMP data were also investigated. Compared with healthy people, this study shows the response rate of patients with ankylosing spondylitis was reduced in the VEMP test, and P13-N23 wave amplitude showed a decrease in AS patients who had VEMP response (p ankylosing spondylitis. The data obtained from this study suggest that AS may lead to decreased sensitivity of the vestibular system.

  8. Update on ankylosing spondylitis: current concepts in pathogenesis.

    Science.gov (United States)

    Smith, Judith A

    2015-01-01

    Ankylosing spondylitis is an insidiously progressive and debilitating form of arthritis involving the axial skeleton. The long delay in diagnosis and insufficient response to currently available therapeutics both advocate for a greater understanding of disease pathogenesis. Genome-wide association studies of this highly genetic disease have implicated specific immune pathways, including the interleukin (IL)-17/IL-23 pathway, control of nuclear factor kappa B (NF-κB) activation, amino acid trimming for major histocompatibility complex (MHC) antigen presentation, and other genes controlling CD8 and CD4 T cell subsets. The relevance of these pathways has borne out in animal and human subject studies, in particular, the response to novel therapeutic agents. Genetics and the findings of autoantibodies in ankylosing spondylitis revisit the question of autoimmune vs. autoinflammatory etiology. As environmental partners to genetics, recent attention has focused on the roles of microbiota and biomechanical stress in initiating and perpetuating inflammation. Herein, we review these current developments in the investigation of ankylosing spondylitis pathogenesis.

  9. Atlantoaxial Subluxation after Pyogenic Spondylitis around the Odontoid Process

    Directory of Open Access Journals (Sweden)

    Atsushi Hasegawa

    2015-01-01

    Full Text Available Study Design. A case report and review of the literature. Objective. The aim of this study was to describe the conservative management of pyogenic spondylitis around the odontoid process. Summary of Background Data. Atlantoaxial subluxation after pyogenic spondylitis is rare. The therapeutic approach to infection of the upper cervical spine is controversial. Methods. Medical chart and radiological images of a 76-year-old male patient were retrospectively reviewed. Radiography revealed atlantoaxial subluxation, and an abscess was seen around the odontoid process on magnetic resonance images. Intravenous antibiotics and a halo vest were used to treat the patient. We then observed the patient’s conservative treatment course. Results. C-reactive protein levels returned to normal 4 weeks after administration of the intravenous antibiotics. The patient’s muscle weakness also completely recovered 8 weeks after administration of the intravenous antibiotics. Because the patient was able to walk without any support, surgical treatment was not necessary. Conclusions. Pyogenic spondylitis of the upper cervical spine is a rare manifestation. Surgical or conservative treatment must be selected carefully based on the patient’s symptoms. If early diagnosis and treatment can be provided to the patients, conservative treatment can be achieved.

  10. Color Doppler indexes in early phase after kidney transplantation and their association with kidney function on six month follow up

    Directory of Open Access Journals (Sweden)

    Atoosa Adibi

    2012-01-01

    Full Text Available Background: Doppler ultrasonography (DU and measurement of its indexes, resistive index (RI and pulsatility index (PI, is used to investigate transplanted kidney hemodynamic status and function. The aim of this study was to determine the correlation between Doppler indexes in the early phase after transplantation with long-term transplanted kidney function. Materials and Methods : In this cross-sectional study on 38 newly kidney transplant patients, we performed DU with assessment of its indexes within 48 hours, 1 week, and 6 months after kidney transplantation. Serum creatinine after stability and 6 months after kidney transplantation were assessed. Cyclosporine level was measured 1 week after kidney transplantation and compared with DU indexes. Results: About 71% of kidney transplanted patients reached their normal initial creatinine level(cr<1.5 mg/ dl and 28% of all patients were involved in kidney dysfunction after 6 months (increase in basic creatinine level more than 25%.There was no significant difference between mean RI and PI in patients with normal and disturbed kidney function based on creatinine level in early posttransplantation period but there was linear correlation between mean RI and PI within 48 hours and 1 week with kidney function after 6 months. Also no association between cyclosporine level and RI and PI was shown. There was a direct association between age and the levels of RI and PI 6 months after transplantation. Conclusion: This study suggests assessment of RI and PI in early period after transplantation and can be used as predictive parameters for long-term function of transplanted kidney and RI more than 0.80 in early phase after transplantation has an acceptable sensitivity and specificity to predict long-term kidney dysfunction.

  11. Cervical Spondylitis and Epidural Abscess Caused by Brucellosis: a Case Report and Literature Review

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    Reşorlu Hatice

    2016-12-01

    Full Text Available Brucellosis is a zoonotic disease widely seen in endemic regions and that can lead to systemic involvement. The musculoskeletal system is frequently affected, and the disease can exhibit clinical involvements such as arthritis, spondylitis, spondylodiscitis, osteomyelitis, tenosynovitis and bursitis. Spondylitis and spondylodiscitis, common complications of brucellosis, predominantly affect the lumbar and thoracic vertebrae.

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

    Directory of Open Access Journals (Sweden)

    Urmila Palaria

    2011-11-01

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

  13. Infectious spondylitis. A retrospective evaluation of the MRI signs; Die infektioese Spondylitis. Eine retrospektive Auswertung der MRT-Merkmale

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-02-01

    Aim and methods: The aim of the present study was to evaluate the MRI criteria of infectious spondylitis (spondylodiscitis). The MR images of 23 patients suffering from spondylodiscitis (78% unspecific, 22% specific) were retrospectively analyzed. Results: The height of the intervertebral discs involved was normal in 40%, reduced in 43% and increased in 17% of the cases. The most common findings can be summarized in an MR triad: (1) The vertebral bodies involved are hypointense in T1-weighted images (100%) with a lack of delineation of the intervertebral discs (53%). (2) The injection of Gd-DTPA yields an enhancement of the vertebral bodies involved and intervertebral discs (95% and 74% respectively). (3) The vertebral bodies and intervertebral discs are hyperintense in T2-weighted sequences (76% and 90% respectively). (orig.) [Deutsch] Um die kernspintomographischen Merkmale der Spondylitis zu ueberpruefen, wurden die MRT-Bilder von 23 Patienten mit einer Spondylitis (78% unspezifisch, 22% spezifisch) retrospektiv analysiert; 40% der befallenen Bandscheiben zeigten eine normale Hoehe, 43% waren verschmaelert und 17% zeigten eine Hoehenzunahme. Die haeufigsten Veraenderungen lassen sich in einer MRT-Trias zusammenfassen: 1. In T1-gewichteten Sequenzen sind die befallenen Wirbelkoerper hypointens (100%) und die Bandscheiben nicht abgrenzbar (53%). 2. Wirbelkoerper und Bandscheiben nehmen Kontrastmittel auf (95 bzw. 74%). 3. Wirbelkoerper und Bandscheiben sind in T2-gewichteten Sequenzen hyperintens (76 bzw. 90%). Dabei stellt sich ein paravertebraler Weichteilbefall in allen Sequenzen isointens zum befallenen Wirbelkoerper dar. Eine Differenzierung zwischen unspezifischer und spezifischer Aetiologie war kernspintomographisch nicht moeglich. (orig.)

  14. One-stage surgical treatment of cervical spine fracture-dislocation in patients with ankylosing spondylitis via the combined anterior-posterior approach.

    Science.gov (United States)

    He, Axiang; Xie, Dong; Cai, Xiaomin; Qu, Bo; Kong, Qin; Xu, Chenhui; Yang, Lili; Chen, Xiongsheng; Jia, Lianshun

    2017-07-01

    The aim of the article is to investigate the efficacy and safety of 1-stage surgical therapy via combined anterior-posterior approach on cervical spine fracture in patients with ankylosing spondylitis (AS).We retrospectively analyzed profiles of 12 AS patients with severe fracture-dislocation of cervical spine received 1-stage combined anterior-posterior surgery in our hospital from October, 2013, to October, 2015, including clinical characteristics, follow-up data, and imaging records. We compared the parameters before and after surgery on the basis of neurological function, bone fusion, Cobb angles of operation segment, Barthel index (BI) score, and incidence rate of complications.A total of 12 patients received 1-stage surgery via combined anterior-posterior approach within 3 days after injury. No severe complications and death occurred. All patients received the successfully anatomical reduction of fracture-dislocation, in which 9 achieved function restoration. The latest follow-up showed the neurological function status of patients was improved. The Cobb angles of operation segments were recovered; the rate of bone fusion was 66.7% at 3 months and 100% at 6 months post-operation. The BI score was improved, 4 cases of moderate dependence and 8 of slight dependence at the latest follow-up compared to 10 of severe dependence and 2 of moderate dependence preoperation. In no cases did severe complications from implanted instrumentation occur.It was high efficacy and safety that the surgical therapy was performed on cervical fracture-dislocation in AS patients by the 1-stage combined anterior-posterior approach. The key of the surgery is the robust stabilization and full decompression of fracture spine at early stage. In addition, if spinal anatomical reduction of fracture segments is difficult to be achieved, the functional restoration should be adopted during the surgery.

  15. The relationships among hyperuricemia, body mass index and impaired renal function in type 2 diabetic patients.

    Science.gov (United States)

    Li, Yongmei; Fan, Xing; Li, Chunjun; Zhi, Xinyue; Peng, Liyuan; Han, Hongling; Sun, Bei

    2017-12-13

    Chronic kidney disease (CKD) is a common chronic microvascular complication and the major cause of death in diabetic patients. This study was conceived to explore the possible mechanisms of how hyperuricemia and obesity contribute to renal function impairment in type 2 diabetic (T2DM) patients. A cross-sectional study in 609 participants recruited from a T2DM population in North China was conducted. The multiplicative interaction between body mass index (BMI) and uric acid (UA) level was assessed using an interaction term in a logistic regression analysis. Our results indicate that male T2DM patients having higher BMI (OR 1.711, p = 0.038), blood urine nitrogen (BUN) (OR 1.100, p = 0.034), and 24-hour urinary micro-albumin levels (OR 1.004, p = 0.021) were much more likely to have high UA. Whereas, for female T2DM patients, the OR of BMI, BUN, and triglyceride were 1.169 (p = 0.001), 1.337 (p = 0.000), and 1.359 (p = 0.006), respectively. In this study population, obesity and elevated UA work together to increase the risk of renal injury. In vitro experiments indicate that reactive oxygen species (ROS) production increased with UA treatment in human renal glomerular endothelial cells (HRGECs), while endothelial nitric oxide synthase (eNOS) production level dropped. UA also increased monocyte chemotactic protein-1 (MCP-1) expression and nuclear factor kappa B (NF-κB) activation. Taken together, our results indicate that high concentrations of UA lead to endothelial dysfunction through the activation of the inflammatory response and induction of oxidative stress, even in non-obese T2DM patients.

  16. Translation and validation of the Danish Foot Function Index (FFI-DK).

    Science.gov (United States)

    Jorgensen, J E; Andreasen, J; Rathleff, M S

    2015-08-01

    The objective of this study was to translate the Foot Function Index (FFI) for use in Danish-speaking patients with foot complaints. The FFI consists of 23 items scored on a numeric rating scale from 0 to 10. The 23 items are grouped into three subscales: pain (nine items), activity limitation (five items), and disability (nine items). The Danish FFI was developed according to the recommended forward/backward translation protocol. The data analysis included reliability [intraclass correlation coefficient (ICC) 2.1] and internal consistency (Cronbach's alpha). Excellent internal consistency was shown for the three subscales: pain (0.99), disability (0.98), and activity limitation (0.98), as for the total score (0.97). The test-retest reliability was excellent: pain subscale: ICC 0.98 [95% confidence interval (CI): 0.97-0.99]; activity limitation subscale: ICC: 0.95 (95% CI: 0.91-0.98); disability subscale: ICC 0.97 (95% CI: 0.95-0.98); total score: ICC: 0.95 (95% CI: 0.91 to 0.98). The mean difference between test and retest was below 1 point and P > 0.08. Bland-Altman plots showed no significant or clinically relevant differences from test to retest in any of the subscales or in the total score. The Danish version of the FFI was found to be valid and reliable and therefore acceptable for use in the Danish population. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Associations between ankle-brachial index and cognitive function: results from the Lifestyle Interventions and Independence for Elders trial

    Science.gov (United States)

    OBJECTIVE: The objective of this study was to evaluate cross-sectional and longitudinal associations between ankle-brachial index (ABI) and indicators of cognitive function. DESIGN: Randomized clinical trial (Lifestyle Interventions and Independence for Elders Trial). SETTING: Eight US academic ce...

  18. A Functional mathematical index for predicting effects of food processing on eight sweet potato(Ipomoea batatas)cultivars

    Science.gov (United States)

    In this paper we apply an improved functional mathematical index (FMI), modified from those presented in previous publications, to define the influence of different cooking processes of eight sweet potato (Ipomoea batatas) cultivars on composition of six bioactive phenolic compounds (flavonoids). Th...

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

    Science.gov (United States)

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

    2016-03-01

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

  20. Impact of treatment with TNF antagonists on total cholesterol in patients with ankylosing spondylitis and psoriatic arthritis.

    Science.gov (United States)

    Maneiro, Jose Ramon; Souto, Alejandro; Gomez-Reino, Juan J

    2017-05-01

    The objective of the study was to analyze the impact of TNF antagonists (TNFa) on the total cholesterol and triglycerides on ankylosing spondylitis (AS) and psoriatic arthritis (PsA). In this single-centre observational study of AS and PsA patients, differences in triglyceride and total cholesterol levels and frequency of hypertriglyceridemia and hypercholesterolemia at 3 and 6 months were analysed in patients treated and not treated with TNFa. General estimation equations and linear regression analysis were used to investigate associations between disease activity and lipid levels and to identify predictors of change. One hundred fifty-seven patients treated, and 157 not treated with TNFa, were included in the study. A transient increase in cholesterol level from baseline to 3 months in TNFa-treated patients was the only statistically significant effect (P Ankylosing Spondylitis Disease Activity Index (P = 0.011) and CRP (P < 0.001), but not Disease Activity Score in 28 Joints (P = 0.095) were found in the whole group. In AS and PsA patients treated with TNFa, mild and transient changes in cholesterol but not in triglyceride levels were associated with changes in disease activity.

  1. Tumor Necrosis Factor-α Inhibition in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Treatment Response, Drug Survival, and Patient Outcome.

    Science.gov (United States)

    Corli, Justine; Flipo, René-Marc; Philippe, Peggy; Bera-Louville, Anne; Béhal, Hélène; Wibaux, Cécile; Paccou, Julien

    2015-12-01

    The purpose of this study was to (1) evaluate baseline characteristics of nonradiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) treated with tumor necrosis factor-α inhibitors (TNFi), (2) assess the response to first TNFi treatment, and (3) compare drug-survival duration and rates. Inclusion criteria were patients with axSpA who initiated first TNFi treatment between April 2001 and July 2014 and were followed up for at least 3 months. Efficacy criteria were an improvement of at least 2 points (on a 0-10 scale) or a 50% improvement in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Baseline characteristics, responses at 12 months, and drug survival were compared between AS and nr-axSpA. A total of 361 patients were included in the study (AS, n = 263 and nr-axSpA, n = 98). Patients with AS were more often men (65.02% vs 45.92%, p = 0.001) and had longer symptom duration (11.71 ± 9.52 vs 7.34 ± 9.30 yrs, p Treatment response and drug survival were similar in patients with AS and nr-axSpA after first TNFi initiation.

  2. Sulfasalazine Treatment Suppresses the Formation of HLA-B27 Heavy Chain Homodimer in Patients with Ankylosing Spondylitis.

    Science.gov (United States)

    Yu, Hui-Chun; Lu, Ming-Chi; Huang, Kuang-Yung; Huang, Hsien-Lu; Liu, Su-Qin; Huang, Hsien-Bin; Lai, Ning-Sheng

    2015-12-29

    Human leukocytic antigen-B27 heavy chain (HLA-B27 HC) has the tendency to fold slowly, in turn gradually forming a homodimer, (B27-HC)₂ via a disulfide linkage to activate killer cells and T-helper 17 cells and inducing endoplasmic reticulum (ER) stress to trigger the IL-23/IL-17 axis for pro-inflammatory reactions. All these consequences lead to the pathogenesis of ankylosing spondylitis (AS). Sulfasalazine (SSA) is a common medication used for treatment of patients with AS. However, the effects of SSA treatment on (B27-HC)₂ formation and on suppression of IL-23/IL-17 axis of AS patients remain to be determined. In the current study, we examine the (B27-HC)₂ of peripheral blood mononuclear cells (PBMC), the mean grade of sarcoiliitis and lumbar spine Bath Ankylosing Spondylitis Radiology Index (BASRI) scores of 23 AS patients. The results indicated that AS patients without (B27-HC)₂ on PBMC showed the lower levels of mean grade of sarcoiliitis and the lumbar spine BASRI scores. In addition, after treatment with SSA for four months, the levels of (B27-HC)₂ on PBMCs were significantly reduced. Cytokines mRNA levels, including TNFα, IL-17A, IL-17F and IFNγ, were also significantly down-regulated in PBMCs. However, SSA treatment did not affect the levels of IL-23 and IL-23R mRNAs.

  3. Face Validity of the Functional Assessment of Cancer Therapy-Breast Symptom Index (FACT- B into Formal Arabic

    Directory of Open Access Journals (Sweden)

    Loulou Kobeissi

    2014-06-01

    Full Text Available Background: Breast cancer affects over one million women annually and is the most common global malignancy among women. Extensive improvements have taken place in the management of breast cancer in recent years and a higher percentage of women are cured from this disease. A proper assessment of the quality of life of women with breast cancer is an essential component in disease management. The Functional Assessment of Cancer Therapy- Breast Symptom Index has been commonly used and well-validated among English speaking populations as well as other populations. To date, no formal translation and evaluation of the Functional Assessment of Cancer Therapy-Breast System Index exists in Arabic. Therefore, this study intends to translate, adapt and face-validate the Functional Assessment of Cancer Therapy-Breast System Index into Arabic, specifically in the context of the Lebanese culture. Methods: We conducted forward and backward translation in Arabic, combined with face validity by clinicians. This was followed by pre-testing to ensure the instrument’s adequacy and cultural sensitivity conducted by the administration of face-to-face interviews with individual breast cancer patients (n=33 and two focus groups (4 women/group to evaluate the relevance and appropriateness of each item and words used in the questionnaire. Results: Study results reinforced the value of the Arabic translated version of the Functional Assessment of Cancer Therapy-Breast System Index in capturing the quality of life of women with breast cancer in Lebanon. Conclusion: The instrument was perceived to be adequate, appropriate for use, culturally sensitive, simple as well as exhaustive. Suggestions have been made to enrich the instruments’ ability to incorporate other quality of life dimensions not captured, as well to enhance the cultural specificity of the Functional Assessment of Cancer Therapy-Breast System Index, when administered among Lebanese women diagnosed with

  4. Long-term outcome of patients with active ankylosing spondylitis with etanercept-sustained efficacy and safety after seven years

    Science.gov (United States)

    2013-01-01

    Introduction Data from clinical studies on the long-term efficacy and safety of anti-tumor necrosis factor (TNF)-α therapy in patients with ankylosing spondylitis (AS) are scarce. This is the first report on continuous treatment with the TNFα fusion protein etanercept over seven years (y). Methods Overall, 26 patients with active AS were initially treated with etanercept 2 × 25 mg s.c./week with no concomitant disease modifying anti-rheumatic drugs (DMARDs) or steroids. The clinical response was assessed by standardized parameters. The primary outcome was the proportion of patients in the Spondyloarthritis International Society (ASAS) partial remission at seven years. AS disease activity scores (ASDAS) for status and improvement were compared to conventional outcome measures. Results Overall, 21/26 patients (81%) completed two years of treatment and 16/26 patients (62%) completed seven years. In the completer analysis, 31% patients were in ASAS partial remission at seven years, while 44% patients showed an ASDAS inactive disease status. Mean Bath AS activity index (BASDAI) scores, which were elevated at baseline (6.3 ± 0.9), showed constant improvement and remained low: 3.1 ± 2.5 at two years and 2.5 ± 2.2 at seven years, while ASDAS also improved (3.9 ± 0.7 at baseline, 1.8 ± 0.9 at two years, 1.6 ± 0.8 at seven years), all P treatment due to adverse events. Patients who completed the study had lower baseline Bath AS function index (BASFI) scores vs. patients who discontinued. No other clinical parameter at baseline could predict any long-term outcome. Conclusions This study confirms the clinical efficacy and safety of etanercept in patients with active AS over seven years of continuous treatment. After seven years, more than half of the initially treated patients remained on anti-TNF therapy, and one-third were in partial remission. Trial Registration ClinicalTrials.gov: NCT01289743 PMID:23786760

  5. Responsiveness and minimal detectable change of the dynamic gait index and functional gait index in persons with balance and vestibular disorders.

    Science.gov (United States)

    Marchetti, Gregory F; Lin, Chia-Cheng; Alghadir, Ahmad; Whitney, Susan L

    2014-04-01

    We performed a retrospective chart review to determine the responsiveness and minimal detectable change (MDC95) in persons with balance and vestibular disorders with the dynamic gait index (DGI) and the functional gait assessment (FGA). The study cohort consisted of 326 patients with a mean age of 60 ± 18.3 years (range, 18-95 years; 69% female). The DGI, FGA, Activities-Specific Balance Confidence (ABC) scale, and the dizziness handicap inventory (DHI) were collected at intake and discharge. The standardized response mean as an index of responsiveness was greater for the FGA (1.25) than for the DGI (0.72). Both measures demonstrated good internal consistency with baseline measures. The amount of pre- to posttreatment change that exceeds chance variation was estimated at 4 points for the DGI and 6 points for the FGA. In both the DGI and the FGA, a magnitude of change equivalent to the respective MDC95 was significantly associated with improvements in self-reported disability as measured by the ABC and DHI. The DGI and the FGA are responsive to change over time in persons with balance and vestibular disorders. More complex gait measures need to be developed, as close to 50% of the subjects received optimal scores at discharge from a physical therapy exercise program, indicating that these measures have a ceiling effect.

  6. The role of myocardial performance index in assessment of left ventricular function in patients with valvular mitral regurgitation.

    Science.gov (United States)

    Hussein, Muataz Fawzi; Al-Mayahi, Samirra Rashid Jabbar; Essa, Samar I

    2017-03-01

    Mitral regurgitation (MR) is the most commonly encountered valve lesion in modern clinical practice. Severe mitral regurgitation may cause systolic dysfunction. Left ventricular ejection fraction may not be an accurate measurement of LV function in patients with mitral insufficiency. Myocardial performance index (MPI) is a simple non invasive measure of myocardial function. The study involved 50 patients with valvular mitral regurgitation and 50 healthy subjects as a control group. Transthoracic echocardiography was carried out for all patients and control group. The echocardiographic measurements included left ventricular end diastolic and end systolic dimensions, left atrial diameter, ejection fraction (EF), and myocardial performance index (MPI). Results revealed insignificant change in MPI between patients with mild MR and controls (26.47%), and significant changes in MPI between patients with moderate and severe mitral regurgitation and control group (29.41%, 41.17% respectively) with p value 0.05), while the changes in EF between patients with moderate and severe mitral regurgitation and control groups were (-9.3%), (-7.4%) respectively with p value <0.05. Myocardial performance index is a good and easily determined index in the assessment of left ventricular function in patients with mitral regurgitation and has the ability to detect LV dysfunction earlier than ejection fraction. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Chinese cross-cultural adaptation and validation of the Foot Function Index as tool to measure patients with foot and ankle functional limitations.

    Science.gov (United States)

    González-Sánchez, Manuel; Ruiz-Muñoz, Maria; Li, Guang Zhi; Cuesta-Vargas, Antonio I

    2017-05-11

    To perform a cross-cultural adaptation and validation of the Foot Function Index (FFI) questionnaire to develop the Chinese version. Three hundred and six patients with foot and ankle neuromusculoskeletal diseases participated in this observational study. Construct validity, internal consistency and criterion validity were calculated for the FFI Chinese version after the translation and transcultural adaptation process. Internal consistency ranged from 0.996 to 0.998. Test-retest analysis ranged from 0.985 to 0.994; minimal detectable change 90: 2.270; standard error of measurement: 0.973. Load distribution of the three factors had an eigenvalue greater than 1. Chi-square value was 9738.14 (p Foot Function Index (Taiwan Version), Short-Form 12 (Version 2) and EuroQol-5D were used for criterion validity. Factors 1 and 2 showed significant correlation with 15/16 and 14/16 scales and subscales, respectively. Foot Function Index Chinese version psychometric characteristics were good to excellent. Chinese researchers and clinicians may use this tool for foot and ankle assessment and monitoring. Implications for rehabilitation A cross-cultural adaptation of the FFI has been done from original version to Chinese. Consistent results and satisfactory psychometric properties of the Foot Function Index Chinese version have been reported. For Chinese speaking researcher and clinician FFI-Ch could be used as a tool to assess patients with foot disease.

  8. Relationship of BODE Index to functional tests in chronic obstructive pulmonary disease

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    Eloisa Maria Gatti Regueiro

    2009-01-01

    Full Text Available OBJECTIVE: To determine if there is a correlation between the BODE Index and variables assessed during the Activities of Daily Living assessment, performance on lower limber tests, and peripheral muscle impairment of the upper limb in patients with chronic obstructive pulmonary disease. MATERIALS AND METHODS: Ten men (aged 58 to 80 years old with moderate to very severe obstruction were evaluated and classified by the BODE Index. They were evaluated by pulmonary ventilation (V•E, oxygen consumption (V•O2, and carbonic gas production (V•CO2 on the ADL assessment; Distance Walking (DW in the Six Minute Walking Test (6MWT and the Six Minute Walking Test on Treadmill (6MWTT; number of repetitions in the Sit-to-Stand Test; and the Hand Grip Strength Test. Correlations were evaluated between the classification and the tests performed (Pearson and Spearman test, p<0.05. RESULTS: The mean of the total score for the BODE Index was 2.80 (±1.03, with three patients scoring in the first quartile (Q1 and seven scoring in the second quartile (Q2. This Index showed a negative correlation with the 6MWTT (r=-0.86, the Sit-to-Stand Test (r=-0.66, and the Hand Grip Strength Test (r=-0.83. CONCLUSIONS: Our results show that there is no correlation between the BODE Index and the ventilatory and metabolic responses in the Activities of Daily Living assessment. On the other hand, a correlation was observed between the BODE Index and the variables assessed in the 6MWTT, Sit-to-Stand Test, and Hand Grip Strength Test in moderate to very severe Chronic Obstructive Pulmonary Disease patients. This suggests that these tests can be employed as predictors of physical exercise capacity, perhaps as complementary tests to the BODE Index.

  9. The risk of asthma in patients with ankylosing spondylitis: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Te-Chun Shen

    Full Text Available The relationship between asthma and ankylosing spondylitis (AS is controversial. We examined the risk of asthma among AS patients in a nationwide population.We conducted a retrospective cohort study using data from the National Health Insurance (NHI system of Taiwan. The cohort included 5,974 patients newly diagnosed with AS from 2000 to 2010. The date of diagnosis was defined as the index date. A 4-fold of general population without AS was randomly selected frequency matched by age, gender and the index year. The occurrence and hazard ratio (HR of asthma were estimated by the end of 2011.The overall incidence of asthma was 1.74 folds greater in the AS cohort than in the non-AS cohort (8.26 versus 4.74 per 1000 person-years with a multivariable Cox method measured adjusted HR of 1.54 (95% confidence interval (CI, 1.34-1.76. The adjusted HR of asthma associated with AS was higher in women (1.59; 95% CI, 1.33-1.90, those aged 50-64 years (1.66; 95% CI, 1.31-2.09, or those without comorbidities (1.82; 95% CI, 1.54-2.13.Patients with AS are at a higher risk of developing asthma than the general population, regardless of gender and age. The pathophysiology needs further investigation.

  10. Clinical-Functional Vulnerability Index-20 (IVCF-20): rapid recognition of frail older adults.

    Science.gov (United States)

    Moraes, Edgar Nunes de; Carmo, Juliana Alves do; Moraes, Flávia Lanna de; Azevedo, Raquel Souza; Machado, Carla Jorge; Montilla, Dalia Elena Romero

    2016-12-22

    To evaluate the adequacy of the Clinical-Functional Vulnerability Index-20, a rapid triage instrument to test vulnerability in Brazilian older adults, for the use in primary health care. The study included convenience sample of 397 patients aged older than or equal to 60 years attended at Centro de Referência para o Idoso (Reference Center for Older Adults) and of 52 older adults the same age attended at the community. The results of the questionnaire, consisting of 20 questions, were compared with those of the Comprehensive Geriatric Assessment, considered a reference for identifying frail older adults. Spearman's correlation was evaluated in the Clinical-Functional Vulnerability Index-20 with the Comprehensive Geriatric Assessment; the validity was verified by the area under the ROC curve; reliability was estimated by the percentage of agreement among evaluators and by the kappa coefficient, both with quadratic weighted. The cut-off point was obtained based on the higher accuracy criterion. Cronbach's alpha, a measure of internal consistency, was estimated. The Spearman's correlation coefficient was high and positive for both groups (0.792 for older adults attended at the Reference Center and 0.305 for older adults from the community [p idosos brasileiros, para utilização pela atenção básica. O estudo incluiu amostra de conveniência de 397 pacientes com idade maior ou igual a 60 anos atendidos em um Centro de Referência para o Idoso e de 52 idosos da mesma idade atendidos na comunidade. Os resultados do questionário, constituído por 20 perguntas, foram comparados com aqueles da Avaliação Geriátrica Ampla, considerada referência para identificação do idoso frágil. Foi avaliada a correlação de Spearman do Índice de Vulnerabilidade Clínico-Funcional-20 com a Avaliação Geriátrica Ampla; a validade foi verificada pela área sob a curva ROC; a confiabilidade foi estimada pelo percentual de concordância entre avaliadores e coeficiente kappa

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

    Science.gov (United States)

    Exarchou, Sofia; Lindström, Ulf; Askling, Johan; Eriksson, Jonas K; Forsblad-d'Elia, Helena; Neovius, Martin; Turesson, Carl; Kristensen, Lars Erik; Jacobsson, Lennart T H

    2015-05-09

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

  12. The NRAMP1 polymorphism as a risk factor for tuberculous spondylitis

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    Bambang Tiksnadi

    2013-03-01

    Full Text Available In the present study, we analysed the association between the incidence of tuberculous spondylitis with the Natural Resistance Associated Macrophage Protein 1 (NRAMP1, also known as Solute Carrier Family 11a member1 polymorphism by studying the genetic segregation of this polymorphism and the incidence of the disease among members of the West Javanese population undergoing surgery for tuberculous spondylitis at our institution. We compared the distribution of NRAMP1 polymorphism at two specific sites, namely D543N, and 3’UTR, among subjects with pulmonary tuberculosis and tuberculous spondylitis. We found no significant differences in distribution of polymorphism between the two groups, or between pulmonary tuberculosis and tuberculous spondylitis compared to healthy subjects. However, a pattern emerged in that polymorphisms at the two sites seemed to be protective against development of tuberculous spondylitis in our study population. We concluded that in the West Javanese population, there is no association between NRAMP1 polymorphism with the propensity for development of pulmonary tuberculosis or tuberculous spondylitis. In fact, NRAMP1 may provide protection against the development of tuberculous spondylitis.

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

    International Nuclear Information System (INIS)

    Abbassioun, K.; Amirjamshidi, A.; Taheri, B.

    2003-01-01

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

  14. Avoiding the 4-index transformation in one-body reduced density matrix functional calculations for separable functionals

    NARCIS (Netherlands)

    Giesbertz, K.J.H.

    2016-01-01

    One of the major computational bottlenecks in one-body reduced density matrix (1RDM) functional theory is the evaluation of approximate 1RDM functionals and their derivatives. The reason is that more advanced approximate functionals are almost exclusively defined in the natural orbital basis, so a

  15. The predictive value of the foot posture index on dynamic function

    DEFF Research Database (Denmark)

    Nielsen, Rasmus Gottschalk; Rathleff, Michael Skovdal; Kersting, U G

    2008-01-01

    Keenan et. al. identified the six-item version of the Foot Posture Index (FPI) as a valid, simple and clinically useful tool. The model combines measures of the standing foot posture in multiple planes and anatomical segments. It provides an alternative to existing static clinical measures when...

  16. The Predictive Value of the Foot Posture Index on Dynamic Function

    DEFF Research Database (Denmark)

    Mølgaard, Carsten Møller; Olesen Gammelgaard, Christian; Nielsen, R. G.

    Keenan et. al. identified the six-item version of the Foot Posture Index (FPI) as a valid, simple and clinically useful tool. The model combines measures of the standing foot posture in multiple planes and anatomical segments. It provides an alternative to existing static clinical measures when...

  17. The Predictive Value of the Foot Posture Index on Dynamic Function

    DEFF Research Database (Denmark)

    Mølgaard, Carsten Møller; Olesen Gammelgaard, Christian; Nielsen, R. G.

    2008-01-01

    Keenan et. al. identified the six-item version of the Foot Posture Index (FPI) as a valid, simple and clinically useful tool. The model combines measures of the standing foot posture in multiple planes and anatomical segments. It provides an alternative to existing static clinical measures when...

  18. Converting the H. W. Wilson Company Indexes to an Automated System: A Functional Analysis.

    Science.gov (United States)

    Regazzi, John J.

    1984-01-01

    Description of the computerized information system that supports the editorial and manufacturing processes involved in creation of Wilson's subject indexes and catalogs includes the major subsystems--online data entry, batch input processing, validation and release, file generation and database management, online and offline retrieval, publication…

  19. Progress of genome-wide association studies of ankylosing spondylitis

    Science.gov (United States)

    Li, Zhixiu; Brown, Matthew A

    2017-01-01

    Ankylosing spondylitis (AS) is an immune-mediated arthritis which primarily affects the spine and sacroiliac joints. Significant progress has been made in discovery of genetic associations with AS by genome-wide association studies (GWAS) over past decade. These findings have uncovered novel pathways involved pathogenesis of the disease and have led to introduction of novel therapeutic treatments for AS. In this Review, we discuss the genetic variations associated with AS identified by GWAS, the major pathways revealed by these AS-associated variations and critical cell types involved in AS development. PMID:29333268

  20. Progress of genome-wide association studies of ankylosing spondylitis.

    Science.gov (United States)

    Li, Zhixiu; Brown, Matthew A

    2017-12-01

    Ankylosing spondylitis (AS) is an immune-mediated arthritis which primarily affects the spine and sacroiliac joints. Significant progress has been made in discovery of genetic associations with AS by genome-wide association studies (GWAS) over past decade. These findings have uncovered novel pathways involved pathogenesis of the disease and have led to introduction of novel therapeutic treatments for AS. In this Review, we discuss the genetic variations associated with AS identified by GWAS, the major pathways revealed by these AS-associated variations and critical cell types involved in AS development.

  1. Left ventricular non-compaction in a patient with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Mehrnoush Toufan

    2016-12-01

    Full Text Available A 58 years old male with a long-standing history of HLA-B27 positive ankylosing spondylitis presented with increasing fatigue and dyspnea on exertion. He had left ventricular dysfunction and enlargement, flail right coronary leaflet of aortic valve with severe eccentric aortic insufficiency along with left ventricular non-compaction in echocardiography. The most common cardiac manifestations of ankylosing spondylitis are aortic insufficiency and conduction disturbances. Involvement of myocardium, in the form of dilated cardiomyopathy and restrictive cardiomyopathy, has also been reported. This case presents a very rare association of ankylosing spondylitis with non-compaction cardiomyopathy.

  2. Developmental trajectories of body mass index and emotional-behavioral functioning of underweight children: A longitudinal study

    OpenAIRE

    Cimino, Silvia; Cerniglia, Luca; Almenara, Carlos A.; Jezek, Stanislav; Erriu, Michela; Tambelli, Renata

    2016-01-01

    Although several studies have addressed developmental trajectories from childhood to adolescence of internalizing/externalizing problems, limited attention has been given to underweight children. Two groups were recruited for this study from a community sample: underweight (Ug, N?=?80, 50% female) and normal weight (NWg, N?=?80, 50% female) to examine the developmental trajectories of body mass index and emotional-behavioral functioning of underweight children from the age two years, and thei...

  3. Body mass index and its correlation with pulmonary function in patients with cystic fibrosis from Cartagena, Colombia

    Directory of Open Access Journals (Sweden)

    Gustavo Mora García

    2011-01-01

    Full Text Available Background. Sinus-pulmonary manifestations are a major concern in CF patients. Pulmonary function shows a strong relationship with nutritional status. In Colombia, malnutrition is a public health issue; however there are no reports that fully analyze nutritional status and lung function in CF children. Materials and Methods. A cross-sectional study was developed conducted with 32 patients registered in the CF Attention Program. Measurements were performed following the NIOSH Spirometry Training Guide. Body Mass Index (Z-Score was calculated according to Onis.et.al. Correlation was determined by a regression model. Results. 14 children were able to perform the test with criteria for the study, mean for age 12.4 ± 3.4 years. % Forced Expiratory Volume1 and % Forced Vital Capacity means were 66.7 ± 28.5 and 69.5 ± 2.0, respectively. Body Mass Index (Z-score mean was -1.17. BMIregression for % Forced Expiratory Volume1, r2=0.31(P<0.01; % Forced Vital Capacity, r2=0.22(P<.01. Conclusions. Results demonstrated a correlation between Body Mass Index and Lung Function. This correlation persists, even in populations with notorious nutritional deficit such as this group. Special nutritional therapies should be implemented for this group and similar populations.

  4. Experimental generation of two-index Bessel-Gauss beams by engineering their angular spectrum functions

    Science.gov (United States)

    Yao, Hainan; Wang, Fei; Cai, Yangjian

    2018-01-01

    Two-index Bessel beams (TIBBs) was introduced by Ornigotti and Aiello (2014) theoretically. In this paper, we propose a simple experimental scheme for generation of two-index Bessel-Gauss beams (TIBGBs), as an extension of the TIBBs. The scheme is based on manipulating the amplitude and phase in the Fourier plane with the use of a spatial light modulator and a spiral phase plate. Furthermore, we experimentally report the generation of the several examples of the TIBGBs based on the proposed optical system. The focusing properties of the TIBGB with indices p = 1 and l = 2 passing through a single lens are investigated both theoretically and experimentally. The experimental results agree well with theoretical predictions.

  5. Effect of annealing on various dielectric functions and refractive index of lead iodide single crystals

    Czech Academy of Sciences Publication Activity Database

    Hassan, M. A. S.; Matuchová, Marie

    2006-01-01

    Roč. 60, 2/3 (2006), s. 51-54 ISSN 1407-009X R&D Projects: GA ČR(CZ) GA102/03/0379; GA ČR(CZ) GA102/04/0959; GA AV ČR(CZ) KSK1010104 Institutional research plan: CEZ:AV0Z20670512 Keywords : dielectric losses * refractive index * characteristics measurement Subject RIV: JA - Electronics ; Optoelectronics, Electrical Engineering

  6. Usefulness of 99mTc-GSA scintigraphy for evaluation of hepatic function. Development of new index

    International Nuclear Information System (INIS)

    Miyamoto, Hirohito; Nagamachi, Shigeki; Jinnouchi, Seishi; Flores, L.G. II; Nakahara, Hiroshi; Ohnishi, Takashi; Futami, Shigemi; Tamura, Shozo; Watanabe, Katsushi

    1998-01-01

    99m Tc-GSA scintigraphy was performed to evaluate reserved hepatic function in 32 patients with hepatobiliary tumor. Each parameters; HH15, LHL15 and T 1/2 showed good correlation with ICG15 in patients without obstructive jaundice. Contrary, each indices did not significantly correlate with ICG15 in cases including obstructive jaundice. Each indices obtained from 99m Tc-GSA scintigraphy was useful parameters to reflect liver functional reserve which was not affected by hyperbilirubinemia. New index, T 1/2 was more useful than other indices for differentiating hepatic dysfunctional state from normal condition. (author)

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

    Directory of Open Access Journals (Sweden)

    Alessandro Marco De Nunzio

    2015-01-01

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

  8. Detection of Chlamydia pneumoniae in Ankylosing Spondylitis Patients

    Directory of Open Access Journals (Sweden)

    Dunya Fareed Salloom

    2018-03-01

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

  9. Transcriptome network analysis reveals potential candidate genes for ankylosing spondylitis.

    Science.gov (United States)

    Zhu, Z-Q; Tang, J-S; Cao, X-J

    2013-12-01

    Ankylosing spondylitis (AS) is a chronic, inflammatory arthritis and autoimmune disease. The main symptom of AS is inflammatory spinal pain; with time, some patients develop ankylosis and spinal immobility. We aim to find cure available for ankylosing spondylitis. We used the GSE11886 series to identify potential genes that related to AS to construct a regulation network. In the network, some of TFs and target genes have been proved related with AS in previous study, such as NFKB1, STAT1, STAT4, TNFSF10, IL2RA, and IL2RB. We also found some new TFs (Franscription Factors) and target genes response to AS, such as BXDC5, and EGFR. Further analysis indicated some significant pathways are associated with AS, including antigen processing and presentation and cytokine-cytokine receptor interaction, etc.; although not significant, there was evident that they play an important role in AS progression, such as apoptosis and systemic lupus erythematosus. Therefore, it is demonstrated that transcriptome network analysis is useful in identification of the candidate genes in AS.

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

    Directory of Open Access Journals (Sweden)

    T. V. Dubinina

    2016-01-01

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

  11. Effects of proprioceptive neuromuscular facilitation-based abdominal muscle strengthening training on pulmonary function, pain, and functional disability index in chronic low back pain patients.

    Science.gov (United States)

    Kim, Beom-Ryong; Lee, Hye-Jin

    2017-08-01

    The purpose of this study was to evaluate the effect of abdominal muscle strengthening training (AMST) using proprioceptive neuromuscular facilitation (PNF) on pulmonary function, pain, and functional disability index in chronic low back pain (CLBP) patients. Thirty CLBP patients were randomly assigned to the traditional physical therapy (control) group (n=15) and PNF-AMST group (n=15). Forced expiratory volume at 1 second (FEV 1 ) was measured to measure changes in pulmonary function. To measure the degree of pain, a visual analog scale (VAS) was used. The Oswestry Disability Index (ODI) was used to assess the disability level due to low back pain. A paired t -test was performed to compare differences within the groups before and after intervention. An independent t -test was performed to compare differences between the test and control groups. The level of significance was set at α=0.05. Within-group changes in FEV 1 were significantly different in the experimental group ( P disability index inpatients with CLBP. We expect it to be useful as one of the programs for CLBP patients in the future.

  12. A case of hypopharyngeal cancer with stenosis, perforation, and pyogenic spondylitis development after chemoradiotherapy

    Directory of Open Access Journals (Sweden)

    Mioko Matsuo

    2016-01-01

    Conclusion: Hypopharyngeal perforation can sometimes be fatal because it can lead to pyogenic spondylitis. Suitable surgical techniques and appropriate doses of antibacterial agents for long-term use were appropriate treatments for the patient in this case.

  13. Clinical Risk Factors for the Presence and Development of Vertebral Fractures in Patients With Ankylosing Spondylitis

    NARCIS (Netherlands)

    Maas, Fiona; Spoorenberg, Anneke; van der Slik, Boukje P. G.; van der Veer, Eveline; Brouwer, Elisabeth; Bootsma, Hendrika; Bos, Reinhard; Wink, Freke R.; Arends, Suzanne

    IntroductionTo investigate the prevalence and incidence of radiographic vertebral fractures and the association with patient characteristics, clinical assessments, and medication use in a large prospective cohort of patients with ankylosing spondylitis (AS) in daily clinical practice.

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

    DEFF Research Database (Denmark)

    Madsen, Ole Rintek; Lindhardsen, Jesper

    2011-01-01

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

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

    Science.gov (United States)

    Tyrrell, Jess Shelagh; Redshaw, Clare Helen

    2016-07-04

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

  16. Quantitative Proteomic Analysis of Peripheral Blood Mononuclear Cells in Ankylosing Spondylitis by iTRAQ

    Science.gov (United States)

    Cai, Anji; Qi, Suwen; Su, Zhuowa; Shen, Huaqing; Yang, Yu; He, Liang

    2015-01-01

    Abstract This study was designed to identify and quantify the different proteins expression levels in ankylosing spondylitis (AS) and to explore the pathogenesis of AS. We performed isobaric tags for relative and absolute quantitation (iTRAQ) coupled with multiple chromatographic fractionation and tandem mass spectrometry to detect the proteins profiling in peripheral blood mononuclear cells (PBMCs) from AS patients and healthy controls. Mascot software and the International Protein Index and the Gene Ontology (GO) database were used to conduct the bioinformatics analysis. The differentially expressed proteins were validated by enzyme‐linked immunosorbent assay (ELISA). A total of 1,232 proteins were identified by iTRAQ, of which 183 showed differential expression and 18 differentially expressed proteins were acute phase reactants. Upon mapping of the differentially expressed proteins to GO database, we found four differentially expressed proteins involved in the biological process of cell killing, including up‐regulated cathepsin G (CTSG), neutrophil defensin3 (DEFA3), protein tyrosine phosphatase receptor type C (PTPRC), and down‐regulated peroxiredoxin‐1(PRDX1),which were consistent with the verified results of ELISA. Our proteomic analyses suggested that the proteins involved in the biological process of cell killing might play an important role in the pathogenesis of AS. PMID:25788137

  17. Associations between inflammation, nocturnal back pain and fatigue in ankylosing spondylitis and improvements with etanercept therapy.

    Science.gov (United States)

    Hammoudeh, Mohammed; Zack, Debra J; Li, Wenzhi; Stewart, V Michelle; Koenig, Andrew S

    2013-08-01

    To investigate the relationships between inflammation, nocturnal back pain and fatigue in ankylosing spondylitis (AS) and the impact of 12 weeks' etanercept treatment versus sulfasalazine or placebo. Data were combined from four clinical trials for patients with AS who received at least one dose of etanercept, sulfasalazine or placebo and had at least one postbaseline assessment value. Linear regression was performed (controlling for site, protocol and demographics), to explore the relationship between inflammation (C-reactive protein [CRP]), nocturnal back pain (visual analog scale [VAS] 0-100 mm) and fatigue (VAS 0-100 mm Bath AS Disease Activity Index fatigue item). Out of 1283 patients (etanercept, n = 867; sulfasalazine, n = 187; placebo, n = 229), improvement in nocturnal back pain was a significant predictor of improvement in fatigue. Significant correlations were found between nocturnal back pain and fatigue, but not CRP levels. Etanercept provided significantly greater pain/fatigue improvement than sulfasalazine or placebo. Improvements in nocturnal back pain and fatigue had weak relationships with improvement in inflammation (CRP level). AS patients treated with etanercept demonstrated superior improvement in nocturnal back pain and fatigue versus sulfasalazine or placebo. Decrease in nocturnal back pain can improve fatigue. Assessing treatment response using CRP levels alone may be misleading without also examining patient-reported outcomes such as back pain and fatigue.

  18. Arterial stiffness is not increased in patients with short duration rheumatoid arthritis and ankylosing spondylitis.

    Science.gov (United States)

    Dzieża-Grudnik, Anna; Sulicka, Joanna; Strach, Magdalena; Siga, Olga; Klimek, Ewa; Korkosz, Mariusz; Grodzicki, Tomasz

    2017-04-01

    Patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have increased cardiovascular (CV) morbidity and mortality. Arterial stiffness is an independent predictor of CV events. The aim of the study was to assess arterial stiffness and inflammatory markers in patients with short duration chronic arthritis. We assessed carotid-femoral pulse wave velocity (PWV), augmentation index (AIx), traditional CV risk factors and inflammatory and endothelial markers in 71 chronic arthritis patients (RA and AS) and in 29 healthy controls. We did not find differences in PWV (for RA, AS and controls, respectively: 10 [8.8-10.9] versus 10.7 [9.1-11.8] versus 9.2 [8.3-11.4] m/s; p = .14) and AIx (for RA, AS and controls, respectively: 24.3 ± 11.5 versus 5.7 ± 12.4 versus 10 ± 12.8%; p = .22). Both groups of arthritis patients had active disease with significantly elevated inflammatory markers compared to controls. There were no correlations between endothelial and inflammatory markers and parameters of arterial stiffness in arthritis patients. When analyzing arthritis patients according to median of PVW, there were no significant differences in inflammatory and endothelial markers. We found that in patients with short duration active RA and AS arterial stiffness was not increased and furthermore, there was no association between markers of systemic inflammation and arterial stiffness.

  19. Deriving a Barthel Index from the Northwick Park Dependency Scale and the Functional Independence Measure: are they equivalent?

    Science.gov (United States)

    Turner-Stokes, Lynne; Williams, Heather; Rose, Hilary; Harris, Sarah; Jackson, Diana

    2010-12-01

    to examine the extent of agreement between Barthel Index scores derived from Northwick Park Dependency Scores (NPDS) and the Functional Independence Measure (FIM) ratings, in an inpatient setting. previously described conversion criteria were applied in a secondary analysis of a large existing dataset, gathered in a tertiary specialist inpatient neurorehabilitation unit. patients with neurological disabilities (N = 1347), mainly following acquired brain injury. comparison of Barthel scores derived from the NPDS (rated by nursing staff) and from parallel FIM scores (rated by the therapy team). very strong intraclass correlations were observed between the total scores (0.93, PBarthel Index ratings derived from NPDS and FIM scores. However, scores may be affected by differential performance with nursing and therapy staff, and should not automatically be regarded as equivalent.

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

    Directory of Open Access Journals (Sweden)

    А.V. Smirnov

    2015-08-01

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

  1. Ankylosing spondylitis and psoriatic arthritis: clinical and economic consequences of the use of etanercept

    OpenAIRE

    Viola Sacchi; Orietta Zaniolo; Ignazio Olivieri

    2010-01-01

    Spondyloarthritis (SpA) is the name for a family of inflammatory rheumatic disease that can affect the spine and joints, ligaments and tendons. Spondyloarthritis disease include ankylosing spondylitis, reactive arthritis, psoriatic arthritis, the spondylitis associated with the inflammatory bowel diseases and the undifferentiated spondyloarthritis. The most common treatments prescribed for spondyloarthritis are nonsteroidal anti-inflammatory drugs (NSAIDs) given in combination with disease-mo...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-11-01

    In cases where MRT fails to reveal abscess formation or typical vertebral changes to confirm the preliminary diagnosis, further examinations are necessary to exclude diseases other than spondylitis. More remote possibilities like insufficiency fracture, rheumatic disorders and neoplasm can mostly be ruled out on the basis of conventional X-ray pictures. Conventional tomography and computed tomography should also be carried out in addition to MRT in the rare case of unconfirmed activated arthrosis or disc removal syndrome. In order to distinguish between infective and non-infective/reactive changes, contrast-enhanced repeat MRT following antibiotic treatment may be very helpful. (orig.) [Deutsch] Wenn bei einer Spondylitis ein dafuer beweisender Abszess oder eine typische Destruktion des Wirbelkoerpers nicht vorliegt, ist auch nach Durchfuehrung einer MRT oft eine differentialdiagnostische Abgrenzung gegenueber anderen Ursachen erforderlich. Ferner stehende Differentialdiagnosen wie Insuffizienzfraktur, rheumatische Erkrankungen und eine Neoplasie koennen mit den Moeglichkeiten des konventionellen Roentgenbildes meist ausgeschlossen werden. An die konventionelle- und Computertomographie sollte - auch nach Durchfuehrung der MRT - noch in unklaren Einzelfaellen von aktivierter Arthrose oder Postdisketomie-Syndrom gedacht werden. Eine gute differentialdiagnostische Moeglichkeit zur Unterscheidung zwischen einem Infekt und einem nicht infektioesen/reaktivem Geschehen ist die Wiederholungs-MRT mit KM-Applikation nach durchgefuehrter antibiotischer Behandlung. (orig.)

  4. Prevalence of psychological disorders, sleep disturbance and stressful life events and their relationships with disease parameters in Chinese patients with ankylosing spondylitis.

    Science.gov (United States)

    Jiang, Yutong; Yang, Mingcan; Lv, Qing; Qi, Jun; Lin, Zhiming; Liao, Zetao; Zhang, Yanli; Wu, Husheng; Song, Hui; Zhan, Feng; Liu, Shengyun; Gao, Guanmin; Hu, Shaoxian; Li, Yinong; Shen, Lingxun; Huang, Anbing; Wei, Qiujing; Cao, Shuangyan; Gu, Jieruo

    2018-02-01

    Our aim was to investigate the prevalence of psychological disorders, sleep disturbance, and stressful life events in Chinese patients with ankylosing spondylitis (AS) and healthy controls, to assess the correlation between psychological and disease-related variables, and finally to detect powerful factors in predicting anxiety and depression. AS patients diagnosed with the modified New York criteria and healthy controls were enrolled from China. Participants completed a set of questionnaires, including demographic and disease parameters, Zung self-rating anxiety scale (SAS), Zung self-rating depression scale (SDS), the Pittsburgh Sleep Quality Index questionnaire (PSQI), and the Social Readjustment Rating Scale (SRRS). The relationship between psychological and other variables was explored. Stepwise multiple regression was used to determine the contributors to each disorder. Of all the 2772 AS patients, 79.1% were male. Mean age was 28.99 ± 8.87 years. Prevalence of anxiety, depression, and sleep disturbance was 31.6% (95% CI, 29.9, to 33.4), 59.3% (95% CI, 57.5, to 61.2), and 31.0% (95% CI, 29.3, to 36.7), respectively. 35.3% had stimulus of psychological and social elements (SPSE). Compared with healthy controls, AS patients had more severe psychological disorders, sleep disturbance, and stressful life events (P sleep disturbance were significant contributors of the SAS scores (P sleep duration were significant contributors of SDS (P sleep disturbance than healthy controls. Pain, functional limitation, sleep disturbance, and education were major contributors to psychological disorders.

  5. The H0 function, a new index for detecting structural/topological complexity information in undirected graphs

    Science.gov (United States)

    Buscema, Massimo; Asadi-Zeydabadi, Masoud; Lodwick, Weldon; Breda, Marco

    2016-04-01

    Significant applications such as the analysis of Alzheimer's disease differentiated from dementia, or in data mining of social media, or in extracting information of drug cartel structural composition, are often modeled as graphs. The structural or topological complexity or lack of it in a graph is quite often useful in understanding and more importantly, resolving the problem. We are proposing a new index we call the H0function to measure the structural/topological complexity of a graph. To do this, we introduce the concept of graph pruning and its associated algorithm that is used in the development of our measure. We illustrate the behavior of our measure, the H0 function, through different examples found in the appendix. These examples indicate that the H0 function contains information that is useful and important characteristics of a graph. Here, we restrict ourselves to undirected.

  6. Psychophysiological effects of aging : developing a functional age index for pilots. II., Taxonomy of psychological factors.

    Science.gov (United States)

    1978-04-01

    One of the major objectives of gerontological aviation psychology is to determine the psychological variables, functions, abilities, skills, and factors that underlie, constitute or are associated with pilot performance and proficiency. They must be ...

  7. Human leukocyte antigen-B27 alleles in Xinjiang Uygur patients with ankylosing spondylitis.

    Science.gov (United States)

    Zou, H-Y; Yu, W-Z; Wang, Z; He, J; Jiao, M

    2015-05-25

    We investigated the distribution of human leukocyte antigen (HLA)-B27 subtypes in Uygur ankylosing spondylitis patients in Xinjiang. B27-positive patients with ankylosing spondylitis were subtyped by using polymerase chain reaction-sequence-based typing. The HLA-B27 subtype frequencies of Uygur patients were compared with those in Han patients in Xinjiang and the other areas of China. B*2705 was the predominant subtype in Uygur patients with a frequency of 58.95%, which was much higher than that in Han patients in Xinjiang (31.58%, P ankylosing spondylitis patients; B*2704 was the main (61.18%) subtype in Han patients in Xinjiang, followed by B*2705 (31.58%) and was similar to the characteristics of Han patients in the other areas of China. B*2724 in Han ankylosing spondylitis patients has not been previously reported. Additionally, the B*2702/B*2705 homozygote was identified in Uygur patients. B*2702/B*2704, B*2704/B*2705, and B*2705/B*2705 homozygotes were identified in 3 Han patients. The distribution of HLAB27 subtypes in Uygur ankylosing spondylitis patients in Xinjiang significantly differed from that in Han patients. Understanding the distribution of HLAB27 subtypes in ethnic minority populations of Xinjiang is important for anthropological genetic studies and for analyzing the impact of genetic background on ankylosing spondylitis susceptibility.

  8. Description and evaluation of a net energy intake model as a function of dietary chewing index

    DEFF Research Database (Denmark)

    Jensen, L.M.; Markussen, B.; Nielsen, N.I.

    2016-01-01

    Previously, a linear relationship has been found between net energy intake (NEI) and dietary chewing index (CI) of the diet for different types of cattle. Therefore, we propose to generalize and calibrate this relationship into a new model for direct prediction of NEI by dairy cows from CI values...... (CINE; min/MJ of NE). Furthermore, we studied the forage-to-concentrate substitution rate in this new NEI model. To calibrate the model on a diverse set of situations, we built a database of mean intake from 14 production experiments with a total of 986 primi- and multiparous lactating dairy cows......, and disturbance, across and within experiments on independent data from 19 experiments including 812 primi- and multiparous lactating dairy cows of different breeds fed 80 different diets ad libitum. The NEI model predicted NEI with an MSPE of 8% of observed, and across the 19 experiments the error central...

  9. Study of the similarity function in Indexing-First-One hashing

    Science.gov (United States)

    Lai, Y.-L.; Jin, Z.; Goi, B.-M.; Chai, T.-Y.

    2017-06-01

    The recent proposed Indexing-First-One (IFO) hashing is a latest technique that is particularly adopted for eye iris template protection, i.e. IrisCode. However, IFO employs the measure of Jaccard Similarity (JS) initiated from Min-hashing has yet been adequately discussed. In this paper, we explore the nature of JS in binary domain and further propose a mathematical formulation to generalize the usage of JS, which is subsequently verified by using CASIA v3-Interval iris database. Our study reveals that JS applied in IFO hashing is a generalized version in measure two input objects with respect to Min-Hashing where the coefficient of JS is equal to one. With this understanding, IFO hashing can propagate the useful properties of Min-hashing, i.e. similarity preservation, thus favorable for similarity searching or recognition in binary space.

  10. Indirect comparison between subcutaneous biologic agents in ankylosing spondylitis.

    Science.gov (United States)

    Migliore, Alberto; Bizzi, Emanuele; Bernardi, Mauro; Picchianti Diamanti, Andrea; Laganà, Bruno; Petrella, Lea

    2015-01-01

    There are four efficacious subcutaneous anti-tumor necrosis factor alpha (TNF-alpha) agents used for the therapy of ankylosing spondilitis (AS), but apparently little or no differences in their effectiveness was proven. By this study, we aimed to compare Assessment in Ankylosing Spondylitis Response Criteria 20 response patterns (ASAS20) between subcutaneous approved biological agents in patients affected by ankylosing spondylitis by means of a mixed treatment comparison of different randomized controlled trials (RCTs) on the efficacy of biological therapies. A search in scientific literature was performed to identify the most complete collection of RCTs available on the selected topic. Similarly designed double-blind, randomized, placebo-controlled trials investigating the efficacy of the subcutaneous and approved TNF-alpha inhibitors such as etanercept, certolizumab pegol, golimumab and adalimumab in the treatment of ankylosing spondylitis patients were identified. The endpoint of interest was ASAS20 response criterium at 12 weeks. Results were analysed simultaneously using Bayesian mixed treatment comparison techniques. Results were expressed as odds ratio (OR) of positive ASAS20 response and associated 95 % credible intervals (CrIs). The probability of being the best treatment was also reported. Only five RCTs matched the inclusion criteria for consequent data extraction and analysis. Mixed treatment comparison of data from such RCTs demonstrated that all subcutaneous anti-TNF-alpha agents are more effective in inducing an ASAS20 response than placebo. Data from 24 weeks' follow-up were not taken into account as early escape granted in some of the studies made results at 24 weeks unmatchable. In our analysis, golimumab proved to be the drug that more probably represents the best choice for achieving ASAS20 response at 12 weeks, although no differences were observed when comparing directly every single subcutaneous anti-TNF-alpha agent against another. Even if

  11. Influence of recombinant human brain natriuretic peptide on myocardial enzymes, serum cardiac function indexes and oxygen metabolism of patients with open heart surgery with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Shu-Tian Song

    2016-09-01

    Full Text Available Objective: To investigate and analyze the influence of recombinant human brain natriuretic peptide on myocardial enzymes, serum cardiac function indexes and oxygen metabolism of patients with open heart surgery with cardiopulmonary bypass. Methods: A total of 42 patients with open heart surgery with cardiopulmonary bypass during the period of June 2014 to January 2016 were randomly divided into the control group of 21 cases and the observation group of 21 cases. The control group was treated with routine postoperative treatment, and the observation group was treated with recombinant human brain natriuretic peptide on the basic treatment of control group, then the myocardial enzymes, serum cardiac function indexes and oxygen metabolism indexes of the two groups before the surgery and at 2 h, 12 h and 24 h after the surgery were respectively detected and compared. Results: There were no significant difference in myocardial enzymes, serum cardiac function indexes and oxygen metabolism indexes between two groups before the surgery (all P>0.05, while the myocardial enzymes and serum cardiac function indexes of the observation group at 2 h ,12 h and 24 h after the surgery were all significantly lower than those of control group, the oxygen metabolism indexes were significantly better than the levels of control group (all P<0.05. Conclusions: The recombinant human brain natriuretic peptide can effectively improve the myocardial enzymes, serum cardiac function indexes and oxygen metabolism state of patients with open heart surgery with cardi

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

    Directory of Open Access Journals (Sweden)

    Paweł Kawalec

    2016-02-01

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

  13. Katz' ADL index assessed functional performance of Turkish, Moroccan, and Dutch elderly

    NARCIS (Netherlands)

    Reijneveld, Sijmen A.; Spijker, Jannie; Dijkshoorn, Henriette

    Background and Objective: We examined the reliability and validity of self-reported limitations encountered in the activities of daily living (ADL) as measure of functional performance, for Turkish, Moroccan, and indigenous Dutch elderly in the Netherlands. Methods: We obtained data on self-reported

  14. SPECTRAL INDEX AS A FUNCTION OF MASS ACCRETION RATE IN BLACK HOLE SOURCES: MONTE CARLO SIMULATIONS AND AN ANALYTICAL DESCRIPTION

    International Nuclear Information System (INIS)

    Laurent, Philippe; Titarchuk, Lev

    2011-01-01

    We present herein a theoretical study of correlations between spectral indexes of X-ray emergent spectra and mass accretion rate ( m-dot ) in black hole (BH) sources, which provide a definitive signature for BHs. It has been firmly established, using the Rossi X-ray Timing Explorer (RXTE) in numerous BH observations during hard-soft state spectral evolution, that the photon index of X-ray spectra increases when m-dot increases and, moreover, the index saturates at high values of m-dot . In this paper, we present theoretical arguments that the observationally established index saturation effect versus mass accretion rate is a signature of the bulk (converging) flow onto the BH. Also, we demonstrate that the index saturation value depends on the plasma temperature of converging flow. We self-consistently calculate the Compton cloud (CC) plasma temperature as a function of mass accretion rate using the energy balance between energy dissipation and Compton cooling. We explain the observable phenomenon, index- m-dot correlations using a Monte Carlo simulation of radiative processes in the innermost part (CC) of a BH source and we account for the Comptonization processes in the presence of thermal and bulk motions, as basic types of plasma motion. We show that, when m-dot increases, BH sources evolve to high and very soft states (HSS and VSS, respectively), in which the strong blackbody(BB)-like and steep power-law components are formed in the resulting X-ray spectrum. The simultaneous detections of these two components strongly depends on sensitivity of high-energy instruments, given that the relative contribution of the hard power-law tail in the resulting VSS spectrum can be very low, which is why, to date RXTE observations of the VSS X-ray spectrum have been characterized by the presence of the strong BB-like component only. We also predict specific patterns for high-energy e-fold (cutoff) energy (E fold ) evolution with m-dot for thermal and dynamical (bulk

  15. Mini-Nutritional-Assessment (MNA) without body mass index (BMI) predicts functional disability in elderly Taiwanese.

    Science.gov (United States)

    Lee, Li-Chin; Tsai, Alan Chung-hong

    2012-01-01

    Nutritional status and functional ability are mutually dependent especially in the elderly. This study examined the functional status-predictive ability of the MNA in a cross-sectional study. We analyzed the dataset of the "Survey of Health and Living Status of the Elderly in Taiwan" (SHLSET). Subjects were 2948≥65 year-old persons who were rated with the long-form (LF) and short-form (SF) MNA with or without BMI for the risk of malnutrition, and with the Activities of Daily Living (ADL) and the Instrument Activities of Daily Living (IADL) for functional status. The ADL and IADL scores were calculated according to rated nutritional status. Receiver Operating Characteristic (ROC) curves were generated for ADL and IADL status predicted by the MNA. Logistic regression was performed to evaluate the association of rated MNA scores with ADL or IADL status. Results showed that both SF and LF of MNA-T1 and T2 were able to predict ADL and IADL disabilities. Those who were rated malnourished or at risk of malnutrition had drastically higher risk of ADL or IADL dependency compared to those who were rated normal. The SF versions performed well in rating nutritional status and predicting ADL and IADL status. Overall, MNA-T2-SF performed at least equally well as MNA-T1-SF in rating functional decline. These results suggest the MNA is able to predict functional decline of the elderly. MNA-T2, especially the SF, a version without BMI should be particularly useful in clinical, long-term care and community settings. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  16. Multicenter analysis of body mass index, lung function, and sputum microbiology in primary ciliary dyskinesia

    DEFF Research Database (Denmark)

    Maglione, Marco; Bush, Andrew; Nielsen, Kim G

    2014-01-01

    BACKGROUND: No studies longitudinally, simultaneously assessed body mass index (BMI) and spirometry in primary ciliary dyskinesia (PCD). METHODS: We determined BMI and spirometry in 158 PCD children and adolescents from London, UK (n = 75), Naples, Italy (n = 23) and Copenhagen, Denmark (n = 60......) at first presentation and during follow-up. Annual BMI and spirometry were prospectively collected and analyzed over blocks of 2, 4, and 6 consecutive years. Sputum pathogens were recorded. RESULTS: Age at first spirometry was 8.7 years (range, 4.2-17.4). Mean Z scores of first measured BMI, FEV1, FVC......, and FEF(25-75) were 0.01, -1.37, -0.84, and -1.68, respectively. First spirometry was not more frequently impaired in patients referred at age ≥6 years than in those referred at preschool age (P = 0.13). There were no differences in slopes for BMI, FEV1, FVC, or FEF(25-75) over any time block. H...

  17. Oral Anaerobic Bacteria in the Etiology of Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Mesut Öğrendik

    2017-06-01

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

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

    Science.gov (United States)

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

    2007-01-01

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

  19. Urolithiasis as an extraarticular manifestation of ankylosing spondylitis.

    Science.gov (United States)

    Korkmaz, Cengiz; Cansu, Döndü Üsküdar; Sayer, John A

    2017-12-01

    Ankylosing spondylitis (AS) affects sacroiliac and axial joints as well as extraarticular organs, such as the eye, lung, bowel, and heart. Although examples of renal involvement in AS, such as IgA nephropathy, amyloidosis, and glomerulonephritis, have been reported, it has not been emphasized that urolithiasis is frequently formed in the clinical course of AS. Growing evidence indicates that urolithiasis may be observed in AS patients and is more frequent than other extraarticular features. In this review, we will discuss frequency and predictors of AS-related urolithiasis and summarize the possible underlying genetic and biochemical mechanisms. We believe an increased awareness of urolithiasis as a complication of AS will encourage future studies that will shed light on disease mechanisms and preventative therapies.

  20. Ankylosing spondylitis and central core disease: case report

    Directory of Open Access Journals (Sweden)

    Scola Rosana Herminia

    2003-01-01

    Full Text Available Ankylosing spondylitis (AS is an inflammatory disorder of unknown cause that primarily affects the axial skeleton. Neurological manifestations of AS are usually related to spinal deformities. Previous studies of the paraspinal muscles of AS patients showed muscle fiber atrophy, and core fibers. On the other hand, central core disease (CCD is a genetic condition that primarily involves the skeletal muscles, but can present articular deformities secondary to muscular weakness. We report the case of a 45-year-old man with clinical and radiological diagnosis of AS and proximal muscular weakness in the lower limbs. Needle electromyography showed myopathic features and nerve conduction study was normal. Muscle biopsy disclosed almost complete predominance of type-1 fibers, and fibers with central cores. This is the first report of AS and CCD. Whether central core myopathy is coincidental or a new association with AS is discussed.

  1. Ankylosing spondylitis: A state of the art factual backbone

    Science.gov (United States)

    Ghasemi-rad, Mohammad; Attaya, Hosam; Lesha, Emal; Vegh, Andrea; Maleki-Miandoab, Tooraj; Nosair, Emad; Sepehrvand, Nariman; Davarian, Ali; Rajebi, Hamid; Pakniat, Abdolghader; Fazeli, Seyed Amirhossein; Mohammadi, Afshin

    2015-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease that affects 1% of the general population. As one of the most severe types of spondyloarthropathy, AS affects the spinal vertebrae and sacroiliac joints, causing debilitating pain and loss of mobility. The goal of this review is to provide an overview of AS, from the pathophysiological changes that occur as the disease progresses, to genetic factors that are involved with its onset. Considering the high prevalence in the population, and the debilitating life changes that occur as a result of the disease, a strong emphasis is placed on the diagnostic imaging methods that are used to detect this condition, as well as several treatment methods that could improve the health of individuals diagnosed with AS. PMID:26435775

  2. Relapsing Polychondritis in a Patient with Ankylosing Spondylitis Using Etanercept

    Directory of Open Access Journals (Sweden)

    Valderilio Feijó Azevedo

    2014-01-01

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

  3. EXACERBATION OF ANKYLOSING SPONDYLITIS AFTER LOW-DOSE METHOTREXATE THERAPY

    Directory of Open Access Journals (Sweden)

    A. V. Orlov-Morozov

    2014-01-01

    Full Text Available Background: Efficacy of methotrexate in ankylosing spondylitis (AS is disputable. Nevertheless, methotrexate is still used for disease-modifying therapy of AS. Aim: To assess efficacy and safety of methotrexate in AS patients. Materials and methods: It was an open comparative study of efficacy of methotrexate (n=12 versus standard therapy (n=12 in AS patients. Results: Negative results of methotrexate therapy were obtained. In the majority of patients methotrexate therapy was associated with increased joint pain, swelling and morning stiffness as well as elevation of erythrocyte sedimentation rate, fever and visceritis. Worsening of symptoms was regarded as exacerbation of inflammatory process. The study was terminated prematurely. Conclusion: Methotrexate demonstrated no therapeutic effect in AS patients. In AS, methotrexate should be administrated under close physician control in order to ensure treatment safety

  4. Late effects of x-ray treatment of ankylosing spondylitis

    International Nuclear Information System (INIS)

    Smith, P.G.

    1984-01-01

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

  5. Photo-induced refractive index and topographical surface gratings in functionalized nanocarbon solid film

    Energy Technology Data Exchange (ETDEWEB)

    McGee, David J.; Ferrie, John; Plachy, Aljoscha [Department of Physics, The College of New Jersey, Ewing, New Jersey 08628 (United States); Joo, Yongho; Choi, Jonathan; Kanimozhi, Catherine; Gopalan, Padma, E-mail: pgopalan@cae.wisc.edu [Department of Materials Science and Engineering, University of Wisconsin-Madison, Madison, Wisconsin 53706 (United States)

    2015-11-02

    We demonstrate that a single-walled carbon nanotube network noncovalently coupled with a pyrene-modified azo-benzene chromophore functions as a host matrix for a broad range of photo-orientation and photomechanical effects. The chromophore could be efficiently reoriented through repeated trans-cis-trans isomerization under linearly polarized 480 nm light, with Δn of 0.012 at 650 nm and fast characteristic rise-times of 0.12 s. Erasable phase diffraction gratings could also be written, with permanent surface relief gratings forming at sufficiently long irradiation times. In addition to demonstrating a mechanism for photo-manipulation of single-walled carbon nanotubes, these results show photo-orientation of chromophores in azo-functionalized single-walled carbon nanotube networks as a path towards the photosensitive tuning of the electrostatic environment of the nanotube.

  6. Photo-induced refractive index and topographical surface gratings in functionalized nanocarbon solid film

    International Nuclear Information System (INIS)

    McGee, David J.; Ferrie, John; Plachy, Aljoscha; Joo, Yongho; Choi, Jonathan; Kanimozhi, Catherine; Gopalan, Padma

    2015-01-01

    We demonstrate that a single-walled carbon nanotube network noncovalently coupled with a pyrene-modified azo-benzene chromophore functions as a host matrix for a broad range of photo-orientation and photomechanical effects. The chromophore could be efficiently reoriented through repeated trans-cis-trans isomerization under linearly polarized 480 nm light, with Δn of 0.012 at 650 nm and fast characteristic rise-times of 0.12 s. Erasable phase diffraction gratings could also be written, with permanent surface relief gratings forming at sufficiently long irradiation times. In addition to demonstrating a mechanism for photo-manipulation of single-walled carbon nanotubes, these results show photo-orientation of chromophores in azo-functionalized single-walled carbon nanotube networks as a path towards the photosensitive tuning of the electrostatic environment of the nanotube

  7. Photo-induced refractive index and topographical surface gratings in functionalized nanocarbon solid film

    Science.gov (United States)

    McGee, David J.; Ferrie, John; Plachy, Aljoscha; Joo, Yongho; Choi, Jonathan; Kanimozhi, Catherine; Gopalan, Padma

    2015-11-01

    We demonstrate that a single-walled carbon nanotube network noncovalently coupled with a pyrene-modified azo-benzene chromophore functions as a host matrix for a broad range of photo-orientation and photomechanical effects. The chromophore could be efficiently reoriented through repeated trans-cis-trans isomerization under linearly polarized 480 nm light, with Δn of 0.012 at 650 nm and fast characteristic rise-times of 0.12 s. Erasable phase diffraction gratings could also be written, with permanent surface relief gratings forming at sufficiently long irradiation times. In addition to demonstrating a mechanism for photo-manipulation of single-walled carbon nanotubes, these results show photo-orientation of chromophores in azo-functionalized single-walled carbon nanotube networks as a path towards the photosensitive tuning of the electrostatic environment of the nanotube.

  8. CORRELATION OF LOW BACK PAIN WITH BODY MASS INDEX, FUNCTIONAL REACH TEST AMONG FEMALE NURSING PROFESSIONALS

    OpenAIRE

    Shameela .T .V; Veena Pais; Shaikhji Saad; Nusaibath M

    2015-01-01

    Background: Among health care workers the highest level of work related back injuries are more affected in nurses. There were many studies done to assess low back pain by using different tools. So this study aimed to identify the prevalence low back pain disability among female nursing professionals and the association between BMI, functional reach test and low back pain, so that a better tool can be used during the clinical examination for the betterment of the patient. The objective of the ...

  9. Mining Time-Resolved Functional Brain Graphs to an EEG-Based Chronnectomic Brain Aged Index (CBAI

    Directory of Open Access Journals (Sweden)

    Stavros I. Dimitriadis

    2017-09-01

    Full Text Available The brain at rest consists of spatially and temporal distributed but functionally connected regions that called intrinsic connectivity networks (ICNs. Resting state electroencephalography (rs-EEG is a way to characterize brain networks without confounds associated with task EEG such as task difficulty and performance. A novel framework of how to study dynamic functional connectivity under the notion of functional connectivity microstates (FCμstates and symbolic dynamics is further discussed. Furthermore, we introduced a way to construct a single integrated dynamic functional connectivity graph (IDFCG that preserves both the strength of the connections between every pair of sensors but also the type of dominant intrinsic coupling modes (DICM. The whole methodology is demonstrated in a significant and unexplored task for EEG which is the definition of an objective Chronnectomic Brain Aged index (CBAI extracted from resting-state data (N = 94 subjects with both eyes-open and eyes-closed conditions. Novel features have been defined based on symbolic dynamics and the notion of DICM and FCμstates. The transition rate of FCμstates, the symbolic dynamics based on the evolution of FCμstates (the Markovian Entropy, the complexity index, the probability distribution of DICM, the novel Flexibility Index that captures the dynamic reconfiguration of DICM per pair of EEG sensors and the relative signal power constitute a valuable pool of features that can build the proposed CBAI. Here we applied a feature selection technique and Extreme Learning Machine (ELM classifier to discriminate young adults from middle-aged and a Support Vector Regressor to build a linear model of the actual age based on EEG-based spatio-temporal features. The most significant type of features for both prediction of age and discrimination of young vs. adults age groups was the dynamic reconfiguration of dominant coupling modes derived from a subset of EEG sensor pairs. Specifically

  10. Mining Time-Resolved Functional Brain Graphs to an EEG-Based Chronnectomic Brain Aged Index (CBAI).

    Science.gov (United States)

    Dimitriadis, Stavros I; Salis, Christos I

    2017-01-01

    The brain at rest consists of spatially and temporal distributed but functionally connected regions that called intrinsic connectivity networks (ICNs). Resting state electroencephalography (rs-EEG) is a way to characterize brain networks without confounds associated with task EEG such as task difficulty and performance. A novel framework of how to study dynamic functional connectivity under the notion of functional connectivity microstates (FCμstates) and symbolic dynamics is further discussed. Furthermore, we introduced a way to construct a single integrated dynamic functional connectivity graph (IDFCG) that preserves both the strength of the connections between every pair of sensors but also the type of dominant intrinsic coupling modes (DICM). The whole methodology is demonstrated in a significant and unexplored task for EEG which is the definition of an objective Chronnectomic Brain Aged index (CBAI) extracted from resting-state data ( N = 94 subjects) with both eyes-open and eyes-closed conditions. Novel features have been defined based on symbolic dynamics and the notion of DICM and FCμstates. The transition rate of FCμstates, the symbolic dynamics based on the evolution of FCμstates (the Markovian Entropy, the complexity index), the probability distribution of DICM, the novel Flexibility Index that captures the dynamic reconfiguration of DICM per pair of EEG sensors and the relative signal power constitute a valuable pool of features that can build the proposed CBAI. Here we applied a feature selection technique and Extreme Learning Machine (ELM) classifier to discriminate young adults from middle-aged and a Support Vector Regressor to build a linear model of the actual age based on EEG-based spatio-temporal features. The most significant type of features for both prediction of age and discrimination of young vs. adults age groups was the dynamic reconfiguration of dominant coupling modes derived from a subset of EEG sensor pairs. Specifically, our

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

    Science.gov (United States)

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

    1988-01-01

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

  12. Biologic Treatment Registry Across Canada (BioTRAC): a multicentre, prospective, observational study of patients treated with infliximab for ankylosing spondylitis

    Science.gov (United States)

    Rahman, Proton; Choquette, Denis; Bensen, William G; Khraishi, Majed; Chow, Andrew; Zummer, Michel; Shaikh, Saeed; Sheriff, Maqbool; Dixit, Sanjay; Sholter, Dalton; Psaradellis, Eliofotisti; Sampalis, John S; Letourneau, Vincent; Lehman, Allen J; Nantel, François; Rampakakis, Emmanouil; Otawa, Susan; Shawi, May

    2016-01-01

    Objectives To describe the profile of patients with ankylosing spondylitis (AS) treated with infliximab in Canadian routine care and to assess the effectiveness and safety of infliximab in real world. Setting 46 primary care rheumatology practices across Canada. Participants 303 biological-naïve patients with AS or patients previously treated with a biological for <6 months and who were eligible for infliximab treatment as per routine care within the Biologic Treatment Registry Across Canada (BioTRAC). Intervention Not applicable (non-interventional study). Primary and secondary outcomes Effectiveness was assessed with changes in disease parameters (AS Disease Activity Score (ASDAS), Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Health Assessment Questionnaire Disease Index (HAQ-DI), physician global assessment of disease activity (MDGA), patient global disease activity (PtGA), back pain, C-reactive protein, erythrocyte sedimentation rate (ESR), morning stiffness). Safety was assessed with the incidence of adverse events (AEs). Results Of the 303 patients included, 44.6% were enrolled in 2005–2007 and 55.4% in 2008–2013. Patients enrolled in 2005–2007 had significantly higher MDGA and ESR at baseline while all other disease parameters examined were numerically higher with the exception of PtGA. Treatment with infliximab significantly (p<0.001) improved all disease parameters over time in both groups. At 6 months, 56% and 31% of patients achieved clinically important (change≥1.1) and major (change≥2.0) improvement in ASDAS, respectively; at 48 months, these proportions increased to 75% and 50%, respectively. Among patients unemployed due to disability at baseline, 12.1% returned to work (mean Kaplan-Meier (KM)-based time=38.8 months). The estimated retention rate at 12 and 24 months was 78.3% and 60.1%, respectively. The profile and incidence of AEs were comparable to data previously reported for tumour necrosis

  13. Application of a functional mathematical index (FMI) for predicting effects of the composition of jujube fruit on nutritional quality and health

    Science.gov (United States)

    In the present study, we extend the concept of a Functional Mathematical Index (FMI) for the assessment and prediction of food quality and safety of jujube fruit, a medicinal food widely consumed in Asian countries. In this study the index has been applied to one field-grown jujube fruit harvested a...

  14. Treatment persistence in patients with rheumatoid arthritis and ankylosing spondylitis.

    Science.gov (United States)

    Machado, Marina Amaral de Ávila; Moura, Cristiano Soares de; Ferré, Felipe; Bernatsky, Sasha; Rahme, Elham; Acurcio, Francisco de Assis

    2016-08-22

    To evaluate treatment persistence in patients with rheumatoid arthritis and ankylosing spondylitis who started therapies with disease-modifying antirheumatic drugs (DMARD) and tumor necrosis factor blockers (anti-TNF drugs). This retrospective cohort study from July 2008 to September 2013 evaluated therapy persistence, which is defined as the period between the start of treatment until it is discontinued, allowing for an interval of up to 30 days between the prescription end and the start of the next prescription. Odds ratio (OR) with 95% confidence intervals (95%CI) were calculated by logistic regression models to estimate the patients' chances of persisting in their therapies after the first and after the two first years of follow-up. The study included 11,642 patients with rheumatoid arthritis - 2,241 of these started on anti-TNF drugs (+/-DMARD) and 9,401 patients started on DMARD - and 1,251 patients with ankylosing spondylitis - 976 of them were started on anti-TNF drugs (+/-DMARD) and 275 were started on DMARD. In the first year of follow-up, 63.5% of the patients persisted in their therapies with anti-TNF drugs (+/-DMARD) and 54.1% remained using DMARD in the group with rheumatoid arthritis. In regards to ankylosing spondylitis, 79.0% of the subjects in anti-TNF (+/-DMARD) group and 41.1% of the subjects in the DMARD group persisted with their treatments. The OR (95%CI) for therapy persistence was 1.50 (1.34-1.67) for the anti-TNF (+/-DMARD) group as compared with the DMARD group in the first year for the patients with rheumatoid arthritis, and 2.33 (1.74-3.11) for the patients with ankylosing spondylitis. A similar trend was observed at the end of the second year. A general trend of higher rates of therapy persistence with anti-TNF drugs (+/-DMARD) was observed as compared to DMARD in the study period. We observed higher persistence rates for anti-TNF drugs (+/-DMARD) in patients with ankylosing spondylitis as compared to rheumatoid arthritis; and a higher

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

    Science.gov (United States)

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

    2017-07-01

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

  16. Etanercept Increases Bone Mineral Density in Ankylosing Spondylitis, but Does Not Prevent Vertebral Fractures: Results of a Prospective Observational Cohort Study.

    Science.gov (United States)

    van der Weijden, Maria A C; van Denderen, J Christiaan; Lems, Willem F; Nurmohamed, Michael T; Dijkmans, Ben A C; van der Horst-Bruinsma, Irene E

    2016-04-01

    Ankylosing spondylitis (AS) is characterized by chronic inflammation leading to ankylosis, but also to low bone mineral density (BMD) and vertebral fractures (VFx). Treatment with tumor necrosis factor-α blockers decreases inflammation and has shown to be effective in increasing BMD. We studied the effects of etanercept (ETN) on BMD and VFx in patients with AS after 2 years of treatment. Further, we studied changes in bone turnover markers and radiological damage. Patients with active AS, treated with ETN for 2 years, were included. BMD lumbar spine and hip were measured at baseline and after 2 years, as well as radiological damage (modified Stoke Ankylosing Spondylitis Spinal Score with the addition of the thoracic spine), VFx (Genant method), and change in bone turnover markers. Forty-nine patients with AS were included. After 2 years of ETN, hip BMD increased by 2.2% (p = 0.014) and lumbar spine BMD by 7.0% (p Ankylosing Spondylitis Disease Activity Index decreased significantly (p < 0.001), as well as C-reactive protein and erythrocyte sedimentation rate (p < 0.001). Despite ETN therapy, the number of patients with VFx more than doubled (from 6 to 15 patients, p = 0.003). Also, the radiological damage increased significantly over time (from 12.1 to 18.5, p < 0.001); however, no significant change in bone turnover markers was found. This prospective longitudinal observational cohort study showed that after 2 years of ETN, BMD of the hip and spine increased significantly, but the number of patients with VFx and the severity of VFx increased as well. Besides that, radiological progression, including the thoracic spine, increased significantly. Thus, the favorable bone-preserving effect is accompanied by unfavorable outcomes on VFx and radiological damage.

  17. Resting-state functional connectivity indexes reading competence in children and adults.

    Science.gov (United States)

    Koyama, Maki S; Di Martino, Adriana; Zuo, Xi-Nian; Kelly, Clare; Mennes, Maarten; Jutagir, Devika R; Castellanos, F Xavier; Milham, Michael P

    2011-06-08

    Task-based neuroimaging studies face the challenge of developing tasks capable of equivalently probing reading networks across different age groups. Resting-state fMRI, which requires no specific task, circumvents these difficulties. Here, in 25 children (8-14 years) and 25 adults (21-46 years), we examined the extent to which individual differences in reading competence can be related to resting-state functional connectivity (RSFC) of regions implicated in reading. In both age groups, reading standard scores correlated positively with RSFC between the left precentral gyrus and other motor regions, and between Broca's and Wernicke's areas. This suggests that, regardless of age group, stronger coupling among motor regions, as well as between language/speech regions, subserves better reading, presumably reflecting automatized articulation. We also observed divergent RSFC-behavior relationships in children and adults, particularly those anchored in the left fusiform gyrus (FFG) (the visual word form area). In adults, but not children, better reading performance was associated with stronger positive correlations between FFG and phonology-related regions (Broca's area and the left inferior parietal lobule), and with stronger negative relationships between FFG and regions of the "task-negative" default network. These results suggest that both positive RSFC (functional coupling) between reading regions and negative RSFC (functional segregation) between a reading region and default network regions are important for automatized reading, characteristic of adult readers. Together, our task-independent RSFC findings highlight the importance of appreciating developmental changes in the neural correlates of reading competence, and suggest that RSFC may serve to facilitate the identification of reading disorders in different age groups.

  18. Serum nitrate levels as an index of endothelial function in pre-eclamsia and normal pregnancy.

    Science.gov (United States)

    Gupta, Rani; Maruthy, K N; Mhaskar, Arun M; Padmanabhan, Laxmi Devi

    2003-04-01

    The study was conducted in St. John's Medical College Hospital and Department of Physiology, with the aim of studying the serum nitrate levels in pre-eclampsia and normal pregnancy. The total number of subjects studied in various groups were 159, control (n = 55), first trimester (n = 13), second trimester normal (n = 42), second trimester pre-eclampsia/PET (n = 5), third trimester normal (n = 32), third trimester pre-eclampsia/PET (n = 12). The serum nitrate was measured by one step enzymatic assay using Nitrate reductase from Aspergillus species. The nitrate levels in the third trimester pre-eclamptic group was found to be significant lower (P = 0.02), as compared to normal subjects, however the renal functions were normal in all the subjects.

  19. Early anti-inflammatory intervention ameliorates axial disease in the proteoglycan-induced spondylitis mouse model of ankylosing spondylitis.

    Science.gov (United States)

    Tseng, Hsu-Wen; Glant, Tibor T; Brown, Matthew A; Kenna, Tony J; Thomas, Gethin P; Pettit, Allison R

    2017-05-30

    Ankylosing spondylitis (AS) is characterised by immune-mediated arthritis and osteoproliferation, ultimately leading to joint ankylosis. Whether inflammation is necessary for osteoproliferation is controversial, fuelled by the unclear efficacy of anti-inflammatory treatments on radiographic progression. In proteoglycan-induced spondylitis (PGISp), a mouse model of AS, inflammation is the prerequisite for osteoproliferation as osteoproliferation was only observed following inflammation-driven intervertebral disc (IVD) destruction. We hypothesised that early intervention with a potent anti-inflammatory therapy would protect IVD integrity and consequently alter disease progression. PGISp mice received vehicle or a combination of etanercept (ETN) plus prednisolone (PRD) therapy for 2 or 6 weeks initiated at an early disease stage. Peripheral arthritis was scored longitudinally. Spinal disease was assessed using a semi-quantitative histological scoring regimen including inflammation, joint destruction and excessive tissue formation. ETN + PRD therapy significantly delayed the onset of peripheral arthritis. IVD integrity was significantly protected when treatment was commenced in early disease. Six-weeks of treatment resulted in trends towards reductions in intervertebral joint damage and excessive tissue formation. IVD score distribution was dichotomized, likely reflecting the extent of axial disease at initiation of therapy. In the sub-group of mice with high IVD destruction scores, ETN + PRD treatment significantly reduced IVD destruction severity, inflammation and bone erosion and reduced cartilage damage and excessive tissue formation. Early intervention with anti-inflammatory treatment not only improved inflammatory symptoms but also ameliorated structural damage of spine in PGISp mice. This preclinical observation suggests that early anti-inflammatory intervention may slow radiographic progression in AS patients.

  20. CORRELATION OF LOW BACK PAIN WITH BODY MASS INDEX, FUNCTIONAL REACH TEST AMONG FEMALE NURSING PROFESSIONALS

    Directory of Open Access Journals (Sweden)

    Shameela .T .V

    2015-12-01

    Full Text Available Background: Among health care workers the highest level of work related back injuries are more affected in nurses. There were many studies done to assess low back pain by using different tools. So this study aimed to identify the prevalence low back pain disability among female nursing professionals and the association between BMI, functional reach test and low back pain, so that a better tool can be used during the clinical examination for the betterment of the patient. The objective of the study is to identify the prevalence of low back pain disability, the association of Low Back Pain(LBP with BMI and functional reach test among female nursing professionals. Methods: A total of 256 subjects were assessed for disability due to back pain using OswestryLBP Disability Questionnaire and the prevalence of disability was determined. The sit and reach test, forward reach test and their BMI were calculated for those who had a disability score of 20 and above (n=87. Results: Data was analyzed using Pearson’s correlation.The study result showed a significant correlation (p=0.03 of sit and reach test with low back pain disability scores. There was a negative correlationseen among BMI and LBP disability score forward reach test and LBP disability score, and BMI and no low back pain disability score. Conclusion: The prevalence of LBP disability among nursing professionals was 33.9%. This study suggest that sit and reach test can be used as an indicator of low back pain. Whereas BMI and forward reach test do not indicate low back pain.

  1. Development and validation of a simple tape-based measurement tool for recording cervical rotation in patients with ankylosing spondylitis: comparison with a goniometer-based approach.

    Science.gov (United States)

    Maksymowych, Walter P; Mallon, Catherine; Richardson, Rhonda; Conner-Spady, Barbara; Jauregui, Edwin; Chung, Cecilia; Zappala, Lisa; Pile, Kevin; Russell, Anthony S

    2006-11-01

    To compare a tape-based tool for measuring cervical mobility in patients with ankylosing spondylitis (AS) with the widely practiced goniometer-based approach. We developed a novel tape-based approach to measurement of lateral cervical rotation of the neck that is minimally affected by flexion/extension movements of the neck. This requires measurement of the difference between a mark at the suprasternal notch and the tragus of the ear. Rotation score is measured in centimeters and constitutes the difference in length between the 2 extremes of cervical rotation (http://www.arthritisdoctors.org/researcher.html). We assessed the tape-based and goniometer-based methods in a total of 263 patients from 3 countries, Canada (n = 205), Australia (n = 29), and Colombia (n = 29), that included patients from community and tertiary-based practice. Intra- and interobserver reliability was assessed in a subset of 44 patients by ANOVA and a 2-way mixed effects model. The Bath AS Disease Activity (BASDAI) and Function (BASFI) Indices, and the modified Stoke AS Spinal Score (mSASSS), were also recorded to assess construct validity by correlation coefficient and regression analysis. Responsiveness was assessed in a subset of 33 patients that were either randomized to anti-tumor necrosis factor-a therapy:placebo (n = 22) or received open label infliximab (n = 4) or pamidronate (n = 7) over a period of 24 weeks. Scores obtained with the tape-based method were normally distributed, while those obtained using the goniometer were skewed towards normal values. Reliability for the goniometer-based approach was excellent [intraclass correlation coefficient (ICC) > 0.90] and very good for the tape-based approach (ICC > 0.80). Significant correlations were noted between age, disease duration, function and structural damage scores, and scores obtained with both methods. Responsiveness was high using raw scores obtained with the goniometer (standardized response mean > 0.80) but was not evident

  2. Global meta-analysis of leaf area index in wetlands indicates uncertainties in understanding of their ecosystem function

    Science.gov (United States)

    Dronova, I.; Taddeo, S.; Foster, K.

    2017-12-01

    Projecting ecosystem responses to global change relies on the accurate understanding of properties governing their functions in different environments. An important variable in models of ecosystem function is canopy leaf area index (LAI; leaf area per unit ground area) declared as one of the Essential Climate Variables in the Global Climate Observing System and extensively measured in terrestrial landscapes. However, wetlands have been largely under-represented in these efforts, which globally limits understanding of their contribution to carbon sequestration, climate regulation and resilience to natural and anthropogenic disturbances. This study provides a global synthesis of >350 wetland-specific LAI observations from 182 studies and compares LAI among wetland ecosystem and vegetation types, biomes and measurement approaches. Results indicate that most wetland types and even individual locations show a substantial local dispersion of LAI values (average coefficient of variation 65%) due to heterogeneity of environmental properties and vegetation composition. Such variation indicates that mean LAI values may not sufficiently represent complex wetland environments, and the use of this index in ecosystem function models needs to incorporate within-site variation in canopy properties. Mean LAI did not significantly differ between direct and indirect measurement methods on a pooled global sample; however, within some of the specific biomes and wetland types significant contrasts between these approaches were detected. These contrasts highlight unique aspects of wetland vegetation physiology and canopy structure affecting measurement principles that need to be considered in generalizing canopy properties in ecosystem models. Finally, efforts to assess wetland LAI using remote sensing strongly indicate the promise of this technology for cost-effective regional-scale modeling of canopy properties similar to terrestrial systems. However, such efforts urgently require more

  3. Evolution of radiographic damage in ankylosing spondylitis: a 12 year prospective follow-up of the OASIS study

    NARCIS (Netherlands)

    Ramiro, Sofia; Stolwijk, Carmen; van Tubergen, Astrid; van der Heijde, Désirée; Dougados, Maxime; van den Bosch, Filip; Landewé, Robert

    2015-01-01

    To describe the evolution of radiographic abnormalities of the spine in patients with ankylosing spondylitis (AS). Patients with AS were followed prospectively with 2 yearly radiographs for 12 years. The modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) was scored by two readers (R1 and

  4. Simple index of functional connectivity at rest in Multiple Sclerosis fatigue.

    Science.gov (United States)

    Buyukturkoglu, Korhan; Porcaro, Camillo; Cottone, Carlo; Cancelli, Andrea; Inglese, Matilde; Tecchio, Franca

    2017-05-01

    To investigate the EEG-derived functional connectivity at rest (FCR) patterns of fatigued Multiple Sclerosis (MS) patients in order to find good parameters for a future EEG-Neurofeedback intervention to reduce their fatigue symptoms. We evaluated FCR between hemispheric homologous areas, via spectral coherence between pairs of corresponding left and right bipolar derivations, in the Theta, Alpha and Beta bands. We estimated FCR in 18MS patients with different levels of fatigue and minimal clinical severity and in 11 age and gender matched healthy controls. We used correlation analysis to assess the relationship between the fatigue scores and the FCR values differing between fatigued MS patients and controls. Among FCR values differing between fatigued MS patients and controls, fatigue symptoms increased with higher Beta temporo-parietal FCR (p=0.00004). Also, positive correlations were found between the fatigue levels and the fronto-frontal FCR in Beta and Theta bands (p=0.0002 and p=0.001 respectively). We propose that a future EEG-Neurofeedback system against MS fatigue would train patients to decrease voluntarily the beta coherence between the homologous temporo-parietal areas. We extracted a feature for building an EEG-Neurofeedback system against fatigue in MS. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  5. Dynamic Functional Stiffness Index of the Ankle Joint During Daily Living.

    Science.gov (United States)

    Argunsah Bayram, Hande; Bayram, Mehmed B

    2018-03-30

    Exploring ankle joint physiologic functional stiffness is crucial for improving the design of prosthetic feet that aim to mimic normal gait. We hypothesized that ankle joint stiffness would vary among the different activities of daily living and that the magnitude of the stiffness would indicate the degree of energy storage element sufficiency in terms of harvesting and returning energy. We examined sagittal plane ankle moment versus flexion angle curves from 12 healthy subjects during the daily activities. The slopes of these curves were assessed to find the calculated stiffness during the peak energy return and harvest phases. For the energy return and harvest phases, stiffness varied from 0.016 to 0.283 Nm/kg° and 0.025 and 0.858 Nm/kg°, respectively. The optimum stiffness during the energy return phase was 0.111 ± 0.117 Nm/kg° and during the energy harvest phase was 0.234 ± 0.327 Nm/kg°. Ankle joint stiffness varied significantly during the activities of daily living, indicating that an energy storage unit with a constant stiffness would not be sufficient in providing energy regenerative gait during all activities. The present study was directed toward the development of a complete data set to determine the torque-angle properties of the ankle joint to facilitate a better design process. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  6. The UBC-40 Urothelial Bladder Cancer cell line index: a genomic resource for functional studies.

    Science.gov (United States)

    Earl, Julie; Rico, Daniel; Carrillo-de-Santa-Pau, Enrique; Rodríguez-Santiago, Benjamín; Méndez-Pertuz, Marinela; Auer, Herbert; Gómez, Gonzalo; Grossman, Herbert Barton; Pisano, David G; Schulz, Wolfgang A; Pérez-Jurado, Luis A; Carrato, Alfredo; Theodorescu, Dan; Chanock, Stephen; Valencia, Alfonso; Real, Francisco X

    2015-05-22

    Urothelial bladder cancer is a highly heterogeneous disease. Cancer cell lines are useful tools for its study. This is a comprehensive genomic characterization of 40 urothelial bladder carcinoma (UBC) cell lines including information on origin, mutation status of genes implicated in bladder cancer (FGFR3, PIK3CA, TP53, and RAS), copy number alterations assessed using high density SNP arrays, uniparental disomy (UPD) events, and gene expression. Based on gene mutation patterns and genomic changes we identify lines representative of the FGFR3-driven tumor pathway and of the TP53/RB tumor suppressor-driven pathway. High-density array copy number analysis identified significant focal gains (1q32, 5p13.1-12, 7q11, and 7q33) and losses (i.e. 6p22.1) in regions altered in tumors but not previously described as affected in bladder cell lines. We also identify new evidence for frequent regions of UPD, often coinciding with regions reported to be lost in tumors. Previously undescribed chromosome X losses found in UBC lines also point to potential tumor suppressor genes. Cell lines representative of the FGFR3-driven pathway showed a lower number of UPD events. Overall, there is a predominance of more aggressive tumor subtypes among the cell lines. We provide a cell line classification that establishes their relatedness to the major molecularly-defined bladder tumor subtypes. The compiled information should serve as a useful reference to the bladder cancer research community and should help to select cell lines appropriate for the functional analysis of bladder cancer genes, for example those being identified through massive parallel sequencing.

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

    Directory of Open Access Journals (Sweden)

    Abderrazak Hajjioui

    2014-01-01

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

  8. The genetic basis of ankylosing spondylitis: new insights into disease pathogenesis

    Science.gov (United States)

    Tsui, Florence WL; Tsui, Hing Wo; Akram, Ali; Haroon, Nigil; Inman, Robert D

    2014-01-01

    Ankylosing spondylitis (AS) is a complex disease involving multiple risk factors, both genetic and environmental. AS patients are predominantly young men, and the disease is characterized by inflammation and ankylosis, mainly at the cartilage–bone interface and enthesis. HLA-B27 has been known to be the major AS-susceptibility gene for more than 40 years. Despite advances made in the past few years, progress in the search for non-human leukocyte antigen susceptibility genes has been hampered by the heterogeneity of the disease. Compared to other complex diseases, such as inflammatory bowel disease (IBD), fewer susceptibility loci have been identified in AS. Furthermore, non-major histocompatibility-complex susceptibility loci discovered, such as ERAP1 and IL23R, are likely contributors to joint inflammation. Identification and confirmation of functional variants remains a significant challenge of investigations involving genome-wide association studies (GWAS). It remains unclear why none of the AS-susceptibility genes identified in GWAS appear to be directly involved in the ankylosing process. Numerous reviews have recently been published on the genetics of AS. Therefore, aside from a brief summary of what AS GWAS has successfully achieved thus far, this review will focus on directions that could address unanswered questions raised by GWAS. PMID:24971029

  9. Immunogenetic study in Chinese population with ankylosing spondylitis: are there specific genes recently disclosed?

    Science.gov (United States)

    Zhai, Jiayu; Rong, Ju; Li, Qiuxia; Gu, Jieruo

    2013-01-01

    Ankylosing spondylitis (AS) is a systemic, autoimmune disease resulting in the destruction of the affected joints. Over the past 5 years, several new genes or genetic regions associated with AS have been identified in the Chinese population. This paper aims to discuss the major findings and related potential mechanisms of these studies in our population. In recent years, due to the rapid advances in computational genetics and technology, there has been an increasing list of well-validated genes or genetic regions associated with AS susceptibility. So far, several genes or genetic regions have now been reported in the Han ethnic Chinese population, containing the major histocompatibility complex (MHC), ERAP1, IL-23R, 12q12, 2p15, 5q14.3, and so on. Different hypotheses for disease mechanisms have been investigated on the basis of the functional studies of these genes or genetic regions. This paper tries to summarize the association of several candidate genes with risk for AS in the Han ethnic Chinese population and aims to identify the novel inflammatory pathways and provide potential strategies for better therapies.

  10. Immunogenetic Study in Chinese Population with Ankylosing Spondylitis: Are There Specific Genes Recently Disclosed?

    Directory of Open Access Journals (Sweden)

    Jiayu Zhai

    2013-01-01

    Full Text Available Purpose. Ankylosing spondylitis (AS is a systemic, autoimmune disease resulting in the destruction of the affected joints. Over the past 5 years, several new genes or genetic regions associated with AS have been identified in the Chinese population. This paper aims to discuss the major findings and related potential mechanisms of these studies in our population. Recent Findings. In recent years, due to the rapid advances in computational genetics and technology, there has been an increasing list of well-validated genes or genetic regions associated with AS susceptibility. So far, several genes or genetic regions have now been reported in the Han ethnic Chinese population, containing the major histocompatibility complex (MHC, ERAP1, IL-23R, 12q12, 2p15, 5q14.3, and so on. Different hypotheses for disease mechanisms have been investigated on the basis of the functional studies of these genes or genetic regions. Summary. This paper tries to summarize the association of several candidate genes with risk for AS in the Han ethnic Chinese population and aims to identify the novel inflammatory pathways and provide p