Clinical rheumatology
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Clinical rheumatology · Nov 2017
Prognostic factors of mortality in Iranian patients with systemic lupus erythematosus admitted to intensive care unit.
The aim was to determine the course, outcome, and determinants of mortality in patients with systemic lupus erythematosus (SLE) in intensive care unit (ICU). SLE patients admitted to ICU from 2004 to 2015 were recruited retrospectively. Demographic data, disease characteristics, causes of admission, baseline SLE disease activity index-2K (SLEDAI-2K) and Acute Physiologic and Chronic Health Evaluation II (APACHE) score, the outcome, and the causes of death were recorded. ⋯ This figure for those with and without septic shock was 13.5 (4.9-11.1) and 22.3 (9.3-24.7) days, respectively (P = 0.016). High APACHE II, septic shock, and duration of mechanical ventilation were the main predictors of death in patients with SLE in ICU. Multicenter studies are needed to draw a fine picture of SLE behavior in ICU.
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Clinical rheumatology · Oct 2017
Disease activity, handgrip strengths, and hand dexterity in patients with rheumatoid arthritis.
Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting the hand joints and leading to impairment in hand functions. Evaluation of functional impairment is necessary for assessing patient's quality of life, disease activity, and treatment outcome. To date, many scientific studies assessed the disease activity of patients with RA, but little attention has been carried out to assess these patients' hand functions and dexterity. ⋯ The QuickDASH is practical to use in clinical practice, and positively correlates with the disease activity. Dexterity measurements with PPT in the RA patient group were found practical and effective in our study. As a result, we can suggest using QuickDASH questionnaire for functional outcomes, handgrip strength measurements for assessment of hand disability and functional impairments, and also dexterity measurements even in patients with low disease activity.
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Clinical rheumatology · Oct 2017
Randomized Controlled TrialGroup-based exercise at workplace: short-term effects of neck and shoulder resistance training in video display unit workers with work-related chronic neck pain-a pilot randomized trial.
Effectiveness of exercise therapy in video display unit (VDU) workers with work-related chronic neck pain (W-RCNP) is unclear. The aim of the study was to assess the efficacy of group-based neck-shoulder resistance exercises on symptoms and muscular function in VDU workers with W-RCNP. Thirty-five employees with CNP were randomly assigned to neck-shoulder resistance exercise (NSRE) group or to conventional stretching and postural exercise (SPE) group. ⋯ NSRE and SPE are feasible and equally effective in reducing pain and pain-related disability as group exercises in W-RCNP. NSRE may provide some advantage in improving strength and endurance in neck muscles. Further, larger studies should confirm these findings and assess whether a better muscle function confers long-term clinical advantages.
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Clinical rheumatology · Sep 2017
ReviewGenomics and epigenomics in rheumatic diseases: what do they provide in terms of diagnosis and disease management?
Most rheumatic diseases are complex or multifactorial entities with pathogeneses that interact with both multiple genetic factors and a high number of diverse environmental factors. Knowledge of the human genome sequence and its diversity among populations has provided a crucial step forward in our understanding of genetic diseases, identifying many genetic loci or genes associated with diverse phenotypes. In general, susceptibility to autoimmunity is associated with multiple risk factors, but the mechanism of the environmental component influence is poorly understood. ⋯ In this context, the development of "-omics" techniques is an opportunity to progress in our knowledge of complex diseases, impacting the discovery of new potential biomarkers suitable for their introduction into clinical practice. In this review, we focus on the recent advances in the fields of genomics and epigenomics in rheumatic diseases and their potential to be useful for the diagnosis, follow-up, and treatment of these diseases. The ultimate aim of genomic studies in any human disease is to understand its pathogenesis, thereby enabling the prediction of the evolution of the disease to establish new treatments and address the development of personalized therapies.
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Clinical rheumatology · Sep 2017
Association of STAT4 rs7574865 and PTPN22 rs2476601 polymorphisms with rheumatoid arthritis and non-systemically reacting antibodies in Egyptian patients.
The aim of this study was to investigate association of protein tyrosine phosphatase non-receptor type 22 (PTPN22) rs2476601 and signal transducer and activator of transcription 4 (STAT4) rs7574865 polymorphisms with rheumatoid arthritis (RA) susceptibility and to assess potential association with the status of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies, serum neopterin, and disease activity. RF, anti-CCP antibodies, and neopterin were assayed in serum of 100 unrelated RA patients and 114 controls. STAT4 rs7574865 G/T and PTPN22 rs2476601 C/T polymorphisms were genotyped by the TaqMan allelic discrimination method. ⋯ No significant associations between STAT4 variant and serum neopterin or disease activity parameters were identified. Our study confirmed the association of STAT4 rs7574865 polymorphism with RA and was the first to indicate an association with RF and anti-CCP antibodies positivity. We also found PTPN22 rs2476601 has no role in susceptibility to RA in Egyptian patients.