Expression of Bcl-2 in inflammatory sites from patients with active Behçet's disease.

Behçet's disease (BD) is a current systemic vasculitis of unknown aetiology. Eyes, skin, joints, the oral cavity, genital system, blood vessels, central nervous system and lung are usually involved. Defective regulation of programmed cell death (apoptosis) may play a role in the development of (BD), and the proto-oncogene Bcl-2 is involved in the control of apoptosis in immunocompetent cells. We therefore wished to investigate the expression of Bcl-2 in the peripheral lymphocytes and in two inflammatory sites of patients with active BD: bronchoalveolar lavage (BAL) and cerebrospinal fluid (CSF) lymphocytes. Levels of Bcl-2 expression in the lymphocytes of patients with BD and, for comparison, in the lymphocytes of healthy controls and non-inflammatory neurological diseases (NIND), were studied by two-colour cytofluorography and RNA analysis. In BD patients, a significant proportion of T cells expressed increased amounts of Bcl-2 protein, both in peripheral blood and in inflammatory sites. Mononuclear cells of patients with BD showed increased amount of Bcl-2 messenger RNA. The in vitro incubation of T lymphocytes with IL-10, significantly increased the Bcl-2 expression, specifically in T lymphocytes from inflammatory sites. In active BD, stimulation of HSV-1 T lymphocytes slightly increased Bcl-2 expression, not significantly different from unstimulated HSV-1 T cells. The occurrence of circulating T lymphocytes with abnormally high Bcl-2 expression in peripheral circulation and in inflammatory sites may be explained in part by the increased in vivo activation levels, and by aetiopathological agent(s): our findings seem to indicate an important role in the chronic inflammation in BD

Spa treatment for primary fibromyalgia syndrome: a combination of thalassotherapy, exercise and patient education improves symptoms and quality of life

Objectives: To study the effect of a combination of thalassotherapy, exercise and patient education in people with fibromyalgia. -\ud Methods: Patients with fibromyalgia, selected from a rheumatology out-patient department and from members of the Dutch fibromyalgia patient association, were pre-randomized to receive either 2 weeks of treatment in a Tunisian spa resort, including thalassotherapy, supervised exercise and group education (active treatment) or treatment as usual (control treatment). Primary outcome measure was health-related quality of life, measured with the RAND-36 questionnaire. Secondary measures included the Fibromyalgia Impact Questionnaire, the McGill Pain Questionnaire, the Beck Depression Inventory, tender point score and a 6-min treadmill walk test. -\ud Results: Fifty-eight participants receiving the active treatment reported significant improvement on RAND-36 physical and mental component summary scales. For physical health, differences from the 76 controls were statistically significant after 3 months, but not after 6 and 12 months. A similar pattern of temporary improvement was seen in the self-reported secondary measures. Tender point scores and treadmill walk tests improved more after active treatment, but did not reach significant between-group differences, except for walk tests after 12 months. -\ud Conclusions: A combination of thalassotherapy, exercise and patient education may temporarily improve fibromyalgia symptoms and health-related quality of life

Levels of soluble Fas/APO-1 in patients with Behçet's disease.

The aim of this study was to quantify soluble Fas/APO-1 (sFas/APO-1) protein in the serum of patients with Behcet's disease (BD) in active and inactive stages, compared with patients with systemic lupus erythematosus (SLE) and patients with rheumatoid arthritis (RA). Soluble Fas/APO-1 was quantified using a sandwich enzyme-linked immunosorbent assay. Increased serum sFas/APO-1 levels were observed in active BD, compared with inactive BD, RA patients and SLE patients. Increased serum sFas/APO-1 levels were correlated with the presence of neurologic manifestations or pulmonary involvement in active BD. In conclusion, increased levels of sFas/APO-1 occurred frequently and exclusively in active BD patients. Preliminary evidence suggested that elevated levels of sFas/APO-1 are associated with the clinical stage and clinical manifestations in BD

Isolated tuberculous arthritis of the dorsal facet joint

AbstractIntroductionSeptic arthritis of the facet joint is a severe infection. The lumbar spine is frequently involved; the dorsal one is rarely affected.Case reportWe present a case of a patient with a history of right cervicobrachial neuralgia with anorexia and asthenia without fever. Performed investigations had concluded to tuberculous arthritis of the dorsal facet joint. The tuberculous etiology is an originality of our observation since it has been reported in only one case. In the absence of histological and bacteriological proof, the diagnosis was established according to clinical, epidemiological and biological data. Treatment was based on antitubercular antibiotics.ConclusionThe tuberculous origin of septic facet joint should be considered in front of trolling and unexplained back pain, especially in endemic countries

L’acupuncture : comme alternative dans la prise en charge de la paralysie faciale peripherique idiopathique : experience tunisienne

La paralysie faciale périphérique idiopathique ou à frigoré (PfPi) est la plus fréquente des paralysies faciales. Elle pose un problème thérapeutique malgré la diversité des traitements proposés. L’acupuncture est une des alternatives proposées parmi cet arsenal thérapeutique. Le but de ce travail est d’évaluer l’apport de l’acupuncture dans le traitement de la PfPi et de dégager les différents facteurs pronostiques pouvant influencer la récupération de la fonction faciale. Notre étude a regroupé 40 patients porteurs de PfPi recrutés aux services d’ORL de l’hôpital régional de Jendouba et de l’hôpital de Charles Nicolle sur une période de 14 mois et pris en charge aux centres d’acupuncture à l’hôpital Mongi Slim et à l’hôpital régional de Jendouba. Tous les patients ont été traités, auparavant, selon le concept de la médecine occidentale, et n’ont été adressés qu’après échec du traitement médical conventionnel. L’évaluation de notre travail est basée sur deux tests : le testing musculaire de freyss et le grading de House et Brackman. L’étude statistique s’est basée sur le logiciel « SPSS ». Les résultats de cette étude montrent que le traitement par acupuncture trouve son indication lorsque le traitement médical conventionnel a échoué, même après un long délai de consultation.Mots-clés : paralysie faciale périphérique, acupuncture, traitement.The Bell’s palsy is the most common peripheral facial paralysis. it poses a therapeutic problem despite the diversity of treatments. Acupuncture is an alternative among the proposed therapeutic arsenal. The purpose of this study was to evaluate the contribution of acupuncture in the treatment of facial paralysis and to identify different prognostic factors that may influence the recovery of facial function. Our study included 40 patients with Bell’s palsy recruited in the services of ENT in Jendouba hospital and Charles Nicolle hospital over a period of 14 months and supported in centers of acupuncture in Mongi Slim hospital and Jendouba hospital. All patients were previously under the concept of medical treatment, and were sent after failure of this treatment. The evaluation of our work is based on two tests: muscle testing of freyss and grading of House and Brackman. The study is based on statistical software "SPSS". The results of this study show that treatment with acupuncture is indicated in Bell’s palsy when conventional medical treatment has failed and even after a long period of consultation.Keywords: facial palsy, acupuncture, treatment

Actinomycotic mycetoma of the talus with bone involvement: Case report

Mycetoma is a chronic granulomatous infection of bacterial (actinomycetoma) or fungal origin. It is uncommon in Maghrebian countries. We report on the case of a 44-year-old Tunisian woman with a 15 year history of actinomycetoma involving the foot. The diagnosis was based on clinical and bacteriological arguments. An X-ray revealed bone lesions by contiguity. The patient was treated with combined antibiotic therapy

Association of sarcoidosis and myasthenia gravis: Case Report

Whereas the coexistence of different autoimmune or rheumatologic diseases with myasthenia gravis (MG) is well documented, its combination with sarcoidosis is extremely rare. Presented here is an interesting case with coexisting MG and sarcoidosis