Current Issue : July - September Volume : 2019 Issue Number : 3 Articles : 8 Articles
Background: The aim of our study was to investigate the influence of conventional synthetic disease-modifying\nanti-rheumatic drugs (csDMARDs) and body mass index (BMI) on circulating drug levels and clinical response to\ntumour necrosis factor inhibitor (TNFi) therapy in axial spondyloarthritis (axSpA) patients.\nMethods: Prospective observational study during 1 year with 2 cohorts (Madrid and Amsterdam) including 180\naxSpA patients treated with standard doses of infliximab or adalimumab. Patients were stratified by BMI, being\n78 (43%) normal weight (18.5-24.9 kg/m^2) and 102 (57%) overweight/obese (less than equal to 25.0 kg/m^2). After the first year\nof treatment, TNFi trough levels were measured by capture ELISA. Clinical response to TNFi was defined as....................
Background: In recent decades, obesity has become a public health problem in many countries. The objective of\nthis study was to evaluate the main joint and extra-articular manifestations related to spondyloarthritis (SpA) after\nbariatric surgery (BS) in a retrospective cohort.\nMethods: Demographic, clinical, laboratory and imaging data from nine patients whose SpA symptoms started\nafter a BS have been described. Modified New York (mNY) criteria for ankylosing spondylitis (AS) and the Assessment of\nSpondyloarthritis International Society (ASAS) criteria for axial (ax-SpA) and peripheral (p-SpA) spondyloarthritis were applied.\nResults: The mean weight reduction after BS was.......................
Introduction: Total knee arthroplasty, being a major surgery, carries a risk of\npost-operative deep vein thrombosis (DVT). The main objective of the\npresent study was to elucidate the association of clinical, laboratory, and\nechographic findings with the occurrence of DVT. Patients and Methods:\nThe present study was prospective and non-randomized, with restricted exclusion\ncriteria. Forty patients were submitted to total knee arthroplasty due\nto osteoarthritis. Patients were clinically evaluated by laboratory tests, assessment\nof pain and calf circumference, and the presence of Homansâ?? sign.\nEcho Doppler was performed in each patient on postoperative day 7. The\nechographic evaluation divided the patients into two groups: positive (G1)\nand negative for thrombosis (G2). All patients received prophylactic heparin\nduring the 7-day hospital admission. Results: Eleven patients complained of\npain (analgesic medication was used during the entire admission). Leg circumference\nvariation from the pre-operative period to post-operative day 7\nwas:........................
Glenoid labrum articular disruption (GLAD) lesions are an uncommon concomitant injury associated with labral tears, occurring\nin 1.5-2.9% of cases. In previous reported cases, the articular lesion is debrided during repair of the labral injury, which may\npredispose patients to osteoarthritis, a longitudinal complication seen in articular debridement of the hip. We report the case of\na 15-year-old healthy adolescent male swimmer who sustained a labral injury with a concomitant GLAD lesion. During\noperative management, three Polyetheretherketone (PEEK) SutureTaks were placed on the glenoid. #2 FiberWire was used to\nimbricate capsular tissue, passed beneath the labrum, and was then subsequently advanced through the fibrous rim of the\ndisplaced cartilage flap/GLAD lesion at the site of each suture anchor. This construct restored tension to the anterior band of\nthe inferior glenohumeral ligament, recreated the anteroinferior labral bumper, and effectively reduced the cartilage flap/GLAD\nlesion to the anterior inferior glenoid. By six months postoperatively, the patient demonstrated near-normal function with full\nrange of motion and evidence of a stable construct on MRI. Unlike previously described cases, this is the first report of a hybrid\ntechnique that simultaneously performed a primary repair of both labral and articular injuries without the use of additional\nimplants for the articular lesion. Primary repair of the labral and articular lesions should provide longitudinal benefit to the\npatient by reducing the risk of developing glenohumeral osteoarthritis....
Introduction. Intra-articular ganglion cysts of the knee joint are rare and mostly incidental findings in magnetic resonance imaging\n(MRI) or arthroscopy. Posterior cruciate ligament (PCL) ganglion cyst in a child is an extremely rare finding, and to the best of our\nknowledge, only one case has been described in the literature. We report a case of a large intra-articular ganglion cyst of the knee\narising from the PCL in an autistic child. Case Presentation. An 8-year-old Caucasian boy affected by autism presented with\nnontraumatic knee pain. His parents, observing childâ??s gait, reported recurrent limp while walking, sometimes accompanied by\nknee locking. Clinical examination was hindered by the noncompliance of the patient and revealed painful limitation of\nterminal flexion and extension. MRI scans showed a large ganglion cyst located in the intercondylar notch. Arthroscopy\nconfirmed an intrasubstance PCL ganglion cyst, extending both anteriorly and posteriorly. Complete excision of the cyst was\nperformed, with full recovery of the child and no recurrence. Conclusion. In pediatric patients with pain or limited knee range of\nmotion, physicians should consider the possibility of a ganglion cyst arising from the PCL, despite its rarity. Arthroscopic\nexcision is a safe and effective procedure that guarantees a complete recovery of the patient with the lowest rate of recurrence....
A congenital absence of the lumbar facet joint is a rare reported condition.This is the case of a 32-year-old male patient presenting\nwith severe low back pain radiating to his right lower limb. Physical examination revealed no motor deficits, but right lower limb\nnumbness was reported over dorsum aspect of the right foot. No other sensory or motor disturbances were reported or found on\nexam. Imaging studies, consisting of a spine MRI and spine CT scan with 3D reconstruction, revealed the absence of the right L5-S1\nzygapophyseal joint. The patient was treated conservatively with resolution of his symptoms on one-month follow-up....
Introduction. Historically, a majority of prosthetic joint infections (PJIs) grew Gram-positive bacteria. While previous studies\nstratified PJI risk with specific organisms by patient comorbidities, we compared infection rates and microbiologic characteristics\nof PJIs by hospital setting: a dedicated orthopaedic hospital versus a general hospital serving multiple surgical specialties. Methods.\nA retrospective review of prospectively collected data on 11,842 consecutive primary hip and knee arthroplasty patients was\nperformed. Arthroplasty cases performed between April 2006 and August 2008 at the general university hospital serving multiple\nsurgical specialties were compared to cases at a single orthopaedic specialty hospital from September 2008 to August 2016. Results.\nThe general university hospital PJI incidence rate was 1.43%, with 5.3% of infections from Gram-negative species. In comparison,\nat the dedicated orthopaedic hospital, the overall PJI incidence rate was substantially reduced to 0.75% over the 8-year timeframe.\nComparing the final two years of practice at the general university facility to the most recent two years at the dedicated orthopaedics\nhospital, the PJI incidence was significantly reduced (1.43% vs 0.61%). Though the overall number of infections was reduced, there\nwas a significantly higher proportion of Gram-negative infections over the 8-year timeframe at 25.3%. Conclusion. In transitioning\nfrom a multispecialty university hospital to a dedicated orthopaedic hospital, the PJI incidence has been significantly reduced\ndespite a greater Gram-negative proportion (25.3% versus 5.3%). These results suggest a change in themicrobiologic profile of PJI\nwhen transitioning to a dedicated orthopaedic facility and that greater Gram-negative antibiotic coverage could be considered....
Objective: We applied systems biology approaches to investigate circadian rhythmicity in rheumatoid arthritis (RA).\nMethods: We recruited adults (age 16â??80 years old) with a clinical diagnosis of RA (active disease [DAS28 > 3.2]).\nSleep profiles were determined before inpatient measurements of saliva, serum, and peripheral blood mononuclear\nleukocytes (PBML). Transcriptome and proteome analyses were carried out by RNA-SEQ and LC-MS/MS. Serum samples\nwere analysed by targeted lipidomics, along with serum from mouse collagen induced-arthritis (CIA). Bioinformatic\nanalysis identified RA-specific gene networks and rhythmic processes differing between healthy and RA.\nResults: RA caused greater time-of-day variation in PBML gene expression, and ex vivo stimulation identified a time-ofday-\nspecific RA transcriptome. We found increased phospho-STAT3 in RA patients, and some targets, including\nphospho-ATF2, acquired time-of-day variation in RA. Serum ceramides also gained circadian rhythmicity in RA, which\nwas also seen in mouse experimental arthritis, resulting from gain in circadian rhythmicity of hepatic ceramide synthases.\nConclusion: RA drives a gain in circadian rhythmicity, both in immune cells, and systemically. The coupling of distant\ntiming information to ceramide synthesis and joint inflammation points to a systemic re-wiring of the circadian\nrepertoire. Circadian reprogramming in response to chronic inflammation has implications for inflammatory\nco-morbidities and time-of-day therapeutics....
Loading....