Decreased Pain Threshold in Juvenile Idiopathic Arthritis: A Cross-sectional Study

2013 ◽  
Vol 40 (7) ◽  
pp. 1212-1217 ◽  
Author(s):  
Anne Leegaard ◽  
Johanne Jeppesen Lomholt ◽  
Mikael Thastum ◽  
Troels Herlin

Objective.To examine the pain threshold in children with juvenile idiopathic arthritis (JIA) compared with healthy children by using a digital pressure algometer.Methods.Fifty-eight children with JIA born between 1995 and 2000 and 91 age-related healthy children participated in the study. We used a digital pressure algometer to measure the pain threshold on 17 symmetric, anatomically predefined joint-related or bone-related areas. All children were asked to rate their current pain on a Faces Pain Scale, and parents of children with JIA were asked to complete a parental revised version of the Child Health Assessment Questionnaire (CHAQ-R). Clinical data were registered on children with JIA.Results.The pain threshold was significantly lower among children with JIA (total mean PT = 1.33 ± 0.69 kg/cm2) when compared with the healthy control group (total mean PT = 1.77 ± 0.67 kg/cm2). The same pattern was found in all areas measured, including negative control areas that are normally unaffected in JIA (p = 0.0001 to 0.005). Overall, the pain threshold was 34% lower in females than in males in both groups (p < 0.0001). We found no correlation between pain threshold and age, current pain experience, disease duration, or disease activity.Conclusion.Children with JIA had a substantially lower pain threshold even in areas usually unaffected by arthritis. Our findings suggest that JIA alters the pain perception and causes decreased pain threshold.

2021 ◽  
Vol 10 (8) ◽  
pp. 1771
Author(s):  
Violetta Opoka-Winiarska ◽  
Ewelina Grywalska ◽  
Izabela Korona-Glowniak ◽  
Katarzyna Matuska ◽  
Anna Malm ◽  
...  

There is limited data on the effect of the novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) on pediatric rheumatology. We examined the prevalence of antibodies against SARS-CoV-2 in children with juvenile idiopathic arthritis (JIA) and a negative history of COVID-19 and the correlation of the presence of these antibodies with disease activity measured by juvenile arthritis disease activity score (JADAS). In total, 62 patients diagnosed with JIA, under treatment with various antirheumatic drugs, and 32 healthy children (control group) were included. Serum samples were analyzed for inflammatory markers and antibodies and their state evaluated with the juvenile arthritis disease activity score (JADAS). JIA patients do not have a higher seroprevalence of anti-SARS-CoV-2 antibodies than healthy subjects. We found anti-SARS-CoV-2 antibodies in JIA patients who did not have a history of COVID-19. The study showed no unequivocal correlation between the presence of SARS-CoV-2 antibodies and JIA activity; therefore, this relationship requires further observation. We also identified a possible link between patients’ humoral immune response and disease-modifying antirheumatic treatment, which will be confirmed in follow-up studies.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Willemijn F. C. de Sonnaville ◽  
Caroline M. Speksnijder ◽  
Nicolaas P. A. Zuithoff ◽  
Daan R. C. Verkouteren ◽  
Nico W. Wulffraat ◽  
...  

Abstract Background Recognition of temporomandibular joint (TMJ) involvement in children with juvenile idiopathic arthritis (JIA) has gained increasing attention in the past decade. The clinical assessment of mandibular range of motion characteristics is part of the recommended variables to detect TMJ involvement in children with JIA. The aim of this study was to explore explanatory variables for mandibular range of motion outcomes in children with JIA, with and without clinically established TMJ involvement, and in healthy children. Methods This cross-sectional study included children with JIA and healthy children of age 6–18 years. Mandibular range of motion variables included active and passive maximum interincisal opening (AMIO and PMIO), protrusion, laterotrusion, dental midline shift in AMIO and in protrusion. Additionally, the TMJ screening protocol and palpation pain were assessed. Adjusted linear regression analyses of AMIO, PMIO, protrusion, and laterotrusion were performed to evaluate the explanatory factors. Two adjusted models were constructed: model 1 to compare children with JIA and healthy children, and model 2 to compare children with JIA with and without TMJ involvement. Results A total of 298 children with JIA and 169 healthy children were included. Length was an explanatory variable for the mandibular range of motion excursions. Each centimeter increase in length increased AMIO (0.14 mm), PMIO (0.14 mm), and protrusion (0.02 mm). Male gender increased AMIO by 1.35 mm. Having JIA negatively influenced AMIO (3.57 mm), PMIO (3.71 mm), and protrusion (1.03 mm) compared with healthy children, while the discrepancy between left and right laterotrusion raised 0.68 mm. Children with JIA and TMJ involvement had a 8.27 mm lower AMIO, 7.68 mm lower PMIO and 0.96 mm higher discrepancy in left and right laterotrusion compared to healthy children. Conclusion All mandibular range of motion items were restricted in children with JIA compared with healthy children. In children with JIA and TMJ involvement, AMIO, PMIO and the discrepancy between left and right laterotrusion were impaired more severely. The limitation in protrusion and laterotrusion was hardly clinically relevant. Overall, AMIO is the mandibular range of motion variable with the highest restriction (in millimeters) in children with JIA and clinically established TMJ involvement compared to healthy children.


2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Pratik Gahalaut ◽  
Nitin Mishra ◽  
Sandhya Chauhan ◽  
Mir Mubashir Ali ◽  
Madhur Kant Rastogi ◽  
...  

Lunula is the white, half-moon shaped area seen in proximal ends of some nails. Though a few studies have described the nail changes that can occur in association with HIV infection, none of these paid much attention to lunula. Aims and Objectives. To study the lunula in fingernails among HIV infected patients. Materials and Methods. An observational, cross-sectional study to record presence of lunula in 168 HIV-positive patients and compare it with age and sex matched 168 healthy HIV-negative control. Anolunula (absence of lunula) in HIV-positive patients was correlated with CD4 counts, stages of HIV infection, time since patient was diagnosed as HIV-positive, and status of antiretroviral therapy. Results. Anolunula was present in significantly more fingernails in HIV-positive patients compared to HIV-negative controls. There was a highly significant difference for total anolunula (anolunula in all fingernails) in study and control group. Incidence of total anolunula was directly proportional to the stage of HIV infection, increasing progressively as the HIV infection advances from stage 1 to stage 4. Conclusion. Absence of lunula is related to not only HIV infection per se but also the stages of HIV infection.


2011 ◽  
Vol 18 (04) ◽  
pp. 638-643
Author(s):  
AMMAR ANWER ◽  
ALI SHAKEEL ◽  
M. HAMAYUN IKRAM ◽  
Shahroona Masud Zaman

Objective: This study was carried out to find out the prevalence of Jervell and Lange Nielsen Syndrome (JLNS) in deaf school children for impaired hearing and to correlate this with consanguineous marriages. Setup: Schools for deaf and dumb children and Sheikh Zayed Medical College, Rahim Yar Khan. Design: Cross sectional, case control study. Period: 2006 - 2007. Methods: Electrocardiographs (ECG’s) of 114 congenitally deaf school children (ages 4-20 years) and also of 23 healthy children with normal hearing function of same age group were recorded. The corrected QT (QTc) interval of all 137 ECGs was evaluated by Bazett’s formula. Mean QTc of healthy children was taken as reference of normal QTc interval. The deaf children with normal QTc were labeled as control group. Patients with long QTc were further evaluated for JLNS by applying Schwartz’s criteria. We also calculated the relationship of the positive cases to consanguineous marriages. Results: We found that 28 deaf children out of 114 cases had QTc intervals longer than 0.44 seconds. This interval was significantly longer [P=0.008] than the QT interval in control group. As per Schwartz’s criteria, 15 out of 28 LQTs cases scored high points (3.5 to 5.5). The presence of consanguineous marriage was 100% in first pedigree of these 28 children. Conclusions: JLNS (an alarming arrhythmic disease associated with congenital deafness) is significantly present (24.6%) in Rahim Yar Khan’s deaf school children. The presence of cousin marriage was 100% in first pedigree of these children.


2020 ◽  
pp. 20-23
Author(s):  
Sneha Upadhyay ◽  
Jyoti Bhavthankar ◽  
Mandakini Mandale ◽  
Nivedita Kaorey

Background: Asthma and its medications have been linked to oral diseases in asthmatic children. Aim: Assessment of the dental caries status, salivary Streptococcus mutans count and S. mutans colony score in children receiving inhaled anti asthmatic medications and their comparison in healthy children Material and Method: A cross-sectional study was performed on 40 asthmatic children and 40 healthy children in the age group of 6-14 years. DMFT/deft indices were calculated and saliva samples were collected. Diluted saliva was inoculated on MSB agar plates. S. mutans count and colony score were analysed after 24-48 hours of inoculation. Results: Statistically significant difference was observed in the mean DMFT/deft index, salivary S. mutans load and S. mutans colony score in children of the asthmatic group and control group. Conclusion: Prevalence of dental caries and cariogenic bacteria is higher in asthmatic children.


2021 ◽  
Vol 162 (12) ◽  
pp. 443-448
Author(s):  
Gábor Xantus ◽  
V. Anna Gyarmathy

Összefoglaló. Gyulladásos bélbetegségben (IBD) a fájdalomérzés komplex szomatikus és pszichés jelenség. Ez utóbbi komponens pontosabb megértése segíthet a megfelelő kezelési stratégia megállapításában. A szorongásos hangulati zavarok és egyes maladaptív viselkedési minták (dohányzás és alkoholfogyasztás) előfordulási gyakorisága jól dokumentált IBD-ben, a kannabiszhasználat hatása ugyanakkor kevésbé ismert. A szerzők szisztematikus áttekintést végeztek annak megértéséhez, hogy vajon magasabb-e a marihuánahasználat gyakorisága felnőtt IBD-s betegek között egészséges kontrollpopulációhoz viszonyítva, és ha igen, akkor melyek a szerhasználat legfontosabb jellemzői. A kutatási periódust szándékosan az elmúlt 7 évre korlátoztuk, ugyanis 2013-tól jelentős változások álltak be a kannabinoidok jogi és orvosi megítélésében az USA-ban. Öt elsődleges és több másodlagos adatbázisban kutattunk előre meghatározott kulcsszavak segítségével 2013 óta teljes szöveggel megjelent, angol nyelvű felnőtt IBD-s populációt vizsgáló epidemiológiai tanulmányok vonatkozásában. 143 rekord közül 7 cikk felelt meg a beválogatási kritériumoknak. Eredményeink szerint a kannabiszhasználat gyakorisága IBD-ben szenvedő felnőtt betegek körében valószínűleg magasabb, mint a kontrollpopulációban: a „valaha, bármikor” használók aránya 54–70% között változott (szemben a 46–60% gyakorisággal a kontrollcsoportban), míg az „aktív használók” esetén a gyakoriság 6,8–25% között változott (vs. a kontrollcsoportban tapasztalt 8,6–14%-kal). A prevalenciaadatok széles variabilitása arra utal, hogy a beválogatott epidemiológiai tanulmányok valószínűleg vagy nem voltak megfelelően tervezve, vagy jelentős heterogenitással bírtak. A pszichés tényezők ellentmondásos mintája azt sugallja, hogy a kannabinoidok egyes esetekben ronthatták, más esetben valószínűleg javították bizonyos prominens tünetek megélését. Javasoljuk ezért, hogy a valós prevalencia megállapítása érdekében a keresztmetszeti vizsgálatok mellé ismételt pszichometriai vizsgálatokon alapuló vizsgálatok is bekerüljenek a további kutatásba. Orv Hetil. 2021; 162(12): 443–448. Summary. Pain perception in inflammatory bowel disease (IBD) is beyond a purely somatic process. In-depth understanding of psychologic elements might enable more effective management in this patient group. Anxiety disorders and certain maladaptive coping strategies like smoking and alcohol consumption are well-documented in IBD, unlike the scarcely researched cannabis use. The authors designed a systematic review, to investigate if the prevalence of cannabis use is higher in IBD that in unselected controls. The research window was intentionally set to cover for the past 7 years, as in 2013 major legislative changes took place in the cannabis decriminalisation process in the United States. 5 primary and several secondary databases were researched with a pre-formulated algorithm registered at PROSPERO for full text epidemiological studies published in English language involving adult IBD patients. Out of 143 records, 7 articles met the in/exclusion criteria. Our results suggest that cannabis use among adult patients with IBD is likely to be higher than in the unselected control population. The proportion of “ever” users varied from 54% to 70% (vs. 46–60% in the control group); and for ‘active users’, the prevalence ranged between 6.8% to 25% (vs. 8.6–14% in the control group). The wide variability in prevalence data suggests that the selected epidemiological studies were either inappropriately designed or were too heterogeneous (or both). The contradictory pattern of psychological factors suggests that cannabinoids might improve or worsen IBD depending on case by case basis. We therefore opine that in addition to cross-sectional papers, studies based on repeated psychometric analysis are needed to establish the real prevalence and inform cannabinoid prescription and holistic management in inflammatory bowel disease. Orv Hetil. 2021; 162(12): 443–448.


Pain Medicine ◽  
2019 ◽  
Vol 21 (9) ◽  
pp. 1902-1912
Author(s):  
Naama Assayag ◽  
Yoram Bonneh ◽  
Shula Parush ◽  
Haim Mell ◽  
Ricky Kaplan Neeman ◽  
...  

Abstract Objective This comparative cross-sectional study aimed to characterize individuals with substance use disorder (SUD) in self-perception of pain sensitivity, experimental auditory aversiveness, and non-noxious sensory responsiveness, as well as examine the associations with SUD. Methods Therapeutic community (TC) individuals with SUD (N = 63, male 88.9%) and healthy controls (N = 60, male 86.7%) completed the Pain Sensitivity Questionnaire (PSQ) and the Sensory Responsiveness Questionnaire–Intensity Scale (SRQ-IS), followed by a psychophysical auditory battery, the Battery of Averseness to Sounds (BAS)–Revised. Results The SUD group scored higher on the PSQ (P &lt; 0.0001), BAS-R aversiveness (P &lt; 0.0001), BAS-R-unpleasantness (P &lt; 0.0001), and on the aftersensation of auditory aversiveness (P &lt; 0.0001) and unpleasantness (P &lt; 0.000). Fifty-four percent of the SUD group vs 11.7% of the control group were identified as having sensory modulation dysfunction (SMD; P &lt; 0.0001). Logistic regression modeling revealed that the SRQ-IS-Aversive score had a stronger relationship, indicating a 12.6-times odds ratio for SUD (P = 0.0002). Finally, a risk score calculated from a linear combination of the logistic regression model parameters is presented based on the PSQ and SRQ. Conclusions This is the first study to explore sensory and aversive domains using experimental and self-reporting in situ, revealing pain perception alteration that co-occurs with high prevalence of SMD, specifically of the over-responsive type. Findings may be significant in clinical practice for treating pain, and for expanding therapeutic modalities as part of broader rehabilitation in TC and beyond, to better meet personalized therapy.


Dose-Response ◽  
2019 ◽  
Vol 17 (2) ◽  
pp. 155932581984083
Author(s):  
Alba Parras-Moltó ◽  
Juan Ribas-Serna

Our aim was to test the effects of Andullation therapy on pain threshold, pain perception, feeling of well-being, arterial pressure, and leg volume in healthy and unhealthy patients. We used a multidirectional vibration (frequency range: 5–40 Hz; peak-to-peak amplitude: 2–8 mm; acceleration: 0.4–2 m/s2) in an undulatory way through the surface of the body when the patient was in contact with a mattress (“andullation”). The vibes traveled from the heel to the head in a random fashion while the participants (N = 50) were lying on the mattress. We measured the pain threshold using an algometer; pain perception and well-being through a visual analog scale (VAS); arterial pressure with an electronic sphygmomanometer; and leg volume with Kuhnke’s technique. Measurements were made just before the first andullation session and after the fifth andullation session. Every participant received andullation sessions of 30 min a day for 5 consecutive days. The patients’ pain threshold significantly ( P < .001) increased by 34.48% and 25.79% in the lumbar and trapezius zones, respectively, after 5 sessions of therapy. The subjective perception of pain decreased by 52.3% and the feeling of well-being increased by 45.1%. The systolic and diastolic pressures significantly ( P < .001) decreased by 6.44 and 4.68 mm Hg on average, respectively. Leg volume significantly decreased ( P < .01) by 64.39 mL after the fifth andullation session. Despite not including a control group in our study, the andullation intervention showed an improvement in pain, well-being, arterial pressure, and lower limb volume in the studied population.


2020 ◽  
Vol 12 (2) ◽  
pp. 149-56
Author(s):  
Desy Wulandari ◽  
Wisnu Barlianto ◽  
Tita Luthfia Sari

BACKGROUND: Vitamin D plays essential role in the regulation of inflammation, such as in pathogenesis of Juvenile Idiopathic Arthritis (JIA). Vitamin D deficiency has been reported among JIA patients, but there were conflicting results regarding the correlation with disease activity. This study aimed to assess vitamin D serum level and its correlation with C-Reactive Protein (CRP) and disease activity in JIA patients.METHODS: Children who were diagnosed with JIA according to International League of Associations for Rheumatology (ILAR) criterias were enrolled as JIA group subjects, while age and sex-matched healthy children were enrolled as the control group subjects. Vitamin D and CRP serum level were measured. Disease activity of JIA patients was calculated by Juvenile Arthritis Disease ActivityScore-27 (JADAS-27).RESULTS: Vitamin D serum level was lower in the JIA group compared to the healthy control group (p=0.000). Among 26 JIA patients, 61.5% were deficient, 30.8% were insufficient, and 7.7% had normal vitamin D. No significant different in CRP level between vitamin D group (p=0.441), but there was significant different in JADAS-27 (p=0.001). The mean of CRP and JADAS-27 were found highest in vitamin D deficiency group. Vitamin D serum level was negatively correlate with CRP (p=0.021, r=-0.452) and JADAS-27 (p=0.001 r=-0.595).CONCLUSION: Low level of vitamin D in JIA patients was inversely related to higher CRP and disease activity,suggesting that vitamin D supplementation could be havepotential role in JIA treatment.KEYWORDS: vitamin D, CRP, disease activity,JADAS-27, JIA


2021 ◽  
pp. 20200399
Author(s):  
Ingrid Tonni ◽  
Andrea Borghesi ◽  
Silvia Tonesi ◽  
Giulia Fossati ◽  
Francesca Ricci ◽  
...  

Objectives: As it is well known, the diagnosis of temporomandibular joint (TMJ) involvement in patients affected by Juvenile Idiopathic Arthritis (JIA) is important to avoid the impairment of mandibular growth. In this context, Magnetic Resonance Imaging (MRI) is the gold-standard for detection of TMJ involvement, however it is expensive and requires patients’ collaboration. The aim of this study was to evaluate if ultrasound may be used as an alternative tool to investigate the acute signs of TMJ involvement in JIA patients. Methods: Lateral periarticular space (LPAS) and joint effusion were evaluated by ultrasound in a study Group A of 8 JIA children (11.6±3.5 years old) with 14 TMJs involved, as confirmed by MRI, and in a control Group B of 7 healthy children (9.3±1.2 years old) without temporomandibular disorders (TMD). The LPAS width values were compared between the two groups using the Mann–Whitney test. The ultrasound images of the JIA group were then matched with the corresponding MR images; the Spearman Rank Correlation test and the Bland–Altman test were used to evaluate the differences. Results: The LPAS values in Group A were statistically significantly higher than those in Group B (p < 0.001). There was no overlap of the LPAS values confidence intervals (CIs) between the two groups. No signs of joint effusion were identified in groups A and B. The Spearman test applied to the values of LPAS measured in ultrasound and the corresponding MR images showed a proportional positive correlation with a ρ of 0.623 and a p < 0.05. Conclusions: Ultrasound can detect differences in the TMJ features between JIA patients and healthy patients and it might be used as a follow-up tool in the assessment of TMJ involvement in subject affected by JIA.


Sign in / Sign up

Export Citation Format

Share Document