Rheumatology international
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It is recommended to evaluate the presence of latent tuberculosis infection (LTBI) prior to the use of antitumor necrosis factor α. The aim of this study is to assess the presence of LTBI in patients with rheumatic diseases undergoing treatment with infliximab in an endemic area for tuberculosis (TB). LTBI was searched through the contact history, chest X-ray and tuberculin skin test with purified protein derivative (PPD) ≥5 mm. ⋯ No significant difference between the reactivity of the PPD and the use of immunosuppressive drugs (P = 0.81) is observed. The immunoprophylaxis with INH showed an efficacy of 95% (20/21); three (1.9%) patients developed active TB (spondylodiscitis, meningitis and lymphadenopathy) after the use of infliximab, reaffirming extrapulmonary involvement. These results suggest that PPD has a low sensitivity for detection of LTBI in RA and that the previous use of immunosuppressive drugs does not affect the response to PPD.
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The objective of the present study was to investigate possible changes in granulysin (GNLY)-mediated cytotoxicity of peripheral blood lymphocytes in psoriatic arthritis (PsA) patients with respect to different phases of the disease. We prospectively enrolled 25 PsA patients in the active phase, 26 PsA patients in remission and 24 healthy controls. The simultaneous detection of intracellular GNLY and cell surface antigens (CD3 and CD56) was performed with flow cytometry. ⋯ The mean fluorescence intensity for GNLY was higher in all lymphocyte subpopulations in the acute phase than in remission and in healthy controls. Accordingly, GNLY-mediated NK cell cytotoxicity against K-562 cells of active phase PsA patients was significantly higher than that in patients in remission or in healthy controls. These findings demonstrated the involvement of GNLY in the worsening of PsA and suggested that GNLY mediated the development of joint lesions.
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Comparative Study
The correlation between durometer score and modified Rodnan skin score in systemic sclerosis.
The aims of the present study were to determine the correlation between durometer scores with modified Rodnan skin scores (MRSS), scleroderma symptoms, and physical functions. A total of 31 patients with systemic sclerosis (SSc, 16 diffuse and 15 limited type) were enrolled in this study. Skin involvement was measured using a durometer and MRSS. ⋯ Total durometer scores correlated well with MRSS (r = 0.537, P = 0.002) and KTF scores (r = 0.608, P < 0.001), but poorly correlated with HAQ disability indices (r = 0.202, P = 0.276), and individual scleroderma-VAS scores. Durometer-measured skin hardnesses were found to correlate well with the MRSS scores of fingers, hands, forearms, upper arms, thighs, and feet. The authors suggest that these skin sites should be included when durometer measurements are made in systemic sclerosis.
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Randomized Controlled Trial
Efficacy of a multidisciplinary treatment program in patients with severe fibromyalgia.
The purpose of this study was to evaluate the efficacy of a multidisciplinary treatment program in patients severely affected by fibromyalgia. Thirty-four fibromyalgia patients were randomly divided into two groups. The control group: 17 women who continued their medical treatment and participated in four educational sessions and the experimental group that included 17 patients who besides the former medical treatment also underwent a weekly 1-h session program for 8 weeks including massage therapy, ischemic pressure on the 18 tender points, aerobic exercise and thermal therapy. ⋯ At that time, considering the threshold for clinical efficacy set at an improvement of 30% or above for the analyzed variables, 25% of the patients met the requirement for improvement of the following: number of symptoms: Visual Analogic Scale for fatigue, Fibromyalgia Impact Questionnaire and Beck Anxiety Inventory. In conclusion, patients with severe manifestations of fibromyalgia can obtain improvement with a short-term, low-cost and simple-delivery multidisciplinary program. However, additional studies including higher numbers of patients are needed to confirm the beneficial effect of this treatment program.
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Osteoarthritis (OA) is the most common chronic joint disorder. Relationships between knee OA and physical performance have been examined, but mainly in patients with knee OA. Clarifying the relationship between knee OA and physical performance among community-dwelling individuals is thus important. ⋯ Furthermore, chair stand and walking took longer for women with painful knee OA than for women with radiographic knee OA. Women with knee OA showed deteriorated performance of chair stand and walking. Painful knee OA was associated with poorer performance than radiographic knee OA.