Erytrocyte Sedimentation Rate Research Articles

Administration of Robusta Coffee (Coffea canephora) Decreased Erythrocyte Sedimentation Rate on Hyperlipidemia Rats

Background: Hyperlipidemia is one of the factors that can trigger atherosclerosis which is characterized by abnormalities in lipid metabolism in the blood, especially increased LDL levels above normal. The increase in level of LDL stimulates the production of several cytokines that can affect the increase in acute phase proteins, especially fibrinogen. The presence of fibrinogen functions in increasing the Erytrocyte Sedimentation Rate (ESR) through its positive charge to neutralize the surface of erythrocytes. Prevention efforts to reduce ESR use herbal plants that do not have side effects, namely robusta coffee. Anti-inflammatory and antioxidant activity in robusta coffee is thought to be effective in reducing ESR through inhibition of cytokine production in the inflammatory response. Objective: This study aimed to determine differences in ESR values ​​after administration of robusta coffee to hyperlipidemia rats. Methods: Fiveteen male Wistar rats were randomly divided into 3 research groups including the control group (K), the hyperlipidemia group (H), and the hyperlipidemia + coffee group (C). Induction of hyperlipidemia by feeding duck egg yolk and pork oil. The calculation of the ESR level uses the Westegreen method in mm/hour. Results and Conclusions: Robusta coffee can affect the decrease in ESR values ​​in hyperlipidemia rats

Abdominal Tüberküloz Tanılı Çocuk Hastaların Retrospektif Olarak Değerlendirilmesi: Tek Merkez Deneyimi

Objective: Abdominal tuberculosis is a kind of extrapulmonary tuberculosis that can usually occur during the lymphohematogenous spread of first Mycobacterium tuberculosis infection, develop by neighborhood from an abdominal focus or a mesenteric lymph node. The aim of this study is to evaluate pediatric cases diagnosed with abdominal tuberculosis. Material and Methods: Between 2012-2018, seven patients diagnosed with abdominal tuberculosis through patients who diagnosed with extrapulmonary tuberculosis in our hospital, were included in study. Demographic and clinical characteristics, diagnostic methods, commenced treatments and clinical follow up of patients were listed from medical records. Results: Of patients, four were female. The mean age was 144.2 ± 42.7 months. None of the patients had a history of tuberculosis contact. The median complaint time was 20 days (5-180). The most frequent complaint was abdominal pain and the most frequent physical examination finding was abdominal tenderness. Mean white blood cell count was 9.26 x 103 ± 4.77 x 103 μ/L, C reactive protein level: 79.9 ± 54.9 mg/dL, erytrocyte sedimentation rate: 45 ± 30 mm/h. Tuberculin skin test was positive in two patients, interferon gamma releasing assay was positive in three patients, and in two patients, both tests were positive. There were findings suggesting tuberculosis on pulmonary imaging in five patients and abdominal imaging in all patients. Histopathological examination of the specimens of six patients revealed findings consistent with tuberculosis. The presence of M. tuberculosis was confirmed microbiologically in clinical specimens taken from three patients. The most common abdominal tuberculosis type was mesenteric lymphadenitis. The mean time from admission to diagnosis was 15 ± 12.8 days. All patients recieved antituberculosis treatment. Conclusion: Abdominal tuberculosis should be kept in mind, in patients presenting with abdominal complaints lasting more than five days. Ultrasonography and computed tomography are useful to determine abdominal tuberculosis type. The disease can be sucsessfully treated with standart antituberculosis treatment.

Abdominal Tüberküloz Tanılı Çocuk Hastaların Retrospektif Olarak Değerlendirilmesi: Tek Merkez Deneyimi

Objective: Abdominal tuberculosis is a kind of extrapulmonary tuberculosis that can usually occur during the lymphohematogenous spread of first Mycobacterium tuberculosis infection, develop by neighborhood from an abdominal focus or a mesenteric lymph node. The aim of this study is to evaluate pediatric cases diagnosed with abdominal tuberculosis. Material and Methods: Between 2012-2018, seven patients diagnosed with abdominal tuberculosis through patients who diagnosed with extrapulmonary tuberculosis in our hospital, were included in study. Demographic and clinical characteristics, diagnostic methods, commenced treatments and clinical follow up of patients were listed from medical records. Results: Of patients, four were female. The mean age was 144.2 ± 42.7 months. None of the patients had a history of tuberculosis contact. The median complaint time was 20 days (5-180). The most frequent complaint was abdominal pain and the most frequent physical examination finding was abdominal tenderness. Mean white blood cell count was 9.26 x 103 ± 4.77 x 103 μ/L, C reactive protein level: 79.9 ± 54.9 mg/dL, erytrocyte sedimentation rate: 45 ± 30 mm/h. Tuberculin skin test was positive in two patients, interferon gamma releasing assay was positive in three patients, and in two patients, both tests were positive. There were findings suggesting tuberculosis on pulmonary imaging in five patients and abdominal imaging in all patients. Histopathological examination of the specimens of six patients revealed findings consistent with tuberculosis. The presence of M. tuberculosis was confirmed microbiologically in clinical specimens taken from three patients. The most common abdominal tuberculosis type was mesenteric lymphadenitis. The mean time from admission to diagnosis was 15 ± 12.8 days. All patients recieved antituberculosis treatment. Conclusion: Abdominal tuberculosis should be kept in mind, in patients presenting with abdominal complaints lasting more than five days. Ultrasonography and computed tomography are useful to determine abdominal tuberculosis type. The disease can be sucsessfully treated with standart antituberculosis treatment.

A Three Year Retrospective Analysis Of Anti-Tnf Treatment Outcomes In Rheumatoid Arthritis And Ankylosing Spondylitis Patients

AbstractBackground/Aims:To investigate the effectiveness and reliability of anti-TNF treatment in Ankylosing Spondylitis-Rheumatoid arthritis patients.Methods:180 patients (110 Rheumatoid arthritis (RA) patients diagnosed according to 1987 American Rheumatism Association criteria, 70 Ankylosing Spondylitis (AS) patients diagnosed according to Modified NewYork Criteria) admitted to the hospital for arthritis and related compliants who were followed up and treated with anti-TNF treatment in the department of Rheumatology&Immunology from 2009 to 2011. We enrolled 100 patients with RA (76 women, 24 men) and 60 patients with AS (16 women, 44 men) to the study, excluded 20 patients according to the exclusion criterias. The response of the patients to the anti-TNF treatment was evaluated by comparing the clinical parameters BASDAI, DAS28 and VAS score; and laboratory measurements of erytrocyte sedimentation rate, C-reactive protein levels of rheumatoid arthritis and ankylosing spondylitis before and six months after the treatment.Results:After the six months of anti Tnf treatment, BASDAI score for AS, DAS28 score for RA, VAS, ESR and CRP levels for both diseases showed a statistically significant improvement, moreover it was determined that demographic variations did not affect these values.Conclusions: Our results demonstrated that anti-TNF treatment is safe and effective treatment modality in patients with Ankylosing Spondylitis and Rheumatoid arthritis. These findings are short-term results of a study, and therefore future studies with larger patient series and long term follow-up are needed to look at outcomes of long term therapies.

Hubungan Antara Kadar Laju Endap Darah (LED) Dengan Kadar C-Reaktiv Protein (CRP) Pada Penderita Tuberkulosis (TBC) Di Wilayah Kerja Puskesmas Alas Barat

Tuberculosis is a disease caused by rod-shaped bacteria (basil) with another name Mycrobacterium tuberculosis. Mycrobacterium tuberculosis enters the body then causes inflammation, inflammation and bacterial invasion which then induces liver cells to synthesize acute phase C-reactive protein protein (CRP). CRP will increase sharply after inflammation, as well as the formation of aggregates derived from the acute phase protein hormone which causes an increase in the Erythrocyte sedimentation rate (ESR)). The purpose of this study was to determine the relationship Erytrocyte sedimentation rate (ESR) and levels of C-Reactiv protein (CRP) in tuberculosis (TBC) patients. This research is an analytical descriptive study using cross sectional. Data collectors are done using the Non Random Accidental Sampling technique. The number of respondents in this study were 11 people with tuberculosis. Based on the results of this study it is known that TBC patients with smear negative as much as 7 people (63.6%) and TB patients with positive smear as much as 4 people (36.4%), both in TB patients with negative smear and positive smear both have levels of ESR not normal with an average ESR level in positive smear of 101.3 mm / hour and the average ESR level in smear negative is 20.8 mm / hour. All TBC patients with smear positive CRP levels (not normal) with an average mean value of CRP of 36 mg / L or an average CRP level in TBC smear negative patients of 0.9 mg / L. Based on the Pearson test results between levels of erythrocyte sedimentation rate (ESR) with C-Reactive protein (CRP) in tuberculosis (TBC) patients obtained a value of p <0.01 (0.000 <0.01). This shows a strong relationship between LED and CRP levels in TB patients

Correlation Between Serum C-Reactive Protein (CRP) and Soluble Cd40 Ligand (sCD40L) with Disease Activity by Modified Rodnan Skin Score (mRSS) in Systemic Sclerosis Patients in Indonesia

Introduction: Systemic Sclerosis (SSc) is a chronic autoimmune disease which presents immunological, endothelial dysfunction, skin and organs fibrosis. The inflammatory process is an important pathophysiology of systemic sclerosis. Disease activity assessment using clinical parameters of Modified Rodnan Skin Score (mRSS) changes and inflammatory laboratory parameters of C-Reactive Protein (CRP), Erytrocyte Sedimentation Rate (ESR) and soluble CD40 ligand. The European Scleroderma Study Group (EscSG) Activity Index uses CRP. CRP is higher sensitivity and specificity than ESR (80% and 91.2%). The study aims to evaluate the correlation between CRP and sCD40L with disease activity by mRSS.Methods: This research was a cross-sectional study, and data of mRSS and sCD40L were obtained from the study, "Blind Clinical Trials Extract Ciplukan Herbs on Clinical Improvement of Skin Disorders, Inflammatory Process, Immunology and Fibrosis in Scleroderma Patients”. CRP examination was done by using the rest samples of the study, conducted in December 2017. Data analysis with Rank-Spearman and Pearson Correlation..Result: There were fifty-eight subjects with mean age 38 ± 11 years old. Most of subjects were female (94.8%) and with a late disease duration > 2 years (74.1 %). Subjects consisted of 35 (60.3%) diffuse SSc and 23 (39.7 %) limited SSc. CRP was measured by Turbidimetric Immunoassay. Median (range) CRP serum was 2.89 (0.16–17.29) mg/L, while the median of sCD40L was 6457 (1018–17976) pg/mL, and the median of mRSS was 17 (4–36). There was no correlation between CRP and sCD40L with mRSS (r = -0.134, p = 0.167; and r = 0.023, p = 0.433).Conclusion: There was no correlation between CRP and sCD40L serum with mRSS in systemic sclerosis patients.

Metabolic Tumor Volume and Soluble Cytokines Levels in Newly Diagnosed Hodgkin Lymphoma: What It Brings into the Staging Precision?

Background: Frontline therapy of Hodgkin lymphoma (HL) is strictly stage-adapted. Staging systems used are based on historical variables which only indirectly reflects tumor load (Ann Arbor stage) or lymphoma cytokine activity (systemic symptoms, erytrocyte sedimentation rate). With new, abbreviated interim PET-tailored chemotherapy schemes (2+2) and reduced radiotherapy protocols, there is a clinical need for precise staging tools. Last years have brought new insight into the prognostic role of metabolic quantitative PET parameters and HL-associated biomarkers. Total metabolic tumor volume (TMTV) measured using fluoro-deoxyglucose PET (FDG-PET) was found to be a predictor of therapy failure after frontline treatment (Kanoun 2014). Interestingly, TMTV was found capable of identifying poor responders within one (intermediate) staging group (Akhtari, 2018; Cottereau 2018). Serum concentrations of thymus and activation-regulated chemokine (TARC) and other cytokines have been proved to have prognostic significance in the patients treated both in the frontline and relapse setting (Moskowitz, 2015; Guidetti 2017). A relationship between pretreatment TMTV, baseline cytokines levels, and current staging systems has not been analyzed yet.Aim: To analyzed quantitative metabolic PET parameters and selected soluble biomarkers in the context of the staging systems used in the U.S. and EuropeMethods: We have analyzed a prospectively enrolled cohort of forty-eight patients with HL who were diagnosed in two large university medical centers from 5/2015 to 2/2018. All pts have undergone pretreatment FDG-PET/CT with quantitative analysis of TMTV, Total Lesion Glycolysis (TLG), Maximum Standardized Uptake Volume (SUVmax.) and the Largest Tumor Diameter (LD) and were sampled for cytokine analysis within 16 (median) days from the PET/CT. We have analyzed a set of four serum biomarkers: CD30 (sCD30), CD163 (sCD163), TARC, and interleukin 6 (sIL6), which were measured using ELISA assays.Results: A cohort consisted of 22 males and 26 females with median age of 42 years (range 21-75). Histology subtype was known in all but one case: nodular sclerosis in 23, mixed cellularity 15, lymphocyte-rich in 5 and nodular-lymphocyte predominant (NLPHL) in four. Ann Arbor stages were as follows: I in 5, II in 20, III in 13 and IV in 10 of the pts with systemic symptoms in 20 (42%) of them. All pts were classified according to the German Hodgkin Study Group (GHSG) and NCCN staging systems. GHSG stages - limited, intermediate and advanced were seen in 8 (17%), 10 (21%) and 30 (62%) pts, respectively. NCCN stages were distributed into early favorable in 8 (17%), early unfavorable in 17 (35%) and advanced in 23 (48%) of the pts. Chemotherapy was applied in all but four pts using: BEACOPPesc, combined BEACOPP+ABVD, ABVD and ABV/COPP protocols in 7, 15, 16 and six pts respectively. Of four pts without chemo one case was treated with local radiotherapy and three with WaW (all of them with NLPHL). Treatment response was known in 41 (85%) of the cases with CR, PR, and PD in 33 (80.5%), 6 (14.6%) and two (4.9%) pts, respectively. Relationships between disease stages and PET-parameters are summarized in Table 1. Briefly, metabolic tumor burden (TMTV, TLG) identified two markedly different groups: low and intermediate/high risk. Similarly, cytokines levels were significantly lower in low-risk patients compared to those with intermediate-high risk (Table 2). Treatment outcome did not correlate either with GHSG nor NCCN stage. We found correlation of sIL-6 (p=0.03) but not sCD30 (p=0.09), sCD163 (p=0.14) and TARC (p=0.57) with CR achievement. In terms of PET-parameters the high TMTV>104 cm3 (P=0.046) and TLG>798 (P=0.003) were associated with not achieving of CR with NPV, PPV and test accuracy of 94.4, 22.0, 58.5 for TMTV and 100%, 36,4%, 66% for TLG, respectively.Conclusion: Adequate frontline treatment policy is vital for achieving an optimal balance between efficacy and toxicity. Current staging systems have a weak correlation with metabolic tumor burden: one-third of those recognized as advanced stage have the low burden, and vice versa about a half of intermediate-risk pts have high tumor burden. Combination of TMTV/TLG and cytokines can be currently used for decision making in borderline stage cases and probably could serve as a backbone for a new staging system in the future.Acknowledgment: IGA_LF_2018_004, MH CZ-DRO (FNOL, 00098892) [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Ozone Decreases Biomarkers of Inflamation (C-Reactive Protein and Erytrocyte Sedimentation Rate) and Improves Pain, Function and Quality of Life in Knee Osteoarthrtitis Patients: A Before-and-After Study and Review of the Literature

Objectives: The aim of this study was to evaluate if ozone is capable of decreasing biomarkers of inflammation (CRP/ESR) and pain, and to improve function and quality of life in knee osteoarthrtitis (OA) patients. Methods: A prospective quasi experimental (before-and-after study) research was performed to investigate the effect of Ozone therapy protocol. The intervention included 4 sessions (1 session/week) of an intra-articular infiltration of a medical mixture of Oxygen-Ozone (95% to 5%) at 20 ug/mL concentration. Biochemical evaluation (CRP and ESR), pain VAS, and WOMAC scales were evaluated before and after the treatment. Results: Overall, 33 patients were evaluated. Mean age was 68.18 ± 8.43 years. Female patients accounted for 75.7% (n = 25) and male patients corresponded to 24.3% (n = 8). Female: male ratio was 3:1. The most frequent radiological KL grade was 2o (n = 22, 66.7%), followed by 3o (n = 8, 24.2%), and 4o (n = 3, 9.1%). Biomarkers of inflammation decreased significantly. C-reactive protein (CRP) diminished from 0.33 ± 0.32 mg/dL to 0.25 ± 0.23 mg/dL (P = 0.0456). Erythrocyte sedimentation rate (ESR) decreased from 15.06 ± 12.09 mm/h to 11.81 ± 8.32 mm/h (P = 0.01). Before treatment, pain measured by VAS was 7.33 ± 1.31 points and decreased to 2.84 ± 1.76 (P < 0.0001). The WOMAC-pain subscale was 14.84 ± 2.77 points and diminished to 5.96 ± 3.53 (P < 0.0001), WOMAC stiffness subscale was 3.06 ± 1.95 points and ameliorated to 1.15 ± 1.3 (P < 0.0001), WOMAC-function subscale was 41.15 ± 12.58 points and decreased to 22.3 ± 11.64 (P < 0.0001). Conclusions: Ozone is capable of both decreasing pain and stiffness and improving function and quality of life in knee OA patients, yet decreases biomarkers of inflammation, such as CRP and ESR.

Diagnostic role of mean platelet volume and neutrophil to lymphocyte ratio in childhood brucellosis.

Background/AimsBrucellosis patients present various non-specific clinical symptoms, such as fever, fatigue, sweating, joint pain, arthritis, myalgia, and headache. Based on the nonspecifity of its clinical signs and symtoms, we decided to evaluate whether mean platelet volume (MPV) , neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) will contribute to the diagnosis.MethodsIn this retrospective study, we reviewed hospital-records of 60 children with a confirmed diagnosis of brucellosis in Kayseri between January 2013 and January 2016, and compared the hematological parameters; white blood cell (WBC) count, hemoglobin (Hb), neutrophil count, lymphocyte count, platelet count, MPV, NLR, and PLR with 55 healthy age and gender matched children. Also, the well known inf lammation markers; erytrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were compared between the patient and control group.ResultsWe found significant difference among the Hb, platelet count, MPV and NLR values between the patient and control group (p < 0.05). There was no difference between WBC, neutrophil count, lymphocyte count and PLR between the patient and control group (p > 0.05). When the patients were divided into groups as arthritis positive and arthritis negative and compared to the control group; we found that the NLR is more significant in between the arthritis positive and control group (p = 0.013). Also, we found significant difference among the ESR and CRP values between the patient and control group (p < 0.001).ConclusionsThe results of this study indicates that MPV and NLR values can be used as markers of inflammation in childhood brucellosis. Also, NLR is more valuable in children with brucella arthritis.

The Relationship Between Chronic Inflammation and Glucidic-Lipidic Profile Disorders in Kidney Transplant Recipients

Abstract Introduction: Chronic inflammation has a proven role in atherogenesis, lipid profile parameters being related to cytokine production. In kidney transplant recipients, interleukin 6 (IL-6) is significantly associated with graft-related outcomes and also alterations of cholesterol and triglyceride metabolism. The aim of this study was to investigate the relationship between chronic inflammation and glucidic-lipidic metabolism disorders in a group of patients with kidney transplantation as renal replacement therapy. Methods: A prospective observational study which enrolled thirtysix non-diabetic kidney transplant recipients was conducted in the Nephrology and Peritoneal Dialysis Department, County Clinic Hospital of Tirgu Mures. The study group was divided as following: recipients with serum IL-6 concentration higher than 3.8 pg/ml (group A) and IL-6 within the normal range (group B). Results: Allograft recipients with higher serum IL-6 had significant higher erytrocyte sedimentation rate(ESR, p=0.0067). Patients with over-the-range levels of IL-6 had significant higher levels of serum cholesterol and LDL-cholesterol respectively (p=0.0242 and p=0.0081). Serum Apo-B was also significant higher in Group A than Group B. Protein excretion was significant higher in patients from group A (p=0.0013). No statistical significant relationship could be proven between elevated levels of IL-6 and hbA1c, insulin and glycosuria disturbances in the two groups. Also, we found no statistical significant association between resistivity and pulsatility indices (both hilum and intragraft) or carotid intima media thickness. Conclusion: Serum interleukin 6 is related to lipid profile disorders and less to glucidic metabolism anomalies in non-diabetic kidney transplant recipients.

A Pediatric Primary Renal Lymphoma Case Presenting with Acute Renal Failure Findings

▪Lymphomatous involvement of the kidneys is a common manifestation of systemic non-Hodgkin’s lymphoma (NHL). In contrast, lymphoma originating within the kidneys is a rare event in children. In this study we report a case of primary renal lymphoma presenting with acute renal failure in a 14-years-old boy. According to histopathological and immunohistochemical examinations, the diagnosis of B-cell renal lymphoma was established.A fourteen years old boy presented to our Pediatric Hematology - Oncology Unit, with 4-month history of weakness and anorexia. He had mild abdominal pain. Physical examination revealed no significant abdominal or systemic. The laboratory data were white blood cell count 4100/mm3; hemoglobin level 10.8 g/dL, mean corpuscular volume 107 fL; mean corpuscular hemoglobin concentration 33.6 g/dL); platelet count 179,000/mm3;erytrocyte sedimentation rate 50mm/h; blood urea nitrogen level 142 mg/dL; creatinine level 4.85 mg/dL; lactate dehydrogenase level 465 IU/L. There were no pyuria or hematuria, and urinary culture and stain results were negative. An abdominal ultrasonography revealed an increase in bilateral kidney sizes. Abdomen computed tomography scan showed an increase in thickness of renal parenchyma with hypodense appearance and with bilateral mild ectasia in pelvicalyceal system.An ultrasonography guided renal biopsy demonstrated precursor B-cell lymphoblastic lymphoma. Hematoxylin and eosin section of these renal masses revealed neoplastic lymphoma cells with increased nuclear-cytoplasmic ratio, prominent nucleoli and mitotic figures.The lymphoma cells stained positivie for terminal deoxynucleotydyl transferase and B-lymphocyte marker CD10 and CD20 immuno-histochemical stain. Extrarenal abdominal involvement was excluded by imaging techniques. Bone marrow examination was normal. He was diagnosed as non-Hodgkin’s lymphoma, pre B-cell type and was treated with multidrug chemotherapy (induction regimen of prednisolone, vincristine, daunorubicin and L-asparaginase) and prophlactic intratecal methotrexate according to British-French-Munster (BFM) protocol. After the initial therapy, renal function test were improved rapidly and during consolidation and maintenance chemotherapy, they continud as normal. The patient is still in complete remission and was followed normal renal function with no sign of disease recurrence 5 years later diagnosis..In conclusion, diagnose of PRL is difficult. Percutaneous kidney biopsy is the most expeditious method towards the establishment of an early diagnosis for appropriate chemotheraph. Early diagnosis and urgent therapy, with supporting therapy are necessary for good prognosis. DisclosuresNo relevant conflicts of interest to declare.

SAT0164 How Many Patients Followed up with Rheumatoid Arthritis (RA) Diagnosis is Really Ra? 1987 ACR Classification Criteria Compared WİTh 2010 Acr/Eular Criteria for REAL RA PatİEnts in Turkey

BackgroundEarly diagnosis is very important for RA. The 2010 ACR/EULAR RA classification criteria has been mainly developed for this purpose. However, these new criteria may cause RA overdiagnosis.ObjectivesWe aimed to...

AB0589 Subclinical atherosclerosis found both in psoriatic arthritis and rheumatoid arthritis

BackgroundCardiovascular disease (CVD) is found in almost all chronic musculoskeletal diseases that include Psoriatic arthritis (PsA) and rheumatoid arthritis (RA).ObjectivesTo assess subclinical atherosclerosis in patients with PsA and RA.MethodsPatients with...

OP0167 Acute Myocardial Infarction is Driven by Chronic Systemic Inflammation, Irrespective of the Kind of Treatment - Data from the German Biologics Register Rabbit

BackgroundRheumatoid arthritis is associated with increased cardiovascular morbidity and mortality including acute myocardial infarction (AMI). Chronic systemic inflammation and accelerated atherosclerosis contribute to this risk. In daily practice, RA-patients with...

Gastroenterological Aspects of Primary Aorto-Enteric Fistulae (PAEF)

Background: Gastrointestinal haemorrhage associated with a primary aorto-enteric fistula (PAEF) is potentially lethal. The aims of this study were to discuss the gastrointestinal characteristics of PAEF, to identify associated laboratory findings and to discuss pitfalls in pre-operative diagnostics. Methods: Medical and surgical charts of patients with PAEF.Results: Individuals with PAEF (n = 7, 68 ± 5 years) presented with multiple episodes of haematemesis (n = 5) and/or melaena (n = 6), all in the presence of aneurysmatic aortas (5.4 ± 1.0 cm). Laboratory testing reflected a state of acute (C-reactive protein, CRP, 94 ± 12 mg/ml ; leucocyte counts, 12.0 ± 1.0.107L) and chronic inflammation (erytrocyte sedimentation rate, ESR 52 ± 5 mm/hr). Prior to operation, a gastroduodenoscopy correctly diagnosed only one PAEF patient and CT scans identified 3. Two patients exsanguinated in a two-week waiting period prior to corrective surgery. Conclusions: Recurrent gastrointestinal blood loss in the presence of an aneurysm requires urgent gastroduodenoscopic evaluation. Computer tomography is sensitive in providing direct or circumstantial evidence of a fistula. A combined acute and chronic inflammatory state associated with PAEF is reflected by elevations of CRP and ESR. A PAEF is a unique form of ruptured aneurysm, and this entity mandates imminent radiological and surgical consultation aimed at instituting aggressive treatment within hours.

Association of macroscopic gut inflammation with disease activity, functional status and quality of life in ankylosing spondylitis

The aim of this cross-sectional study was to evaluate the frequency of intestinal inflammation and its association with disease activity, functional status and quality of life in patients with ankylosing spondylitis (AS). A total of 25 patients with AS had undergone ileocolonoscopy and concomitant histological study. Clinical and demographical parameters, BASDAI, BASFI, and SF-36 scores were compared between patients with and without macroscopic gut inflammation (MGI). Colonoscopic study revealed MGI in 9 patients and macroscopically normal gut mucosa in 16 patients. On histological examination, of 25 patients 20 had gut inflammation, mostly in ileum. BASDAI score was higher (P < 0.05), SF-36 pain and physical scores, and chest expansion measurement were lower (P = 0.00, P = 0.01, P = 0.01), duration of morning stiffness was longer (P = 0.01) in patients with MGI. Serum C-reactive protein, erytrocyte sedimentation rate levels were similar between groups (P > 0.05). There is high prevalence of histological gut inflammation in AS patients. More active disease should suggest gut inflammation in AS patients.

Monitoring parameters in the management of patients with tubo-ovarian complexes

Objective: The aim of the study was to determine which of the monitored parameters is most suitable for following the treatment of tubo-ovarian complex (TOC). Methods: In 35 patients treated conservatively for TOC, serum levels of C-reactive protein (CRP), erytrocyte sedimentation rate (ESR) and tumor-associated antigen 125 (CA-125) were determined at the beginning as well as on days 5, 10, 15 and 20 of treatment. TOC size was measured ultrasonographically prior to and on day 20 of treatment. We compared the dynamics of these parameters. Spearman's correlation test was used to establish the connection between levels of CRP, ESR, CA-125 and the size of the TOC. Results: CRP follows the course of acute inflammation quickly, ESR and CA-125 with some delay. The correlation between the size of the tumor on admission and the CRP levels was established on days 5–10, ESR from the beginning until day 15 and the CA-125 levels on days 10–20 of treatment. On day 20, only the levels of CA-125 correlated with the size of the TOC measured on the same day (R=0.49, P=0.01) and only the difference between its levels correlated with the difference in TOC (R=0.41, P=0.01). Conclusion: Determination of CRP, and somewhat less ESR, is more suitable for following the treatment of TOC in the acute phase while CA-125 and measuring of TOC size is more suitable in the subacute phase.

Special extract of BOSWELLIA serrata (H 15) in the treatment of rheumatoid arthritis

H15, a special extract of the gum resin of Boswellia serrata (BS) is effective in the treatment of rheumatoid arthritis (RA). These findings were obtained in more than 260 patients by using a range of different clinical approaches for evaluation. The criteria for assessment were mainly joint swelling, pain, erytrocyte sedimentation rate (ESR), stiffness, additional use of NSAID, side effects and tolerance. The therapeutic action was mainly proven by comparing H15 with a placebo standard therapy. H15 is:

Effects of Strength Training on Neuromuscular Function and Disease Activity in Patients with Recent-onset Inflammatory Arthritis

Thirty-nine consecutive patients with recent-onset rheumatoid or psoriatic arthritis were randomly allotted for six months period either to the experimental progressive dynamic strength training group (EG, 10 women and 11 men; 41 +/- 10 yrs), or to the control group (CG, 10 women and 8 men; 45 +/- 11 yrs) who just maintained their habitual physical activities. All patients received antirheumatic medication throughout the experimental period. During the study period significant improvements took place in the EG in maximal muscle strength of all examined muscle groups (31.5% for the knee extensors, p < 0.001; 14.8% and 10.7% for the trunk flexors and extensors, p < 0.01; 27.8% and 20.4% for grip strength, p < 0.001) as well as in erytrocyte sedimentation rate (p < 0.05). Ritchie's articular index (RI) (p < 0.001) and HAQ (p < 0.01). In the CG only the decrease in RI was statistically significant (p < 0.05). Erosive changes in joints increased only slightly and less in the EG than in the CG. The present results suggest that dynamic strength training in early arthritis increases the neuromuscular performance without detrimental effects on disease activity or joint damage.