AB1072 ROLE OF ULTRASOUND IN DETECTION OF SHOULDER JOINT PATHOLOGIES IN ASYMPTOMATIC RHEUMATOID ARTHRITIS PATIENTS

Background:Rheumatoid arthritis (RA) is a chronic inflammatory disease that results in progressive destruction of structural components of the joints1.It commonly affects the shoulder leading to pain, tenderness and decreased range of motion2.Increased shoulder pain has been found to correlate strongly with disease severity3, however there is little information available in the literature regarding shoulder pathologies in asymptomatic RA patients.Objectives:To determine the prevalence of pathologies in asymptomatic shoulders in rheumatoid arthritis patients and role of ultrasound to detect it.Methods:A cross-sectional study including two groups, first group included 36 RA patients, meeting the ACR/EULAR classification criteria for RA with no shoulder complaints. The second group included 36 healthy control subjects of similar age groups and sex, with no shoulder complaints. They were recruited from rheumatology outpatient clinic in Mansoura University Hospital. Only asymptomatic shoulders of both groups were examined clinically by inspection, palpation and special tests, then examined by ultrasound using Toshiba Xario 200 machine with 13 MHz superficial probe including biceps tendon, subscapularis tendon, supraspinatus tendon, subacromial subdeltoid (SASD) bursa, infraspinatus tendon, posterior glenohumeral joint for effusion or synovitis, acromioclavicular joint and humeral head for erosions. Findings of both groups were compared to each other.Results:Asymptomatic shoulders in RA patients showed significant number of pathologies in 72% of the examined patients in comparison with healthy subjects (17%). According to frequency, humeral erosions were detected in 12 patients (33%), acromioclavicular osteoarthritis in 8 patients (22%), biceps tenosynovitis, supraspinatus tendinopathy, glenohumeral effusion in 6 patients (17%), subscapularis tendinopathy in 4 patients (11.%), SASD bursitis in 2 patients (6%), Infraspinatus tendinopathy in 1 patient (3%).The healthy group showed less number of pathologies including supraspinatus tendinopathy 3 (8%), acromioclavicular osteoarthritis 2 (6%), humeral erosions 1 (3%).Conclusion:A significant high rate of different pathologies can be present in shoulders of RA patients despite negative history and normal physical examination. Ultrasound can be used for early detection and better management before irreversible joint destruction.References:[1]Weishaupt D, Schweitzer ME (2004) MR imaging of septic arthritis and rheumatoid arthritis of the shoulder. Magn Reson Imaging Clin N Am 12:111–124[2]Varache S, Cornec D, Morvan J, et al. Diagnostic accuracy of acr/eular 2010 criteria for rheumatoid arthritis in a 2-year cohort. The Journal of rheumatology. 2011; 38(7): 1250-1257.[3]Van de Sande MA, De Groot JH, Rozing PM. Clinical implications of rotator cuff degeneration in the rheumatic shoulder. Arthritis care & research. 2008; 59(3): 317-324.Disclosure of Interests:None declared

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Immunoregulatory Role of Interleukin-37 in Rheumatoid Arthritis; Relation to Disease Activity and Joint Destruction

The Medical Journal of Cairo University ◽

10.21608/mjcu.2018.60305 ◽

2018 ◽

Vol 86 (September) ◽

pp. 3341-3348

Author(s):

DALIA B. EL-BOHOTY, M.Sc.; DOAA S. AL-ASHKAR, M.D. ◽

MAALY M. MABROUK, M.D.; HALA M. NAGY, M.D.

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Joint Destruction

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The Role of Synovial Fibroblasts in Mediating Joint Destruction in Rheumatoid Arthritis

Current Pharmaceutical Design ◽

10.2174/1381612053381945 ◽

2005 ◽

Vol 11 (5) ◽

pp. 563-568 ◽

Cited By ~ 40

Author(s):

Ingmar Meinecke ◽

Edita Rutkauskaite ◽

Steffen Gay ◽

Thomas Pap

Keyword(s):

Rheumatoid Arthritis ◽

Joint Destruction ◽

Synovial Fibroblasts

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Cross-sectional study of rheumatoid arthritis treatment in a university hospital.

Annals of the Rheumatic Diseases ◽

10.1136/ard.44.6.372 ◽

1985 ◽

Vol 44 (6) ◽

pp. 372-378 ◽

Cited By ~ 14

Author(s):

W T Friesen ◽

Y A Hekster ◽

L B van de Putte ◽

F W Gribnau

Keyword(s):

Rheumatoid Arthritis ◽

Cross Sectional Study ◽

University Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Rheumatoid Arthritis Treatment

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Histamine index and clinical expression of rheumatoid arthritis activity

Vojnosanitetski pregled ◽

10.2298/vsp1004286t ◽

2010 ◽

Vol 67 (4) ◽

pp. 286-290 ◽

Cited By ~ 2

Author(s):

Aleksandra Tomic-Lucic ◽

Suzana Pantovic ◽

Gvozden Rosic ◽

Zdravko Obradovic ◽

Mirko Rosic

Keyword(s):

Rheumatoid Arthritis ◽

Synovial Fluid ◽

Disease Activity ◽

Disease Activity Score ◽

Joint Destruction ◽

Clinical Expression ◽

Histamine Concentration ◽

Significant Difference ◽

Rheumatoid Arthritis Activity

Background/Aim. Many arguments prove the pathophysiologic role of histamine in the process of remodeling and joint destruction in rheumatoid arthritis. The aim of our study was to find out if there was a relation between histamine concentration in synovial fluid and blood with clinical expression of disease activity. Methods. Histamine concentration in synovial fluid and blood was determinated in 19 patients with rheumatoid arthritis. Histamine concentration measurement was based on the Shore's fluorometric method. Histamine index (HI) was evaluated as a ratio between histamine concentration in synovial fluid and blood. Disease activity score, DAS 28 (3), with three variables (erythrocyte sedimentation rate, the number of swelled joints and the number of tender joints) was also evaluated. Results. Our results showed that there was no significant difference in concentration of histamine in synovial fluid and blood related to disease activity. However, there was a significant difference in the histamine index which was increased proportionally with disease activity. Conclusion. Our study indicates that histamine index could be useful in estimation of rheumatoid arthritis activity.

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The Novel Role of MIF in the Secretion of IL-25, IL-31, and IL-33 from PBMC of Patients with Rheumatoid Arthritis

Molecules ◽

10.3390/molecules26164968 ◽

2021 ◽

Vol 26 (16) ◽

pp. 4968

Author(s):

Samuel García-Arellano ◽

Luis Alexis Hernández-Palma ◽

Sergio Cerpa-Cruz ◽

Gabriela Athziri Sánchez-Zuno ◽

Melva Guadalupe Herrera-Godina ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Mononuclear Cells ◽

Joint Destruction ◽

Study Groups ◽

Joint Disease ◽

The Novel ◽

Peripheral Blood Mononuclear ◽

Cytokine Dysregulation ◽

New Evidence

Rheumatoid arthritis (RA) is an autoimmune inflammatory joint disease with complex pathogenesis associated with cytokine dysregulation. Macrophage migration inhibitory factor (MIF) plays a role in systemic inflammation and joint destruction in RA and could be associated with the secretion of other immune-modulatory cytokines such as IL-25, IL-31, and IL-33. For the above, our main aim was to evaluate the IL-25, IL-31, and IL-33 secretion from recombinant human MIF (rhMIF)-stimulated peripheral blood mononuclear cells (PBMC) of RA patients. The rhMIF and lipopolysaccharide (LPS) plus rhMIF stimuli promote the secretion of IL-25, IL-31, and IL-33 (p < 0.05) from PBMC of RA patients. The study groups, the different stimuli, and the interaction between both showed a statistically significant effect on the secretion of IL-25 (p < 0.05) and IL-31 (p < 0.01). The study of the effect of the RA patient treatments and their interaction with the effect of stimuli did not show an interaction between them. In conclusion, our study generates new evidence for the role of MIF in the secretion of IL-25, IL-31, and IL-33 and its immunomodulatory effect on RA.

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Number of individual ACPA reactivities in synovial fluid immune complexes, but not serum anti-CCP2 levels, associate with inflammation and joint destruction in rheumatoid arthritis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2017-212627 ◽

2018 ◽

Vol 77 (9) ◽

pp. 1345-1353 ◽

Cited By ~ 6

Author(s):

Azita Sohrabian ◽

Linda Mathsson-Alm ◽

Monika Hansson ◽

Ann Knight ◽

Jörgen Lysholm ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Synovial Fluid ◽

Disease Activity ◽

Immune Complexes ◽

Magnetic Beads ◽

Joint Destruction ◽

Joint Pathology ◽

A New Technique ◽

Laboratory Measures

IntroductionIndividual patients with rheumatoid arthritis (RA) show divergent specific anti-citrullinated protein/peptide antibodies (ACPA) patterns, but hitherto no individual ACPA specificity has consistently been linked to RA pathogenesis. ACPA are also implicated in immune complexes (IC)-associated joint pathology, but until now, there has been no method to investigate the role of individual ACPA in RA IC formation and IC-associated pathogenesis.MethodsWe have developed a new technique based on IC binding to C1q-coated magnetic beads to purify and solubilise circulating IC in sera and synovial fluids (SF) from 77 patients with RA. This was combined with measurement of 19 individual ACPA in serum, SF and in the IC fractions from serum and SF. We investigated whether occurrence of individual ACPA as well as number of ACPA in these compartments was related to clinical and laboratory measures of disease activity and inflammation.ResultsThe majority of individual ACPA reactivities were enriched in SF as compared with in serum, and levels of ACPA in IC were regulated independently of levels in serum and SF. No individual ACPA reactivity in any compartment showed a dominating association to clinical and laboratory measures of disease activity and severity. Instead, the number of individual ACPA reactivities in the IC fraction from SF associated with a number of markers of joint destruction and inflammation.ConclusionsOur data highlight the polyclonality of ACPA in joint IC and the possibility that a broad ACPA repertoire in synovial fluid IC might drive the local inflammatory and matrix-degrading processes in joints, in analogy with antibody-induced rodent arthritis models.

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1211. Microbiologic Evaluation of Mobile Phones and Hands of Healthcare Professionals in Two Intensive Care Units in a Brazilian University Hospital

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1074 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S435-S435

Author(s):

Evelyn Patricia Sanchez Espinoza ◽

Lauro Viera Perdigão Neto ◽

Sania Alves dos Santos ◽

Camila Risek ◽

Maria Renata Gomes Franco ◽

...

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Mobile Phones ◽

Bacterial Colonization ◽

Healthcare Setting ◽

University Hospital ◽

High Rate ◽

High Morbidity ◽

Dominant Hand ◽

Cross Sectional

Abstract Background Healthcare-associated infections (HAIs) are a worldwide concern because of their high morbidity, mortality, and associated costs. Mobile phones (MP) are an important work tool in the healthcare setting, but they can be a reservoir of nosocomial pathogens if not carefully cleaned and cause re-contamination of the healthcare professional’s (HCP) hands. We aimed to evaluate bacterial colonization of HCP’s hands and their respective MPs. Methods A cross-sectional study was performed in two Intensive Care Units (ICUs), an internal medicine and a burn unit, of a Brazilian tertiary university hospital. These units were chosen because of their different hand hygiene (HH) compliance. We assessed HH and MP handling practices by an electronic inquiry and collected samples from the dominant hand (DH) by the sterile bag technique and of MPs by moistened sterile swab. MALDI-TOF was used for bacterial identification and Dilution Agar (DA) was used to screen Gram-negative bacteria (GNB) susceptibility to carbapenems and colistin. Results Forty-seven HCPs were evaluated; of whom, 30% were medical residents, 19% nurses, 17% nurse-technicians, 17% physiotherapists, 13% cleaning staff, and 4% radiology technicians.Overall, 85% of HCPs reported use of MP at work, 26% had never cleaned it, and 34% reported optimal HH compliance practices. All of them believed that MPs can have HAIs agents. DH culture showed 94% of colonization and the most common Gram-positive bacteria (GPB) and GNB were S. epidermidis (n = 17∕44) and A. baumannii complex (n = 11∕44), respectively. MP were colonized in 89% of the cases and the most common GPB and GNB were S. epidermidis (n = 16∕42) and Pseudomonas spp (n = 9∕42), respectively. Overall, in the screening 38% of GNB were resistant to meropenem and 22% to colistin. A. baumannii was the most common meropenem (n = 4) and colistin (n = 2) resistant GNB. In the two units, 32% of HCPs had the same microorganism species isolated in the MP and in the DH (Table 1). Conclusion There was a high rate of bacterial colonization on the MP and DH of HCPs and some of these bacteria were carbapenem or colistin resistant. A policy for MP handling in the healthcare setting should be implemented in order to avoid cross-contamination between the MP and the hand of HCPs. Disclosures All authors: No reported disclosures.

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Extra-glenohumeral joint shoulder surgery in rheumatoid arthritis: The role of bursectomy, acromioplasty, and distal clavicle excision

Journal of Shoulder and Elbow Surgery ◽

10.1016/s1058-2746(09)80112-2 ◽

1994 ◽

Vol 3 (2) ◽

pp. 66-69 ◽

Cited By ~ 11

Author(s):

N. Sean Simpson ◽

Ian G. Kelly

Keyword(s):

Rheumatoid Arthritis ◽

Glenohumeral Joint ◽

Shoulder Surgery ◽

Distal Clavicle

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Placebo use in clinical practice by nurses in an Iranian teaching hospital

Nursing Ethics ◽

10.1177/0969733011398093 ◽

2011 ◽

Vol 18 (3) ◽

pp. 364-373 ◽

Cited By ~ 5

Author(s):

Nayereh Baghcheghi ◽

Hamid Reza Koohestani

Keyword(s):

Clinical Practice ◽

Teaching Hospital ◽

Descriptive Study ◽

Placebo Treatment ◽

Self Report ◽

University Hospital ◽

Cross Sectional ◽

The Past ◽

Knowledge And Attitude

The present study was carried out to explore Iranian nurses’ use of placebos in clinical practice and their knowledge and attitude towards its use. A cross-sectional, descriptive study was conducted using self-report questionnaires. All nurses working in a university hospital in Arak (n = 342) were invited to participate in the study. Among 295 respondents, 221 (75%) reported that they had used at least one placebo within the past year and 179 (81%) told patients they were receiving actual medication. The most common reason and symptom for placebo use were after unjustified demand for medication and pain, respectively. Only 60 (20.33%) of the nurses believed that placebos should never be used. Results showed that most nurses in our study had used placebos and probably will continue to use them. Placebo use is viewed as ethically permissible among nurses. Some patients benefit from the placebos, but their use raises ethical questions. The role of placebo treatment, its mechanisms, and its ethics issues should be taught to nurses.

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