Sedimentation Rate Research Articles

Efficacy and safety of methotrexate plus hydroxychloroquine combination therapy vs. methotrexate monotherapy in the treatment of rheumatoid arthritis: A randomized controlled clinical trial.

To explore the efficacy and safety of combination therapy with methotrexate (MTX) plus hydroxychloroquine (HCQ) vs. MTX monotherapy in patients with rheumatoid arthritis (RA). Sixty patients without prior RA treatments were randomly allocated in a 1:1 ratio to two groups: one receiving MTX plus HCQ, and the other receiving MTX monotherapy. We conducted a comparative analysis before and after the 12-week trial, evaluating the visual analogue scale (VAS), the disease activity score in 28 joints (DAS), serum inflammatory factor (including serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), as well as the outcome of the World Health Organization Quality of Life Brief Version questionnaire (WHOQOL-BREF) and the treatment-emergent adverse events (TEAEs) for all the participants in the study. At the 12th week of the trial, a more remarkable decrease in pain score (VAS), disease activity score (DAS), and serum inflammatory factor levels could be noticed in individuals on the combination therapy. The quality of life score was as well found to be higher in the MTX + HCQ group than the MTX monotherapy group. The incidence of adverse reactions in the MTX + HCQ and the MTX monotherapy groups were 10.00% and 6.67%, respectively. However, no statistical significance could be observed (p > .05). In our study, both the MTX + HCQ combination therapy and MTX monotherapy demonstrated improvements in symptoms, conditions and quality of life for patients with RA. Notably, the combination therapy could achieve better outcomes across all indices compared to MTX monotherapy, highlighting its potential as the optimal first-line treatment for RA. © 2024 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

49169 Impact of secukinumab on high-sensitivity C-reactive protein and erythrocyte sedimentation rate: Post hoc analysis of pooled data from the SUNSHINE and SUNRISE Phase 3 randomized trials

49169 Impact of secukinumab on high-sensitivity C-reactive protein and erythrocyte sedimentation rate: Post hoc analysis of pooled data from the SUNSHINE and SUNRISE Phase 3 randomized trials

Overview of latent tuberculosis-related central serous chorioretinopathy: Review and case report

We present a case of multifocal central serous chorioretinopathy (CSCR) in a 40-year-old male who presented with gradual loss of vision in both of his eyes during the previous 3 months. The anterior segment examination was normal; the dilated fundus examination revealed severe retinal elevation in the macular area in both eyes. Optical coherence tomography confirmed the presence of subretinal fluid with a central macular thickness of 353 μm OD and 356 μm OS. On the basis of ocular findings, a diagnosis of multifocal CSCR was made. One month later, the patient complained of further vision loss. His erythrocyte sedimentation rate was elevated, and the Mantoux test (22 mm × 22 mm), the QuantiFERON TB gold (5 IU/ml), and the cytomegalovirus immunoglobulin G (2277.92 AU/ml) yielded positive results. A diagnosis of latent tuberculosis infection was made. After 2 months of starting antitubercular treatment, the patient’s visual acuity improved.

Serum Endocan Levels in Children with Acute Rheumatic Fever.

Acute rheumatic fever is an immunologically delayed autoimmune sequel of throat infection caused by group A streptococcus. The aim of this study was to evaluate endocan levels in patients with acute rheumatic fever and compare with the control group. The aim of this study was to evaluate endocan levels in patients with acute rheumatic fever and compare with the control group. Twenty-three children with acute rheumatic fever (11 men, 12 females; mean age 13 ± 2.7 years; range 5 to 15 years) and a healthy control group of 31 children (16 men, 15 females; mean age 13.8 ± 2.4 years; range 5 to 15 years) were recruited. The sedimentation rate, C-reactive protein, antistreptolysin-O titres, and endocan levels were examined in each group. Before anti-inflammatory therapy, endocan levels in the acute rheumatic fever group were not statistically significant to those in the control group, respectively (200.64 ng/L, 120.71 ng/L, P = 0.208). After anti-inflammatory therapy, endocan levels were significantly higher in the acute rheumatic fever group than in the control group, respectively (260.87 ng/L vs. 120.71 ng/L, P < 0.01). A significant difference was found in endocan levels before and after anti-inflammatory therapy in the group of acute rheumatic fever, respectively (200.64 ng/L vs. 260.87 ng/L, P = 0.033). Endocan levels after anti-inflammatory therapy were statistically higher in the severe carditis group compared to those of the mild carditis group, respectively (344.56 ng/L vs. 191.01 ng/L, P < 0.01). Our study showed that serum endocan levels increased during the subacute phase of acute rheumatic fever. We suggest that serum endocan level can be used as a new biomarker to identify the degree of cardiac involvement in acute rheumatic fever.

Uptake time and enrichment mechanism of rare earth elements in deep-sea bioapatite

Bioapatite is widely recognized as the primary carrier for rare earth elements and yttrium (REY) in deep-sea REY-rich muds. The incorporation of REY into bioapatite occurs at the water-sediment interface, which has the potential to serve as a proxy for reconstructing paleoenvironmental conditions. The timing of REY uptake and the fractionation of rare earth elements (REEs) within bioapatite are crucial factors to understanding the application of these proxies. In this study, we present in-situ geochemical data for bioapatite obtained from surface sediments in the high sedimentation rate Somali Basin of the northwestern Indian Ocean (NWIO), as well as fish teeth within nodules from the low sedimentation rate in the northwestern Pacific Ocean (NWPO). Our findings indicate that the uptake time of REY occurred rapidly, with the ΣREY content reaching 7265 μg/g in bioapatite from the surface sediments in the NWIO within several thousand years. The bone fragments exhibited a high ΣREY content, which was primarily attributed to substitution processes. This led to a notably elevated proportion of middle rare earth elements (MREE) compared to fish teeth. In contrast, the adsorption and substitution mechanisms responsible for REY incorporation decreased from the root to the tip in fish teeth, resulting in a pronounced decline in ΣREY content. The adsorption mechanism was identified as the primary process responsible for REY uptake in the fish teeth within the studied nodules from the NWPO. The fractionation pattern of REEs in these teeth exhibited similarities to that of fish teeth from the NWIO. Therefore, we inferred that the fish teeth within the studied nodules may preserve the original information during late diagenesis. The variation of REY contents in the nodules was influenced by the redox environment, and there is no evidence to support the migration of REY from the nodules into the fish teeth.

Correlation of Serum Vitamin D and High-Density Lipoprotein (HDL) Cholesterol Levels With Disease Activity in Rheumatoid Arthritis: A Single-Center Experience From Eastern India.

Background Rheumatoid arthritis (RA) is a progressive, symmetric, and erosive polyarthritis with a variety of extraarticular manifestations such as mononeuritis multiplex, central nervous system vasculitis, Felty's syndrome, dyslipidemia, carditis, and interstitial lung disease. Vitamin D plays a role in both adaptive and innate immunity, and its deficiency leads to the development of many autoimmune disorders. Additionally, RA patients have a lipid paradox consisting particularly of dysfunctional and low levels of high-density lipoprotein (HDL) with reduced low-density lipoprotein lowering effect, which increases cardiovascular morbidity and potentiates widespread systemic inflammation. Both are modifiable risk factors. Although there are numerous studies on vitamin D and HDL cholesterol in disease progression in RA, there is sparse literature from India studying both these factors in combination. In this study, we tried to establish the correlation of serum vitamin D and HDL cholesterol levels, if any, with disease activity using the Disease Activity Score 28 Erythrocyte Sedimentation Rate (DAS28 ESR) score. Methods A descriptive cross-sectional study comprising 80 patients was conducted at a tertiary care center in Eastern India over 12 months. Newly diagnosed RA patients aged >17 years satisfying the diagnostic criteria were included. Serum vitamin D level and HDL cholesterol were measured. Then, the DAS28 ESR score was calculated, and a correlation was looked for between serum vitamin D and HDL cholesterol. Results Patients aged 35-43 years accounted for 32 (42.5%) of participants, of whom 58 (72.5%) were females. Almost half, 38 (47.5%), had vitamin D deficiency. The mean vitamin D level was 22.988 ± 10.01 ng/ml. The mean HDL cholesterol level was 42.3 ± 7.23 mg/dl. The mean DAS28-ESR score was 3.81 ± 1.19. A statistically significant inverse correlation was found between vitamin D levels and DAS28 ESR score (p -0.0003) and HDL (p -0.000349). Conclusions Vitamin D deficiency and low HDL cholesterol levels are more common in RA patients. These factors may contribute to increased disease activity. Both are treatable factors in addition to conventional therapies.

Датирование современной осадочной толщи краевых бассейнов Восточного Мурмана (Кольский полуостров) на примере губ Ярнышная и Зеленецкая

The authors have studied sediment genesis in the Kola Peninsula bays, the most popular and developed part of the coastal shelf by the population. The main tool used is the method of radioisotope chronology of sedimentary layers based on changes in the specific activity of the natural isotope 210Pb and technogenic 137Cs. It has been revealed that the marginal basins of Murman are characterized by monotonous sedimentation in recent centuries. The average sedimentation rate is 0.15—0.17 cm/year. The sedimentary sequence is composed of silty-pelite-sized material. It has been established that the role of ice rafting in the formation of bottom sediment in coastal bays has decreased over the past centuries.

The Relationship of Immune Markers with Severity and Heritability of Depressive Disorder: A Cross-Sectional Hospital-Based Study from North India

Background: Inflammatory response plays a pivotal role in the pathophysiology of depression. With this background, we planned this study to see if immune markers, interleukin 6 (IL-6), and erythrocyte sedimentation rate (ESR) are raised in subjects with major depressive disorder (MDD) and compare its level with healthy controls and first-degree relatives of subjects. We also explored if variation in the level of these markers was related to the severity of depression. Methods: This comparative observational study included 120 subjects, who were divided into three groups of 40 individuals each. Group 1 was the MDD group, group 2 was the healthy first-degree relative group, and group 3 was the healthy control group. All the subjects were then made to undergo estimation of IL-6 (pg/mL) and ESR (mm/h) from our hospital biochemistry lab. The patients in group 1 were additionally screened for the severity of depression. Results: The mean IL-6 and ESR measure within the MDD group was 9.20 ± 13.40 (pg/mL) and 5.90 ± 5.35 (mm/h), respectively. We found that the mean and median values of both IL-6 and ESR were highest in the MDD group as compared to other groups, which were statistically significant ( p &lt;0.05). A pairwise comparison found no significant difference in the IL-6 and ESR scores among the healthy controls and healthy first-degree relatives. The mean of IL-6 was highest in individuals with moderate severity of depression, while the mean of ESR was highest in individuals with severe depression. Conclusion: The immune markers, IL-6 and ESR, were significantly raised in the MDD group; however, the levels did not correlate significantly with the differential severity of the depressive disorder as per Hamilton depression rating scale (HAM-D) scores.

Pengaruh penundaan pemeriksaan terhadap laju endap darah pada sampel darah EDTA

Introduction: Blood is an essential component of living organisms, ranging from primitive animals to humans. Under physiological conditions, blood always remains within blood vessels to carry out its functions (Bakta, 2020). The Erythrocyte Sedimentation Rate (ESR), also known as blood sedimentation rate, is an examination to determine the rate at which erythrocytes settle in non-coagulated blood (blood containing anticoagulants) in a vertical tube over a specific period. The Westergren method for ESR measurement is the most satisfactory method currently used in hospitals and clinics. This study aims to determine the difference in Erythrocyte Sedimentation Rate values between EDTA blood samples examined immediately and those delayed for 3 hours at room temperature. Method: This analytical descriptive research compares the results of Erythrocyte Sedimentation Rate examinations conducted immediately and those delayed for 3 hours using the Westergren method at room temperature. The study involved 30 samples obtained from outpatient and inpatient patients by venous blood collection. Findings: The statistical analysis using Paired t-Test showed that the P Value was 0.00 (P &lt; 0.05), indicating a significant difference between immediate and delayed examinations for 3 hours at room temperature using the Westergren method. Conclusion: Based on the research findings, it is recommended to conduct Erythrocyte Sedimentation Rate examinations with EDTA blood samples immediately as it is more effective.

The Effectiveness and Safety of Wu Tou Decoction on Rheumatoid Arthritis-A Systematic Review and Meta-Analysis.

Rheumatoid arthritis (RA) is an autoimmune disease primarily affecting the joints and requires various treatments, including medication, injection, and physiotherapy. Wu tou decoction (WTD) is a traditional Chinese medicine prescribed for RA, with several articles documenting its effectiveness in RA treatment. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of WTD for RA. We searched for randomized controlled trials (RCTs) comparing WTD with conventional treatments (including medication, injection, and physiotherapy) from its inception to May 2024. Primary outcomes were disease activity scores, including effective rate, tender joint count, and morning stiffness. Secondary outcomes comprised blood test results (erythrocyte sedimentation rate, C-reactive protein, and rheumatoid factor) and adverse events. Nineteen RCTs involving 1794 patients were included. Statistically, WTD demonstrated better improvement than conventional treatments (18 medications and 1 injection) across the effective rate, joint scale, and blood tests, regardless of the treatment type (monotherapy or combination therapy). Adverse events were reported in 11 studies, with no statistical differences observed between them. The numerical results showed that WTD may offer potential benefits for managing RA. However, the significant discrepancy between clinical practice and the low quality of the RCTs remains a limitation. Therefore, further well-designed studies with larger patient cohorts are needed to draw definitive conclusions.

Effects of vitamin D supplementation on diabetic foot ulcer healing: a meta-analysis.

To systematically review the effect of vitamin D supplementation on diabetic foot ulcer (DFU) healing. The PubMed, Web of Science, Science direct, Ebsco host, CNKI, WanFang, VIP, and CBM databases were electronically searched to collect randomized controlled trials (RCTs) on the impact of vitamin D supplementation on DFUs from inception to 19 November 2022. Two researchers independently screened the literature, extracted the data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. A total of seven studies involving 580 patients were included. The results of meta-analysis showed that compared with control group, the wound healing efficiency rate (RR = 1.42, 95%CI 1.03 to 1.95, P= 0.03) and wound reduction rate (MD = 13.11, 95%CI 4.65 to 21.56, P < 0.01) of the experimental group were higher; the change values of the wound area (MD = -3.29, 95%CI -4.89 to 1.70, P < 0.01) and 25 (OH) D (MD = 9.63, 95%CI 6.96 to 12.31, P < 0.01) were larger. Supplementation of vitamin D on DFU patients can improve glucose metabolism and insulin indexes: hemoglobin A1c (MD = -0.44, 95%CI -0.62 to -0.26, P < 0.01), fasting insulin (MD = -3.75, 95%CI -5.83 to -1.67, P < 0.01), HOMA - β (MD = -5.14, 95%CI -8.74 to -1.54, P < 0.01), and quantitative insulin sensitivity check index (MD = 0.02, 95%CI 0.01 to 0.02, P < 0.01). It can also improve inflammation and oxidative stress markers: high sensitivity C-reactive protein (MD = -0.83, 95%CI -1.06 to -0.59, P < 0.01), erythrocyte sedimentation rate (MD = -15.74, 95%CI -21.78 to -9.71, P<0.01), nitric oxide (MD = 1.81, 95%CI 0.07 to 3.55, P= 0.04), and malondialdehyde (MD = -0.43, 95%CI -0.61 to -0.24, P<0.01). There was no statistically significant difference in changes of fasting plasma glucose, homeostasis model of assessment-insulin resistance, total antioxidant capacity, glutathione, very low density lipoprotein cholesterol, low density lipoprotein cholesterol, and high density lipoprotein cholesterol (P>0.05). The current evidence suggests that vitamin D supplementation can significantly promote DFU healing by lowering blood sugar and alleviating inflammation and oxidative stress. Key messages What is already known on this topic Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus, with high morbidity, mortality and resource utilization. Vitamin D has the effect of lowering blood sugar, improving insulin sensitivity, and increasing anti-inflammatory response. Clinical research on vitamin D supplementation for the treatment of DFU is increasing, but due to the lack of combing and integration, the actual efficacy of vitamin D in patients is unclear. What this study adds This meta-analysis has shown that vitamin D supplementation can significantly promote DFU healing by lowering blood glucose and alleviating inflammation and oxidative stress. How this study might affect research, practice or policy This study preliminarily found the effectiveness of vitamin D supplementation on the healing of DFU, which can provide a reference for the treatment of DFU by medical staff.

Nature‐based shoreline protection in newly formed tidal marshes is controlled by tidal inundation and sedimentation rate

AbstractMany tidal marshes have been lost by past land use changes, but are nowadays increasingly restored and created to provide valuable ecosystem services such as nature‐based flood and erosion protection along estuarine shorelines. To be functional for flood and shoreline erosion protection, restored and created tidal marshes should develop erosion resistant sediment beds. Here, we investigated which factors drive the spatial variations in sediment strength and erosion resistance in a developing tidal marsh restoration site. Our results show that decreasing tidal inundation frequency, decreasing sedimentation rate, and better drainage led to stronger consolidation in deeper sediment layers. This consolidation resulted in greater sediment strength, quantified here by shear strength and penetration resistance. Generally, sediment strength was greater when sediment had higher bulk density, while a higher water and fine fraction (= clay and silt) content decreased sediment strength. Overall, all measurement locations were relatively erosion resistant, likely caused by the dense root network and cohesive sediment. To restore or create resilient tidal marshes for nature‐based flood and shoreline erosion protection, we should thus aim for sites with relatively low tidal inundation frequency, moderate sedimentation rates, and cohesive sediment mixtures of clay, silt, and sand, which are well drained and have potential for vegetation establishment. These conditions have a high likelihood of resulting in restored or created tidal marshes that contribute to nature‐based flood and shoreline erosion protection.

Significance of inflammatory biomarkers in clinical diagnostics: Erythrocyte sedimentation rate versus other inflammatory biomarkers: A review

Significance of inflammatory biomarkers in clinical diagnostics: Erythrocyte sedimentation rate versus other inflammatory biomarkers: A review

Clinical efficacy and pharmacological mechanism analysis of Xubi Capsule in the treatment of patients with liver and kidney deficiency osteoarthritis.

To explore the clinical efficacy and pharmacological mechanism analysis of Xubi capsule in the treatment of patients with liver and kidney deficiency osteoarthritis (OA). In this single-center retrospective study, 120 patients with liver and kidney deficiency OA admitted to the Hangzhou Fuyang Hospital of Traditional Chinese Medicine from January 2020 to May 2022 were included, and patients were divided into the intervention group (n = 60) and the control group (n = 60) according to their treatment. The control group was treated with Ibuprofen, while the intervention group was treated with Xubi capsule combined with Ibuprofen. According to the network pharmacology method, the mechanism of the Xubi capsule in the treatment of patients with liver and kidney deficiency OA was analyzed. After the treatment, the total effective rate in the intervention group was 93.33%, which was significantly higher than that in the control group (P < .001). After treatment, compared with the control group, the degree of joint swelling and tenderness in the intervention group were lighter, the muscle strength was better, the level of erythrocyte sedimentation rate was lower, and the pain visual score was lower (P < .05), while the C-reactive protein level was significantly lower (P < .001). The effective chemical composition of Xubi capsules is 176, with quercetin and palmitoleic acid being the most associated with diseases. There are 209 intersection targets between drugs and diseases. A total of 119 gene ontology cellular components were significantly enriched. The combination of traditional Chinese medicine and Western medicine adopted in this study can effectively treat patients with liver and kidney deficiency OA and relieve the joint pain of patients. In a multicomponent and multitarget approach, the Xubi capsule breaks through the limitations of traditional nonsteroidal anti-inflammatory drugs and has good clinical application value.

Prognostic analysis of concurrent Pneumocystis jirovecii pneumonia in patients with systemic lupus erythematosus: a retrospective study

BackgroundSystemic lupus erythematosus (SLE) has been less deadly since the advent of corticosteroid-sparing medications. SLE patients still have a higher mortality rate than the general population. Infectious disease is reported as one of the major causes of death in patients with SLE. Although bacteria are the most often isolated pathogens from patients with SLE, Pneumocystis jirovecii pneumonia (PJP) is more deadly than bacterial infection.MethodsWe retrospectively enrolled consecutive patients with SLE concurrent with PJP (SLE-PJP) in our center between January 2014 and December 2022. The participants were classified into two groups: survivors and non-survivors. Cox regression models and Kaplan‒Meier survival analyses were conducted to explore prognostic factors for survival.ResultsThere were 57 patients with SLE (42.0 ± 15.8 years old, 78.9% female) complicated with PJP, 22 (38.6%) of whom died. Compared with the survival group, the non-survival group had more patients with hyperglycemia or diabetes mellitus, invasive ventilation (p < 0.01), respiratory failure, intensive care unit admission, non-invasive ventilation, and hospital-acquired pneumonia (p < 0.05). The non-survival group showed a higher neutrophil percentage, lactate dehydrogenase, D-dimer (p < 0.001), urea, high-sensitivity C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), and ferritin (p < 0.05). It also had lower minimal albumin, hemoglobin (p < 0.001), immunoglobulin G, complement 3, peripheral lymphocyte count, platelet, NK cell count, and CD4+ T-cell count (p < 0.05). Multivariate analysis indicated that hyperglycemia or diabetes mellitus (HR = 4.25, p < 0.01, 95% CI: 1.51–11.97), thrombocytopenia (HR = 4.22, p < 0.01, 95% CI: 1.63–10.91) and lower complement 3 (C3) (HR = 4.06, p < 0.01, 95% CI: 1.60-10.33) were independent risk factors for the survival of SLE-PJP patients.ConclusionsThe mortality rate of patients with SLE-PJP is still high. Hyperglycemia, decreased C3, and thrombocytopenia are independent survival risk factors.

Acute phase reactants

The serum concentrations of certain proteins are altered in various conditions such as infection, trauma, inflammatory arthritis, malignancy, autoimmune and systemic inflammatory diseases. These proteins are known as positive or negative acute phase reactants. While albumin and transferrin belong to the negative acute phase reactants, alpha-1-acid glycoprotein, alpha-1-antitrypsin, alpha-2-macroglobulin, C-reactive protein, ceruloplasmin, haptoglobin, serum amyloid A and fibrinogen are known as positive acute phase reactants. This review discusses the clinical use of C-reactive protein, erythrocyte sedimentation rate and procalcitonin.

Diagnostic Value of Whole-Body MRI in Pediatric Patients with Suspected Rheumatic Diseases.

Background and Objectives: The diagnosis of rheumatic diseases in children is challenging and requires the use of advanced imaging examinations such as whole-body magnetic resonance imaging (MRI). Whole-body MRI allows visualization of bone marrow edema (BME), muscle edema, joint effusion and changes in the soft tissues surrounding the joints. The aim of this study was to collect and compare whole-body MRI findings, laboratory results and clinical manifestations of pediatric patients with suspected rheumatic disease. Materials and methods: In this retrospective single-center study, 33 patients who underwent whole-body MRI were included. Their age ranged from 9 to 17 years, and 24 (72.73%) of the patients were female. Patients were diagnosed as follows: juvenile idiopathic arthritis (27.27%), juvenile idiopathic inflammatory myopathies (21.21%), chronic nonbacterial osteomyelitis (21.21%) and other medical conditions (30.30%), such as arthritis associated with infection, scleroderma, Takayasu arteritis, polyarteritis nodosa and joint damage. Results: The most common symptom reported by 26 (79.79%) patients was pain. On physical examination, the limitation of joint mobility was examined in 17 (51.51%), swelling of the joints was observed in 12 (36.36%) patients and decreased muscle strength was noticed in 11 (33.33%) patients. An increase in the C-reactive protein (12%), erythrocyte sedimentation rate (9%), leukocyte count (9%) and creatine kinase (CK) (18%) was observed. Whole-body MRI revealed myositis (30%), joint effusion (27%) and BME (24%). The statistical analysis showed a significant relationship between myositis and the elevated CK level (p < 0.05). Conclusions: The most common symptom in the studied population was pain, while the limitation of joint mobility was found in more than half of patients. Myositis was the most commonly imaged lesion on the whole-body MRI and it was related to an increase in the CK level.

Disease Activity, Inflammation Markers, and Quality of Life Are Associated with Muscle Strength in Croatian Rheumatoid Arthritis Patients-A National-Based Study.

Background and Objectives: Rheumatoid arthritis (RA) patients experience sarcopenia and decreased muscle mass and handgrip strength, leading to decreased quality of life and disability. The prevalence of RA varies across regions. This study aimed to evaluate the factors associated with RA in Croatian regional centres and explore correlations between clinical parameters and muscle strength. Materials and Methods: Included in this study were 267 stable RA patients from four Croatian clinical centres. The patients' mean age was 60.4 ± 12.0 years, with 12.7% of them being male. For each study participant, information was gathered on their anthropometric characteristics, clinical and laboratory indicators, quality of life, disease activity, and sociodemographics. Results: The main results showed that in the female RA participants, the significant positive predictors are weight, height, exercise, VAS, and haemoglobin level. The negative predictors are the use of conventional synthetic disease-modifying anti-rheumatic drugs, the use of biological disease-modifying anti-rheumatic drugs, the number of tender joints, the number of swollen joints, the estimated sedimentation rate, the C-reactive protein, the disease activity score, the parameters of the EQ5D, and being prescribed with three or more medications. In the male RA participants, significant predictors of muscle strength are only weight, height, and anxiety/depression difficulties, according to the EQ5D. Conclusions: This study showed correlations between muscle strength and the parameters of disease activity, inflammation parameters, health-related quality of life, therapy, and exercise in the female RA participants in Croatia.

Analysis of ultrasound coronary parameters and blood red cell distribution width and N-terminal pro-brain natriuretic peptide concentrations following coronary lesions in children with Kawasaki disease.

Aims/Background Kawasaki disease is an acute inflammatory condition primarily affecting the young children. It can lead to coronary artery abnormalities, which can worsen the prognosis. Early diagnosis of coronary disease is crucial for the effective treatment and the prognosis evaluation. To explore the clinical significance of ultrasound examination characteristics, peripheral blood red cell distribution width, and changes in N-terminal pro-brain natriuretic peptide levels for the early detect coronary artery abnormality in children with Kawasaki disease. Methods The case-control study was conducted. 85 Kawasaki disease patients diagnosed in our hospital from January 2020 to December 2023 were selected as the Kawasaki disease group. 100 healthy children who received physical examination in the Department of Child Healthcare during the same period were selected as control group. The cardiac ultrasound indicators, erythrocyte sedimentation rate, C-reactive protein, white blood cell, neutrophil percentage, platelet count, D-dimer, red cell distribution width, N-terminal pro-brain natriuretic peptide of two groups were compared. The Kawasaki disease group was further divided into the coronary artery lesion group and the non-coronary artery lesion group based on whether coronary artery lesions occurred in the Kawasaki disease patients. The differences of above indicators were compared. Results The left main coronary artery, left anterior descending branch, and right coronary artery Z-scores of the Kawasaki disease group were all higher than those of the control group (p < 0.05). There was no significant difference in left ventricular ejection fraction between Kawasaki disease group and control group (p > 0.05). The erythrocyte sedimentation rate, C-reactive protein, neutrophil percentage, platelet count, D-dimer, red cell distribution width, and N-terminal pro-brain natriuretic peptide of Kawasaki disease group were all higher than those of control group (p < 0.05). The left main coronary artery, left anterior descending branch, and right coronary artery Z-scores of Kawasaki disease patients with coronary artery lesions were all higher than those of Kawasaki disease patients without coronary artery lesions (p < 0.05). The left ventricular ejection fraction of Kawasaki disease patients with coronary artery lesions was lower than that of Kawasaki disease patients without coronary artery lesions (p < 0.05). The erythrocyte sedimentation rate, C-reactive protein, white blood cell, neutrophil percentage, platelet count, D-dimer, red cell distribution width, and N-terminal pro-brain natriuretic peptide of Kawasaki disease patients with coronary artery lesions were all higher than those of Kawasaki disease patients without coronary artery lesions, and the differences were statistically significant (p < 0.05). After treatment, the left main coronary artery, left anterior descending branch, and right coronary artery Z-scores of Kawasaki disease patients with coronary artery lesions significantly decreased (p < 0.05), and the left ventricular ejection fraction significantly increased (p < 0.05). The erythrocyte sedimentation rate, C-reactive protein, white blood cell, neutrophil percentage, platelet count, D-dimer, red cell distribution width, and N-terminal pro-brain natriuretic peptide of Kawasaki disease patients with or without coronary artery lesions significantly decreased after treatment compared with before treatment in the same group (p < 0.05). Conclusion Kawasaki disease patients with coronary artery lesions exhibit significantly increased coronary artery vessel diameter, as well as elevated red cell distribution width and N-terminal pro-brain natriuretic peptide concentration. The combined use of ultrasound combined with red cell distribution width and N-terminal pro-brain natriuretic peptide examination can assist in determining whether Kawasaki disease patients have coronary artery lesions and assessing the clinical treatment effect.

Baseline systemic inflammatory indices and clinicopathological features to predict the outcome of acute tubulointerstitial nephritis : Asingle-center retrospective study.

Acute tubulointerstitial nephritis (AIN) is an immune-mediated disorder that can cause acute kidney injury (AKI). We aimed to investigate the characteristics of patients with AIN and predictive factors for treatment response. In this study, thirty-one patients diagnosed with AIN on kidney biopsy between 2006 and 2021 were included. Baseline clinical, histopathological, and laboratory findings, including complete blood count (CBC), creatinine, erythrocyte sedimentation rate, C‑reactive protein, C3, C4, systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and urinalysis were evaluated. Treatment response, mortality, and creatinine levels at the time of last follow-up were also noted. The median age was 46 years and 80.6% were female. Median baseline creatinine and proteinuria levels were 4.1 mg/dL and 0.84 gram/day. The median follow-up period was 14months and 93.5% received immunosuppressives. End-stage kidney disease (ESKD) developed in five patients (16.1%). Renal recovery (creatinine < 1.4 mg/dL) was observed in 17 patients (54.8%). Higher degrees of interstitial fibrosis, tubular atrophy, granuloma formation, global glomerulosclerosis, and higher baseline hemoglobin levels, in addition to alonger interval between first symptom to initiation of immunosuppressives were associated with renal nonrecovery, statistically. Also, patients who progressed to ESKD had higher baseline hemoglobin (p = 0.033) and lymphocyte (p = 0.044) and lower PLR levels (p = 0.016), as well as higher degrees of global glomerulosclerosis (p = 0.014), interstitial fibrosis (p = 0.042), and tubular atrophy (p = 0.030). Treatment response rates are low for AIN, which may lead to ESKD. Besides chronicity in histopathology specimens, higher baseline hemoglobin levels and lower platelet-to-lymphocyte ratio might be prognostic. Further studies should be conducted on new markers for AIN.