Rheumatology international
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Review Case Reports
Severe strongyloidiasis and systemic vasculitis: comorbidity, association or both? Case-based review.
A possible association between strongyloidiasis and systemic vasculitis is rarely reported in the literature. We report the case of a patient with severe strongyloidiasis and an angiographic finding consistent with polyarteritis nodosa. Diagnosis of strongyloidiasis was made by finding of larvae and adult parasites in samples of the upper gastrointestinal tract mucosa and stool. ⋯ However, the clinical course was complicated with pulmonary tuberculosis. Despite tuberculostatic therapy and supportive measures, a lethal outcome occurred. The report is followed by a focused review of the available literature on the association of strongyloidiasis and systemic vasculitis.
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Randomized Controlled Trial
The effect of cryotherapy on fibromyalgia: a randomised clinical trial carried out in a cryosauna cabin.
Evidence of symptomatic treatment for fibromyalgia (FM) is very low. Whole body cryotherapy (WBC) modulates different neurotransmitters, which might have a role in pain alleviation and could exert an effect on FM. Our aim was to evaluate the efficacy of WBC for the control of pain and impact of disease in FM. ⋯ A period effect was noted, with residual effect of WBC; therefore, only results from the first sequence were analysed. ∆VAS pain, ∆FIQ and ∆ICAF scores were significantly larger in the WBC group after the first period (3.0 vs 0.3 in ∆VAS pain; 32.1 vs 0.4 in ∆FIQ; 13.7 vs 0.07 in ∆ICAF; all p < 0.001), and were confirmed after adjustment. In conclusion, WBC with a Cryosense TCT cabin may be a useful adjuvant therapy for FM; further studies on long-term effect and compared to other physical therapies are warranted. Trial registration NCT03425903.
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Comparative Study
Gender does not make a difference in "composite psoriatic disease activity index (CPDAI)" in patients with psoriatic arthritis.
The aim of the study was to investigate the relationship of CPDAI with other follow-up parameters and to evaluate gender differences in measures in psoriatic arthritis (PsA) patients. This cross-sectional study included patients with PsA followed up at a rheumatology outpatient clinic. Disease activity was assessed using CPDAI, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Visual Analog Scale (VASglobal) and Disease Activity Score (DAS28). ⋯ However, objective disease parameters such as ESR, CRP, tender/swollen joint counts, DAS28 and BASMI were similar in both gender groups. This study confirmed that CPDAI, a compound scale to assess disease activity in PsA, was well correlated with other disease activity measurements. Although subjective disease scores were higher in female patients, CPDAI was not affected by gender.
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To study vertebral fracture (VF) prevalence and the scanographic bone attenuation coefficient of the first lumbar vertebra (SBAC-L1) on computed tomography scans (CT-scans) in systemic sclerosis patients. This monocentric retrospective study included patients followed from 2000 to 2014 and fulfilling ACR/EULAR 2013 criteria for systemic sclerosis and who underwent a thoracic or thoraco-abdomino-pelvic CT-scan during their follow-up. Clinical characteristics for sclerosis and osteoporosis risk factors were collected. ⋯ In multivariate analysis, only age (especially patients older than 63 years, OR = 1.08, CI 95% 1.04-1.13, p = 0.001) and calcinosis (OR = 6.04, CI 95% 1.27-28.70, p = 0.02) were independently associated with a SBAC-L1 ≤ 145 HU. On a large sample of patients with systemic sclerosis, the VF prevalence on CT-scan was low (4.3%) while 50% of the patients presented a SBAC-L1 ≤ 145 HU. Interestingly, the presence of calcinosis, periarticular calcifications or acro-osteolysis was linked with low SBAC-L1 and should lead to an osteoporosis screening, especially for patients under 63 years old.
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Platelet to lymphocyte ratio (PLR) has been introduced as a useful index to estimate the current inflammatory burdens in various diseases. In this study, we investigate whether PLR is associated with the severity of ANCA-associated vasculitis (AAV). We retrospectively reviewed the medical records of 163 patients with AAV, collected clinical, laboratory and radiological data and calculated Birmingham vasculitis activity score (BVAS). ⋯ In the univariable binary logistic regression analysis, BUN ≥ 17.45 mg/dL (OR 3.730), Cr ≥ 1.12 mg/dL (OR 3.519), ESR ≥ 83.5 mm/h (OR 2.785), CRP ≥ 20.0 mg/L (OR 2.612), PLR ≥ 272.0 (OR 4.231) and ANCA positivity (OR 2.306) were associated with severe AAV. In the multivariable binary logistic regression analysis, only PLR ≥ 272.0 was an independent predictor of severe AAV at diagnosis (OR 2.734, 95% CI 1.247, 5.993). In conclusion, PLR at diagnosis is associated with the current activity of vasculitis in AAV patients.