Wrist ultrasound analysis of patients with early rheumatoid arthritis

In the present study, we evaluated 42 wrists using the semi-quantitative scales power Doppler ultrasound (PDUS) and gray scale ultrasound (GSUS) with scores ranging from 0 to 3 and correlated the results with clinical, laboratory and radiographic data. Twenty-one patients (17 women and 4 men) with rheumatoid arthritis according to criteria of the American College of Rheumatology were enrolled in the study from September 2008 to July 2009 at Universidade Estadual de Campinas (UNICAMP). The average disease duration was 14 months. The patients were 66.6% Caucasians and 33.3% non-Caucasians, with a mean age of 42 and 41 years, respectively. A dorsal longitudinal scan was performed by ultrasound on the radiocarpal and midcarpal joints using GE LOGIQ XP-linear ultrasound and a high frequency (8-10 MHz) transducer. All patients were X-rayed, and the Larsen score was determined for the joints, with grades ranging from 0 to V. This study showed significant correlations between clinical, sonographic and laboratory data: GSUS and swollen right wrist (r = 0.546), GSUS of right wrist and swelling of left wrist (r = 0.511), PDUS of right wrist and pain in left wrist (r = 0.436), PDUS of right wrist and C-reactive protein (r = 0.466). Ultrasound can be considered a useful tool in the diagnosis of synovitis in early rheumatoid arthritis mainly when the anti-cyclic citrullinated peptide and rheumatoid factor are negative, and can lead to an early change in the therapeutic decision44

Wrist ultrasound analysis of patients with early rheumatoid arthritis

In the present study, we evaluated 42 wrists using the semi-quantitative scales power Doppler ultrasound (PDUS) and gray scale ultrasound (GSUS) with scores ranging from 0 to 3 and correlated the results with clinical, laboratory and radiographic data. Twenty-one patients (17 women and 4 men) with rheumatoid arthritis according to criteria of the American College of Rheumatology were enrolled in the study from September 2008 to July 2009 at Universidade Estadual de Campinas (UNICAMP). The average disease duration was 14 months. The patients were 66.6% Caucasians and 33.3% non-Caucasians, with a mean age of 42 and 41 years, respectively. A dorsal longitudinal scan was performed by ultrasound on the radiocarpal and midcarpal joints using GE LOGIQ XP-linear ultrasound and a high frequency (8-10 MHz) transducer. All patients were X-rayed, and the Larsen score was determined for the joints, with grades ranging from 0 to V. This study showed significant correlations between clinical, sonographic and laboratory data: GSUS and swollen right wrist (r = 0.546), GSUS of right wrist and swelling of left wrist (r = 0.511), PDUS of right wrist and pain in left wrist (r = 0.436), PDUS of right wrist and C-reactive protein (r = 0.466). Ultrasound can be considered a useful tool in the diagnosis of synovitis in early rheumatoid arthritis mainly when the anti-cyclic citrullinated peptide and rheumatoid factor are negative, and can lead to an early change in the therapeutic decision

The Modified Us7 Score In The Assessment Of Synovitis In Early Rheumatoid Arthritis

Objective: To evaluate the modified US7 score (MUS7 score SYN) in the assessment of patients with early rheumatoid arthritis (ERA). In addition, dorsal and palmar recesses of the wrists as well as of small joints of the hands and feet were examined for the presence of synovitis by means of a global assessment of joints. Methods: The study sample comprised 32 patients treated for arthritis, with an average disease duration of 13 months. An ultrasound machine with high frequency transducer was used. Hands were also X-rayed and analysed by Larsen score. Results: Out of the 832 examined joints, synovitis was detected in 173 (20,79%), tenosynovitis in 22 (4,91%), and erosions in 3 (1,56%). Synovitis was predominantly detected in the dorsal recess (73,38%) of MCP and PIP joints, when compared with palmar recess (26%). The presence of synovitis in the joints evaluated correlated with clinical (HAQ-DI, DAS28), laboratory (ACPA, RF, CRP), and ultrasound results (r = 0,37 to r = 0,42; p = 0,04 to p = 0,003). We found correlation of the MUS7 score SYN of the gray scale US or of the power Doppler US with DAS28 (PCR) values (r = 0,38; p = 0,0332), and with CRP results (r = 0,39; p = 0,0280), respectively. Conclusion: The dorsal recess, the wrist, and small joints can be considered as important sites to detect synovitis by the MUS7 score SYN in patients with ERA.544287294Sokka, T., Pincus, T., Quantitative joint assessment in rheumatoid arthritis (2005) Clin Exp Rheumatol, 23, pp. S58-62Scott, D.L., Antoni, C., Choy, E.H., Vanriel, P.L.C.M., Joint counts in routine practice (2003) Rheumatology, 42, pp. 919-923Hart, L.E., Tugwell, P., Buchanan, W.W., Norman, G.R., Grace, M., Southwell, D., Grading of tenderness as a source of interrater error in the Ritchie articular index (1985) J Rheumatol, 12, pp. 716-717Wakefield, R.J., Brown, A.K., O'Connor, P.J.O., Emery, P., Power Doppler sonography: improving disease activity assessment in inflammatory musculoskeletal disease (2003) Arthritis Rheum, 48, pp. 285-288Ostergaard, M., Szkudlarek, M., Ultrasonography a valid method for assessing rheumatoid arthritis (2005) Arthritis Rheum, 52, pp. 681-686Balint, P., Sturrock, R.D., Musculoskeletal ultrasound imaging: a new diagnostic tool for the rheumatologist? (1997) Br J Rheumatol, 36, pp. 1141-1142Hau, M., Schultz, H., Tony, H.P., Evaluation of pannus and vascularization of the metacarpophalangeal and proximal interphalangeal joints in rheumatoid arthritis by highresolution ultrasound (multidimensional linear array) (1999) Arthritis Rheum, 42, pp. 2303-2308Walther, M., Harms, H., Krenn, V., Radke, S., Trutz-Peter, F., Gohlke, F., Correlation of power Doppler sonography with vascularity of the synovial tissue of the knee joint in patients with osteoarthritis and rheumatoid arthritis (2001) Arthritis Rheum, 44, pp. 331-338Ostergaard, M., Court-Payen, M., Gideon, P., Ultrasonography in arthritis of the knee A comparison with MR imaging (1995) Acta Radiol, 36, pp. 19-26Backhaus, M., Ohrndorf, S., Kellner, H., Strunk, J., Backhaus, T.M., Hartung, W., Evaluation of a Novel 7-Joint Ultrasound Score in Daily Rheumatologic Practice: A Pilot Project (2009) Arthritis Rheum, 61, pp. 1194-1201Wakefield, R.J., D'Agostino, M.A., Iagnocco, A., Filippucci, E., Backaus, M., Scheel, A.K., OMERACT Ultrasound group priorities (2007) J Rheumatol, 34, pp. 848-851Ten Cate, D.F., Luime, J.J., Swen, N., Gerards, A.H., De Jager, M.H., Basoski, N.M., Hazes, J.M., Jacobs, J.W., Role of ultrasonography in diagnosing early rheumatoid arthritis and remission of rheumatoid arthritis - a systematic review of the literature (2013) Arthritis Res Ther, 15, p. R4. , Jan 8Arnett, F.C., The American Rheumatism Association 1987 revised criteria for classification of rheumatoid arthritis (1988) Arthritis Rheum, 31, pp. 315-324Aletaha, 2010 Rheumatoid Arthritis Classification Criteria An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative (2010) Arthtiis & Rheum, 62, pp. 2569-2581Larsen, A., Dale, K., Eck, M., Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films (1977) Acta Radiol Diagn (Stockh), 18, pp. 481-491Larsen, A., Thoen, J., Hand radiography in 200 patients with rheumatoid arthritis repeated after an interval of one year (1987) Scand J Rheumatol, 6, pp. 395-401Backhaus, M., Burmester, G.R., Gerber, T., Grassi, W., Machold, K.P., Swen, W.A., Wakefield, R.J., Manger, B., Guidelines for musculoskeletal ultrasound in rheumatology (2001) Ann Rheum Dis, 60, pp. 641-649Szkudlarek, M., Court-Payen, M., Strandberg, C., Karlund, M., Klausen, T., Ostergaard, M., Power Doppler ultrasonography for assessment of synovitis in the metacar-pophalangeal joints of patients with rheumatoid arthritis (2001) Arthritis Rheum, 44, pp. 2018-2023Ohrndorf, S., Fischer, I.U., Kellner, H., Strunk, J., Hartung, W., Reiche, B., Burmester, G.R., Backhaus, M., Reliability of the novel 7-joint ultrasound score: results from an inter- and intraobserver study performed by rheumatologists (2012) Arthritis Care Res (Hoboken), 64, pp. 1238-1243. , AugNaredo, E., Bonilla, G., Gamero, F., Uson, J., Carmona, L., Laffon, A., Assessment of inflammatory activity in rheumatoid arthritis: a comparative study of clinical evaluation with grey scale and power Doppler ultrasonography (2005) Ann Rheum Dis, 64, pp. 375-381Szkudlarek, M., Narvestad, E., Klarlund, M., Court-Payen, M., Thomsem, H.S., Ostergaard, M., Ultrasonography of the metatarsophalangeal joints in rheumatoid arthritis: Comparison with magnetic resonance imaging, conventional radiography, and clinical examination (2004) Arthritis Rheum, 50, pp. 2103-2112Brown, A.K., O'Connor, P.J., Roberts, T.E., Wakefield, R.J., Karim, Z., Emery, P., Recommendations for musculoskeletal ultrasonography by rheumatologists: Setting global standards for best practice by expert consensus (2005) Arthritis Rheum, 53, pp. 83-92D'Agostino, M.A., Ayral, X., Baron, G., Ravaud, P., Breban, M., Dougados, M., Impact of ultrasound imaging on local corticosteroid injections of symptomatic ankle, hind-, and mid-foot in chronic inflammatory diseases (2005) Arthritis Rheum, 53, pp. 284-292Bresnihan, B., Kane, D., Sonography and subclinical synovitis (2004) Ann Rheum Dis, 63, pp. 333-334Brown, A.K., Conaghan, P.G., Karim, M.A., An explanation for the apparent dissociation between clinical remission and continued structural deterioration in rheumatoid arthritis (2008) Arthritis Rheum, 58, pp. 2958-2967Taylor, P.C., Steuer, A., Gruber, J., Cosgrove, D.O., Blomley, M.J., Marsters, P.A., Comparison of ultrasonographic assessment of synovitis and joint vascularity with radiographic evaluation in a randomized, placebo-controlled study of infliximab therapy in early rheumatoid arthritis (2004) Arthritis Rheum, 50, pp. 1107-1116Wakefield, R.J., Gibbonw, W., Conaghan, P.G., The value of sonography in the detection of bone erosions in patients with rheumatoid arthritis: a comparison with conventional radiography (2000) Arthritis Rheum, 43, pp. 2762-2770Cyteval, C., Doppler ultrasonography and dynamic magnetic resonance imaging for assessment of synovitis in the hand and wrist of patients with rheumatoid arthritis (2009) Semin Musculoskelet Radiol, 13, pp. 66-73Navalho, M., Resende, C., Rodrigues, A.M., Pereira da Silva, J.A., Fonseca, J.E., Campos, J., Canhao, H., Bilateral evaluation of the hand and wrist in untreated early inflammatory arthritis: a comparative study of ultrasonography and magnetic resonance imaging (2013) J Rheumatol, 40, pp. 1282-1292Mendonca, J.A., Yazbek, M.A., Laurindo, I.M., Bertolo, M.B., Wrist ultrasound analysis of patients with early rheumatoid arthritis (2011), 44, pp. 11-15Scheel, A.K., Hermann, K.G., Ohrndorf, S., Werner, C., Schimer, C., Detert, J., Prospective 7 year long term follow-up imaging study comparing radiography, ultrasonography and magnetic resonance imaging in rheumatoid arthritis finger joints (2006) Ann. Rheum. Dis., 65, pp. 595-600Backhaus, M., Kamradt, T., Sandrock, D., Loreck, D., Fritz, J., Wolf, K.J., Arthritis of the finger joints: A comprehensive approach comparing conventional radiography, scintigraphy, ultrasound, and contrast-enhanced magnetic resonance imaging (1999) Arthritis Rheum, 42, pp. 1232-1245Aletaha, D., Nell, V.P.K., Stamm, T., Uffmann, M., Pflugbeil, S., Machold, K., Acute phase reactants add little to composite disease activity indices for rheumatoid athritis: validation of a clinical activity score (2005) Arthritis Res Ther, 7, pp. R796-806Filippucci, E., Luz, K.R., Di Geso, L., Salaffi, F., Tardella, M., Carotti, M., Interobserver reliability of ultrasonography in the assessment of cartilage damage in rheumatoid arthritis (2010) Ann Rheum Dis, 69, pp. 1845-1848Gutierrez, M., Filippucci, E., Ruta, S., Salaffi, F., Blasetti, P., Geso, L.D., Grassi, W., Inter-observer reliability of high-resolution ultrasonography in the assessment of bone erosions in patients with rheumatoid arthritis: experience of an intensive dedicated training programme (2011) Rheumatology, 50, pp. 373-380Chakr, R.M., Mendonca, J.A., Brenol, C.V., Xavier, R.M., Brenol, J.C., Assessing rheumatoid arthritis disease activity with ultrasound (2013) Clin Rheumatol, , May 2

Infliximab Reduces Cardiac Output In Rheumatoid Arthritis Patients Without Heart Failure [infliximabe Reduz Débito Cardíaco Em Pacientes Com Artrite Reumatoide Sem Insuficiência Cardíaca]

Objective: Human anti-tumor necrosis factor (TNF-α) monoclonal antibody (infliximab) is used to treat autoimmune diseases such as rheumatoid arthritis (RA). Although the risk of worsening heart failure has been described in patients under chronic treatment, the acute cardiovascular effects of this drug are unknown in RA patients without heart failure. Methods: 14 RA patients with normal echocardiography and no history of heart failure were evaluated during the 2-hour infliximab (3-5 mg/kg) infusion period, using a noninvasive hemodynamic beat-to-beat system (Portapres). Stroke volume (SV); systolic, diastolic and mean blood pressures (SBP, DBP and MBP, respectively); cardiac output (CO); heart rate (HR); and total peripheral vascular resistance (PVR) were recorded. All patients also received saline infusion instead of infliximab as a control. Significant differences in hemodynamic parameters were determined using Tuckey's test. All values were expressed as mean ± standard deviation (SD). Results: Fourteen RA patients (6M/8F) with mean age of 47.2 ± 8.8 years were evaluated. A significant decrease was found in cardiac output and stroke volume (7.04 ± 2.3 to 6.12 ± 2.1 l/min and 91 ± 29.0 to 83 ± 28.8 mL/beat, respectively) after infliximab infusion. Although not statistically significant, a progressive increase was detected in SBP, DBP and total PVR during infusion. Saline infusion did not cause significant hemodynamic changes in the same group of RA patients. No adverse effects were observed during the infusion period. Conclusion: Acute infliximab administration decreased cardiac output due to low stroke volume in RA patients without heart disease. The results also demonstrated that, in spite of its negative inotropic effect, infliximab enhanced BP, probably by increasing PVR. © 2012 Elsevier Editora Ltda. All rights reserved.586698702Smolen, J.S., Aletaha, D., Koeller, M., Weisman, M.H., Emery, P., New therapies for treatment of rheumatoid arthritis (2007) Lancet., 370, pp. 1861-1874Doan, T., Massarotti, E., Rheumatoid arthritis: An overview of new and emerging therapies (2005) J Clin Pharmacol., 45, pp. 751-762Mann, D.L., Inflammatory mediators and the failing heart: Past, present, and the foreseeable future (2002) Circ Res., 91, pp. 988-998Lysander, W.J., van Lieshout, J.J., Non-invasive pulsatile arterial pressure and stroke volume changes from the human finger (2005) Exp Physiol., 90, pp. 437-446Wallberg-Jonsson, S., Johansson, H., Ohman, M.L., Rantapaa-Dahlqvist, S., Extent of inflammation predicts cardiovascular disease and overall mortality in seropositive rheumatoid arthritis. 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Adapting Agriculture to Climate Change: A Synopsis of Coordinated National CropWild Relative Seed Collecting Programs across Five Continents

The Adapting Agriculture to Climate Change Project set out to improve the diversity, quantity, and accessibility of germplasm collections of crop wild relatives (CWR). Between 2013 and 2018, partners in 25 countries, heirs to the globetrotting legacy of Nikolai Vavilov, undertook seed collecting expeditions targeting CWR of 28 crops of global significance for agriculture. Here, we describe the implementation of the 25 national collecting programs and present the key results. A total of 4587 unique seed samples from at least 355 CWR taxa were collected, conserved ex situ, safety duplicated in national and international genebanks, and made available through the Multilateral System (MLS) of the International Treaty on Plant Genetic Resources for Food and Agriculture (Plant Treaty). Collections of CWR were made for all 28 targeted crops. Potato and eggplant were the most collected genepools, although the greatest number of primary genepool collections were made for rice. Overall, alfalfa, Bambara groundnut, grass pea and wheat were the genepools for which targets were best achieved. Several of the newly collected samples have already been used in pre-breeding programs to adapt crops to future challenges

Adapting Agriculture to Climate Change: A Synopsis of Coordinated National Crop Wild Relative Seed Collecting Programs across Five Continents

The Adapting Agriculture to Climate Change Project set out to improve the diversity, quantity, and accessibility of germplasm collections of crop wild relatives (CWR). Between 2013 and 2018, partners in 25 countries, heirs to the globetrotting legacy of Nikolai Vavilov, undertook seed collecting expeditions targeting CWR of 28 crops of global significance for agriculture. Here, we describe the implementation of the 25 national collecting programs and present the key results. A total of 4587 unique seed samples from at least 355 CWR taxa were collected, conserved ex situ, safety duplicated in national and international genebanks, and made available through the Multilateral System (MLS) of the International Treaty on Plant Genetic Resources for Food and Agriculture (Plant Treaty). Collections of CWR were made for all 28 targeted crops. Potato and eggplant were the most collected genepools, although the greatest number of primary genepool collections were made for rice. Overall, alfalfa, Bambara groundnut, grass pea and wheat were the genepools for which targets were best achieved. Several of the newly collected samples have already been used in pre-breeding programs to adapt crops to future challenges.info:eu-repo/semantics/publishedVersio