Correlation between lequesne's pain- function index and kellgren-Lawrence radiological classification in knee osteoarthritis

Background: With regard to the high prevalence of osteoarthritis and importance of its classification we evaluated the association between the severity of clinical signs, level of pain and function of joints, and radiological classification. Materials and Methods : This cross sectional study evaluated 100 knee osteoarthritis patients who were diagnosed by ACR (American College of Rheumatology) criteria. It was performed in Bagyiatallah Hospital in Iran during 2003-2004. In clinical evaluation, Lequesne's index of pain and function were used. Knee radiographies were classified using Kellgrn-Lawerence. The results were analyzed statistically through chi-square test. Results: There were 84 females and 16 males (mean age: 52 years old) in this study. The results of clinical classification were as follow: mild (10), moderate (21), severe (58), and very severe (11). The results of radiological classification were as follow: normal (12), suspicious (0), mild (25), moderate (47), and severe (16). There was no significant association between clinical and radiological classifications (p=0.104). There was also no significant difference between males and females (p>0.2). Conclusions: There was no significant association between clinical classification and radiological grading

EFFECT OF INTRAMUSCULAR GOLD THERAPY ON THE COURSE OF RHEUMATOID ARTHRITIS

Gold preparations are one of the oldest disease modifying drugs in the treatment of rheumatoid arthritis. This are different reports about the effects and complications of these compoumis. these opposite reports may he due to the difference in genetic ami ethnic background of patients. This study was designed to evaluate our results in gold therapy ami compare them with those of western countries. We evaluated the results of gold therapy in 75 rheumatoid arthritis patients. Gold had good effects in 2/3 of patients anil adverse effects was found in 1/4. the effect of golti was appeared after 6 months on clinical parameters and after 3 months on laboratory data. Tlie beneficial effect of golti was lost after 24 months of treatment

CONVULSION AND ITS RELATION TO ANTI-DNA ANTIBODY LEVELS IN SYSTEMIC LUPUS ERYTHEMATOSUS

The neuropsychiatric manifestations of systemic lupus erythematosus are frequent. One of the most serious presentations is convulsion. This study was carried out to evaluate the relation between convulsion and anti-DNA antibody levels. An analytic, retrospective case-controlled study was carried out, with reference to 1001 recorded cases of systemic SLE lupus erythematosus in Lupus Unit, Rheumatology Center, Shariati Hospital, Tehran University of Medical Sciences. Thefrequency of convulsion was 13.3%. There was no significant difference in the frequency of convulsoin inpatients with different levels of anti-DNA antibodies. Anti-DNA antibody is not an important diagnostic and activity criterion for neuropsychiatric manifestations of SLE

IN TIME VARIATION OF PATHERGY PHENOMENON IN BEHCET'S DISEASE

The pathergy phenomenon (PP) is one of the hallmarks of Behcet's Disease (BD). It has been reported to be positive from 17.5% to 83% of cases in different studies. PP is used as a diagnosis criterion in the Dilsen criteria, the Japan criteria, the International criteria, and the Iran criteria. It is therefore important to know wether PP is a fix manifestation of the disease or a cyclic manifestation like mucocutaneous disorders. To evaluate the charaterist'tc of P'P over a period of time, 77 patients were selected randomly (rcgaardless of their disease activity or their disease manifestations), to have a second pathergy test, lite pathcrgy test was performed by needle puncture on the skin of the forearm. Three methods were used: 1- needle prick with a 21 - gauge needle. 2- needle prick with a 25  gauge needle. 3- needle prick with a 25-guage needle and the injection of I drop of a sterile normal saline solution. Tlie result was evaluated 24 hours Liter. Tlie shortest interval between two tests-was one month and the longest 13 years. Die mean interval was 35.4 months, the standard deviation was 36.6 Tlurty-nine patients had a negative PI' at their first evaluation. At the second evaluation, 27 remained negative while 12 changed to positive. Thirty-eight patients had a positive PP at their first evaluation. At the second evaluation, 19 remained positive while 19 changed to negative. Although there is a difference between the two groups, it is not statistically significant (x=3.813 , p=0.05). Our data demonstrates that the pathergy phenomenon is waxing and waning, like the majority of other manifestations of Behcet's Disease. TJierefore, it may be repeated for diagnosis purposes

Heat shock protein 70 level of synovial fluid in rheumatoid arthritis versus osteoarthritis: a comparative study

Background: Heat-shock proteins are part of a strictly controlled biological system that allows organisms to respond to environmental stresses. Different proinflammatory cytokines are present in the synovial tissue of rheumatoid arthritis patients. Such tissues respond to stress and induce heat-shock proteins. In addition, synovial cells are exposed to mechanical stress caused by joint motion. The effects of mechanical stress on the metabolism of the synovial cells may be substantial, even pathogenic. Heat-shock proteins are often implicated in the pathogenesis of rheumatoid arthritis. Here, we compare the levels of heat-shock protein 70 from the synovial fluid of rheumatoid arthritis and osteoarthritis patients.Methods: Synovial fluid samples from 34 rheumatoid arthritis patients and 34 osteoar-thritis patients were analyzed for heat-shock protein 70 by an ELISA method. Statistical analysis was performed using independent T-test and one-way ANOVA. Differences were considered statistically significant at p< 0.05.Results: The mean value of synovial fluid heat-shock protein 70 levels in rheumatoid arthritis patients was 156.30 ±128.51 and that of osteoarthritis patients was 14.98 ±11.58. The differences were statistically significant at p<0.0001. For seven rheumatoid arthritis patients suffering from mechanical knee pain, synovial fluid analysis revealed non-inflammatory effusion. The mean value of synovial fluid heat-shock protein 70 level in inflammatory synovial fluid of rheumatoid arthritis patients was significantly higher at 191±121.73 and that of non-inflammatory synovial fluid from rheumatoid arthritis patients was 21.93 ±10.06 (p< 0.05).Conclusion: The level of heat shock protein 70 is higher in inflammatory arthritis than in non-inflammatory arthritis. Considering that patients with rheumatoid arthritis are known to have a hypertrophic synovial-lining layer, and that heat-shock protein 70 is known to protect cells against a variety of toxic conditions as well as apoptotic death, further research is needed to determine if heat-shock protein 70 induction is a sign of significant changes in the cellular and tissue metabolism or is actively participating in the pathogenesis of rheumatoid arthritis

EVALUATION OF IL1-α AND TNF-α SERUM LEVELS IN RHEUMATOID ARTHRITIS PATIONTS WITH ACTIVE AND INACTIVE, WITH OR WITHOUT BONE EROSION

Rheumatoid arthritis is the most common inflammatory joint disease with 1 percent prevalence in community which presents with symmetrical polyarthritis of hands with inflammatory behavior. Several studies in recent years were conducted for evaluation of inflammatory cytokines such as IL1-α (Interlukin 1α) and TNF- α (Tumor necrosis factor) in rheumatologic disorders including rheumatoid arthritis to find new treatment methods base to pathogenesis. In this study different serum levels of IL1-α and TNF- α in 160 rheumatoid arthritis patients with active and inactive disease and also disease with or without bone erosion are assessed. 4% of our patients had rheumatoid nodule and 70% of all patients had positive RF, IL1-α, and TNF- α levels. Active with bone erosion patients had IL1-α and TNF- α serum levels higher than active without bone erosion patients; it was not significant in T-test but it was significant in Mann-Whitney Test. The results was the same as expected; IL1-α, and TNF- α serum levels were higher in active with bone erosion in comparison with inactive without bone erosion patients

MicroRNA-21 and microRNA-29a modulate the expression of collagen in dermal fibroblasts of patients with systemic sclerosis

MicroRNAs (miRNAs) are well-known candidates for modulating the dysregulated signaling pathways during fibrosis. In this study, we investigated the expression pattern of 16 miRNAs, which have previously been confirmed or predicted to target genes involved in extracellular matrix (ECM) homeostasis. Primary culture of dermal fibroblasts was obtained from skin biopsies of diffused cutaneous SSc (dcSSc) patients and healthy controls. Expression of let-7a, miR-1, miR-15a, miR-17, miR-19a, miR-20a, miR-21, miR-27b, miR-26a, miR-29a, miR-29b, miR29c, miR-141, miR-125a-5p, miR-193a-3p, and miR-200a were quantified by Real-time PCR. Functional analysis of microRNAs was performed using synthetic oligonucleotides. To further confirm the pro- or anti-fibrotic effects of miRNAs, normal fibroblasts were treated with 10 ng/mL of transforming growth factor (TGF)-β to generate an in vitro model of dermal fibrosis. miR-21 and miR-29a were upregulated and downregulated, respectively, in both dcSSc and TGF-β-treated fibroblasts. We observed that restoration of miR-29a expression or blockade of miR-21 function negatively affected collagen production. COL1A1 expression in SSc fibroblasts is more sensitive to changes of miR-29a and miR-21 expression in compare to normal fibroblasts. miR-29a alone was effective to decrease TGF-β-induced collagen production in dermal fibroblasts. miR-21 and TGF-β had synergistic effects on induction of collagen production. However, neither miR-21 nor miR-29a affected alpha smooth muscle actin (α-SMA) expression in the presence or absence of TGF-β in dermal fibroblasts. miR-21 and miR-29a as pro- and anti-fibrotic miRNAs modulate collagen production in an opposing manner. Focusing on miR-21 and miR-29s as therapeutic targets would be effective in patients with SSc or other fibrotic diseases which show aberrant expression of collagen expression

Isolated Hematuria in SLE Patients and its Association with Proteinuria, Uri-nary Cast and SLE Disease Activity

Isolated hematuria and its association with proteinuria, and urinary cast and systemic lupus erythematosus (SLE) disease activity, and decision for renal biopsy is a dilemma for physician in SLE patients. The aim of this study was to investigate 1. whether isolated hematuria is associated with active SLE, 2. to determine duration between hematuria and proteinuria and urinary cast, and 3. to determine renal histological type in SLE patients with isolated hematuria. All episodes of isolated hematuria between 1981 and 1997 were identified from Lupus Unit, Rheumatology Research Center database. Isolated hematuria was defined as >5 RBC/hpf in the absence of urinary infection and other renal manifestations. Relation of hematuria was assessed with proteinuria and urinary cast and SLE disease activity. Needle renal biopsy was done in 19 SLE patents with isolated hematuria. 4.42% (31/700) of our cohort had at least one episode of isolated hematuria. Out of 31 patients in whom the isolated hematuria was the first documented renal manifestation, 11 patients (35.48%) developed another renal manifestation (25.8% proteinuria and 9.67% casts). 54.54% (6/11) of patients developed proteinuria and urinary cast within 3 months. The mean time for development of a second renal manifestation for the patients with isolated hematuria was 19.9 months. Renal needle biopsy was performed for 19 patients (5.78% type IV, 63.15% type III and 21.50% type II). The results of the present study indicate that isolated hematuria is not rare in SLE patients. Also, there was no significant relationship between isolated hematuria and anti ds-DNA, C3, C4 and major organ involvement in patients with SLE. Our study suggests that SLE patients who have isolated hematuria should undergo renal biopsy and that isolated hematuria should be considered a manifestation of active renal SLE

A Phase IV Study of the Safety and Efficacy of CinnoPar®in Iranian Patients with Osteoporosis

The safety of teriparatide has been studied in various phase III and phase IV trials. However, a postmarketing study of the biosimilar of teriparatide, CinnoPar®, has not been conducted on Iranian patients. This was a phase IV study conducted on osteoporotic patients who received an Iranian teriparatide biosimilar with a dose of 20 μg daily. The primary outcome of this study was to monitor for adverse events (AEs). Effectiveness as the secondary outcome was measured using the EQ-5D quality-of-life questionnaire and back pain Visual Analogue Scale (VAS) score. Among 193 analyzed patients between September 2015 and March 2019, the most common AEs were hypercalcemia (4), nausea, and pain (3). No deaths, serious AEs, or other significant AEs occurred in this study. The mean EQ-5D scores decreased after the course of the treatment from 2.3 ± 0.66 at the baseline to 2 ± 0.66. The mean back pain VAS scores also decreased from 4.9 ± 3.6 at baseline to 1.8 ± 2.1 at the end of the study. Both changes were statistically significant (p<0.001). Consistent with the findings of previous studies and the drug monograph, no new safety concern was observed with this biosimilar teriparatide, and the drug was effective based on the VAS score and EQ-5D in osteoporotic patients. © 2021 Ahmadreza Jamshidi et al