Carotid intima-media thickness in spondyloarthritis patients

CONTEXT AND OBJECTIVE Accelerated atherosclerosis has become a major problem in rheumatic inflammatory disease. The aim here was to analyze carotid intima-media thickness (IMT) in spondyloarthritis (SpA) patients and correlate this with clinical parameters and inflammatory markers. DESIGN AND SETTING Cross-sectional analytical study at Rheumatology Outpatient Clinic, Evangelical University Hospital, Curitiba. METHODS IMTs (measured using Doppler ultrasonography) of 36 SpA patients were compared with controls. The IMT in SpA patients was associated with inflammatory markers, like erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); and with clinical parameters, like axial or peripheral involvement, dactylitis, HLA B27, uveitis occurrence, Bath Ankylosing Spondylitis Functional Index (BASFI) and lipid profile. RESULTS The mean IMT in SpA patients was 0.72 ± 0.21 mm; in controls, 0.57 ± 0.13 mm (P = 0.0007). There were no associations with ESR, CRP, BASDAI or clinical data. In univariate analysis, greater IMT was seen in patients with longer disease duration (P = 0.014; Pearson R = 0.40; 95% confidence interval, CI = 0.06 to 0.65); higher triglycerides (P = 0.02; Spearman R = 0.37; 95% CI = 0.03 to 0.64); and older age (P = 0.0014; Pearson R 0.51; 95% CI = 0.21 to 0.72). CONCLUSION SpA patients have a higher degree of subclinical atherosclerosis than in controls, thus supporting clinical evidence of increased cardiovascular risk in rheumatic patients

Carotid intima-media thickness in spondyloarthritis patients Espessamento da camada média-íntima da carótida em pacientes com espondiloartrite

CONTEXT AND OBJECTIVE Accelerated atherosclerosis has become a major problem in rheumatic inflammatory disease. The aim here was to analyze carotid intima-media thickness (IMT) in spondyloarthritis (SpA) patients and correlate this with clinical parameters and inflammatory markers. DESIGN AND SETTING Cross-sectional analytical study at Rheumatology Outpatient Clinic, Evangelical University Hospital, Curitiba. METHODS IMTs (measured using Doppler ultrasonography) of 36 SpA patients were compared with controls. The IMT in SpA patients was associated with inflammatory markers, like erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); and with clinical parameters, like axial or peripheral involvement, dactylitis, HLA B27, uveitis occurrence, Bath Ankylosing Spondylitis Functional Index (BASFI) and lipid profile. RESULTS The mean IMT in SpA patients was 0.72 &#177; 0.21 mm; in controls, 0.57 &#177; 0.13 mm (P = 0.0007). There were no associations with ESR, CRP, BASDAI or clinical data. In univariate analysis, greater IMT was seen in patients with longer disease duration (P = 0.014; Pearson R = 0.40; 95% confidence interval, CI = 0.06 to 0.65); higher triglycerides (P = 0.02; Spearman R = 0.37; 95% CI = 0.03 to 0.64); and older age (P = 0.0014; Pearson R 0.51; 95% CI = 0.21 to 0.72). CONCLUSION SpA patients have a higher degree of subclinical atherosclerosis than in controls, thus supporting clinical evidence of increased cardiovascular risk in rheumatic patients.<br> CONTEXTO E OBJETIVO A aterog&#234;nese acelerada tem se tornado um grande problema nas doen&#231;as reum&#225;ticas inflamat&#243;rias. O objetivo foi analisar a espessura da camada &#237;ntima-m&#233;dia (ECIM) da car&#243;tida em pacientes com espondiloartrite (ES) e relacion&#225;-la com par&#226;metros cl&#237;nicos e marcadores inflamat&#243;rios. TIPO DE ESTUDO E LOCAL Estudo transversal anal&#237;tico no Ambulat&#243;rio de Reumatologia do Hospital Universit&#225;rio Evang&#233;lico de Curitiba. M&#201;TODOS A ECIM (medida por Doppler) de 36 pacientes com ES foi comparada com controles. A ECIM de pacientes com ES foi associada com marcadores inflamat&#243;rios, como velocidade de hemossedimenta&#231;&#227;o (VHS), prote&#237;na C-reativa (PCR), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), e com par&#226;metros cl&#237;nicos, como envolvimento axial e perif&#233;rico, dactilite, HLA B27, ocorr&#234;ncia de uve&#237;te, Bath Ankylosing Spondylitis Functional Index (BASFI) e perfil lip&#237;dico. RESULTADOS A ECIM m&#233;dia em pacientes com ES foi de 0,72 &#177; 0,21 mm, enquanto nos controles foi de 0,57 &#177; 0,13 mm (P = 0,0007). N&#227;o se encontrou associa&#231;&#227;o com VHS, PCR, BASDAI e dados cl&#237;nicos. Em an&#225;lise univariada, maior ECIM foi encontrado nos indiv&#237;duos com maior dura&#231;&#227;o de doen&#231;a (P = 0,014; R Pearson = 0,40; 95% intervalo de confian&#231;a, IC = 0,06 to 0,65), aumento nos triglicer&#237;deos (P = 0,02; R Spearman = 0,37; 95% IC = 0,03 to 0,64) e maior idade (P = 0,0014; R Pearson 0,51; 95% IC = 0,21 to 0,72). CONCLUS&#195;O Pacientes com ES t&#234;m maior grau de aterosclerose subcl&#237;nica do que controles, dando suporte &#224;s evid&#234;ncias cl&#237;nicas de aumento de risco cardiovascular em pacientes com doen&#231;as reum&#225;ticas

Prevalence of deep vein thrombosis in patients with paraplegia caused by traumas

BACKGROUND: Deep vein thrombosis is a common disease among people who are immobilized. Immobility is inherent to paraplegia and leads to venous stasis, which is one of the factors covered by Virchow's triad describing its development. Trauma is the primary cause of paraplegia and is currently increasing at a rate of 4% per year. OBJECTIVE: To determine the prevalence of deep vein thrombosis in paraplegic patients whose paraplegia was caused by traumas, using color Doppler ultrasonography for diagnosis. METHODS: This was a cross-sectional observational study of 30 trauma-induced paraplegia patients, selected after analysis of medical records at the neurosurgery department of a University Hospital in Curitiba, Brazil, and by a proactive survey of associations that care for the physically disabled. The prevalence of deep vein thrombosis was analyzed using 95% confidence intervals. RESULTS: Spinal cord trauma was the cause of paraplegia in 29 patients. The most common cause of trauma was gunshot wounding, reported by 17 patients. Deep vein thrombosis was diagnosed by color Doppler ultrasonography in 14 patients in the sample. The most often affected vein was the posterior tibial, in 11 patients. The left lower limb was involved three times more often than the right. Edema was observed in 25 individuals, cyanosis in 14, ulcers in 8 and localized increase in temperature in 13. CONCLUSIONS: Deep vein thrombosis was prevalent, occurring in 46.7% of the patients