Physiotherapeutic treatment in complex therapy of rheumatoid arthritis of a temporomandibular joint

Author(s):  
N.V. Lapina ◽  
E.V. Izhnina ◽  
V.Yu. Skorikov ◽  
S.D. Grishechkin ◽  
E.V. Kochurova
Author(s):  
T.S. Golubtsova ◽  
A.B. Peskov ◽  
S.V. Peskova ◽  
M.P. Markevich ◽  
V.V. Gnoevykh ◽  
...  

Anemia occurs in approximately 30–70 % of patients with rheumatoid arthritis (RA). The most common cause of low hemoglobin level is chronic inflammation. Hyperbaric oxygenation (HBO) reduces the chronic inflammatory process, hypoxia severity and stimulates erythropoiesis. Therefore, HBO can be considered as one of the promising methods for treating anemia of chronic inflammation. The primary objective of the study is to carry out the efficacy analysis of rheumatoid arthritis (RA) complex therapy using hyperbaric oxygenation (HBO) for comparison results in patients with anemia and with a normal hemoglobin level. Materials and Methods. To assess the advisability of HBO in patients with RA and concomitant anemia, we analyzed indicators of RA activity and local joint inflammation in 120 patients. 30 patients were treated according to the standard scheme, 30 patients underwent one and 60 patients – five additional HBO sessions (1.3 atm during 40 min). Patients who underwent HBO were divided into two subgroups with normal and low hemoglobin levels. Results. On the 14th day of inpatient hospitalization, we fixed decrease in RA activity indices in all groups. The decrease in the activity of RA and local joint inflammation in patients who underwent HBO was faster than in patients who were treated according to the standard scheme, and in patients who underwent only one HBO session. Better results were observed in patients with concomitant anemia compared with patients with normal hemoglobin level. It was confirmed by a significant decrease in acute-phase blood values (ESR and CRP) and RA activity indices (assessment of disease activity (by a doctor and by a patient), CDIA, SDIA and DAS28). Conclusion. Additional HBO in complex RA therapy contributes to the efficacy of inpatient treatment. The most pronounced effect is observed in patients with both RA and anemia. Keywords: hyperbaric oxygenation, rheumatoid arthritis, anemia. Анемия встречается у 30–70 % больных, страдающих ревматоидным артритом (РА). Наиболее частой причиной снижения уровня гемоглобина крови является хроническое воспаление. Гипербарическая оксигенация (ГБО) способствует уменьшению активности хронического воспалительного процесса, выраженности гипоксии и стимулирует эритропоэз, следовательно, применение ГБО можно рассматривать как один из перспективных методов лечения анемии хронического воспаления. Цель работы – провести сравнительный анализ эффективности комплексной терапии пациентов, страдающих ревматоидным артритом, с включением курса гипербарической оксигенации на фоне анемии и при нормальном значении уровня гемоглобина крови. Материалы и методы. Для оценки целесообразности проведения курса ГБО у больных, страдающих РА с сопутствующей анемией, проведен динамический анализ показателей активности РА и локального воспаления в суставе у 120 пациентов (30 пациентов получили лечение по стандартной схеме, 30 больных дополнительно прошли 1 сеанс ГБО и 60 пациентов прошли 5 сеансов ГБО при 1,3 атм в течение 40 мин). Пациенты, прошедшие курс ГБО, были разделены на две подгруппы: с нормальным и сниженным уровнем гемоглобина. Результаты. На 14-й день госпитализации у всех пациентов отмечали регресс клинических проявлений артрита. Снижение показателей активности РА и локального воспаления в суставе у пациентов, прошедших курс ГБО, происходило быстрее, чем у больных, получивших лечение по стандартной схеме, и пациентов, прошедших один сеанс ГБО. Более высокие результаты лечения получены у больных с сопутствующей анемией по сравнению с пациентами с нормальными значениями гемоглобина, что подтверждено значимым снижением острофазовых показателей крови (СОЭ и СРБ) и индексов активности РА (ООАВ, ООАБ, CDIA, SDIA и DAS28). Выводы. Включение курса ГБО в стандартную схему терапии РА повышает эффективность стационарного лечения. Наиболее выраженный эффект наблюдается у больных с РА и анемией. Ключевые слова: гипербарическая оксигенация, ревматоидный артрит, анемия.


2018 ◽  
Vol 68 (12) ◽  
pp. 2987-2991
Author(s):  
Cristina Iordache ◽  
Bogdan Vascu ◽  
Eugen Ancuta ◽  
Rodica Chirieac ◽  
Cristina Pomirleanu ◽  
...  

Temporomandibular joint (TMJ) is commonly involved in various immune-mediated rheumatic disorders accounting for significant disability and impaired quality of life. The aim of our study was to assess inflammatory and immune parameters in patients with TMJ arthritis related to rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) and to identify potential relation with severity and dysfunction of TMJ pathology. We performed a cross-sectional study in a cohort of 433 consecutive RA, 32 JIA, 258 AS, and 103 PsA. Only patients presenting with clinically significant TMJ involvement (273) related to their rheumatic condition were included in the final analysis. TMJ involvement is traditionally described in chronic inflammatory rheumatic disorders, particularly in patients with higher levels of inflammation as detected in rheumatoid arthritis and psoriatic arthritis. Disease activity and severity, as well as biological and positive serological assessments (rheumatoid factor, anti-cyclic citrullinated peptide, IL-1) remain significant determinants of the severity of TMJ arthritis.


1985 ◽  
Vol 66 (4) ◽  
pp. 318-318
Author(s):  
L. V. Chernetsova ◽  
A. G. Ibragimova

The comparative analysis of treatment of 76 patients with rheumatoid arthritis using electromagnetic waves of the decimeter range and lithium electrophoresis, depending on the activity of the process and the type of drug therapy.


2021 ◽  
Author(s):  
Kohei Nagai ◽  
Takenobu Ishii ◽  
Yasushi Nishii

Abstract Background Rheumatoid arthritis of the temporomandibular joint (TMJ-RA) has been reported to have a larger incidence range than systemic rheumatoid arthritis (RA). The presence or absence of mechanical stress (MS) is considered a factor in this. In this study, we hypothesized that TMJ-RA develops or worsens when excessive MS is applied to the temporomandibular joint of RA mouse models. We aimed to clarify the relationship between TMJ-RA and MS through morphological and histological evaluation. Methods Collagen antibody-induced arthritis (CAIA) was induced in male DBA/1JNCrlj 9–12 weeks old mice by administering Type II collagen antibody and lipopolysaccharide to produce RA model mice. MS was applied to the mandibular condyle. The group was separated into non-RA (control group (N = 5) and MS group (N = 5)), and RA group (CAIA group (N = 5)and CAIA MS group (N = 5)). To confirm the morphological changes in the mandibular condyle, micro-CT imaging was performed. Histological evaluation of the TMJ was performed by hematoxylin and eosin staining for condylar cartilage cell layer thickness, Safranin O staining for proteoglycans, and tartrate-resistant acidic phosphatase staining for osteoclast count. Immunohistochemical evaluation was performed to assess the localization of cartilage destruction enzymes using ADAMTS-5 (a disintegrin and metalloproteinase with thrombospondin motifs) antibody. Additionally, CD3 (cluster of differentiation), CD45, and γδ TCR (T cell receptor) antibodies were used to localize and identify the type of lymphocytes. Results In the CAIA MS model, a three-dimensional analysis of the temporomandibular joint by microcomputer tomography showed a crude change in the surface of the mandibular condyle. Histological examination revealed a decrease in the chondrocyte layer width and an increase in the number of osteoclasts in the mandibular condyle. T cell accumulation was observed, and γδ T cell involvement was confirmed. Conclusions In the CAIA model, the TMJ was less sensitive to the initiation of RA. However, the results suggested that it was exacerbated by MS, and that γδ T cells may be involved in TMJ-RA.


1987 ◽  
Vol 28 (1) ◽  
pp. 35-39 ◽  
Author(s):  
O. Ekberg ◽  
I. Redlund-Johnell ◽  
K. G. Sjöblom

Pharyngeal function was studied in 31 patients with rheumatoid arthritis. Eighteen of these patients had dysphagia. Cervical spine abnormalities were present in 14. Destruction of the capitulum and/or ramus of the mandible was registered in 9. Pharyngeal dysfunction was revealed in 20. Patients with a vertical dislocation of the C1–C2 in relation to the occipital bone and patients with destruction of the capitulum and/or ramus of the mandible had an increased frequency of pharyngeal dysfunction. Pharyngeal dysfunction is thought to be due to mechanical factors and caused by derangements of muscular attachments and turning points.


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