Rheumatology international
-
Comparative Study Clinical Trial
As compared to allopurinol, urate-lowering therapy with febuxostat has superior effects on oxidative stress and pulse wave velocity in patients with severe chronic tophaceous gout.
We prospectively evaluated whether an effective 12-month uric acid-lowering therapy (ULT) with the available xanthine oxidase (XO) inhibitors allopurinol and febuxostat in patients with chronic tophaceous gout has an impact on oxidative stress and/or vascular function. Patients with chronic tophaceous gout who did not receive active ULT were included. After clinical evaluation, serum uric acid levels (SUA) and markers of oxidative stress were measured, and carotid-femoral pulse wave velocity (cfPWV) was assessed. ⋯ Both febuxostat and allopurinol effectively lower SUA levels in patients with severe gout. However, we observed that febuxostat also appeared to be beneficial in preventing further arterial stiffening. Since cardiovascular events are an important issue in treating patients with gout, this unexpected finding may have important implications and should be further investigated in randomized controlled trials.
-
The purpose of this study is to adapt the Hip disability and Osteoarthritis Outcome Score-Physical function Short-form (HOOS-PS) to Turkish language and to evaluate the psychometric properties of the Turkish version in patients with primary hip osteoarthritis. After the translation from the source language (English) to the target language (Turkish), synthesis, back translation, revision, and pretest stages were done. Next, 50 patients with primary hip osteoarthritis were asked to fill out the Turkish version of the HOOS-PS two times with one week interval. ⋯ Both scores verify that the Turkish HOOS-PS is a reliable tool. Spearman's rank correlation coefficients between the HOOS-PS and overall WOMAC (r = 0.653), WOMAC physical functions (r = 0.626), WOMAC pain (r = 0.629) subscales, overall Lequesne (r = 0.650), and Lequesne daily living activities (r = 0.620) subscales were high (r > 0.6), and moderate correlations were found between the HOOS-PS and WOMAC stiffness (r = 0.511), Lequesne pain (r = 0.569), and Lequesne-walking distance (r = 0.578) subscales (0.6 > r > 0.2), thus providing proof for the validity of the Turkish form. The Turkish HOOS-PS was found to be reliable and valid for patients with primary hip osteoarthritis.
-
Case Reports
Cryoglobulinemic vasculitis in systemic sclerosis successfully treated with mycophenolate mofetil.
Cryoglobulinemic vasculitis is extremely rare in patients with systemic sclerosis (SSc). So far, only two cases of cryoglobulinemic vasculitis in SSc were described in the literature. This report is about a patient with SSc and secondary Sjőgren's syndrome, who developed typical clinical features of small-vessel vasculitis, including arthritis, purpura, microhaematuria, gangrene of fingers, and toes and myocardial ischemia, in the presence of mixed cryoglobulinemia, ANA, rheumatoid factor, and anti-SSA/Ro antibodies. Symptoms and signs of vasculitis worsened despite initial treatment with corticosteroids and cyclophosphamide, but improved significantly when mycophenolate mofetil was used instead cyclophosphamide.