Rheumatology international
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Comparative Study
Evaluation of an interferon gamma assay in the diagnosis of latent tuberculosis infection in patients with rheumatoid arthritis.
The tuberculin skin test is not an ideal screening test for the patients with rheumatoid arthritis to identify cases of latent tuberculosis infection (LTBI) prior to the start of treatment with anti-TNFs, as it responds inadequately to late hypersensitivity, which is fundamental for producing a response to the inoculated antigen. Assays based on detection of the production of IFNγ in vitro by mononuclear peripheral cells stimulated by specific antigens are more specific than PPD in detecting LTBI. The aim of this study was to evaluate the performance of T-SPOT. ⋯ TB varied from 87 to 90% and the negative-predictive value (NPV) from 94.4 to 100%. It can be concluded that the T-SPOT. TB showed high specificity and NPV, proving the capability of identifying false-negative cases of PPD, raising the level of safety for the use of anti-TNFs.
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Cardiovascular pathology is frequent in systemic lupus erythematosus (SLE). Left ventricular (LV) diastolic dysfunction is its common findings. The aim of the study was to assess the systolic and diastolic function of the left ventricle (LV) in SLE patients without clinically evident cardiovascular disease, using pulsed Doppler echocardiography. ⋯ Increased the value of SLEDAI correlated with increased A' and decreased E, E/A ratio and E'/A' ratio in SLE subjects. Further analysis concerning the strong connection of these parameters with patients' age, however, revealed no statistically significant correlation between SLEDAI values and LV diastolic function parameters. In long (>10 years) disease duration LV diastolic properties were worse.
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Angiogenesis in synovia is a characteristic of RA patients. We examined whether IL-6 or TNF-alpha induce tubule formation in a co-culture system of fibroblast-like synovial cells from RA patients (RA-FLS) and human umbilical vein endothelial cells (HUVEC). The effects of IL-6 and TNF-alpha on the expression of angiogenic factors in RA-FLS and HUVEC, and the proliferation of HUVEC were also studied. ⋯ IL-6 + sIL-6R stimulation of RA-FLS strongly induced mRNA expression of VEGF, but not of other angiogenic factors, such as EGF, bFGF, TGF-beta, IL-1, TNF-alpha and IL-8. Neither IL-6 nor IL-6/sIL-6R promoted HUVEC proliferation, whereas TNF-alpha significantly inhibited VEGF-induced HUVEC proliferation. In conclusion, IL-6/sIL-6R complex showed angiogenic activity via the production of VEGF from RA-FLS, but TNF-alpha was anti-angiogenic in our experimental system.
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The aim of this article is to study the prevalence, clinicolaboratory features, WHO histological types, therapy and renal outcome of lupus nephritis (LN) in Saudi Arabia. During the 27-year-period (1980-2006), 299 (47.9%) cases of LN were identified among the 624 cases of systemic lupus erythematosus (SLE) follow-up at King Khalid University Hospital, Riyadh. The female:male ratio in LN was 8.3:1, with a mean age of 32 years and a mean age of onset of 23 years. ⋯ Different treatment modalities did not have significant effect on survival in the whole LN cohort (P = >0.05). However, pulse cyclophosphamide favored remission in Classes II, III, IV, and V (P = 0.023). The main causes of death were renal failure (50%) and infections (44.4%).
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Randomized Controlled Trial
Effects of electrical stimulation program on trunk muscle strength, functional capacity, quality of life, and depression in the patients with low back pain: a randomized controlled trial.
The aim of this clinical trial was to evaluate the effects of electrical stimulation (ES) program on trunk muscle strength, functional performance, quality of life (QOL) in the patients with chronic low back pain (CLBP). A total of 41 patients with definite CLBP were included in this study. These patients were randomized into two groups. ⋯ Except depression and social function, the improvements for all the parameters were better in the ES group than in the control group. We observed that ES program was very effective in improving QOL, functional performance and isometric strength. In conclusion, we can say that ES therapy provides comfortable life functions by improving muscle strength, functional performance and QOL.