CORRELATIONS BETWEEN CARIOUS DISEASE AND INFLAMMATORY SYNDROME IN RHEUMATOID ARTHRITIS

We aimed to analyse parameters defining carious disease in patients with rheumatoid arthritis (RA) and to evaluate potential correlations with inflammatory systemic parameters related to RA. Materials and method. We performed a complex clinical oral exam (DMFT, PI, RFR, RFS, CT) and inflammatory tests (ESR, C-reactive protein) and ASLO in seven patients known with RA. The results were statistically analyzed by SPSS 16 programs and Spearman`s correlation. The results showed a positive correlation between ASLO and DMFT, PI, CT, ESR and DMFT, PI, CT, C-reactive protein and variable: CT, PI; negative correlations were reported between ASLO and RFR, RFS, while C-reactive protein also associated with DMFT, RFR, RFS. Conclusions RA can influence the patient's cariogenic risk

The prevalence of temporo mandibular joint in degenerative disease

Rezumat Articulaţia temporomandibulară (ATM), prin poziţie şi funcţie se integrează sistemului stomatognat (SSG), iar prin morfologie se aliniază sistemului articular general; aceste elemente fac ca patologia ATM să înregistreze numeroase aspecte, conturate şi înţelese mai bine în ultima perioadă prin elocvenţa metodelor imagistice. Scopul lucrării: identificarea prevalenţei afectării ATM în bolile reumatismale degenerative. Material şi metodă: studiu prospectiv pe 42 pacienţi cu artroză (OA), generalizată sau localizată la nivelul articulaţiilor mari (şold, genunchi), definitş conform ACR, şi un lot martor alcătuit din 33 bolnavi cu alte afecţiuni. Pacienţii au fost spitalizaţi în Clinica Reumatologie a Spitalului Clinic de Recuperare Iaşi, Romania în perioada 01.01.2005—31.07.2006. Rezultate şi discuţii: prevalenţa simptomatologiei ATM a înregistrat următoarele: durerea articulară, semn dominant, în 92.86% cazuri; durerea musculară frecvent la nivelul muşchiului maseter (71.43%) şi pterigoidian intern (47.62%); contractură musculară la nivelul muşchiului temporal (83.33%). Concluzii: simptomatologia afectării ATM trebuie corect apreciată şi corelată cu modificările imagistice locale, modificările la nivelul întregului SSG sau modificări articulare axiale şi periferice, în vederea stabilirii etiologiei şi terapiei optime.Summary Recent advances in imaging techniques of temporo-mandibular joint (TMJ) result in a better understanding of TMJ pathology, taking into account that TMJ is included in both stomatognatic and articular system Objectives: to identify the prevalence of TMJ involvement in degenerative rheumatic disorders. Material and methods: prospective study on 42 patients with either generalized or localized (hip, knee) osteoarthritis (OA), defined according to ACR criteria, and 33 controllers. Patients were hospitalized in Rheumatology Department, Rehabilitation Hospital, Iasi, Romania during 01.01.2005—31.07.2006. Results: the prevalence of TMJ symptoms registered the following: articular pain, commonly reported, in 92.86% cases; muscular pain frequently in both maseter (71.43%) and internal pterigoidian (47.62%) muscles; muscular contracture in temporal muscle (83.33%). Conclusions: both correct assessment of TMJ involvement and identification of potential relationship between TMJ symptoms and imagistic details are necessary in order to establish etiology and optimal management of TMJ pathology

Progressive skin fibrosis is associated with a decline in lung function and worse survival in patients with diffuse cutaneous systemic sclerosis in the European Scleroderma Trials and Research (EUSTAR) cohort.

Objectives To determine whether progressive skin fibrosis is associated with visceral organ progression and mortality during follow-up in patients with diffuse cutaneous systemic sclerosis (dcSSc). Methods We evaluated patients from the European Scleroderma Trials and Research database with dcSSc, baseline modified Rodnan skin score (mRSS) ≥7, valid mRSS at 12±3 months after baseline and ≥1 annual follow-up visit. Progressive skin fibrosis was defined as an increase in mRSS >5 and ≥25% from baseline to 12±3 months. Outcomes were pulmonary, cardiovascular and renal progression, and all-cause death. Associations between skin progression and outcomes were evaluated by Kaplan-Meier survival analysis and multivariable Cox regression. Results Of 1021 included patients, 78 (7.6%) had progressive skin fibrosis (skin progressors). Median follow-up was 3.4 years. Survival analyses indicated that skin progressors had a significantly higher probability of FVC decline ≥10% (53.6% vs 34.4%; p<0.001) and all-cause death (15.4% vs 7.3%; p=0.003) than non-progressors. These significant associations were also found in subgroup analyses of patients with either low baseline mRSS (≤22/51) or short disease duration (≤15 months). In multivariable analyses, skin progression within 1 year was independently associated with FVC decline ≥10% (HR 1.79, 95% CI 1.20 to 2.65) and all-cause death (HR 2.58, 95% CI 1.31 to 5.09). Conclusions Progressive skin fibrosis within 1 year is associated with decline in lung function and worse survival in dcSSc during follow-up. These results confirm mRSS as a surrogate marker in dcSSc, which will be helpful for cohort enrichment in future trials and risk stratification in clinical practice

NEW INSIGHTS ON THE ROLE OF VE-CADHERIN IN RHEUMATOID ARTHRITIS

The aim of our study was to evaluate serum VEcadherine (VE-CAD) in Rheumatoid Arthritis (RA) and to investigate the potential relations between VE-CAD and the demographic, clinical, biological and disease activity scores. Materials and method: prospective observational study on 64 consecutive RA patients, assessed according to a standard protocol including demographics, disease (clinical, inflammatory, immunological) characteristics, serum VE-CAD (ELISA) and disease activity score (DAS28). Results: a significant correlation was noticed between VE-CAD serum levels and the age of male RA patients; the serum levels of VE-CAD tend to increase in the second and third stage of RA and to decrease in the fourth stage; although the maximum VE-CAD serum levels were significantly lower in RA patients undergoing anti-TNF therapy, no conclusion that anti-TNF therapy might affect in any way the VE-CAD serum levels could be attained. Conclusions: VE-CAD could represent a new biomarker of disease activity, particularly in the subset of RA patients with normal CRP level

TEMPOROMANDIBULAR JOINT INVOLVEMENT IN RHEUMATOID ARTHRITIS PATIENTS - CORRELATIONS WITH DISEASE ACTIVITY AND QUALITY OF LIFE

The aim of this study was to assess symptoms and signs of temporomandibular joint (TMJ) involvement in patients with rheumatoid arthritis and to offer a complex outlook of the TMJ evaluation in routine practice in rheumatic patients. We performed a prospective observational study in consecutive patients with different inflammatory and degenerative rheumatic conditions and secondary TMJ involvement, aiming to realise a complex (epidemiological, clinical, biological and imaging) description of TMJ pathology. The results of the present study showed that TMJ involvement was usually reported in different RA subtypes. The presence of TMJ issues was significantly associated with several individual RA parameters defining disease activity such as tender and swollen joints and also with disability and impaired life quality as suggested by high HAQ scores. TMJ pathology remains a major cause of altered quality of life in patients with chronic inflammatory rheumatic conditions such as RA

INFLUENCE OF POSTURE ADOPTED BY DENTIST ON SPINE

Posture influences at work on the entire musculoskeletal apparatus, but with great consequences for the spine. Postural dentists use two totally different ways of working: seated working position and postural working position. The seating position is currently considered the ergonomic and postural is considered all unergonomic. This study aims to analyze the disco-vertebral and muscle pain, the conditions for carrying out or postural seating. The study was conducted on two groups A and B consisting of 43 random and that 47 dentists (49 women, 41 men), aged 30-55 years (maximum age of assets). The primary composition of the lots was the position taken during medical activity. Group A was selected for orthostatic position and group B seated on a wheelchair. In conclusion, there is an ideal working posture for the dentist, such as orthostatic position and sitting with the three types of support may be required for the backbone. Must always wanted workstations that causes less fatigue as being major change position after a period of time (maximum one hour)

Volumetric Cone Beam Computed Tomography for the Assessment of Oral Manifestations in Systemic Sclerosis: Data from an EUSTAR Cohort

Background: Oral health issues are commonly reported in systemic sclerosis (SSc), comprising a broad spectrum of manifestations, e.g., reduced mouth opening, periodontal disease, increased periodontal ligament (PDL) space width, and mandibular resorption. We aimed to assess oral radiographic abnormalities, particularly PDL space widening and erosions, and to identify potential relations with disease measures. Methods: cross-sectional study in 43 SSc and matching controls receiving systematic oral assessments (full mouth dental/periodontal) and imaging (radiographs and cone beam computed tomography (CBCT)). Associations between disease variables and radiologic findings were investigated by univariate and multivariate analysis (SPSS-v.20, p < 0.05). Results: CBCT demonstrated generalized PDL space widening in up to half SSc, with at least one tooth involved, essentially in the posterior region (p < 0.05). Significant correlations between number of teeth with PDL space widening and disease severity, skin score, disease subset, topoisomerase I specificity, age, and disease duration were reported (p < 0.05). Additionally, mandibular erosions were described in one out of four patients, commonly condylar erosions. Conclusions: Tridimensional CBCT approach confirmed widening of PDL and mandibular erosions as common dental findings in scleroderma. Furthermore, widened PDL spaces correlated with several disease characteristics including severity, skin extent, and antibody profile