scholarly journals Anti-CCP antibody in rheumatoid arthritis patients and its relation with severity of the disease

2021 ◽  
Vol 12 (1) ◽  
pp. 36-40
Author(s):  
Roksana Yasmin ◽  
HN Sarker

Background: Rheumatoid arthritis (RA) is a systemic inflammatory disease characterized by chronic and erosive polyarthritis causing irreversible joint disability. It is the most common persistent inflammatory arthritis, affecting from 0.5 to 1% of the general population worldwide. Antibodies to citrullinated proteins (anti-CCP antibody) have been described in patients with RA and these appear to be the most specific marker of the disease. Methods: This cross-sectional study was carried out at department of medicine, Sher-E-Bangla Medical College Hospital, Barisal Form July’ 2016 to December’ 2016. All rheumatoid arthritis patients attending at OPD and those got admitted under Medicine Dept, who was satisfying the inclusion and exclusion criteria were included consecutively and purposively in this study. Results: Total 70 cases were included; the mean age was found 46.57±13.10 years in anti-CCP antibody positive group and 44.19±11.21 years in anti-CCP antibody negative group. Female were predominant in both groups. Duration of disease was around 8 years in both groups. Mean ESR was 29.0±22.0 mm in anti-CCP antibody positive group and 12.25±10.6 mm in anti-CCP antibody negative group. Mean rheumatoid factor was 189.4±102.1 U/L in anti-CCP antibody positive group and 66.5±36.0 U/L in anti-CCP antibody negative group. Mean DAS 28 score was 4.6±1.4 and 3.6±1.3 in anti-CCP antibody positive and negative group respectively. The mean difference was statistically significant (p<0.05) between the groups. Patients in disease remission had lower anti-CCP antibody titer than those with low, moderate or high disease activity. Significantly positive correlation (r=0.596; p=0.001) between severity of rheumatoid arthritis and anti CCP antibody level was observed. Conclusion: In RA patients’ disease was more severe in anti-CCP antibody positive group and significantly positive correlation between anti-CCP antibody level with disease severity of RA was observed. BIRDEM Med J 2022; 12(1): 36-40

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Ahmad Gholami ◽  
Jassem Azizpoor ◽  
Elham Aflaki ◽  
Mehdi Rezaee ◽  
Khosro Keshavarz

Introduction. Rheumatoid arthritis (RA) is a chronic progressive inflammatory disease that causes joint destruction. The condition imposes a significant economic burden on patients and societies. The present study is aimed at evaluating the cost-effectiveness of Infliximab, Adalimumab, and Etanercept in treating rheumatoid arthritis in Iran. Methods. This is a cost-effectiveness study of economic evaluation in which the Markov model was used. The study was carried out on 154 patients with rheumatoid arthritis in Fars province taking Infliximab, Adalimumab, and Etanercept. The patients were selected through sampling. In this study, the cost data were collected from a community perspective, and the outcomes were the mean reductions in DAS-28 and QALY. The cost data collection form and the EQ-5D questionnaire were also used to collect the required data. The results were presented in the form of an incremental cost-effectiveness ratio, and the sensitivity analysis was used to measure the robustness of the study results. The TreeAge Pro and Excel softwares were used to analyze the collected data. Results. The results showed that the mean costs and the QALY rates in the Infliximab, Adalimumab, and Etanercept arms were $ 79,518.33 and 12.34, $ 91,695.59 and 13.25, and $ 87,440.92 and 11.79, respectively. The one-way sensitivity analysis confirmed the robustness of the results. In addition, the results of the probabilistic sensitivity analysis (PSA) indicated that on the cost-effectiveness acceptability curve, Infliximab was in the acceptance area and below the threshold in 77% of simulations. The scatter plot was in the mentioned area in 81% and 91% of simulations compared with Adalimumab and Etanercept, respectively, implying lower costs and higher effectiveness than the other two alternatives. Therefore, the strategy was more cost-effective. Conclusion. According to the results of this study, Infliximab was more cost-effective than the other two medications. Therefore, it is recommended that physicians use this medication as the priority in treating rheumatoid arthritis. It is also suggested that health policymakers consider the present study results in preparing treatment guidelines for RA.


2020 ◽  
pp. 014556132097550
Author(s):  
Hakan Avcı ◽  
Burak Karabulut

Objective: This study aimed to conduct a study to evaluate the relation between otolaryngology-specific symptoms and computed tomography findings in ambulatory care COVID-19 patients. Patient and Methods: The study was conducted with medical records of 987 (82%) patients with confirmed COVID-19 virus via real-time reverse transcription-polymerase chain reaction between March 11, 2020, and April 21, 2020. Patients were divided into 2 groups as computed tomography (CT)-negative and CT-positive groups considering the presence of the CT findings depicting COVID-19 disease. Results: The mean age was significantly higher in CT-positive group than CT-negative group (41.53 ± 12.82 vs 36.61 ± 11.81, P < .001). Cough and shortness of the breath were observed with a significantly higher rate in CT-positive group than that of CT-negative group (44% vs 29.9%, P = .001 and 18.4% vs 9.7%, P = .002, respectively). Conclusions: In conclusion, advanced age, cough, and shortness of breath could be related to CT scan positivity.


2020 ◽  
Vol 163 (3) ◽  
pp. 473-479 ◽  
Author(s):  
İbrahim Sayin ◽  
Kadriye Kart Yaşar ◽  
Zahide Mine Yazici

Objective To identify the taste and smell impairment in coronavirus disease 2019 (COVID-19)–positive subjects and compare the findings with COVID-19–negative subjects using the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) Anosmia Reporting Tool. Setting Tertiary referral center/COVID-19 pandemic hospital. Study Design Comparative study. Subjects and Methods After power analysis, 128 subjects were divided into 2 groups according to real-time polymerase chain reaction (RT-PCR) COVID-19 testing results. Subjects were called via telephone, and the AAO-HNS Anosmia Reporting Tool was used to collect responses. Results The mean age of the study group was 38.63 ± 10.08 years. At the time of sampling, rhinorrhea was significantly high in the COVID-19–negative group, whereas those complaints described as “other” were significantly high in the COVID-19–positive group. There was a significant difference in the smell/taste impairment rates of the groups (n = 46% [71.9%] for the COVID-19–positive group vs n = 17 [26.6%] for the COVID-19–negative group, P = .001). For subjects with a smell impairment, anosmia rates did not differ between the groups. The rates of hyposmia and parosmia were significantly high in the COVID-19–positive group. For the subjects with taste impairment, ageusia rates did not differ between groups. The rate of hypogeusia and dysgeusia was significantly high in the COVID-19–positive group. Logistic regression analysis indicates that smell/taste impairment in COVID-19–positive subjects increases the odds ratio by 6.956 (95% CI, 3.16-15.29) times. Conclusion COVID-19–positive subjects are strongly associated with smell/taste impairment.


2020 ◽  
Vol 3 (1) ◽  
pp. e1-e4
Author(s):  
Rabia Razaq

Background: Accurate prenatal estimation of birth weight is useful in the management of labour and delivery. Objective: To determine the correlation between clinical estimated fetal weight with actual birth weight in 3rd trimester of pregnancy and to determine the correlation between Ultrasonographic fetal weight assessment with actual birth weight in 3rd trimester of pregnancy. Material & Methods: This cross sectional study with non-probability purposive sampling technique was conducted in three tertiary care hospitals of Punjab, Department of Obstetrics & Gynaecology, Allied Hospital, Faisalabad, Lady Aitcheson Hospital Lahore and Lady Willington Hospital Lahore. Informed consent was obtained from each female to use their data for research purpose. Demographic details were also noted. Then females undergo CEFW was done by using Johnson’s formula. Then ultrasonography was done on every female by experienced radiologists to get UEFW. FW measurement was done by using Shepard formula. Then females were followed-up till delivery of fetus. Actual birth weight (ABW) was noted on birth. Pearson correlation was used to measure the correlation coefficient for CEFW and UEFW with ABW. P-value≤0.05 was taken as significant. Results: In our study the mean age of the patients was 29.60±6.23 years and the mean gestational age of 33.30±2.31 weeks. The mean BMI value of the patients was 23.08±1.26 Kg/m2, the mean CEFW value 2219.60±556.41 grams while the mean UEFW value of the patients was 2227.77±521.94 grams and the mean value of ABW of the patients was 2284.00±515.29 grams. In our study the positive correlation was found between the CEFW, UEFW with ABW of the baby. Conclusion: Our study results concluded that both the clinical estimation ultrasonography estimation showed the feasible and reliable results. Both showed positive correlation with actual birth weight.


2013 ◽  
Vol 2 (1) ◽  
pp. 14-20
Author(s):  
Samaresh Chandra Hazra ◽  
Ehsanul Kabir ◽  
Nafiza Ahmed

Background: Doxepin hydrochloride is a dibenzoxepin tricyclic, has a potent H1 & H2 receptor blocking actions. If topical doxepin can effectively control pruritus associated with eczematous dermatoses, we can use it as adjunctive therapy and can reduce the drawbacks of topical steroids and antihistamines. Methods: An interventional study from january 2010 to june 2010 has done in the department of dermatology and venereology, Faridpur Medical College Hospital, Bangladesh to evaluate the efficacy of topical doxepin cream in eczematous dermatoses. We included moderate to severe pruritic eczematous dermatoses patient in this study. Results: Improvement of pruritus was assessed at day 3 and at day 7 by both Visual analogue scale (VAS) and Itch severity scale (ISS). At day 3 by VAS 61.3 %( 57) patients showed improvement and at day 7 improvement rate increases to 84.9% (79). By ISS improvement at day 3 was 68.9% (64) and increased to 90.3% (84) at day 7. Improvement was experienced by all types of eczema patients. An average of 27.27% (29.88% by VAS and 24.65% by ISS) reduction of pruritus noticed at the end of day 3 and at the end of study, response increases to 55.58% (57.10% by VAS and 54.06% by ISS). Paired sample t test was done both for visual analogue scale (VAS) and itch severity scale (ISS) that compare the mean pruritus reduction at day 3 and day 7 with baseline pruritus (day-0). Pruritus reduction was statistically significant at day 3 and day 7 both by VAS & ISS.Conclusion: Doxepin cream is highly effective in relieving pruritus associated with eczematous dermatoses but it has little effect on eczema itself.DOI: http://dx.doi.org/10.3329/updcj.v2i1.13955 Update Dent. Coll. j: 2012; 2 (1): 14-20


1993 ◽  
Vol 1 (2) ◽  
pp. 91-93
Author(s):  
Iris Ayala-Rodriguez ◽  
Joseph Apuzzio

Objective: To compare the epidemiology and hospital course of patients with acute salpingitis with and without coincident human immunodeficiency virus (HIV) seropositivity.Methods: Patients admitted to the UMDNJ-University Hospital in Newark, New Jersey from January 1, 1991, to December 31, 1991, with acute salpingitis were studied.Results: Eight percent of all hospitalized patients with acute salpingitis were HIV-positive. The mean age of the HIV-negative group was 25.4 compared with 29.6 years in the HIV-positive group. Gonorrhea and chlamydia were present in 49% and 22%, respectively, in HIV-negatives and in 40% and 20% of HIV-positives. Two of 5 (40%) HIV-positive patients had tuboovarian abscesses compared with 12 of 59 (20%) HIV-negative patients. Three of 5 (60%) HIV-positive patients had admission WBC counts fewer than 10,000/mm3 compared to 6 of 59 (12%) of HIV-negatives (P = 0.024). The hospital stay was 5.4 days for HIV-positives and 5.8 days for HIV-negatives.Conclusions: Eight percent of hospitalized patients with acute salpingitis were HIV-seropositive. Neisseria gonorrhoeae and chlamydia were commonly found organisms in both groups. The initial WBC count was lower for HIV-positive patients. The hospital course of both groups was similar.


Author(s):  
ANOOP KUMAR ◽  
PREETI SHARMA ◽  
PRADEEP KUMAR ◽  
ASHOK KUMAR

Objectives: The aim of this study is to estimate the level of creatine kinase-myocardial band (CK-MB), C-reactive protein (CRP), and lactate dehydrogenase (LDH) biomarker in myocardial infarction (MI) (troponin T-positive) and compare with normal healthy individuals (Troponin-T [TnT] negative). Methods: A cross-sectional study on 172 patients involving 100 patients with nondiabetic MI and 72 apparently healthy controls with no history of diabetes and/or MI was done from December 2017 to May 2018. The diagnosis of MI was established with electrocardiogram findings and TnT estimation. Blood samples were gathered and processed for the estimation of CK-MB, LDH, and CRP. Results: The mean age of the cases was 62.15±7.75 years and in the controls was 61.49±8.35 years (p=0.592). The mean value of CK-MB, LDH, and CRP in the TnT positive group was 111.94±29.59 IU/L, 564.43±110.99 IU/L, and 15.69±4.04 mg/L, whereas in the TnT negative group was 16.36±3.77 IU/L, 223.68±36.23 IU/L, and 6.08±2.02 mg/L, respectively (p<0.0001). CK-MB was deranged in 100% of TnT positive group, and in only 2.78% in TnT negative group (p<0.0001). LDH was deranged in 100% TnT positive group, and in 16.67% in TnT negative group (p<0.0001). CRP was deranged in 4% TnT positive group, and in 0% in TnT negative group (p=0.141). Conclusion: This study indicated that CK-MB and LDH are sensitive cardiac markers for the diagnosis of MI.


Author(s):  
Alia Fazaa ◽  
Hiba Bettaieb ◽  
Meriem Sellami ◽  
Saoussen Miladi ◽  
Kmar Ouenniche ◽  
...  

Objectives: This study aims to assess the different delays of rheumatoid arthritis (RA) patients’ journey from disease onset to treatment initiation and to identify possible influencing factors. Patients and methods: This cross-sectional study included a total of 100 patients (14 males, 86 females; mean age: 56.5±12.4 years; range, 26 to 82 years) who met the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) criteria for RA between January 2019 and January 2020. Demographic and clinical data and disease characteristics were collected from the patient interviews and medical files. Five different intervals were defined from symptom onset until the initiation of conventional synthetic disease-modifying anti- rheumatic drugs (csDMARDs). Results: The mean age at RA onset was 46.6±12.4 years. Median delays from onset of symptoms until general practitioner (GP) and rheumatologist consultations were six (range, 0.25 to 240) months and 12 (range, 0 to 242) months, respectively. Median delays from onset of symptoms to RA diagnosis and treatment with csDMARDs were 15.7 (range, 2 to 252) months and 18 (range, 2 to 270) months, respectively. The mean number of consultations was 7.3±4.2 and the median number of physicians visited before the diagnosis was three (range, 1 to 8). The RA diagnosis delay was associated with rural geographic environment (p=0.02), lack of social insurance (p=0.027), progressive symptoms onset (p=0.006), morning stiffness (p=0.023), being initially examined by a GP (p=0.02), number of consultations (p<0.001; r=0.49), and number of physicians consulted before diagnosis (p=0.001; r=0.33) respectively. Based on the patients’ self-perception, the main causes of this long delay were lack of financial means (33%), wait times until exploration results (31%), wait times until the first GP or rheumatologist visit (26%), and geographical difficulty in accessing healthcare services (18%). Conclusion: Our study results suggest that patients with RA experience a significant delay until diagnosis and initiation of treatment. Healthcare providers should urgently consider factors related to diagnosis delay to shorten RA patients’ journey.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Bożena Targońska-Stępniak ◽  
Maria Majdan

Objectives. Rheumatoid arthritis (RA) is a systemic, inflammatory disease. Serum amyloid A (SAA) is an acute-phase protein, involved in pathogenesis of atherosclerosis. The aim of the study was to assess serum concentration of SAA in RA patients, with reference to other inflammatory parameters and markers of extra-articular involvement.Methods. The study population consisted of 140 RA patients, low/moderate disease activity (L/MDA) in 98 (70%) patients and high disease activity (HDA) in 42 (30%). Comprehensive clinical and laboratory assessment was performed with evaluation of electrocardiogram and carotid intima-media thickness.Results. The mean SAA concentration [327.0 (263.4) mg/L] was increased highly above the normal value, even in patients with L/MDA. Simultaneously, SAA was significantly higher in patients with HDA versus L/MDA. The mean SAA concentration was significantly higher in patients treated with glucocorticoids, was inversely associated with QTc duration, and was markedly higher in patients with atherosclerotic plaques, emphasizing increased CV risk. SAA was significantly higher in patients with increased cystatin-C level.Conclusions. In RA patients, high serum SAA concentration was strongly associated with activity of the disease and risk of CV and renal involvement. Recurrent assessment of SAA may facilitate searching patients with persistent inflammation and risk of extra-articular complications.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 860.1-861
Author(s):  
Y. Hotta ◽  
Y. Nasu ◽  
K. Nishida ◽  
M. Matsuhashi ◽  
M. Watanabe ◽  
...  

Background:In Japan, Methotrexate (MTX) has been approved in 1999, the first biologic DMARD (bDAMRD) in 2003, and the Janus kinase (JAK) inhibitors have been used since 2013. Although it is expected that the recent advancement of drug therapy would contribute the decrease in the incidence of orthopaedic surgeries by preventing structural damages1, 2), we are still facing a considerable number of patients who require surgical interventions3).Objectives:To investigate the recent trends of patient’s background who underwent the orthopaedic surgery for rheumatoid arthritis, number of orthopaedic intervention, and the type of the surgery.Methods:We reviewed the records of 1569 patients with RA who underwent orthopedic surgeries between 2004 and 2019 in our institution. The mean age of patients was 62.8 (22-88) years-old with disease duration of 20.9 (0.5-64) years. Data of these patients such as age, disease duration, medication (Glucocorticoid; GC, MTX, b/tsDMARD), type of surgeries (total joint replacement; TJR, hand surgery, foot surgery, spine surgery, and others), and preoperative serum CRP level were collected. We analyzed the annual change of these demographic and clinical data. Then, we compared them between CRP negative (<1.5g/l) and CRP positive group. Cochran-Armitage trend test,χ square test, or unpaired T-test was performed for statistical analysis. P <0.05 was considered significant.Results:Among all cases, 426 cases (27.2%) were treated with b/tsDMARDs at the time of operation. MTX and GC were used in 937 cases (59.7%) and 1015 cases (64.7%), respectively. The mean age and disease duration of RA showed an increasing trend, although the CRP level was dramatically decreased during the study period. While the rate of MTX use has not changed significantly (p=0.102), the number of cases treated by b/ts DMARD increased significantly to 46.7% (p<0.001). In contrast, the rate of GC use dicreased significantly (p<0.001). Although the annual number of surgeries have not changed, the proportion of cases who performed TJR decreased dramatically (59.6% in 2011, 29.5% in 2019), and the surgeries for hand and foot increased significantly (p<0.001) (Fig 1). The annual mean preoperative CRP level also decreased from 18.8±1.95 to 4.89±0.81 (Fig 2). Compared to CRP positive group (n=1,113), the patients in CRP negative group (n=446) showed significantly younger age(p<0.001), shorter disease duration (p=0.031), lower late of GC use, and a higher rate of b/tsDAMRD use. The proportion of patients who underwent TJR was significantly higher in CRP positive group (p<0.001).Conclusion:Along with the increasing use of b/tsDMARD, the preoperative disease control of RA, as well as the type of demanded surgeries have dramatically changed.References:[1] Yamanaka H, Tanaka E, Nakajima A, et al. A large observational cohort study of rheumatoid arthritis, IORRA: Providing context for today’s treatment options.Mod Rheumatol2020;30:1-6.[2] Matsumoto T, Nishino J, Izawa N, et al. Trends in Treatment, Outcomes, and Incidence of Orthopedic Surgery in Patients with Rheumatoid Arthritis: An Observational Cohort Study Using the Japanese National Database of Rheumatic Diseases.J Rheumatol2017;44:1575-82.[3] Momohara S, Tanaka S, Nakamura H, et al. Recent trends in orthopedic surgery performed in Japan for rheumatoid arthritis.Mod Rheumatol2011;21:337-42.Disclosure of Interests:Yoshifumi Hotta: None declared, Yoshihisa Nasu: None declared, Keiichiro Nishida Grant/research support from: K. Nishida has received scholarship donation from CHUGAI PHARMACEUTICAL Co., Eisai Co., Mitsubishi Tanabe Pharma and AbbVie GK., Speakers bureau: K. Nishida has received speaking fees from CHUGAI PHARMACEUTICAL Co., Eli Lilly, Janssen Pharmaceutical K.K., Eisai Co. and AYUMI Pharmaceutical Corporation., Minami Matsuhashi: None declared, Masahito Watanabe: None declared, Ryuichi Nakahara: None declared, Toshifumi Ozaki: None declared


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