Coxitis in early axial spondyloarthritis

In Russia, coxitis is one of the most common extra-axial manifestations of ankylosing spondylitis (AS). However, many issues regarding its early diagnosis remain unresolved.Objective: to compare the clinical manifestations of coxitis with the data from an instrumental examination of CoRSAR cohort (Cohort of Early Axial Spondyloarthritis) patients.Patients and methods. Examinations were made in 175 patients (mean age, 28.2±5.7 years) diagnosed as having axial spondyloarthritis (axSpA) with inflammatory back pain lasting up to 5 years, which occurred at the age of ≤45 years. There was non-radiographic axSpA (nraxSpA) in 69 patients and AS in 106 patients. 87% of patients were HLA-B27-positive. The median disease duration was 23.8 [1–60] months; BASDAI was 3.3±1.94. Regardless of complaints, all the patients underwent hip X-ray and ultrasound studies and 54 more patients had magnetic resonance imaging (MRI).Results and discussion. The clinical signs of coxitis were present in 95 (54%) patients, of them 60% were diagnosed with AS and 40% had nraxSpA. According to the numerical pain rating scale (NPRS), the median hip joint pain was 4 [3; 7]. Limited joint movement was observed in 6 (3.4%) patients. The level of hip joint pain correlated with BASDAI (r=0.53) and ASDAS (r=0.30). The ultrasound signs of coxitis were detected in 42 (24%) patients; of them 26 (62%) had the clinical manifestations of hip joint injury, and such changes were absent in 16 patients. The patients with ultrasound signs of coxitis were noted to have a higher disease activity; peripheral arthritis and enthesitis were more common. According to MRI, coxitis was diagnosed in 39 (72%) of the 54 examinees, while the disease was asymptomatic in 10%.Conclusion. Different diagnostic methods used in patients with early axSpA could reveal coxitis in 33% of cases. The patients with coxitis show higher laboratory disease activity than those without hip joint injury. It is necessary to include MRI and ultrasound in the mandatory examination of patients with axSpA.

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Do Illness Perceptions and Coping Strategies Change Over Time in Patients Recently Diagnosed With Axial Spondyloarthritis?

The Journal of Rheumatology ◽

10.3899/jrheum.191353 ◽

2020 ◽

Vol 47 (12) ◽

pp. 1752-1759

Author(s):

Miranda van Lunteren ◽

Robert Landewé ◽

Camilla Fongen ◽

Roberta Ramonda ◽

Désirée van der Heijde ◽

...

Keyword(s):

Back Pain ◽

Disease Activity ◽

Coping Strategies ◽

Illness Perceptions ◽

Rating Scale ◽

Axial Spondyloarthritis ◽

Numeric Rating Scale ◽

And Coping ◽

Numeric Rating ◽

Over Time

ObjectiveIt is unknown if in axial spondyloarthritis (axSpA) patients’ illness perceptions and coping strategies change when disease activity changes.MethodsPatients diagnosed with axSpA and with 1 or more follow-up visits (1 and/or 2 yrs in the SPACE cohort) were included. Mixed linear models were used for illness perceptions (range 1–5), coping (range 1–4), back pain (numeric rating scale range 0–10), health-related quality of life (range 0–100), physical and mental component summary (PCS and MCS; range 0–100), work productivity loss (WPL; range 0–100), and activity impairment (AI; range 0–100%), separately, to test if they changed over time.ResultsAt baseline, 150 axSpA patients (mean age 30.4 yrs, 51% female, 65% HLA-B27+) had a mean (SD) numeric rating scale back pain of 4.0 (2.5), PCS of 28.8 (14.0), MCS of 47.8 (12.4), WPL of 34.1% (29.8), and AI of 38.7% (27.9). Over 2 years, clinically and statistically significant improvements were seen in the proportion of patients with an Ankylosing Spondylitis Disease Activity Score (ASDAS) of low disease activity (from 39% at baseline to 68% at 2 years), back pain (−1.5, SD 2.2), AI (−14.4%, SD 27.2), PCS (11.1, SD 13.3), and WPL (−15.3%, SD 28.7), but MCS did not change (0.7, SD 13.9; P = 0.201). In contrast, illness perceptions and coping strategies did not change over a period of 2 years. For example, at 2 years patients believed that their illness had severe “consequences” (2.8, SD 0.9) and they had negative emotions (e.g., feeling upset or fear) towards their illness [“emotional representation”, 2.5 (0.8)]. Patients most often coped with their pain by putting pain into perspective [“comforting cognitions”, 2.8 (0.6)] and tended to cope with limitations by being optimistic [“optimism”, 2.9 (0.7)].ConclusionWhile back pain, disease activity, and health outcomes clearly improved over 2 years, illness perceptions and coping strategies remained remarkably stable.

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Remission structure in schizoaffective disorder

Psychiatry Neurology and Medical Psychology ◽

10.26565/2312-5675-2020-14-01 ◽

2020 ◽

Keyword(s):

Schizoaffective Disorder ◽

Clinical Remission ◽

Partial Remission ◽

Negative Symptoms ◽

Rating Scale ◽

Clinical Signs ◽

Clinical Manifestations ◽

Social Adaptation ◽

Medical Documentation ◽

Complete Clinical Remission

The article describes the comparative study of clinical and dynamic structure of remission in schizoaffective disorder (SAD), depending on its type. With the help of the clinical-psychopathological method with an analytical study of tavailable medical documentation and the method of follow-up examination, remissions were analyzed in 78 patients with SAD. In parallel, during the year, the severity of clinical manifestations of the disease was determined using psychometric scales (Young Mania Rating Scale – YMRS, Hamilton Depression Rating Scale – HDRS, Positive and Negative Symptoms Scale – PANSS). Several degrees of remission were identified – partial, complete clinical and complete functional remission. By partial remission, we understood a state when there was a pronounced reduction in clinical manifestations, but residual productive symptoms, poor insight and social maladjustment were observed. Complete clinical remission indicated the absence of any clinically significant signs, but social functioning was reduced. Full functional remission was characterized by the absence of any clinical signs and patient’s good social adaptation. All patients went through the stage of partial remission, however, about half of them (40 observations – 51.3%) went into complete clinical remission. Persistent partial remission which later did not transform into clinical remission was observed in 38 patients with SAD (48.7%). It was represented by the following syndromes — asthenic (28.9%), hypersthenic (23.8%), psychopathic (34.2%), residual delusional syndrome (13.1%). Complete functional remission was found in 19 patients (24.4%). The data obtained indicate that the longest and most complete remissions were observed in manic and depressive types of SAD compared with mixed ones. In the manic type of SAD complete functional remission was more common (12 cases – 38.7%), with the depressive type - complete clinical remission (8 patients – 32.0%), with the mixed type - partial remission (10 patients – 38.5%). Depending on the type of SAD remission there is a different risk of disease recurrence, therefore, the treatment and rehabilitation measures, the appointment of maintenance therapy should be differentiated.

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Follow-up survey of the prevalence, diagnosis, clinical manifestations and treatment of Spirocerca lupi in South Africa

Journal of the South African Veterinary Association ◽

10.4102/jsava.v85i1.1169 ◽

2014 ◽

Vol 85 (1) ◽

Cited By ~ 4

Author(s):

Remo Lobetti

Keyword(s):

South Africa ◽

Clinical Signs ◽

Clinical Manifestations ◽

Clinical Findings ◽

Seasonal Distribution ◽

Diagnostic Methods ◽

Post Mortem ◽

Spirocerca Lupi ◽

Important Disease

Spirocercosis is an important disease in South Africa. The object of this study was to determine if there had been a change in the prevalence, clinical manifestations and treatment of Spirocerca lupi over a 14-year period. A questionnaire was sent to 577 veterinary practices throughout South Africa in 2012. Of responders, 76% indicated that S. lupi occurred in their area, whilst 24% indicated that it did not; 84% considered S. lupi not to be a new phenomenon, whereas 16% considered it to be new. Monthly or seasonal distribution of the disease was not reported, and 76% of responders reported it to occur in no specific breed of dog, whereas 24% reported a breed risk, most considering large breeds to be at greater risk. No specific age or sex was identified as at higher risk. Common owner complaints were vomiting, weight loss, cough, or regurgitation. Reported clinical findings tended to mirror the clinical signs reported by owners. Most common diagnostic methods used were radiology, endoscopy, faecal flotation, and post mortem examination. Forty-four percent did not report seeing asymptomatic cases, 40% reported asymptomatic cases and 16% did not know. Associated complications were reported by 85% of responders, and included oesophageal neoplasia, hypertrophic osteopathy and acute haemothorax. Four different drugs were used as therapy: doramectin, ivermectin, milbemycin and Advocate®, with 9% of the responders using a combination of these four; 85% considered treatment to be effective and 15% ineffective. Treatment was considered more effective if the disease was diagnosed early and there were no complications. Two important conclusions were that more cases are being seen and that efficacy of therapy has increased, with a decrease in the mortality rate.

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Mycoplasma bovis infections and co-infections with other Mycoplasma spp. with different clinical manifestations in affected cattle herds in eastern region of Poland

Bulletin of the Veterinary Institute in Pulawy ◽

10.1515/bvip-2015-0049 ◽

2015 ◽

Vol 59 (3) ◽

pp. 331-338 ◽

Cited By ~ 4

Author(s):

Ewelina Szacawa ◽

Krzysztof Niemczuk ◽

Katarzyna Dudek ◽

Dariusz Bednarek ◽

Ruben Rosales ◽

...

Keyword(s):

Dairy Cows ◽

Denaturing Gradient Gel Electrophoresis ◽

Direct Detection ◽

Clinical Signs ◽

Clinical Manifestations ◽

Diagnostic Methods ◽

Mycoplasma Bovis ◽

Eastern Region ◽

Culture Methods ◽

Cattle Herds

AbstractThe aim of the study was to evaluate the presence ofMycoplasma bovisinfection and co-infections with otherMycoplasmaspp. infections in cattle. The tested population was one in the eastern region of Poland containing 66 dairy cows and 23 calves showing different clinical signs and suffering from pneumonia, mastitis, and arthritis. The incidence ofM. bovisin co-infections with otherMycoplasmaspp. was examined using serological traditional mycoplasma culture methods, and the molecular methods - PCR and polymerase chain reaction/denaturing gradient gel electrophoresis (PCR/DGGE). The PCR/DGGE method for detectingMycoplasmaspp. in cattle was used for the first time in Poland. The seroprevalence ofM. bovisin the affected cattle herds in the eastern region of Poland was 47.8% in calves and 19.7% in dairy cows. The direct detection and identification ofM. bovisfrom nasopharyngeal swabs by PCR revealed that 56.5% of calves were positive, but all of the dairy cows were negative. The PCR/DGGE identified eight (34.8%) instances ofM. argininiand eight (26.1%) instances ofM. bovirhinisco-infecting withM. bovisin ten calves. The seroprevalence ofM. bovisin the tested population was 33.7%. Any future attempts to control mycoplasma infections require an insight into the current epidemiological situation ofM. bovisinfection and its relationship to other mycoplasmas in causing clinical disease in cattle. Using these diagnostic methods we have demonstrated that mycoplasmal infections are often caused by multiple species ofMycoplasmaand not just the primaryM. bovispathogen.

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Increased CD21-CD27- atypical memory B cells as a biomarker of clinical disease activity in patients with systemic lupus erythematosus

10.21203/rs.3.rs-1061479/v1 ◽

2021 ◽

Author(s):

Alice Horisberger ◽

Morgane Humbel ◽

Natalia Fluder ◽

Florence Bellanger ◽

Craig Fenwick ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

B Cells ◽

Disease Activity ◽

Lupus Erythematosus ◽

Clinical Signs ◽

Clinical Manifestations ◽

Memory B Cells ◽

Clinical Disease ◽

Systemic Lupus ◽

Clinical Disease Activity

Abstract Background Determining disease activity in systemic lupus erythematosus (SLE) patients is challenging and limited by the lack of reliable biomarkers. Analysis of the altered distribution of circulating B cells has shown promise for assessment disease activity. Yet studies are limited by variable classifications of B subsets. Therefore, we studied peripheral B cells using high-dimensional tools to identify a valid biomarker of disease activity.Methods We studied B cells in two separate cohorts of patients included in the Swiss SLE Cohort Study. In discovery cohort A, we analyzed cryopreserved PBMCs from 30 SLE, and 30 age-, sex- and ethnicity matched healthy controls (HC) by mass cytometry. In validation cohort B, fresh blood from 63 SLE, 14 Sjögren syndrome (pSS), 14 Sarcoidosis (Sarc), and 39 age-matched HC were analyzed by flow cytometry.Results In cohort A, using unsupervised clustering analysis, we identified 7 metaclusters within B cells. Two metaclusters were increased in SLE and exhibited a phenotype of atypical memory B cells (aMBC): CD21-, CD27-, CD11c+ and CXCR5-. Based on cohort A results, we confirmed in cohort B the increase in CD21-CD27- aMBC in SLE, compared to healthy and disease controls. In both cohorts, aMBC were associated with the severity of clinical manifestations. Compared to classical biomarkers, aMBC showed a significant correlation with clinical signs of disease activity. Conclusion aMBC were expanded in SLE, and the increase correlated with clinical disease activity. According to our data, aMBC represents a robust and easily accessible biomarker to assess disease activity in patients with SLE.

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Clinical manifestations, disease activity and disease burden of radiographic versus non-radiographic axial spondyloarthritis over 5 years of follow-up in the DESIR cohort

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2019-216218 ◽

2019 ◽

Vol 79 (2) ◽

pp. 209-216 ◽

Cited By ~ 5

Author(s):

Clementina López-Medina ◽

Anna Molto ◽

Pascal Claudepierre ◽

Maxime Dougados

Keyword(s):

Sick Leave ◽

Disease Activity ◽

Mixed Models ◽

Disease Burden ◽

Axial Spondyloarthritis ◽

Clinical Manifestations ◽

Rheumatic Manifestations ◽

Patient Reported ◽

Over Time

ObjectivesTo compare the clinical manifestations, disease activity and disease burden between patients with radiographic (r-axSpA) and non-radiographic axial spondyloarthritis (nr-axSpA) over a 5-year follow-up period in the Devenir des Spondylarthropathies Indifferénciées Récentes (DESIR) cohort.MethodsPatients from the DESIR cohort who had X-ray images of the sacroiliac joints available at baseline and did not leave the study during the 5-year follow-up period because of a diagnosis other than axSpA were included. A unilateral rating of ‘obvious sacroiliitis’ by the local reader was considered sufficient for classification as r-axSpA. The incidence of first episodes of peripheral and extra-rheumatic manifestations was compared between the two groups using the incidence rate ratio and Cox regressions adjusted for sex, age and tumour necrosis factor blocker (TNFb) intake. Mean values of patient-reported outcomes (PROs) and days of sick leave over 5 years of follow-up were compared using mixed models adjusted for sex, age, TNFb intake and baseline values.ResultsIn total, 669 patients were included, of whom 185 (27.7%) and 484 (72.3%) were classified as r-axSpA and nr-axSpA, respectively. At baseline, the r-axSpA patients showed a significantly higher prevalence of males. After adjusting for age, sex and TNFb intake, Cox regressions for peripheral and extra-rheumatic manifestations did not show any significant differences between groups. Mixed models also showed similar mean levels in PROs and days of sick leave between groups over time.ConclusionThe incidence of peripheral and extra-rheumatic manifestations as well as the disease burden over time remained similar between r-axSpA and nr-axSpA groups after adjusting for intermediate variables.Trial registration numberNCT01648907

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Gestational trophoblastic disease: Literature review

Medicinski pregled ◽

10.2298/mpns1104188m ◽

2011 ◽

Vol 64 (3-4) ◽

pp. 188-193 ◽

Cited By ~ 2

Author(s):

Vera Milenkovic ◽

Biljana Lazovic

Keyword(s):

Hydatidiform Mole ◽

Clinical Signs ◽

Clinical Manifestations ◽

Signs And Symptoms ◽

Gestational Trophoblastic Disease ◽

Modern Technology ◽

Diagnostic Methods ◽

Trophoblastic Disease ◽

Gestational Trophoblastic Diseases ◽

Clinical Signs And Symptoms

Gestational trophoblastic disease is characterized by abnormal proliferation of pregnancy-associated trophoblastic tissue with malignant potential. Gestational trophoblastic disease covers a spectrum of conditions including hydatidiform mole, invasive mole, choriocarcinoma and placental site trophoblastic tumour. It is very important to understand the pathophysiology and natural history of the disease in order to achieve faster recognition and effective treatment. The presence and course of the disease can be monitored with quantitative levels of human chorionic gonadotrophin in all cases. Clinical signs and symptoms are usually insufficient to diagnose and predict the extent of disease. Nowadays, gestational trophoblastic diseases are the best treated gynaecological malignancy thanks to modern technology. This review covers various aspects of gestational trophoblastic disease: its development, epidemiology, aetiology and pathogenesis, as well as its classification, clinical manifestations and diagnostic methods.

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POS0987 INFLAMMATION OF THE HIP JOINTS IN EARLY AXIAL SPONDYLOATRITIS: DATA ANALYSIS OF VISUALIZATION METHODS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2432 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 761-761

Author(s):

E. Agafonova ◽

T. Dubinina ◽

A. Demina ◽

D. Rumiantceva ◽

S. Erdes

Keyword(s):

Disease Activity ◽

Hip Joint ◽

Early Stage ◽

Clinical Manifestations ◽

Epidemiological Studies ◽

Inflammatory Back Pain ◽

Hip Joints ◽

The Us ◽

Magnetic Resonance Imaging Mri ◽

Functional Indices

Background:According to epidemiological studies in Russia, the inflammation of the hip joints occurs in half of patients with ankylosing spondylitis (AS). There have been practically no studies devoted to the investigations of coxitis in patients with early axial spondyloarthritis (axSpA). It is still unknown what factors cause the development of coxitis in axSpA; there is no generally accepted algorithm for diagnosing this condition, especially at an early stage. Previous studies have shown that coxitis in patients with AS develops on average 5–10 years after the onset of the disease, some patients already have irreversible changes in the hip joint at the time of diagnosis, and some do not develop coxitis never.Objectives:To compare the clinical manifestations of coxitis with the results of magnetic resonance imaging (MRI), ultrasound (US), and radiography of the hip.Methods:We examined 175 patients (mean age 28.0 ± 5.92 years) with axSpA (ASAS, 2009), with a duration of inflammatory back pain of no more than 5 years, from the CoRSaR cohort. The median duration of the disease was 21 [3–60] months. BASDAI - 4.0 ± 2.0, BASFI - 2.0 [0.4; 3.5]. Among the included patients, 69 (39.4%) had nr-axSpA, and 106 - AS; 87% were HLA-B27 positive. All patients underwent US examination of the hip joint. When synovitis was detected, the patients underwent MRI examination of the hip joint. The increase in the cervical-capsular distance (CCD) more than 7 mm was considered as an ultrasonic coxitis. The median CCD was 7.5 [7.0; 8.2] mm. For coxitis in MRI, osteitis of the head of the hip or acetabulum and synovitis were taken. Radiographic severity of coxitis was determined by BASRI hip.Results:According to the US data, synovitis of the hip joint was detected in 54 from 175 (30.9%) patients. Pain in the hip joint had 33 (61%) patients. There was no correlation between the intensivity of pain and CCD. CCD significantly correlated with laboratory indicators of disease activity, such as ESR (r = 0.34; p <0.05) and CRP (r = 0.3; p <0.05). Only 7 (13.0%) patients had BASRI hip stages II or III and the rest had normal hip joints. 39 (72%) had MRI manifestations of coxitis: 36 (66%) patients had synovitis, 1 (2%) had bone marrow edema, and 2 (4%) had a combination of synovitis with osteitis. Patients with and without radiographic coxitis did not differ in terms of disease activity and functional indices.Conclusion:In early axSPA:- 30.9% of patients have hip synovitis, and among them, MRI signs of coxitis have 72%, and X-ray coxitis - 13%;- ultrasound synovitis is only confirmed by MRI in 70% of cases;- it seems that the radiological progression of coxitis does not depend on the activity of the disease.Disclosure of Interests:None declared.

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DISTRIBUTION OF STRONGYLOIDES STERCORALIS AMONG DOGS OF DIFFERENT HOUSING GROUPS IN KYIV AND KYIV REGION, CLINICAL MANIFESTATIONS AND DIAGNOSTIC METHODS

EUREKA Health Sciences ◽

10.21303/2504-5679.2020.001423 ◽

2020 ◽

Vol 5 ◽

pp. 99-107

Author(s):

Sofia Dashchenko ◽

Natalia Soroka ◽

Olena Semenko

Keyword(s):

Biochemical Analysis ◽

Venous Blood ◽

Clinical Signs ◽

Clinical Manifestations ◽

Strongyloides Stercoralis ◽

Acute Stage ◽

Diagnostic Methods ◽

String Test ◽

Group 2 ◽

Group 1

Strongyloidiasis in dogs, despite its uncertain zoonotic status, is potentially danger for dogs owners. It is considered that strongyloidiases characteristic for tropical and subtropical regions, but in recent years it is increasingly found in non-endemic countries. The aim. To determine the extent of the invasion, clinical signs and diagnostic methods of strongyloidiasis in dogs of different groups in Kyiv and Kyiv region. Materials and methods. A total of 364 dogs were studied (130 animals lived in shelters (Group 1) and 234 in homes (Group 2). Diagnosis of strongyloidiasis was performed by native smear and Baerman methods. Additionally, the sensitivity of the modified string test was tested. Samples of venous blood were taken from dogs with confirmed strongyloidiasis for haematological and biochemical analysis. Results. A study found that the extent of invasion (EI) in shelters and home dogs was 3.0±0.36 % (4/130; Group 1) and 2.5±0.25 % % (6/234; Group 2) respectively. It was found that three repetitions of the Baerman method test increased its efficiency to 90.5 %. The sensitivity of the modified string test was 100 %. Clinical manifestations included disorders of the respiratory (20 %: 2/10) and digestive systems (80 %: 8/10), weight loss (70 %: 7/10). Blood tests did not reveal changes specific to strongyloidiasis, eosinophilia was observed in only one dog in the acute stage of the disease. Conclusions. The results of our studies indicate the presence of strongyloidiasis in dogs in Kyiv and Kyiv region and probability of the spread of the pathogen in the environment. Symptoms in dogs with strongyloidiasis were nonspecific and cannot be used for diagnosis. A modified string test and Baerman method has demonstrated high efficacy and may be recommended to clarify the diagnosis of a chronic invasion.

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Subacute Combined Degeneration: A Retrospective Study of 68 Cases with Short-Term Follow-Up

European Neurology ◽

10.1159/000488913 ◽

2018 ◽

Vol 79 (5-6) ◽

pp. 247-255 ◽

Cited By ~ 8

Author(s):

Jie Cao ◽

Zhu-yi Su ◽

Sha-bei Xu ◽

Chen-chen Liu

Keyword(s):

Vitamin B12 ◽

Rating Scale ◽

Clinical Signs ◽

Clinical Manifestations ◽

Serum Vitamin ◽

Short Term ◽

Subacute Combined Degeneration ◽

Laboratory Test Results ◽

Time Of Admission

Purpose: The study aimed to analyze the clinical characteristics, laboratory test results, neuroimaging findings, and outcomes in patients diagnosed with subacute combined degeneration (SCD). Materials and Methods: A total of 68 patients with SCD who had been appropriately treated for no less than 6 months were included in our study. Histories, results of routine blood tests, biochemical indices, serum vitamin B12 levels, and spinal magnetic resonance imaging (MRI) findings from the patients were studied and analyzed. Clinical signs and symptoms, graded using a functional disability rating scale, were scored at the time of admission and 3 and 6 months after admission. Results: Limb numbness, limb weakness, and gait disturbances were the most common symptoms in patients with SCD. All patients showed clinical improvement to different degrees at the follow-up visits after vitamin B12 treatment. No differences in rating score were found in patients grouped by sex, hemoglobin level, serum vitamin B12, or MRI manifestations at the time of admission or at the follow-up visits. Younger patients and those with shorter disease courses had better rating scores at the short-term follow-up visits. Conclusion: Anemia, low levels of serum vitamin B12, and MRI abnormalities in the spinal cord are not expected to be associated with worse clinical manifestations. The age of onset and course of disease are important in evaluating the short-term prognosis of patients with SCD.

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