4 research outputs found
Entezitis as a predictor of the manifestation of psoriasis arthritis
Psorijaza je autoimunska sistemska inflamatorna bolest, čija je učestalost u
opštoj populaciji oko 2-3%. Pored promena na koži, bolesnik sa psorijazom je sa povišenim rizikom za pojavu depresije, gojaznosti, dijabetesa, inflamatornih bolesti creva, hipertenzije, bolesti srca. Najčešći komorbiiditet psorijaze je psorijazni artritis (PsA). Entezitis je jedan od tri ključna klinička znaka PsA.
Metode. Biće sprovedena prospektivna studija (studija slučaj-kontrola) kojom će biti obuhvaćeno 180 pacijenata obolelih od psorijaze (patohistološki
verifikovane), koji nisu lečeni sistemskom terapijom, izuzev uskospektralne UVB
fototerapije ili PUVA terapije.
Ovim bolesnicima će biti izveden ultrasonografski pregled enteza i kalkulacija
MASEI i GUESS skora, procena kvaliteta života kroz Dermatološki indeks
kvaliteta života (DLQI), popunjavanje i poređenje upitnika za procenu rizika
psorijaznog artritisa. Biće registrovani demografski i podaci o dosadašnjem toku
i trenutnoj aktivnosti bolesti (PASI skor), podaci o komorbiditetima.
Ultrasonografski pregledi enteza biće izvedeni u Institutu za radiologiju
Vojnomedicinske akademije u Beogradu, na ultrazvučnom aparatu
Resona 7 firme Mindray. Biće korišćena ultrazvučna sonda L14-6WU.
Očekivani rezultati. Prisustvo entezitisa na osnovu ultrasonografskog pregleda
enteza može imati prediktivnu vrednost za ispoljavanje psorijaznog artritisa i
utiče na kvalitet života kod bolesnika sa psorijazom, upitnici za procenu rizika
od psorijaznog artritisa mogu pružiti dodatne validne informacije, pojedini
klinički parametri (trajanje i aktivnost psorijaze) i stepen sistemske inflamacije
mogu imati prediktivnu vrednost za ispoljavanje psorijaznog artritisa i uticati na
kvalitet života kod bolesnika sa psorijazom. Prisustvo komorbiditeta (pogotovu na
lokomotornom sistemu), stepen depresije i subjektivna interpretacija bola mogu
imati negativnu prediktivnu vrednost za ispoljavanje psorijaznog artritisa.
Očekivani zaključak. Na osnovu dobijenih rezultata zaključićemo da
ultrasonografski pregled enteza predstavlja značajan korak u skrinigu pacijenata sa
psorijazom. Subjektivni parametri dobijeni preko upitnika za skrining bolesnika
sa psorijazom imaju određeni, ali manji značaj u odnosu na objektivni
ultrasonografski pregled.Psoriasis is an autoimmune systemic inflammatory disease, with a prevalence
of about 2-3% in the general population. In addition to skin changes, a patient with psoriasis is elevated risk of depression, obesity, diabetes, inflammatory bowel disease, hypertension, heart disease. The most common comorbidity of psoriasis is psoriatic arthritis (PsA). Entezitis represents one of the three key clinical signs of PsA.
Methods. A prospective study (case-control study) will be conducted to cover 180 patients with psoriasis (histopathologically verified) who have not been treated with systemic therapy, except for narrow-spectrum UVB phototherapy or PUVA therapy. These patients will undergo an ultrasonographic examination of the enthesis and calculations of MASEI and GUESS scores, assessment of quality of life through the Dermatological Quality of Life Index (DLQI), completing and comparing the psoriasis arthritis risk assessment questionnaire. Demographics and data on the existing and current activity of the
disease will be registered (PASI score), comorbidities data. The ultrasonographic examinations of the enthesis will be performed at the Institute of Radiology of the Military Medical
Academy in Belgrade, using the Mindray ultrasound device Resona 7. An L14-6WU ultrasonic probe will be used.
Expected results. The presence of enthesitis based on an ultrasonographic examination of
the enthesis may have predictive value for the manifestation of psoriatic arthritis and affect
the quality of life in patients with psoriasis, psoriatic arthritis risk assessment questionnaires
may provide additional valid information, individual clinical parameters (duration and activity of psoriasis) and degree of systemic inflammation may be predictive for manifestation of
psoriatic arthritis and affect quality of life in patients with psoriasis. Presence of comorbidities (especially on the locomotor system), degree of depression and subjective interpretation
of pain may have negative predictive value for the manifestation of psoriatic arthritis.
Expected conclusion. Based on the results obtained, we will conclude that an ultrasonographic examination of the enthesis represents a significant step in the screening of patients with psoriasis. Subjective parameters obtained through the screening questionnaire for
patients with psoriasis have certain, but less significance compared to objective ultrasonographic examination
Treatment of degenerative chronic low back pain with fluoroscopically guided epidural procaine-corticosteroid injection
Background/Aim. Low back pain is one of the most common painful conditions in the modern age. Therefore, it is very important to establish the most effective protocol for the treatment of this condition. The aim of this study was to find out if fluoroscopically, guided epidural procainecorticosteroid injection is effective in the treatment of degenerative chronic low back pain. Methods. This prospective cohort study was performed in the Military Medical Academy from September 2005 to June 2006 and included 60 patients of both sexes, 34-85 years of age. Degenerative changes of lumbosacral spine were determined by magnetic resonance imaging. The intensity of low back pain was evaluated by subjective (Roland's scale) and objective parameter (Lazarevic sign). Epidural procaine-corticosteroid injection was applied in the patients with low back pain not responding to conservative therapy. After the application of injection, effects of the therapy were followed up. Results. In 92% of the patients there was a reduction of pain intensity for three months, in 4.8% a reduction for a month, but after another injection they felt pain reduction for the next three months. One patient (2.3%) had pain reduction for one month. Conclusion. In the treatment of degenerative chronic low back pain, not responding to conservative therapy with nonsteroidal anti-inflammatory drugs, epidural procaine-corticosteroid injection have a satisfactory short-term as well as a long-term analgesic effect