According to an epidemiological study, hip joint involvement was detected in 12–56% of patients with axial spondyloarthritis (axSpA) in Russia. Data on the incidence of coxitis in patients with axial psoriatic arthritis (axPsA) are lacking. The aim of the study was to compare radiographic changes in the hip joints in patients with axial spondyloarthritis and axial psoriatic arthritis and to evaluate the relationship between coxitis and disease activity. Material and methods. The study included 222 patients with a mean age of 35.7±12.7 years. The first group included 108 patients who met the 2009 ASAS (Assessment of SpondyloArthritis International Society) criteria for axSpA or the 1984 criteria for ankylosing spondylitis (AS); The second group included 114 patients with axPsA who met the CASPAR (ClASsification for Psoriatic ARthritis) criteria. Signs of axial involvement in psoriatic arthritis (PsA) were determined using instrumental imaging methods. Diagnosis required the presence of radiologically reliable sacroiliitis (SI), i.e., bilateral stage ≥II or unilateral stage ≥III according to Kellgren, or active sacroiliitis according to magnetic resonance imaging. The presence of at least one syndesmophyte (paraspinal ossificate) in the cervical (CS) or lumbar (LS) spine, as well as ankylosis of the facet joints of the CS, were also taken into account. The mean age of disease onset was 26.3±20.3 years; HLA-B27 was detected in 54% of patients. The diagnosis of coxitis was established based on a pelvic X-ray and calculation of the Bath Ankylosing Spondylitis Radiology Hip Index (BASRI hip) for each joint. Results. Radiographic evidence of coxitis was detected in 52 of the 222 patients included in the study, including 22 patients with AS and 30 patients with axPsA. Patients with axPsA were older than those with axSpA (median age 32 years and 45 years, respectively; p<0.05). Radiographic coxitis was more common among men with axSpA and equally common among men and women with axPsA. The ASDAS (Axial Spondyloarthritis Disease Activity Score) index value was high in both groups; however, it was statistically significantly higher in patients with axPsA than in patients with axSpA (on average, 2.1 and 3.2, respectively; p<0.05). Acute phase indices (C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)) were slightly higher in axSpA than in axPsA (CRP – 5.8 and 4.2 mg/L; ESR – 20 and 17 mm/h, respectively), but these differences were not statistically significant (p>0.05). Functional impairment according to BASFI (Bath Ankylosing Spondylitis Functional Index) was more pronounced in axPsA than in patients with axSpA (p<0.05). Peripheral arthritis was also more common in patients with axPsA (96.6% and 59.0%, respectively; p<0.05). Conclusion. Radiographic coxitis was detected in 20% of patients with axSpA and 26% with axPsA. In previous studies, the incidence of radiographic coxitis in patients with psoriatic arthritis did not exceed 10%. According to our study, patients with axPsA had high clinical and laboratory indicators of disease activity, as well as significant functional impairment.

Pathogen-specific biomarker profiles in periprosthetic joint infection.

Novel hematological indices SII and NLR: Aiding diagnosis, differentiating subtypes, and reflecting disease activity in juvenile idiopathic arthritis.

Proof of concept for an age- and inflammation-adjusted model for the establishment of pediatric serum copper reference intervals.

Enhanced lymphotoxin alpha DNA hypermethylation and correlation with genetic polymorphism in rheumatoid arthritis among the Chinese population.

Background: Osteoarthritis (OA) is a chronic degenerative joint condition that causes discomfort and alters the structure of bone joints. This research seeks to establish connections between changes in inflammatory and hematological markers in clinically diagnosed OA. Aims and Objectives: The study aims to determine if variations occur in hematological parameters (mean platelet volume [MPV], platelet [PLT], platelet distribution width, neutrophil-to-lymphocyte ratio [NLR], red cell distribution width [RDW], platelet-to-lymphocyte ratio [PLR], Plateletcrit, white blood cell [WBC], red blood cell [RBC], RDW-to-platelet ratio [RPR]) and inflammatory response indicators (erythrocyte sedimentation rate [ESR] and C-reactive protein [CRP]) across different stages of clinically confirmed OA. Materials and Methods: The investigation involved 300 patients with clinically diagnosed OA at the pathology and orthopedics departments of Integral Institute of Medical Science and Research, Lucknow. Results: Significant alterations were seen in the NLR and PLR values of OA patients. RBC and MPV measurements were considerably lower in individuals with OA. No substantial changes were noted in WBC, RDW, PLT count, and RPR levels. In OA patients, MPV and RBC showed negative correlations with ESR and CRP. Conclusion: Significant differences in inflammatory and hematological markers were observed between OA grades. With additional research, these factors could potentially be utilized for grading and diagnosing OA.

Clinical trials have demonstrated the efficacy of sarilumab in preventing radiographic progression. This study investigated the structural remission rate and factors associated with radiographic progression in patients with rheumatoid arthritis (RA) treated with sarilumab in clinical practice. Of 114 patients treated with sarilumab across four centers, 59 with radiographic assessments at baseline and Week 52 were included. Radiographic progression was assessed using the van der Heijde-modified Total Sharp score (mTSS). Patients were divided into methotrexate (MTX) + and MTX - groups; the structural remission rate (ΔmTSS ≤ 0.5) and associated factors were analyzed. The median age was 69.0years, median disease duration 10.0years, mean disease activity score 28-erythrocyte sedimentation rate 4.94, and median modified Health Assessment Questionnaire 0.5, with no differences between groups. Baseline median erosion score was 21.0, joint space narrowing score was 22.0, and mTSS was 37.0. At Week 52, the mean changes were: erosion 0.33, joint space narrowing score 0.18, and mTSS 0.51, with a structural remission rate of 78.0%, 82.4% for the MTX + group, and 76.2% for the MTX - group. The mean change in joint space narrowing score was higher in the MTX - group (0.42) than in the MTX + group (- 0.20) (p = 0.038). Baseline glucocorticoid (GC) use was associated with radiographic progression (odds ratio, 13.1; 95% confidence interval, 2.51-68.9; p = 0.002). Sarilumab was associated with limited radiographic progression in patients with RA in clinical practice. Associations with MTX use and baseline GC exposure should be interpreted cautiously given the observational design. Key Points • This study reports the structural remission rate and factors associated with radiographic progression in patients with rheumatoid arthritis treated with sarilumab in clinical practice. • The structural remission rate for sarilumab was 78.0%. The change in the joint space narrowing score was significantly higher in the MTX- group (0.42 ± 1.34) compared with the MTX + group (- 0.20 ± 1.22). • Glucocorticoid use was associated with radiographic progression at 52weeks (odds ratio, 13.1).

Mercury and other trace elements in gull chicks from a highly urbanised environment: effects on chick growth, physiology, and health condition.

Initial safety outcomes of adipose-derived mesenchymal stem cell for rotator cuff tear: A 3-year pilot trial.

Highly reworked subtropical mudflat still provides carbon sequestration due to high sedimentation rate

Inflammatory bowel disease (IBD) is a chronic gastrointestinal disorder influenced by multiple factors including genetic susceptibility, immune dysregulation, environmental triggers, and nutritional status. Nutritional deficiencies are common in IBD patients and may contribute to disease progression and poor clinical outcomes. In this study, we examined how early nutritional intervention affected clinical remission rates, disease activity, and quality of life in newly diagnosed IBD patients. We retrospectively analyzed clinical data from 153 newly diagnosed IBD patients, dividing them into two groups: 78 patients who received early nutritional intervention combined with conventional treatment (intervention group) and 75 patients who received conventional treatment alone (control group). Following treatment periods of 4, 8, 12, and 24 wk, we assessed clinical remission rates, disease activity indices (CDAI for Crohn's disease and Mayo scores for ulcerative colitis), quality of life scores (IBDQ), inflammatory markers, nutritional status, and disease-related complications. Early nutritional intervention led to enhanced clinical remission rates beginning at 8 wk and continuing through 24 wk. Disease activity indices showed progressive improvement in the intervention group, with both CDAI scores in Crohn's disease patients and Mayo scores in ulcerative colitis patients demonstrating notable reductions by the 24-wk assessment. Quality of life scores improved substantially in the intervention group, particularly evident at the 12 and 24-wk time points. Inflammatory markers, including C-reactive protein, erythrocyte sedimentation rate, and fecal calprotectin, exhibited marked decreases in patients receiving nutritional intervention. Nutritional parameters demonstrated improvement in the intervention group, with both serum albumin and prealbumin levels showing restoration toward normal ranges. Additionally, patients in the intervention group experienced lower rates of rehospitalization, extraintestinal complications, and disease relapse during the 24-wk follow-up period. These findings indicate that early nutritional intervention significantly improves clinical outcomes in newly diagnosed IBD patients by enhancing remission rates, reducing disease activity and inflammatory burden, optimizing nutritional status, and decreasing complications. This intervention strategy may represent a valuable therapeutic approach for improving both short-term and long-term prognosis in IBD management.

Background: Rheumatoid Arthritis (RA) is a persistent autoimmune disorder that leads to chronic joint inflammation and markedly diminishes patients’ quality of life. Standard RA management typically involves combination pharmacotherapy, including Disease-Modifying Anti-Rheumatic Drugs (DMARDs), Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), and corticosteroids. Purpose: This study was designed to analyze the cost-effectiveness of triple-drug therapy (DMARD–NSAID–corticosteroid) in comparison with double-drug therapy (DMARD–NSAID), and to explore determinants influencing RA treatment in the outpatient setting of Ciremai Hospital. Method: The research applied a retrospective observational method with a cross-sectional approach, utilizing patient medical records from 2020 to 2025. Therapeutic effectiveness was evaluated by identifying the proportion of patients who exhibited decreased erythrocyte sedimentation rate (ESR) values. Economic assessment was conducted through the calculation of the Average Cost-Effectiveness Ratio (ACER) and the Incremental Cost-Effectiveness Ratio (ICER). Result: The analysis showed that the majority of patients were within the 40–60-year age range (60%) and were predominantly women (83.3%). The mean direct medical cost per patient receiving triple therapy (IDR 3,049,466) exceeded that of patients receiving double therapy (IDR 2,116,391). From a clinical perspective, triple therapy demonstrated superior effectiveness (88.2%) relative to double therapy (69.2%). The ACER for triple therapy amounted to IDR 3,466,439 per effectiveness unit, whereas double therapy yielded an ACER of IDR 3,066,517 per effectiveness unit, indicating greater cost-efficiency for double therapy. The ICER was determined to be IDR 4,911,974.

The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact on public health. In the present study, we aimed to analyze the association of certain inflammatory biomarkers with severe COVID-19 and to explore the role of diabetes mellitus (DM) and vaccination status in relation to COVID-19 severity, intensive care need and mortality. Associated comorbidities (DM, obesity, cardiovascular, neurological, endocrine, hepatic, renal, pulmonary, rheumatological, psychiatric, hematological diseases, cancer and HIV), as well as inflammatory biomarkers, like ferritin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen, lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were analyzed in 866 subjects, according to vaccination status. In unvaccinated subjects, the highest AUROC curve for severe COVID-19 was recorded for CRP (0.668), and in the vaccinated group, the highest was recorded for SII (0.694). In age- and comorbidity-adjusted analyses, diabetes mellitus was associated with higher odds of severe COVID-19, ICU admission, and mortality among unvaccinated patients. This analysis was not feasible in the vaccinated group because of the very low number of unfavorable outcomes. These findings emphasize the potential role of vaccination in attenuating the excess risk linked to comorbidities-particularly diabetes mellitus-and support the use of accessible inflammatory biomarkers for early risk stratification. The results should be interpreted within the specific epidemiological phases of the pandemic and in the context of the observational study design.

This study aimed to characterize the clinical spectrum and the bacteriological and microbiological etiology of pediatric primary subacute hematogenous osteomyelitis (PSAHO) and to evaluate a modern diagnostic approach for these infections. A single-center, 25-year retrospective review (2000-2025) of 107 consecutive cases of PSAHO was performed. Clinical presentation, traditional inflammatory markers, conventional cultures and nucleic acid amplification tests (NAATs) on blood, and bone and oropharyngeal samples were assessed. Most patients (73.8%) were <4 years. Fever was uncommon (15.9%), and inflammatory markers were frequently normal (white blood cell counts in 81.1%, C-reactive protein levels in 60.4%) and abnormal in 69.2% for erythrocyte sedimentation rates and in 53.8% for platelet count. Low diagnostic sensitivity of conventional blood (4.2%) and bone (25.7%) sample cultures has been reported. In contrast, a comprehensive NAAT-based approach identified or strongly suggested a pathogen in 44.9% of cases. Kingella kingae was the predominant pathogen in children under 4. Oropharyngeal PCR tests potentially identified the pathogen in another 20 cases, and its presence could be reasonably suspected in a further 68 (63.6%). MRI was essential for diagnosis, identifying all lesions, whereas the sensitivity of radiographs was low (<50%). All patients recovered completely, regardless of the management strategy. This study provides three critical advances for clinical practice: (1) PSAHO should be considered in a limping toddler even without fever or elevated inflammatory markers, and MRI is the imaging modality of choice; (2) NAATs are indispensable for etiologic diagnosis, revealing age-dependent pathogens; (3) Oropharyngeal PCR is a useful diagnostic adjunct.

Cutaneous tuberculosis, a rare extrapulmonary manifestation, constitutes a minor fraction of the overall TB disease burden, with scrofuloderma being the most common variant in paediatric populations. We present the case of a 7-year-old girl with a two-year history of recurrent abscesses on her chest and back that had recently enlarged. Previous incomplete treatment provided only temporary improvement. Clinical examination revealed classic signs of scrofuloderma, including multiple undermined ulcers with seropurulent discharge, sinuses, and puckered scars, accompanied by bilateral cervical lymphadenopathy in an otherwise systemically well child. Diagnostic workup revealed microcytic anaemia, an elevated erythrocyte sedimentation rate, and a strongly positive Mantoux test. Histopathological examination of a skin biopsy showed chronic inflammatory infiltrates with multinucleated giant cells, confirming the diagnosis. The patient was started on a standard four-drug antitubercular therapy regimen. This case underscores the characteristic clinical presentation of scrofuloderma in a child and highlights the critical importance of a high index of suspicion and the necessity of a complete, supervised course of ATT to achieve cure and prevent relapse, even in the absence of pulmonary involvement.

Evidence on the association between nutritional status and clinical characteristics in nontuberculous mycobacterial pulmonary disease (NTM-PD) remains limited. We investigated this association and its impact on longitudinal outcomes in a nationwide cohort. We analysed 627 patients from the NTM-KOREA cohort study who had initiated antibiotic therapy for NTM-PD. Baseline nutritional status was assessed using the Prognostic Nutritional Index (PNI) and Mini Nutritional Assessment Short Form (MNA-SF) tools. Clinical characteristics, physical function, and health-related quality of life (HRQOL) using Quality of Life Questionnaire-Bronchiectasis (QOL-B) were evaluated. Longitudinal analyses were performed at 6 and 12 months after therapy initiation. In the baseline anlysis group (N = 627; mean age: 64.3 ± 9.7 years; females: 73.7%), 112 (17.9%) patients were classified as malnourished according to the PNI, and MNA-SF identified 319 (50.9%) patients at risk and 40 (6.4%) as malnourished. Multivariable regression analysis revealed that the PNI-defined malnutrition group was associated with increased odds (odds ratio [95% confidence interval]) of having dyspnoea (2.37 [1.34 to 4.11]), acid-fast bacilli smear positivity (2.26 [1.44 to 3.57]), and cavitary lesions (2.03 [1.25 to 3.37]). This group was also associated with higher BACES (body mass index, age, cavity, erythrocyte sedimentation rate, and sex) scores (β = 0.9), shorter 6-min walking distance (β = -42.1m), and lower QOL-B scores across physical functioning (β = -10.6), role functioning (β = -7.4), and respiratory symptoms (β = -8.0) (all P < 0.001). In the longitudinal anlysis group (n = 457), poor nutritional status reduced the likelihood of 6-month respiratory symptom improvement (0.44 [0.22 to 0.87]). In the treatment outcome analysis group (n = 119), MNA-defined malnutrition was significantly associated with an increased risk of premature treatment discontinuation within 1 year (26.41 [2.82 to 633.89]). Baseline nutritional status was closely associated with disease severity and HRQOL in NTM-PD. Preliminary longitudinal data suggested that malnutrition may negatively impact symptomatic improvement and treatment adherence, highlighting the need for routine nutritional assessment. ClinicalTrials.gov identifier NCT03934034, Registration date May 1, 2019.

Complete blood count (CBC) and erythrocyte sedimentation rate (ESR) are essential tests in clinical practice. The Mindray BC-6800 Plus integrates CBC and ESR analysis through its Easy-W ESR module and a hybrid platelet channel (PLT-H) designed to improve platelet quantification, especially under interference. A prospective analytical study was conducted following CLSI guidelines (EP05-A3, EP06-A, EP09c). A total of 460 venous samples were analyzed across multiple modes (Auto, Open-Vial, Predilute). PLT-H was compared with PLT-O and reference values; ESR with the BC-760CS, which shares the same ESR module validated against Westergren. Interference testing included samples with low MCV (< 75 fL) and high MPV (> 10 fL). PLT-H background was consistently < 5 × 109/L. Precision met predefined limits (CV ≤ 4% whole blood, ≤ 8% predilute; ESR SD ≤ 2 mm/h at ≤ 20 mm/h, CV ≤ 10% at > 20 mm/h). Carryover was ≤ 0.2%. PLT-H showed excellent linearity to 5000 × 109/L (r = 0.999) and tighter bias distribution than PLT-O. Agreement was strong for ESR between BC-6800 Plus and BC-760CS (r = 0.989) and for PLT-H versus PLT-O (r = 0.992). PLT-H maintained robustness in interference-prone samples (r = 0.992). The BC-6800 Plus demonstrated excellent analytical performance for ESR and PLT-H, delivering accurate, reproducible, and interference-resistant results. It supports efficient, high-quality testing in modern laboratories.

Background: Obsessive–Compulsive Disorder (OCD) is a chronic psychiatric illness characterized by intrusive thoughts and repetitive behaviors that significantly impair functioning and quality of life. Emerging evidence suggests that neuroinflammation and immune dysregulation may contribute to the pathophysiology of OCD. Peripheral inflammatory markers and composite indices such as the Systemic Immune-Inflammation Index (SII) have gained attention as potential biomarkers reflecting the interplay between immune activation and neuropsychiatric disorders. Objectives: To assess and compare markers of inflammation and the Systemic Immune-Inflammation Index in patients with Obsessive–Compulsive Disorder and healthy controls, and to evaluate their potential association with the disorder. Methods: This case–control study included 60 participants, comprising 30 patients diagnosed with OCD and 30 age- and sex-matched healthy controls. Diagnosis of OCD was established using standard clinical diagnostic criteria. Venous blood samples were collected from all participants under aseptic conditions. Laboratory parameters assessed included total leukocyte count, neutrophil count, lymphocyte count, platelet count, erythrocyte sedimentation rate (ESR). The Systemic Immune-Inflammation Index was calculated using the formula: SII = Platelet count × Neutrophil count / Lymphocyte count. Statistical comparisons between groups were performed using appropriate parametric or non-parametric tests, with p &lt; 0.05 considered statistically significant. Results: Patients with OCD demonstrated significantly higher levels of inflammatory markers, including neutrophil count, platelet count, ESR, compared to healthy controls. Lymphocyte counts were relatively lower in the OCD group. Consequently, the calculated SII values were significantly elevated among OCD patients, indicating heightened systemic inflammatory status. The findings suggest a measurable inflammatory imbalance in individuals with OCD. Conclusion: The study indicates that patients with OCD exhibit increased systemic inflammation and elevated SII compared to healthy individuals. These findings support the hypothesis that immune-inflammatory mechanisms may play a role in the pathophysiology of OCD. Peripheral inflammatory markers and SII may serve as accessible adjunct biomarkers for understanding disease mechanisms and guiding future research on targeted therapeutic approaches.

Robotic-assisted total knee arthroplasty (RA-TKA) aims to improve surgical accuracy and reduce soft-tissue trauma. The bone-milling technique may further decrease mechanical stress during bone preparation. This study primarily compared systemic inflammatory biomarkers between bone-milling RA-TKA and conventional TKA (C-TKA), with secondary assessments of perioperative parameters, radiographic alignment, and early postoperative outcomes. This prospective randomized controlled trial included 30 RA-TKAs and 30 C-TKAs performed between August 2023 and December 2024 in patients with Kellgren-Lawrence grade IV knee osteoarthritis. All RA-TKA procedures were conducted during the operating surgeon's early learning phase with the robotic platform. Serum interleukin (IL)-6, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), creatine kinase (CK), and lactate dehydrogenase (LDH) were measured preoperatively and at 6h, 1day, 3days, 2weeks, and 6weeks postoperatively. Perioperative variables, radiographic alignment, and 6-week Knee Society Score (KSS) and visual analog scale (VAS) pain scores were compared. Postoperative inflammatory biomarkers did not differ significantly between groups at any time point, and the corresponding effect sizes were small, indicating minimal biological differences. Estimated blood loss was comparable (p = 0.753). RA-TKA demonstrated significantly improved postoperative mechanical alignment (mechanical axis [MA] deviation: 0.3 ± 2.4° versus 2.8 ± 3.4°; p = 0.002) but required longer tourniquet times (121.4 ± 15.3min versus 95.0 ± 13.3min; p < 0.001). Early functional outcomes were similar, with no significant differences in KSS (p = 0.114) or VAS pain scores at 6weeks (p = 0.508). Bone-milling RA-TKA did not reduce systemic inflammatory responses compared with C-TKA, with small effect sizes confirming minimal biological differences. However, it provided superior radiographic alignment, while perioperative parameters and early postoperative recovery remained comparable except for longer tourniquet time.

The Enlarged Lymph-Node Ratio Performs Well for Diagnosing Periprosthetic Joint Infection After Total Hip Arthroplasty.