1,721,007 research outputs found
Synovial inflammation drives structural damage in hand osteoarthritis: A narrative literature review
No full textAbstract: Background: Ultrasound is one of the most promising candidates for
the detection of inflammation and structural damage in hand osteoarthritis.
Objective: To evaluate new advances of US as a diagnostic and prognostic tool in
hand osteoarthritis assessment.
Methods: We conducted a Medline on PubMed search for articles about “ultrasonography”
and “hand OA” published between January 2012 and 15th April
2016, limiting our search to articles on human adults in English, excluding those
involving systemic inflammatory diseases, visualization of joints other than hands,
ultrasound guided injections and surgical procedures. Reviews, case reports, letters,
position statements and ex vivo studies were excluded. Concordance between ultrasound and
conventional radiography and magnetic resonance imaging was evaluated.
Results: Total 46 records were identified, and 16 articles were selected: four showed only ultrasound
structural damage (osteophytes, cartilage pathology), six only ultrasound inflammatory variables
(synovial thickness, effusion and power Doppler signal), six should considered both ultrasound structural
and inflammatory features as well as erosions and two were epidemiological studies. Ultrasound
synovitis and power Doppler signal were more frequent in erosive hand osteoarthritis. Followup
studies found that ultrasound inflammatory features at baseline are independently associated with
radiographic progression; power Doppler signal was the strongest predictor of structural damage.
Ultrasound is a reliable tool for cartilage and osteophyte assessment (when performed with static
images) and shows a good concordance with magnetic resonance imaging for osteophytes, erosions
and synovitis.
Conclusions: Ultrasound detected inflammation may predict radiographic progression and may be
used in prospective clinical trials of hand osteoarthritis and in everyday clinical practice
Efficacy and safety of tocilizumab in refractory rheumatoid arthritis: a real life cohort from a single centre
No full textTocilizumab (TCZ) is an effective treatment in patients with rheumatoid arthritis (RA) refractory to anti-tumour necrosis factor-α. However, only few studies in real life have evaluated the efficacy of TCZ in long-standing rheumatoid arthritis (LSRA). Our aim was to evaluate the efficacy and safety of tocilizumab in refractory LSRA
Tocilizumab for severe refractory neuro-Behçet: three cases IL-6 blockade in neuro-Behçet
No full textObjectives: To describe the response to IL-6 blockade [tocilizumab (TCZ)] in three patients affected by highly refractory neuro-Behcet disease (NBD).
Methods: Three patients who had failed synthetic immunosuppressants and TNF-alpha antagonists combined with glucocorticoids received TCZ after obtaining their informed consent. Two patients underwent TCZ infusions at 8 mg/kg every 4 weeks for a mean period of 24 months, while in one patient, the frequency of TCZ infusions was increased to every other week after 21 months due to a disease flare. Concomitant therapy with synthetic agents and low-to-medium dose glucocorticoids was continued. Clinical and imaging findings were assessed before and after the onset of TCZ therapy.
Results: In all our patients, a very short time lag between the onset of treatment with TCZ and the clinical response was observed. A partial response occurred in two patients and a nearly complete response in one. Some loss of efficacy occurred after 18 months in one patient, but there was again a significant improvement when the interval between the infusions was shortened. TCZ was overall well tolerated and no serious adverse events occurred. In two patients, the prednisone dose could successfully be tapered to about 20 mg/day, while in another patient glucocorticoids could safely be withdrawn. Brain MRI remained virtually unchanged in all patients.
Conclusions: Although TCZ has not yet been included among the medications recommended for the treatment of NBD, our data suggest that it may be considered for patients with refractory NBD
The Role of Tumor Necrosis Factor-α Blockers in Psoriatic Disease. Therapeutic Options in Psoriatic Arthritis
No full textPsoriatic arthritis (PsA) is a chronic inflammatory disease affecting peripheral and axial joints, usually associated with psoriasis (PsO) and involving various systems and organs (eye inflammation, such as uveitis; and involvement of nail and enthesis), and it usually requires a multidisciplinary treatment approach. Tumor necrosis factor-α (TNF-α) is overexpressed in psoriatic synovium and skin plaques and its selective inhibition by anti-TNF-α agents has been demonstrated to reduce TNF-α levels in the articular environment, reversing the synovial hyperproliferative phenotype. Studies performed on anti-TNF-α agents in PsA demonstrated that they are able to reduce neutrophil and macrophage infiltration as well as vascular cell adhesion protein 1 expression with ensuing synovial thickness normalization. The efficacy of anti-TNF-α agents for all PsA manifestations (peripheral arthritis, axial involvement, enthesopathy, and skin disease) suggests that anti-TNF-α efficacy might be related to the ability to influence angiogenesis and osteoclastogenesis, reduce synovial inflammation, and slow radiological disease progression. This review describes the role of anti-TNF-α in each manifestation of PsA
Elevated serum levels of alarmin S100A8/A9 in patients with hand osteoarthritis
No full textNo abstract availabl
High Circulating Levels of IL-4 and IL-10 in Progressive Pseudorheumatoid Dysplasia Patient
No full textNo abstract availabl
Improvement of Function and Its Determinants in a Group of Axial Spondyloarthritis Patients Treated with TNF Inhibitors: A Real-Life Study
Full text linkIntroduction The aim of this work is to investigate the improvement of physical function and its determinants in axial spondyloarthritis (SpA) patients treated with tumor necrosis factor (TNF) inhibitors in a real clinical practice setting. Methods An observational study was conducted in patients with axial SpA treated with anti-TNF from 2010 to 2018 with a minimum 6 months of follow-up. All patients fulfilled ASAS or the modified New York criteria. The Bath Ankylosing Spondylitis Metrology Index (BASMI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) were used as objective and self-reported functional indices. The improvement of function and factors associated were evaluated for the present study, as well as disease activity and patient-reported outcome measures. Results A total of 183 patients with axial SpA were examined. Among them, 27 were non-radiographic axial SpA, while the remaining 156 were ankylosing spondylitis patients. BASFI and BASMI significantly improved during follow-up. Improvement of metrology index BASMI inverse correlated with disease duration (rho - 0.2, p = 0.009) and directly correlated with the improvement of BASDAI (rho 0.26, p = 0.003) and CRP (rho 0.26, p = 0.0003). Improvement of BASFI significantly inversely correlated with disease duration and directly correlated with the improvement of BASDAI, CRP, and baseline ESR. Male sex, lower disease duration, high ESR, and the improvement of BASDAI were found to be associated with the improvement of BASFI. Conclusions Our results showed that in real-life settings, patients improve in BASMI and BASFI. Furthermore, factors associated with this improvement were identified
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
- …
