scholarly journals The clinical and MRI effect of TNF-α inhibitor in spondyloarthritis patients with hip involvement: a real-world prospective clinical study

2021 ◽  
Author(s):  
Kui Zhang ◽  
Yan Zheng ◽  
Qing Han ◽  
Ying Liu ◽  
Weitao Wang ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Group Versus ◽  
Quantitative Mri ◽  
Control Group ◽  
Prospective Clinical Study ◽  
Clinical Trial Registry ◽  
Hip Arthritis ◽  
Tnf Α ◽  
Long Term Follow Up ◽  
Basic Treatment

Abstract Background: Hip involvement is an important cause of disability and poor prognostic in patients with spondyloarthritis (SpA). TNF-α inhibitor treatment had been demonstrated to be effective in SpA patients with hip arthritis, however, quantitative assessment with magnetic resonance imaging (MRI) in the long-term follow-up still needs further application.Methods: A total of 239 patients were involved in this study, MTX and SSZ were given as basic treatment. 165 patients received TNF-α inhibitor plus basic treatment and 74 patients received basic treatment only as control. The clinical symptoms were assessed at baseline, week 12, week 24, and week 52. The MRI performances of hip arthritis including bone marrow edema (BME) and synovitis were quantitatively assessed using Hip MRI Inflammation Scoring System (HIMRISS).Results: The clinical symptoms of ESR, CRP, BASDAI, Harris, and ASDAS-ESR of both groups got significant clinical remission at week 52 (p<0.001). However, the disease activity change levels at week 52 in control group were significantly worse than TNF group. In week 52, MRI performance showed significant remission trend in TNF-α inhibitor group versus baseline of which total HIMRISS scores decreased significantly ( 26.49±10.37 vs 20.59±9.41, p<0.001), but the control group only had slight improvement trend (p<0.05).Conclusions: TNF-α inhibitor could significantly and better improve the clinical and MRI manifestation of hip involvement in SpA patients than controls. Quantitative MRI assessment combined with clinical assessment could accurately evaluate the treatment effect of TNF-α for SpA patients with hip involvement, and help to guide targeted treatment.Trial registration: Chinese Clinical Trial Registry, ChiCTR-ONRC-11001846, Registered 28 November 2011. Retrospectively registered http://www.chictr.org.cn/showproj.aspx?proj=7701

scholarly journals The Clinical and MRI Effect of TNF-α Inhibitors in Spondyloarthritis Patients With Hip Involvement: A Real-World Observational Clinical Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Kui Zhang ◽  
Yan Zheng ◽  
Qing Han ◽  
Ying Liu ◽  
Weitao Wang ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Activity Index ◽  
Group Versus ◽  
Quantitative Mri ◽  
Harris Hip Score ◽  
Control Group ◽  
Hip Arthritis ◽  
Tnf Α ◽  
Basic Treatment

ObjectivesHip involvement is an important cause of disability and poor prognosis in patients with spondyloarthritis (SpA). Tumor necrosis factor (TNF)-α inhibitor treatment has been demonstrated to be effective in SpA patients with hip arthritis; however, quantitative assessment using MRI in long-term follow-up needs further application and observation.MethodsA total of 239 patients were involved in this study. Methotrexate and sulfasalazine were given as basic treatment. In total, 165 patients received TNF-α inhibitors plus basic treatment, and 74 received basic treatment only, as controls. Clinical symptoms were assessed at baseline and at weeks 12, 24, and 52. MRI performances of hip arthritis, including bone marrow edema (BME) and synovitis, were quantitatively assessed using the Hip Inflammation MRI Scoring System (HIMRISS).ResultsThe clinical values of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Harris hip score, and Ankylosing Spondylitis Disease Activity Score (ASDAS)-ESR in both groups showed significant clinical remission at week 52 (p &lt; 0.001). However, the change in disease activity levels at week 52 in the control group was significantly worse than in the TNF-α inhibitor group. At week 52, MRI showed a significant remission trend in the TNF-α inhibitor group versus baseline, and total HIMRISS scores were significantly decreased (26.49 ± 10.37 vs. 20.59 ± 9.41, p &lt; 0.001); the control group only had slight improvement (p &lt; 0.05).ConclusionsTNF-α inhibitors could significantly improve clinical and MRI manifestations of hip involvement in patients with SpA. Quantitative MRI assessment combined with clinical assessment can be used to accurately evaluate the treatment effect of TNF-α in SpA patients with hip involvement to help guide targeted treatment.

Effect of Nudge-Based Intervention on Adherence to Physician Visit Recommendations and Early Health Outcomes among Individuals Identified with Chronic Kidney Disease in Screens

2021 ◽  
pp. ASN.2021050664
Author(s):  
Shingo Fukuma ◽  
Shusaku Sasaki ◽  
Masataka Taguri ◽  
Rei Goto ◽  
Toshihiro Misumi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Health Outcomes ◽  
Behavioral Economics ◽  
Physician Visit ◽  
Group Versus ◽  
Control Group ◽  
Trial Registry ◽  
Clinical Trial Registry ◽  
Screening Programs ◽  
Early Health

BackgroundAlthough CKD screening programs have been provided in many settings, little is known as to how we can effectively translate those screening programs into improved health.MethodsWe conducted a randomized clinical trial on national health screening for CKD in Japan between April 2018 and March 2019. A total of 4011 participants in CKD screening programs aged 40–63 years were randomly assigned to two interventions or the control, with a ratio of 2:2:1, respectively: (1) the nudge-based letter that contained a message on the basis of behavioral economics, (2) the clinical letter including general information about CKD risks, and (3) the control (informed only of the screening results). The main outcome was adherence to a recommended physician visit within 6 months of the intervention. The secondary outcomes were eGFR, proteinuria, and BP 1 year after the intervention.ResultsCompared with the control group, the probability of undergoing a recommended physician visit was higher among participants who received the nudge-based letter (19.7% for the intervention group versus 15.8% for the control; difference, +3.9 percentage points [pp]; 95% CI, +0.8 to +7.0; P=0.02) and the clinical letter (19.7% versus 15.8%; difference, +3.9 pp; 95% CI, +0.8 to +7.0; P=0.02). We found no evidence that interventions were associated with improved early health outcomes.ConclusionsThe behavioral economics intervention tested in this large RCT had limited effect on changing behavior or improving health outcomes. Although the approach has promise, this study demonstrates the challenge of developing behavioral interventions that improve the effectiveness of CKD screening programs.Clinical Trial registry name and registration number: University Hospital Medical Information Network Clinical Trial Registry, UMIN000035230

scholarly journals Study protocol for a parallel-group, double-blinded, randomized, controlled, noninferiority trial: the effect and safety of hybrid electroconvulsive therapy (Hybrid-ECT) compared with routine electroconvulsive therapy in patients with depression

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Han Rong ◽  
Shu-xian Xu ◽  
Jing Zeng ◽  
Ying-jia Yang ◽  
Jie Zhao ◽  
...  
Keyword(s):  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Clinical Symptoms ◽  
Event Related Potential ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Parallel Group ◽  
Magnetic Resonance Imaging Mri ◽  
Double Blinded ◽  
Low Charge

Abstract Background Electroconvulsive therapy (ECT) is the most rapid and effective treatment for patients with depression, ECT can achieve remarkable antidepressant effects in the initial 3–4 sessions, but significant side effects limit its use. However, recent low-charge electrotherapy (LCE) studies have demonstrated antidepressant or antipsychotic effects with significantly fewer side effects. The aim of this study is to propose a novel two-step charge set strategy for ECT treatment, referred to as Hybrid-ECT, to decrease side effects by using a low charge while preserving treatment efficacy. Methods/design A randomized, double-blinded, standard-controlled, parallel-group design will be carried out. We plan to enroll 112 inpatients diagnosed with depression (unipolar or bipolar) and randomly assign them to conventional ECT (control group) or to Hybrid-ECT (treatment group, 3 ECT sessions followed by LCE sessions (approximately 2.8 joules per session)). We will evaluate participants across a wide variety of domains including clinical symptoms, cognitive, psychological and functional metrics. We will also perform magnetic resonance imaging (MRI) and event-related potential (ERPs) assessments during treatment to explore brain function differences between ECT and LCE. Discussion This research proposes a simple but completely novel ECT strategy that aims to rapidly relieve depressive symptoms and minimize side effects. The mechanism of ECT and LCE will be further discussed. Trial registration Chinese Clinical Trial Registry, Number: ChiCTR1900022905 (Registration date: April 30, 2019).

scholarly journals Mouse duodenum as a model of inflammation induced by enterotoxigenic Escherichia coli K88

2016 ◽  
Vol 60 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Kai Wang ◽  
Yu Qi ◽  
Shushuai Yi ◽  
Zhihua Pei ◽  
Na Pan ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Clinical Symptoms ◽  
Treated Group ◽  
Model Material ◽  
The Body ◽  
Enterotoxigenic Escherichia Coli ◽  
Control Group ◽  
Mucous Layer ◽  
E Coli ◽  
Tnf Α

Abstract Introduction: The aim of the experiment was to establish the enterotoxigenic Escherichia coli K88 (ETEC K88)-induced BALB/c mouse duodenum inflammation model. Material and Methods: Mice were administered different concentrations of E. coli K88 (1.0 × 107-109 CFU/mL) for 3 d by means of an esophageal catheter. Results: The results showed that the treated group expressed several significant clinical symptoms, such as reduced dietary demands and weight loss, an increased presence of IL-1α, TNF-α, and MPO in the peripheral blood, and some pathological changes in the duodenum. On the 6th-8th days, the body weight of the mice was the lowest. On the 8th day, there were significant differences in IL-1α, TNF-α, and MPO levels compared to the control group (P < 0.05), the gap between the duodenum mucous layer and the muscular layer had widened, the number of goblet cells was increased, and the inflammatory infiltrate and inflammation changes in the lamina propria and the mucous layer were the most obvious. Conclusion: The duodenum inflammation was the most severe on day 8; thus, the model was successfully established. In addition, varying concentrations of ETEC K88 did not significantly influence the duodenum inflammation (P > 0.05).

scholarly journals Assessment of Inflammatory Markers in Children with Cow’s Milk Allergy Treated with a Milk-Free Diet

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1057
Author(s):  
Jadwiga Ambroszkiewicz ◽  
Joanna Gajewska ◽  
Magdalena Chełchowska ◽  
Grażyna Rowicka
Keyword(s):  
Clinical Symptoms ◽  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Control Group ◽  
Low Grade ◽  
Healthy Children ◽  
Milk Allergy ◽  
Cow's Milk ◽  
Cow's Milk Allergy ◽  
Tnf Α

Background: The aim of the study was to establish whether the use of a strict milk-free diet in children with cow’s milk allergy, resulting in the resolution of clinical symptoms of the disease, also extinguishes the inflammatory reaction induced by the allergy. Methods: We examined 64 children (aged 3–6 years) with a diagnosed cow’s milk allergy who had been treated with an elimination diet for at least six months and showed remission of the disease’s clinical symptoms as a result of the treatment. The control group consisted of 30 healthy children of the same age following an unrestricted age-appropriate diet. Concentrations of cytokines, calprotectin, and adipokines (leptin, resistin, chemerin, neutrophilic lipocalin associated with gelatinase—NGAL) were determined in the serum samples obtained from the studied children by immunoenzymatic assays. Results: Patients with CMA had significantly higher median values of serum IL-6, TNF-α, resistin, chemerin and NGAL in comparison to the healthy children (p < 0.05, p < 0.001, p < 0.05, p < 0.01, p < 0.001, respectively). Serum concentrations of IL-10, leptin, calprotectin and CRP as well as in WBC count were in the same range in both studied groups. We observed direct statistically significant correlations between levels of IL-10 and CRP (p = 0.005), IL-10 and WBC (p = 0.045), TNF-α and WBC (p = 0.038), calprotectin and WBC (p < 0.001), chemerin and CRP (p < 0.001) as well as between NGAL and WBC (p = 0.002) in children with CMA. Conclusion: The use of a strict milk-free diet by children with CMA, resulting in the resolution of clinical symptoms of the disease, does not seem to extinguish the inflammation induced by the allergy. The findings of this study—elevated IL-6, TNF-α, resistin, chemerin and NGAL levels in patients with CMA—suggest that these parameters seem to be involved in the generation of a low-grade proinflammatory environment observed in cow‘s milk allergy and could be used to monitor the effectiveness of treatment.

scholarly journals EFFICIENCY OF TREATMENT OF INFLAMMATORY PERIODONTAL DISEASES IN PREGNANT WOMEN

2021 ◽  
Vol 74 (5) ◽  
pp. 1065-1068
Author(s):  
Nataliia G. Gadzhula ◽  
Olena L. Cherepakha ◽  
Olena V. Lezhnova
Keyword(s):  
Pregnant Women ◽  
Oral Hygiene ◽  
High Efficiency ◽  
Periodontal Diseases ◽  
Group Versus ◽  
Main Group ◽  
Control Group ◽  
Periodontal Tissues ◽  
Prophylactic Measures ◽  
Basic Treatment

The aim: To study the clinical efficciency of the proposed scheme of gingivitis treatment in women with physiological course of pregnancy. Materials and methods: Clinical approbation of the proposed complex of therapeutic and prophylactic measures was carried out in 32 pregnant women with gingivitis, aged 18 to 35 years. The efficiency of the treatment was assessed by the dynamics of the clinical picture, the index assessment of an oral hygiene and the periodontium condition in each trimester of pregnancy. Results: According to the data of performed observations, the high efficiency of the proposed treatment scheme is shown: 84.4% in the main group versus 46.9% in the control group. It has been clinically proven that the proposed scheme of inflammatory periodontal diseases treatment in terms of therapeutic efficiency exceeds the generally accepted basic treatment. Conclusions:The use of the proposed complex of therapeutic and prophylactic measures in the main group of patients contributed to the elimination of the inflammatory process in the periodontal tissues, suspended the progression of existing diseases, made it possible to prevent the emergence of new nosological forms, improved the condition of the oral hygiene, which makes it possible to recommend it for treatment of periodontal diseases in pregnant women.

scholarly journals Effect of Moxibustion on β-EP and Dyn Levels of Pain-Related Indicators in Patients with Rheumatoid Arthritis

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yingni Wang ◽  
Siyu Tao ◽  
Zeyun Yu ◽  
Yun Luo ◽  
Yuan Li ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Treatment Group ◽  
Clinical Symptoms ◽  
Inflammatory Factors ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Tnf Α ◽  
Significant Difference ◽  
Routine Inspection ◽  
Anti Inflammatory

Background. Rheumatoid arthritis (RA) is a systemic immunodeficiency disease characterized by persistent synovial inflammation, pannus formation, and bone and cartilage destruction, resulting in joint malformations and function decline. Objective. The purpose of this study is to evaluate the effect of moxibustion on clinical symptoms and levels of pain-related indicators beta-endorphin (β-EP) and dynorphin (Dyn) in patients with RA and to explore the potential anti-inflammatory and analgesic mechanisms of moxibustion in RA treatment. Methods. A total of 64 patients with RA who met the inclusion criteria were randomly and equally classified into the control and treatment groups. The control group received conventional treatment (oral methotrexate, folate, or leflunomide prescribed for a long time). The treatment group was treated with moxibustion at ST36 (Zusanli), BL23 (Shenshu), and Ashi points with respect to the control group. Patients’ clinical symptoms and routine inspection indexes (rheumatoid factor [RF], erythrocyte sedimentation rate [ESR], and C-reactive protein [CRP]) were recorded before and after treatment. Serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), β-EP, and Dyn were determined by enzyme-linked immunosorbent assay (ELISA). The software SPSS24.0 was used for statistical analysis. Results. (1) Compared with the pretreatment result, both of the two groups’ clinical symptoms and routine inspection indexes (RF, ESR, and CRP) improved ( P  < 0.05), and the improvement of clinical symptoms in the treatment group outperformed that in the control group ( P  < 0.05). (2) TNF-α and IL-1β levels decreased significantly in the treatment group after treatment ( P  < 0.01), while no significant difference was observed in the control group ( P  > 0.05). (3) β-EP and Dyn levels in the treatment group were significantly increased after treatment ( P  < 0.01, P  < 0.01), but the control group showed no significant difference ( P  > 0.05, P  > 0.05). It is worth mentioning that the serum TNF-α, IL-1β, β-EP, and Dyn levels between the two groups were significantly different after 8 weeks of treatment ( P  < 0.05). (4) Differences in the serum β-EP and Dyn levels in the patients of the treatment group were correlated with TNF-α and IL-1β levels after treatment, and the correlation was mainly negative (r < 0). Conclusion. Moxibustion can improve joint pain in patients with RA using conventional western medicine. One of the mechanisms may affect the serum β-EP and Dyn levels by downregulating the inflammatory factors to play an anti-inflammatory and analgesic role.

scholarly journals Clinical study on wenmaitongguan decoction combined with Moxibustion in the treatment of lower extremity arteriosclerosis obliterans

2021 ◽  
Vol 3 (3) ◽  
pp. 39-49
Author(s):  
Fuxu GE ◽  
Jingbao WANG ◽  
Laijie LIU ◽  
Wansheng LI ◽  
Bin ZHAO
Keyword(s):  
Treatment Group ◽  
Lower Extremity ◽  
Intermittent Claudication ◽  
Clinical Symptoms ◽  
Control Group ◽  
Inflammatory Factor ◽  
Vascular Endothelial ◽  
Arteriosclerosis Obliterans ◽  
Tnf Α ◽  
The Difference

Objective To explore the efficacy of wenmaitongguan decoction combined with Moxibustion in the treatment of lower extremity arteriosclerosis obliterans. Methods From January 2020 to January 2021, 150 patients with lower extremity arteriosclerosis obliterans were randomly divided into treatment group (76 cases) and control group (74 cases). The treatment group was treated with wenmaitongguan decoction combined with moxibustion, and the control group was treated with alprostadil. The clinical efficacy, the distance of intermittent claudication, brachial femoral index, no, endothelin-1 and inflammatory factor (TNF-α、CRP) were compared between the two groups before treatment, 7 days and 4 weeks after treatment。 Results 1. There was no difference in vascular endothelial function before treatment (P > 0.05); The level of ET-1 in the treatment group was significantly lower than that in the control group at 7 days and 4 weeks after treatment (P < 0.05), while the level of no in the treatment group was significantly higher than that in the control group (P < 0.05). 2. The level of ABI and intermittent claudication at 7 days and 4 weeks after treatment were significantly improved (P < 0.05), The difference was statistically significant (P < 0.05). 3. Tumor necrosis factor (TNF--α) in two groups、 Comparison of C-reactive protein (CRP),before treatment，There was no difference in CRP、TNF-α (P > 0.05); The level of water in the treatment group was significantly lower than that in the control group 7 days and 4 weeks after treatment (P < 0.05). Conclusion: wenmaitongguan decoction combined with moxibustion can alleviate clinical symptoms by reducing vascular endothelial injury, reducing vascular endothelial inflammatory reaction, restoring vascular tension, expanding peripheral blood vessels and improving peripheral microcirculation.

Possibilities of correction of menopausal disorders in women with the use of medicine Menopace

2016 ◽  
pp. 95-100
Author(s):  
G.I. Reznichenko ◽  
◽  
N.Yu. Reznichenko ◽  
V.Yu. Potebnya ◽  
K.I. Kovalenko ◽  
...  
Keyword(s):  
General Condition ◽  
Clinical Symptoms ◽  
Average Score ◽  
Control Group ◽  
Climacteric Syndrome ◽  
Basic Subgroup ◽  
Menopausal Syndrome ◽  
Natural Menopause ◽  
Surgical Menopause ◽  
Observation Period

The objective: to determine the efficacy of medicine «Menopace» in treatment of women with natural and surgical menopause. Patients and methods. 20 women (I group) with a natural menopause were examined (basic subgroup consisted of 10 patients who used Menopace for 3 months; control subgroup consisted of 10 patients). 20 women (II group) with surgical menopause were examined (basic subgroup consisted of 10 patients who received Menopace for 3 months; control subgroup consisted of 10 patients). Results. The average score of neurovegetative and emotional manifestations of climacteric syndrome during the observation period decreased in women with natural and surgical menopause who used Menopace, compared with subgroups of patients who had not used the medicine. Conclusions. 1. The use of the medicine Menopace in women with natural menopause after 3 months showed the disappearance of clinical symptoms of climacteric syndrome in 70% of the cases, and significant improvement in general condition in 30% of cases. 2. During surgical menopause after 1 month of treatment with Menopace manifestations of sweating were observed 4.5 times less often than in control group, tides were observed 7 times less often than in control group. Neurovegetative and psychoemotional symptoms of menopause were absent in 80% of women after 3 months of treatment and in 20% of cases significant improvement was shown. 3. The obtained results give grounds to recommend wide use of Menopace in practical work for the treatment of menopausal syndrome during natural and surgical menopause. Key words: menopause, therapy, Menopace.

The Predictive Role of Biochemical Plasma Factors in Patients with Severe Traumatic Brain Injuries

2019 ◽  
Vol 70 (5) ◽  
pp. 1754-1757
Author(s):  
Marius Toma Papacocea ◽  
Ioana Anca Badarau ◽  
Mugurel Radoi ◽  
Ioana Raluca Papacocea
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Cell ◽  
Brain Injuries ◽  
Hematological Parameters ◽  
Group Versus ◽  
Public Health Problem ◽  
Traumatic Brain Injuries ◽  
High Rate ◽  
Control Group

Traumatic brain injuries (TBI) represent a high impact public health problem due to a high rate of death , long term disability and occurrence especially in young adults. Despite several promising animal studies, several parameters were proposed as biological markers and were assessed for this aim. Our study proposes the study of the early biochemical changes in association to hematological parameters for severe TBI patients prognosis. 43 patients with acute TBI were included in study based on clinical, laboratory and imagistic findings. The severity of the TBI was established by Glasgow Coma Scale GCS 3-8. In all patients were evaluated hematologic parameters (Red blood cell count - RBC, Hematocrit, blood Hemoglobin, White blood cell - WBC, Platelet count and biochemical parameters (glucose, urea, creatinine, electrolytes). Outcome was expressed as Glasgow Outcome Scale (GOS), between 1-5. Values were compared to control group -15 cases. Significant early differences in body temperature, heart rate, and systolic blood pressure were observed in TBI group versus control (p[0.05). After correlation, laboratory findings significantly associated to severe outcome - GOS = 1, 2 - (p[0.05) were plasma Na decrease and significant glucose increase. An early increase of temperature and decrease of Na may predict a severe outcome in patients with acute TBI; association with shifts in heart rate and blood pressure, imposes aggressive treatment measures.

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