scholarly journals Nailfold Capillaroscopy Characteristics of Antisynthetase Syndrome and Possible Clinical Associations: Results of a Multicenter International Study

2018 ◽  
Vol 46 (3) ◽  
pp. 279-284 ◽  
Author(s):  
Marco Sebastiani ◽  
Konstantinos Triantafyllias ◽  
Andreina Manfredi ◽  
Miguel Angel González-Gay ◽  
Natalia Palmou-Fontana ◽  
...  

Objective.To describe nailfold videocapillaroscopy (NVC) features of patients with antisynthetase syndrome (AS) and to investigate possible correlations with clinical and serological features of the disease.Methods.We retrospectively analyzed NVC images of 190 patients with AS [females/males 3.63, mean age 49.7 ± 12.8 yrs, median disease duration 53.7 mos (interquartile range 82), 133 anti-Jo1 and 57 non–anti-Jo1-positive patients]. For each patient, we examined number of capillaries, giant capillaries, microhemorrhages, avascular areas, ramified capillaries, and the presence of systemic sclerosis (SSc)-like pattern. Finally, we correlated NVC features with clinical and serological findings of patients with AS. Concomitantly, a historical cohort of 75 patients with antinuclear antibody–negative primary Raynaud phenomenon (RP) and longterm followup was used as a control group (female/male ratio 4.13/1, mean age 53.9 ± 17.6 yrs) for NVC measures.Results.NVC abnormalities were observed in 62.1% of AS patients compared with 29.3% of primary RP group (p < 0.001). An SSc-like pattern was detected in 67 patients (35.3%) and it was associated with anti-Jo1 antibodies (p = 0.002) and also with a longer disease duration (p = 0.004). Interestingly, there was no significant correlation between the presence of SSc-like pattern and RP, and only 47% of patients with SSc-like pattern had RP.Conclusion.NVC abnormalities are commonly observed in AS, independently from the occurrence of RP. The presence of an SSc-like pattern could allow identification of a more defined AS subtype, and prospective studies could confirm the association with clinical and serological features of AS.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1155.1-1155
Author(s):  
P. Bora Karsli ◽  
N. Guven ◽  
I. Sunar ◽  
Ş. Ataman

Background:Enthesitis is one of the key feature of psoriatic arthritis (PsA), it is usually overlooked in the asymptomatic patients. Nail disease often precedes PsA and nailfold videocapillaroscopy (NVC) is a useful technique for evaluating changes in microcirculation of nail that is considered to play an important role for early detection of enthesitis and PsA [1-4].Objectives:To investigate the link between NVC findings and severity of peripheral enthesitis scores in patients with PsA.Methods:In this cross-sectional single center study, 34 consecutive PsA patients and as control group (healthy controls - HC), 22 subjects without rheumatic diseases were involved. Psoriasis area severity index (PASI) was used to express severity of psoriasis (Ps) and percentage of affected area. Leeds enthesitis index (LEI) comprised assesment of lateral epicondyles of humerus, medial condyles of femur, and the insertion of the Achilles tendon. Madrid Sonographic Enthesitis Index (MASEI) was applied to quantify the extent of sonographic entheseal abnormalities. MASEI-inflammatory, MASEI-damage and as a sum of these MASEI-total scores were recorded. NVC was performed on eight fingers in each subject.Results:We enrolled 34 patients with PsA (median age=47.74 years, median disease duration=6.91 years) and 22 HC (median age=46.77 years). There were no significant differences between two groups concerning age, gender distribution and body mass index. Ps and PsA disease duration in terms of years were not correlated with MASEI and NVC scores. PASI score associated with MASEI-inflammatory score (r=0.40, p=0.01). There were significant correlation between the NVC score and MASEI-inflammatory (r=0.53, p=0.001) and MASEI-total scores (r=0.35, p=0.04) (Table 1). No association was found between LEI and NVC scores (p=0.34). MASEI enthesitis and NVC scores were significantly higher in the patient group (p=0.00).Table 1.Correlation between the capillaroscopy findings and MASEI- inflammatory and MASEI-total scores in patients with psoriatic arthritisMASEICapillaroscopyPsAHCMASEI-inflammatory r0.53**0.7 p0.0010.75MASEI-total r0.35*0.19 p0.040.38Spearman’s Correlation Coefficient; ** Correlation is significant at the 0.01 level (2-tailed), * Correlation is significant at the 0.05 level (2-tailed).p< 0.05 statistic significanceMASEI: Madrid Sonographic Enthesitis Index, PsA: psoriatic arthritis, HC: healthy controlsConclusion:NVC may objectively reflect the peripheric enthesopathy severity and give opportunity for early diagnosis of PsA.References:[1]Kaeley, Gurjit S., et al. “Enthesitis: a hallmark of psoriatic arthritis.” Seminars in arthritis and rheumatism. Vol. 48. No. 1. WB Saunders, 2018.[2]Ash, Zoe R., et al. “Psoriasis patients with nail disease have a greater magnitude of underlying systemic subclinical enthesopathy than those with normal nails.” Annals of the Rheumatic Diseases 71.4 (2012): 553-556.[3]Smith, Vanessa, et al. “Nailfold capillaroscopy and clinical applications in systemic sclerosis.” Microcirculation 23.5 (2016): 364-372.[4]Ribeiro, Camila Ferrari, et al. “Periungual capillaroscopy in psoriasis.” Anais brasileiros de dermatologia 87.4 (2012): 550-553.Disclosure of Interests:None declared


Cephalalgia ◽  
2002 ◽  
Vol 22 (8) ◽  
pp. 667-671 ◽  
Author(s):  
O Sjaastad ◽  
TA Fredriksen

The influence of pregnancy upon the head pain of cervicogenic headache (CEH) has been studied in 14 patients (number of pregnancies 25). Migraine was used as control group ( n = 49; number of pregnancies 116). CEH was diagnosed according to The Cervicogenic Headache International Study Group guidelines. Migraine was diagnosed according to International Headache Society (IHS) guidelines; a further requirement was that at least eight of nine solitary IHS diagnostic requirements of migraine were present. In 79%—or more—of CEH patients, attacks seemed to appear just as usual during pregnancy; in one patient, attacks stopped completely, and in two there may have been a minor reduction of attacks. A significantly lower number of migraine patients (up to 18%) were more or less uninfluenced by pregnancy (CEH vs. migraine P < 0.0001, X2 test). The lack of response to pregnancy may be a sort of biological marker in CEH. It may also help in clinically distinguishing CEH from migraine when CEH starts early in life, i.e. prior to pregnancies.


2008 ◽  
Vol 35 (12) ◽  
pp. 2359-2362 ◽  
Author(s):  
KAZUHIRO KOMURA ◽  
AYUMI YOSHIZAKI ◽  
MASANARI KODERA ◽  
YOHEI IWATA ◽  
FUMIHIDE OGAWA ◽  
...  

ObjectiveTo determine levels of serum soluble OX40 (also termed CD134, a member of the tumor necrosis factor receptor superfamily) and their clinical associations in patients with systemic sclerosis (SSc).MethodsSerum soluble OX40 levels were examined by ELISA in 53 patients with SSc, 15 patients with systemic lupus erythematosus (SLE), and 32 healthy individuals.ResultsOX40 levels were significantly elevated in SSc patients (125.7 ± 5.7 pg/ml) compared to patients with SLE (80.7 ± 1.7 pg/ml; p < 0.005) and controls (88.2 ± 3.0 pg/ml; p < 0.0001). Elevated OX40 levels were found to be associated with disease duration of less than 2 years (p < 0.05).ConclusionOur results suggest that serum soluble OX40 levels correlate with the early-onset of SSc disease.


Author(s):  
Alaa M. Hammad ◽  
Waleed Qirim ◽  
Ameen Alassi ◽  
Dana Hyassat

Background: Type 2 diabetes mellitus (T2DM) is a chronic condition with an impairing effect on multiple organs. Numerous respiratory disorders have been observed in patients with T2DM. However, T2DM e ect on pulmonary function is ff inconclusive. Aims: In this study, we investigated the effect of T2DM on respiratory function and the correlation of glycemic control, diabetes duration and insulin intake. Methods: 1500 patients were recruited for this study, 560 having T2DM for at least a year were included in the final data, in addition to 540 healthy volunteers. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced expiratory flow at 25-75% (FEF 25-75%), as well as FEV1/FVC ratio values were measured. Results: A two-sample t-test showed that z-scores produced by Al-Qerem et al.’s equations for FEV1, FVC, and FEF 25-75% were significantly lower for the T2DM group than the control group (p < 0.01). FEV1/FVC ratio in T2DM group were significantly higher (p < 0.01). Multiple linear regression analysis found that glycemic control represented by HbA1c as well as disease duration were negatively associated with pulmonary function (p < 0.01). However, insulin intake was found to have no significant correlation with the pulmonary function. Conclusion: T2DM was linked to reduced pulmonary function and was consistent with a restrictive ventilation pattern. HbA1c as well as disease duration were independent risk factors for reduced pulmonary function.


Lupus ◽  
2017 ◽  
Vol 27 (3) ◽  
pp. 436-444 ◽  
Author(s):  
A R Poliwczak ◽  
E Waszczykowska ◽  
B Dziankowska-Bartkowiak ◽  
M Koziróg ◽  
K Dworniak

Background Systemic lupus erythematosus is a progressive autoimmune disease. There are reports suggesting that patients even without overt signs of cardiovascular complications have impaired autonomic function. The aim of this study was to assess autonomic function using heart rate turbulence and heart rate variability parameters indicated in 24-hour ECG Holter monitoring. Methods Twenty-six women with systemic lupus erythematosus and 30 healthy women were included. Twenty-four hour ambulatory ECG-Holter was performed in home conditions. The basic parameters of heart rate turbulence and heart rate variability were calculated. The analyses were performed for the entire day and separately for daytime activity and night time rest. Results There were no statistically significant differences in the basic anthropometric parameters. The mean duration of disease was 11.52 ± 7.42. There was a statistically significant higher turbulence onset (To) value in patients with systemic lupus erythematosus, median To = –0.17% (minimum –1.47, maximum 3.0) versus To = –1.36% (minimum –4.53, maximum –0.41), P < 0.001. There were no such differences for turbulence slope (Ts). In the 24-hour analysis almost all heart rate variability parameters were significantly lower in the systemic lupus erythematosus group than in the healthy controls, including SDANN and r-MSSD and p50NN. Concerning the morning activity and night resting periods, the results were similar as for the whole day. In the control group, higher values in morning activity were noted for parameters that characterise sympathetic activity, especially SDANN, and were significantly lower for parasympathetic parameters, including r-MSSD and p50NN, which prevailed at night. There were no statistically significant changes for systemic lupus erythematosus patients for p50NN and low and very low frequency. There was a positive correlation between disease duration and SDNN, R = 0.417; P < 0.05 and SDANN, R = 0.464; P < 0.05, a negative correlation between low/high frequency ratio and r-MSSD, R = –0.454; P < 0.05; p50NN, R = –0.435; P < 0.05 and high frequency, R = –0.478; P < 0.05. In contrast, there was no statistically significant correlation between heart rate turbulence and other variables evaluated, including disease duration and the type of autoantibodies. Conclusion: Our study confirms the presence of autonomic disorders with respect to both heart rate variability and heart rate turbulence parameters and the presence of diurnal disturbances of sympathetic–parasympathetic balance. Further studies are required.


Toxics ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 70 ◽  
Author(s):  
Fatemeh Amiri ◽  
Masoud Neghab ◽  
Fatemeh Shouroki ◽  
Saeed Yousefinejad ◽  
Jafar Hassanzadeh

This study was undertaken to determine whether exposure of operating room personnel to inhalation anesthetics, nitrous oxide, isoflurane, and sevoflurane was associated with any hematological changes. This historical cohort study was performed in 2018 at a large public hospital in Shiraz, where 52 operating room personnel and 52 administrative staff were investigated. The blood sample was taken from all individuals for Complete Blood Count. Furthermore, demographic information was collected through questionnaires. Mean atmospheric concentrations of nitrous oxide, isoflurane, and sevoflurane, to which subjects were exposed, were 850.92, 2.40, and 0.18 ppm, respectively. The hematological parameters were within the normal range in both groups. However, the mean values of hemoglobin, hematocrit, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red blood cell count in the exposed group were significantly lower than the control group. No significant differences were noted between the two groups as far as other hematological factors were concerned. These findings provide circumstantial evidence to further substantiate the notion that occupational exposure to inhalation anesthetics, under the exposure scenario explained in this study, is associated with subtle, subclinical, prepathologic hematological changes. Long-term consequence and ramifications of these effects require further investigation. The range of exposure levels to anesthetic gases in operating rooms.


2020 ◽  
Vol 13 (1) ◽  
pp. 36-40
Author(s):  
İhsan Kuzucu ◽  
Tuba Çandar ◽  
Deniz Baklacı ◽  
İsmail Güler ◽  
Rauf Oğuzhan Kum ◽  
...  

Objectives. Calprotectin, a protein released by neutrophils, has been used in many studies as a biomarker showing the presence of inflammation. In this study, it was aimed to investigate the relationship between serum calprotectin level and response to the treatment of idiopathic sudden sensorineural hearing loss (ISSHL).Methods. The present study is a prospective, cross-sectional historical cohort study. The study group consisted of 44 patients with ISSHL, and the control group consisted of 41 healthy volunteers without ear pathology. At the same time, patients in the study group were divided into three groups according to the response to ISSHL treatment (recovered, partially recovered, unrecovered). The relationship between the groups was statistically evaluated in terms of serum calprotectin levels.Results. The mean serum calprotectin value was 75.67±19.48 ng/mL in the study group and 50.24±29.14 ng/mL in the control group (<i>P</i>=0.001). Serum calprotectin value according to the severity of hearing loss in the mild, moderate and severe was 66.20±8.82, 70.35±16.77, and 91.23±19.73 ng/mL, respectively. Serum calprotectin value in the severe group was significantly higher compared to the moderate and mild groups (<i>P</i>=0.004, <i>P</i>=0.001, respectively). Serum calprotectin value according to the treatment response in the recovered, partially recovered and unrecovered groups was 63.36±11.54, 80.17±12.06, and 85.33±22.33 ng/mL, respectively. Serum calprotectin value in the recovered group was significantly lower compared to the partially recovered and unrecovered groups (<i>P</i>=0.002, <i>P</i>=0.001, respectively).Conclusion. Serum calprotectin value informs the clinician about both the severity of hearing loss and the response to treatment. Hence, serum calprotectin can be used as an important biomarker in ISSHL patients for the determination of the prognosis of disease.


Author(s):  
Shelja Deswal ◽  
Jyoti Yadav ◽  
Mohit Deswal ◽  
Harpreet Singh

Background: Rheumatoid arthritis (RA) is a chronic multisystem disease of unknown etiology characterized by persistent inflammatory synovitis, usually involving peripheral joints in a symmetric distribution. RA is a systemic disease often associated with cutaneous and organ-specific extra-articular manifestations the mucociliary clearance system protects the lower respiratory system by trapping and removing inhaled pathogenic viruses and bacteria, in addition to nontoxic and toxic particulates (e.g., pollen, ash, mineral dust, mold spores, and organic particles), from the lungs. Effective clearance requires both ciliary activity and the appropriate balance of periciliary fluid and mucus.Methods: This was a case control study conducted in the Department of Physiology, Pt. B.D. Sharma PGIMS, Rohtak in 50 females of age group 30-50 years. Control group comprised of 25 healthy volunteer females while study group comprised of 25 rheumatoid arthritis female patients with disease duration of more than five years. Proven cases of RA (as per 1987 ACR criteria) were taken with disease duration of more than five years from Rheumatology clinic of Pt. B.D. Sharma PGIMS, Rohtak. Nasal mucociliary clearance time was evaluated by saccharin method.Results: The results of our study showed abnormal mucociliary clearance in rheumatoid arthritis patients.Conclusions: The study shows an abnormal mucociliary clearance in rheumatoid arthritis patients. Impairment of mucociliary clearance seems to be the result of qualitative and quantitative alterations in respiratory secretions.


2021 ◽  
Author(s):  
Muhammet Cuneyt Bilginer ◽  
Abbas Ali Tam ◽  
Berna Evranos Ogmen ◽  
Bagdagul Yuksel Guler ◽  
Nagihan Ugurlu ◽  
...  

Abstract Background: This study aimed to investigate the relationship between early changes in retinal layer thickness and thiol–disulfide homeostasis in patients with type II diabetes mellitus (T2DM).Materials-Methods: There were 69 patients with T2DM (61 patients without retinopathy, 8 patients with retinopathy) and 21 healthy controls. In patients without retinopathy, 31 of the patients had a disease duration under 10 years, 30 of the patients had a disease duration over 10 years. Retinal layer thickness of the right eye was measured using Spectral Domain Optical Coherence Tomography. Results: Patients with T2DM and healthy controls had mean ages of 48.40 ± 8.25 years and 45.94 ± 7.32 years, respectively. The ganglion cell layer and retinal pigment epithelium thicknesses were significantly lesser in patients without diabetic retinopathy than those in the control group. In patients without diabetic retinopathy and with a disease duration of under 10 years, there was a negative correlation between the retinal nerve fiber layer thickness (µm) and disulphide/total thiol ratio, between the inner nuclear layer thickness (µm) and disulphide/native thiol ratio as well as disulphide/total thiol ratio (r= −0.376, p= 0.037; r= −0.356, p= 0.050; r= −0.380, p= 0.035, respectively) and positive correlation between the INL thickness (µm) and native thiol/total thiol ratio (r= 0.359, p= 0.047).Conclusion: Early changes in retinal layers in patients with DM were associated with thiol–disulfide homeostasis. Administration of therapeutic supplements may aid in the management of low thiol concentrations; this increases the importance of the study findings.


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