scholarly journals Response and Side Effects from Rheumatoid Arthritis Therapy at Dr. Soetomo General Hospital Surabaya 2017

Author(s):  
Ayu Imamatun Nisa ◽  
Awalia Awalia ◽  
Jusak Nugraha

Introduction: Rheumatoid arthritis (RA) is an autoimmune disease which mainly attacks synovial membrane and causes systemic manifestation. During treatment, controlling disease activity is needed to prevent further complication. On the other hand, medications used in the treatment of RA may bring various side effects. It is important to evaluate side effects from the given therapy.Methods: This study aimed to evaluate response and side effects of therapy in RA patients. The samples were collected from 59 RA patients at Rheumatology Division of Outpatient Clinic in Department of Internal Medicine Dr. Soetomo General Hospital Surabaya in 2017. This study method was descriptive observational with cross sectional design using medical records.Results: Pain was reduced in 83.1% patients, Erythrocyte Sedimentation Rate (ESR) increased in 61.4% patients, and C-Reactive Protein (CRP) decreased in 50% patients. Based on the statistic analysis, ESR decreased significantly (p = 0.012) while CRP decreased not significantly (p = 0.415). The side effects were observed from clinical and laboratory data. Based on clinical symptoms, there were alopecia in 1.7% patient, dyspepsia in 78% patients, infection in 27.1% patients, and other symptoms including itchy skin, neuropathy, hyperuricemia, hyperkalemia and Acute Kidney Injury (AKI). Meanwhile, abnormalities in laboratory data include increased aspartate transaminase (AST) in 3.8% patients, increased alanine transaminase (ALT) in 26.1% patients, increased Blood Urea Nitrogen (BUN) in 7.9% patients, increased creatinine serum in 7.9% patients, decreased hemoglobin in 15.5% patients, and decreased leukocytes in 3.4% patients.Conclusion: Most patients had a good therapeutic response based on decreased pain, while ESR had a significant decrease and CRP did not have significant decrease. Side effects discovered in patients were various

2021 ◽  
Vol 10 (19) ◽  
pp. 4587
Author(s):  
Mateusz Kotecki ◽  
Robert Gasik ◽  
Piotr Głuszko ◽  
Iwona Sudoł-Szopińska

Background: Cervical spine lesions are a common manifestation of rheumatoid arthritis (RA). The purpose of this study was to conduct a retrospective analysis of radiological lesions in cervical spine in patients with RA and to correlate findings with clinical and laboratory parameters. Methods: Overall, 240 consecutive patients with RA were referred for imaging by clinicians based on symptoms suggesting cervical spine involvement and/or long disease duration. In each patient, lateral radiographs and MRI of the cervical spine were performed. The imaging data were correlated with clinical records and laboratory data. Results: The cervical spine was affected in 179 patients (75%). The most common lesions were anterior atlanto-axial subluxation (AAS; 58%), subaxial subluxation (58%), and demineralization (48%). Cervical spine involvement was linked to longer disease duration (p = 0.007), the presence of rheumatoid factor (RF; p = 0.010), elevated C-reactive protein (CRP) levels (p = 0.016), and accelerated erythrocyte sedimentation rate (ESR; p = 0.025). Longer disease duration was associated with anterior AAS (p = 0.005), subaxial subluxation (p = 0.005), and basilar settling (p = 0.003). Conclusions: As many as 75% of RA patients develop lesions that can be observed on radiographs and through MRI. The most frequent radiological findings include anterior AAS and subaxial subluxation. Long disease duration, RF seropositivity, and elevated inflammatory markers were risk factors for cervical spine involvement.


2016 ◽  
Vol 28 (4) ◽  
pp. 389-396 ◽  
Author(s):  
Henry Namme Luma ◽  
Servais Albert Fiacre Bagnaka Eloumou ◽  
Ellis Atemlefeh Fualefeh-Morfaw ◽  
Agnes Malongue ◽  
Elvis Temfack ◽  
...  

While gastrointestinal disease is common among HIV infected individuals, the prevalence and distribution of ano-rectal pathology has not been well studied in our setting. The objective of this study therefore was to determine the prevalence and determinants of ano-rectal pathology in HIV infected patients attending the Douala General Hospital HIV treatment centre. A hospital-based cross-sectional study was undertaken. We collected socio-demographic, clinical and laboratory data using a structured questionnaire and patients’ files. Each study participant had a full physical and ano-rectal examination. We further studied factors associated with having at least one ano-rectal lesion by logistic regression reporting odds ratios (ORs) and their 95% confidence intervals (CI). We included 390 HIV infected patients. The mean age was 41 (SD: 8) years and 48% were men. Median duration since HIV diagnosis was 3 (interquartile range: 2–5) years and median CD4 cell count was 411 (interquartile range: 234–601) cells/mm3. Prevalence of ano-rectal pathology was 22.8% (95% CI: 18.7–27.3). Hemorrhoids and proctitis were most common lesions found; each in 10% of patients. From multivariate logistic regression, factors associated with ano-rectal pathology were CD4 < 350 cells/ml (OR: 2.1, 95% CI: 1.1–4.2), not on highly active antiretroviral therapy (OR: 2.2, 95% CI: 1.1–4.6), inpatient (OR: 2.3, 95% CI: 1.2–4.3), ano-rectal intercourse (OR: 5.0, 95% CI: 1.7–15.1), and more than one sexual partner (OR: 2.4, 95% CI: 1.3–4.2). Ano-rectal pathology is common amongst HIV infected patients. Care givers should actively investigate and treat them as this will improve the quality of life of people living with HIV/AIDS.


2021 ◽  
Vol 48 (1) ◽  
Author(s):  
Eman A. Baraka ◽  
Mona G. Balata ◽  
Shereen H. Ahmed ◽  
Afaf F. Khamis ◽  
Enas A. Elattar

Abstract Background This study aimed to measure the serum and synovial interleukin (IL)-37 levels in rheumatoid arthritis (RA) patients compared to patients with primary knee osteoarthritis (PKOA) and healthy controls and to detect its relation to RA disease activity. Results This cross-sectional study included 50 RA patients with a mean age of 40.24 ± 8.62 years, 50 patients with PKOA with a mean age of 56.69 ± 4.21, and 40 healthy controls with a mean age of 41.75 ± 7.38 years. The mean serum IL-37 level in the RA patients (382.6 ± 73.97 pg/ml) was statistically significantly (P < 0.001) the highest among the studied groups; however, it showed a non-significant difference between the PKOA patients (70.38 ± 27.49 pg/ml) and the healthy controls (69.97 ± 25.12 pg/ml) (P > 0.94). Both serum and synovial IL-37 levels were significantly positively correlated with disease activity scores (r = 0.92, P< 0.001 and r = 0.85, P < 0.001), tender joint counts (r = 0.83, P < 0.001 and r = 0.82, P < 0.001 ), swollen joint counts (r = 0.72, P < 0.001 and r = 0.60, P < 0.001), visual analog scale (r = 0.82, P < 0.001 and r = 0.82, P < 0.001), erythrocyte sedimentation rate (r = 0.75, P < 0.001 and r = 0.65, P < 0.001), and C-reactive protein (r = 0.93, P < 0.001 and r = 0.79, P < 0.001), respectively. Conclusion Serum and synovial IL-37 were significantly elevated in the RA patients, and they were closely correlated. Being less invasive, the serum IL-37 could be a marker of disease activity and could reflect the effective disease control by drugs. Having an anti-inflammatory effect could not suggest IL-37 as the key player to control inflammation alone, but its combination with other anti-proinflammatory cytokines could be investigated.


2019 ◽  
Vol 3 (3) ◽  
Author(s):  
David Franli ◽  
Makmur Sitepu ◽  
Hotma Partogi Pasaribu ◽  
Sake Juli Martina

Introduction. Chronic energy deficieny (CED) is a condition of a body characterized by low body weight and low energy stores, possibly limited physical capacity due to deprivation of food over a long period time. Ministry of Health ( Kemenkes) showed that in 2015, 305 out of 100.000 death of pregnant women is realated to malnutriotion and CED. Objective. The aim of this study is to determine the overview of pregnant women nutritional status based on mid-upper arm circumference (MUAC) in Sundari Medan General Hospital. Method. The study was an observational descriptive study with a cross sectional design. The samples of this study consists of pregnant women from Sundari Medan Genaral Hospital, who had fulilled the inclusion and esclusion criteria by total sampling. Results.. Among 60 samples, the prevalance of Non-CED woman (85%) was found higher than the mild malnutrition (15%). Conclusion. Prevalance of CED pregnant women was found higher in risky age, middle educated and high income family.  


2018 ◽  
Vol 64 (6) ◽  
pp. 509-517
Author(s):  
Geraldo Bezerra da Silva Junior ◽  
Sérgio Luiz Arruda Parente Filho ◽  
Douglas de Sousa Soares ◽  
Rodrigo da Nóbrega de Alencar ◽  
Tiago Tomaz Teles Peixoto ◽  
...  

SUMMARY OBJECTIVE: HIV-related mortality is still high, especially in developed countries. The aim of this study is to investigate factors associated to death in HIV-infected patients. METHODS: This is a cross-sectional study with all HIV adult patients admitted to a tertiary infectious diseases hospital in Fortaleza, Northeast Brazil, from January 2013 to December 2014. Patients were divided into two groups: survivors and non-survivors. Demo-graphical, clinical and laboratory data were compared and a logistic regression was performed in order to investigate risk factors for death. P values ≤0.05 were considered statistically significant. RESULTS: A total of 200 patients with mean age of 39 years were including in the study, 69.5% males. Fifteen patients (7.5%) died. Non-survivors presented a higher percentage of males (93.3 vs. 67.3%, p = 0.037). Non-survivors presented AKI (73.3 vs. 10.3%, p < 0.001), liver dysfunction (33.3 vs. 11.5, p = 0.031), dyspnea (73.3 vs. 33.0%, p = 0.002) and disorientation (33.3 vs. 12.4%, p = 0.025) more frequently. Non-survivors also had higher levels of urea (73.8 ± 52.7vs. 36.1 ± 29.1 mg/dL, p < 0.001), creatinine (1.98 ± 1.65 vs. 1.05 ± 1.07 mg/dL, p < 0.001), aspartate aminotransferase (130.8 vs. 84.8 U/L, p = 0.03), alanine aminotransferase (115.6 vs. 85.4 U/L, p = 0.045) and lactate dehydrogenase (LDH) (1208 vs. 608 U/L, p = 0.012), as well as lower levels of bicarbonate (18.0 ± 4.7 vs. 21.6 ± 4.6 mEq/L, p = 0.016) and PCO2 (27.8 ± 7.7 vs. 33.0 ± 9.3 mmHg, p = 0.05). In multivariate analysis, disorientation (p = 0.035, OR = 5.523, 95%CI = 1.130 – 26.998), dyspnoea (p = 0.046, OR = 4.064, 95%CI = 1.028 – 16.073), AKI (p < 0.001, OR = 18.045, 95%CI = 4.308 – 75.596) and disseminated histoplasmosis (p = 0.016, OR = 12.696, 95%CI = 1.618 – 99.646) and LDH > 1000 U/L (p = 0.038, OR = 4.854, 95%CI = 1.093 – 21.739) were risk factors for death.]CONCLUSION: AKI and disseminated histoplasmosis (DH) were the main risk factors for death in the studied population. Neurologic and respiratory impairment as well as higher levels of LDH also increased mortality in HIV-infected patients.


2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Athina Nikolarakou ◽  
Dana Dumitriu ◽  
Pierre-Louis Docquier

Primary arthritis of chondrosternal joint is very rare and occurs in infants less than 18 months of age. Presentation is most often subacute but may be acute. Child presents with a parasternal mass with history of fever and/or local signs of infection. Clinical symptoms vary from a painless noninflammatory to a painful mass with local tenderness and swelling, while fever may be absent. Laboratory data show low or marginally raised levels of white blood cells and C-reactive protein, reflecting, respectively, the subacute or acute character of the infection. It is a self-limiting affection due to the adequate immune response of the patient. Evolution is generally good without antibiotherapy with a progressive spontaneous healing. A wait-and-see approach with close follow-up in the first weeks is the best therapeutic option.


Author(s):  
Meily Manoppo ◽  
Hermie MM Tendean ◽  
Joice MM Sondakh

Objective: To compare the level of high sensitivity C-Reactive Protein (hs-CRP) on patients with premature rupture of membranes (PROM) at term pregnancy. Methods: The study was cross-sectional design. The data collection included age, parity, gestational age, birth weight, and APGAR score on 28 pregnant women at term pregnancy consisting of 14 subjects of Premature Rupture of Membrane (PROM) less than 12 hours and the remaining one was equal or more than 12 hours. We took blood samples from the subjects for the examination of hs-CRP level. Data were analyzed using non-parametric statistical test and processed using Statistical Package for Social Sciences (SPSS) version 20. Results: The mean hs-CRP level on PROM <12-hour and 12-hour group was 12.9 and 17.8 mg/l. There was not significant difference on hs-CRP level between both of group at term pregnancy (p=0.734). Conclusion: The level of hs-CRP does not have association with the incidence of PROM. [Indones J Obstet Gynecol 2017; 5-1: 12-15] Keywords: high sensitivity C-Reactive Protein, premature ruptures of membranes, term pregnancy


Author(s):  
Néstor Agra ◽  
Ana Teresa Afonso ◽  
Antón Sande ◽  
Ignacio Veleiro ◽  
José Enrique Paz ◽  
...  

IntroductionInflammatory status could play a role in alterations of blood pressure (BP) circadian rhythm. The aim of our study is to compare levels of usual inflammatory markers in patients with and without circadian BP abnormalities.Material and methodsThis is a cross-sectional design study with retrospective data analysis which included patients from an Internal Medicine Department with normal and high BP levels older than 18 years who were separated into two groups according to the circadian profile of BP (dipper and non-dipper) based on the results of 24-hour ambulatory BP monitoring. Patients were assessed for demographic characteristics and cardiovascular risk factors. We considered as inflammatory markers the platelet count (PTC), erythrocyte sedimentation rate (ESR), ultra-sensitive C-reactive protein, ferritin, fibrinogen, and uric acid.ResultsThe study included 551 patients (mean age of 54 years, 47% women). The non-dipper group had a higher percentage of individuals with higher ESR (OR = 1.77, 95% CI: 1.23–1.55, p = 0.001), uric acid (OR = 1.50, 95% CI: 1.04–2.16, p = 0.028) and fibrinogen (OR = 1.72, 95% CI: 1.18–2.51, p = 0.001) and a higher percentage of patients with higher PTC (OR = 0.54, 95% CI: 0.37–0.78, p = 0.005). These results were independent of age, waist circumference, presence of arterial hypertension, diabetes or hyperlipidemia, and use of antihypertensive drugs including renin angiotensin aldosterone system blockers.ConclusionsPatients with impaired circadian BP rhythm were associated with an unfavorable inflammatory status independently of BP levels. This fact could play a role in the prognostic differences observed between dipper and non-dipper patients.


2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Hendrika N. C. Dewi ◽  
Michaela E. Paruntu ◽  
Murniati Tiho

Abstract: Cigarette are the most cause of death around the world. Smoking cigarrete is harmful to the organs because it contains many toxic chemical that can stimulate inflammatory process. Smoking cigarrete is a risk factors for heart disease and chronic pulmonary disease (COPD). C-reactive protein (CRP) are a non spesific inflammatory marker that can elevated in both local and systemic disease. Beside biomarker, CRP also use as prognostic marker for inflammation. The purpose of this study was to identify the level of serum CRP of smokers aged >40 years old. Twenty eight smokers were eligible to this criteria and participated in this study. Cross-sectional design with a descriptive method was employed in this study. Sampels were analysed in laboratory for serum CRP levels. The results showed that 23 subjects (82%) had normal (negatif) serum CRP level and five subjects (18%) had positive serum CRP level. It can be concluded that serum CRP level of >40 years old smokers in Kolombo village, west Bitung two were mostly in normal level.Keywords: c-reactive protein (crp), active smoker, at age >40 years oldAbstrak: Rokok menjadi salah satu penyebab kematian terbesar di dunia. Merokok membahayakan hampir semua organ tubuh karena mengandung berbagai bahan kimia berbahaya yang dapat merangsang proses peradangan dan merupakan faktor utama penyakit jantung dan penyakit paru obstruktif kronik (PPOK). C-Reactive Protein (CRP) merupakan petanda inflamasi non-spesifik yang meningkat pada penyakit lokal maupun sistemik. Selain biomarker CRP juga dijadikan sebagai penanda prognostik untuk inflamasi. Tujuan dari penelitian ini untuk mengetahui kadar CRP serum pada perokok berusia >40 tahun. Dua puluh delapan perokok memenuhi syarat untuk kriteria ini dan berpartisipasi dalam penelitian ini. Penelitian ini menggunakan desain cross-sectional dengan metode deskriptif. Kadar CRP serum sampel dianalisis di laboratorium. Hasil penelitian menunjukkan bahwa 23 subyek (82%) memiliki kadar CRP serum normal (negatif) dan lima subjek (18%) memiliki kadar CRP serum positif. Dapat disimpulkan bahwa kadar CRP serum perokok berusia >40 tahun di desa Kolombo, Bitung barat dua kebanyakan dalam kadar normal.Kata kunci: c-reactive protein (crp), perokok aktif, usia >40 tahun.


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Qingxi Zhang ◽  
Qiang Liu ◽  
Chutong Lin ◽  
Yangjin Baima ◽  
Hu Li ◽  
...  

Abstract Objective To estimate the prevalence of rheumatoid arthritis (RA) in the Tibet Autonomous Region (China). Methods A population-based cross-sectional survey was conducted on 1458 residents of Luoma Town, Tibet Autonomous Region, who were aged ≥ 40 years old. We interviewed participants using questionnaires, and rheumatoid factor (RF), anti-citrullinated protein antibodies (ACPA), and C-reactive protein (CRP) were determined. The identification of RA in this study was on the basis of criteria issued by the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) guideline. Results Herein, 782 participants completed all items of RA. The overall prevalence of RA was 4.86%, and the prevalence was higher in women than that in men (7.14% vs. 2.56%, p = 0.005). The age-standardized prevalence of RA was 6.30% (95% confidence interval (CI) 4.20–8.64%), which was 2.46% (95% CI 1.04%, 4.10%) and 9.59% (95% CI 5.93%, 13.77%) in men and women, respectively. Conclusion The prevalence of RA is relatively higher in the Tibet than that in other areas of China.


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