RESUMO
The enzymes of the family peptidylarginine deiminases (PADs) have an important role in the pathogenesis of rheumatoid arthritis (RA) due to their association with the anti-citrullinated protein antibodies (ACPA) production. To evaluate the association between single-nucleotide polymorphisms (SNPs) in the PADI2 gene and RA susceptibility, related clinical parameters, and the serologic status of autoantibodies in a women population with RA from southern Mexico, a case-control study was conducted (case n=229; control n=333). Sociodemographic characteristics were evaluated, along with clinical parameters, inflammation markers, the levels of ACPAs as anti-cyclic citrullinated peptides (anti-CCPs), anti-modified citrullinated vimentin (anti-MCV), and rheumatoid factor (RF). Genomic DNA was extracted from peripheral blood, and three SNPs of the PADI2 gene (rs1005753, rs2057094, and rs2235926) were performed by qPCR using TaqMan probes. The data analysis reveals that the carriers of the T allele for rs2057094 and rs2235926 presented an earlier onset of the disease (ß= -3.26; p = 0.03 and ß = -4.13; p = 0.015, respectively) while the carriers of the T allele for rs1005753 presented higher levels of anti-CCPs (ß= 68.3; p = 0.015). Additionally, the T allele of rs2235926 was associated with a positive RF (OR = 2.90; p = 0.04), anti-MCV (OR = 2.92; p = 0.05), and with the serologic status anti-CCP+/anti-MCV+ (OR = 3.02; p = 0.03), and anti-CCP+/anti-MCV+/RF+ (OR = 3.79; p = 0.004). The haplotypes GTT (OR =1.52; p = 0.027) and TTT (OR = 1.32; p = 0.025) were associated with the presence of RA. In addition, in this study the haplotype TTT is linked to the presence of radiographic joint damage defined by a Sharp-van der Heijde score (SHS) ≥2 (OR = 1.97; p = 0.0021) and SHS ≥3 (OR = 1.94; p = 0.011). The haplotype TTT of SNPs rs1005753, rs2057094, and rs2235926 of the PADI2 gene confers genetic susceptibility to RA and radiographic joint damage in women from southern Mexico. The evidence reveals that SNPs of the PADI2 gene favors the presence of a positive serologic status in multiple autoantibodies and the clinical manifestations of RA at an early onset age.
Assuntos
Artrite Reumatoide/epidemiologia , Artrite Reumatoide/etiologia , Autoanticorpos/imunologia , Predisposição Genética para Doença , Articulações/imunologia , Articulações/patologia , Polimorfismo de Nucleotídeo Único , Proteína-Arginina Desiminase do Tipo 2/genética , Adulto , Idoso , Artrite Reumatoide/diagnóstico , Autoanticorpos/sangue , Biomarcadores , Estudos de Casos e Controles , Feminino , Frequência do Gene , Estudos de Associação Genética , Haplótipos , Humanos , Articulações/diagnóstico por imagem , Desequilíbrio de Ligação , México/epidemiologia , Pessoa de Meia-Idade , Fenótipo , Vigilância da População , Índice de Gravidade de Doença , Fatores Sexuais , Avaliação de Sintomas , Adulto JovemRESUMO
OBJECTIVES: The primary objective was to determine the impact of sharing musculoskeletal ultrasound (MUS) results with rheumatologists on worsening patient-reported outcomes (PROs) at 6 months of follow-up in rheumatoid arthritis (RA) patients with clinical remission. Secondary objectives were to describe MUS findings and to compare the proportion of patients with flares, according to the DAS28-ESR, following the intervention. METHODS: Ninety-four consecutive outpatients with clinical remission had PROs and a treatment proposal recorded at study entry. MUS was then performed by trained specialists who were blinded to clinical assessments. Forty-seven patients were randomised (1:1) to either the intervention group (MUS data shared with the primary rheumatologist) or the control group (data not shared); changes in the treatment proposal were recorded. PROs worsening and the proportion of patients with ares were compared between both groups at 6±2 months of follow-up. The study received IRB approval. Appropriate statistics were used. RESULTS: At baseline, patients from the intervention and control groups had similar characteristics; 43 and 41 patients, respectively, completed the 6-month follow-up period. PROs worsening at 6 months of follow-up were similar between groups, as were the DAS28-ESR and the proportion of patients who flared. In general, MUS findings were in accordance with the clinical remission status, although power Doppler synovitis was detected in up to 37% of the patients. RA-related treatment was increased in all the patients from the intervention group with discordant findings between clinical and MUS assessments. CONCLUSIONS: The addition of MUS to clinical evaluation of RA outpatients in remission did not prevent worsening PROs at 6 months.
Assuntos
Antirreumáticos , Artrite Reumatoide , Sinovite , Ultrassonografia/métodos , Antirreumáticos/uso terapêutico , Artrite Reumatoide/diagnóstico por imagem , Artrite Reumatoide/tratamento farmacológico , Humanos , Articulações/diagnóstico por imagem , Doenças Musculoesqueléticas/diagnóstico por imagem , Medidas de Resultados Relatados pelo Paciente , Indução de Remissão , Índice de Gravidade de Doença , Sinovite/diagnóstico por imagem , Sinovite/tratamento farmacológicoRESUMO
OBJECTIVES: The aims of the present study were to monitor, by radiographic examination, the skeletal development of the pelvis and the femorotibial joints of the domestic cat from the first week of life until the closing of the growth plates. METHODS: Radiographic examinations were collected from 15 domestic cats at weekly intervals during the first month and every 2 weeks from the second to the fourth month of age. After that, examinations were performed monthly until the age of 18 months. RESULTS: The ischiopubic growth plate closed at 2 months of age, followed by the fusion of the iliopubic, ilioischial, proximal femoral, greater trochanter and proximal fibular growth plates. The distal femur and proximal tibial growth plates were the last to close, with fusion occurring at 18 months. The mean time to closure of the iliopubic, ilioischial and distal femoral growth plates was shorter in females. The ossification centers first appeared, in ascending order, beginning with the lesser trochanter, followed by the greater trochanter, proximal fibular epiphysis, tibial tuberosity, patella, ischial tuberosity and lateral sesamoid of the popliteus muscle. CONCLUSIONS AND RELEVANCE: The complete closure of the growth plates of domestic cats occurs at approximately 18 months of age. Skeletal maturation at approximately 18 months of age is an important parameter to be considered in radiographic evaluation of certain skeletal changes, evolution of fractures and nutritional imbalance.
Assuntos
Gatos/crescimento & desenvolvimento , Fíbula/crescimento & desenvolvimento , Articulação do Quadril/crescimento & desenvolvimento , Articulações/crescimento & desenvolvimento , Pelve/crescimento & desenvolvimento , Radiografia/veterinária , Tíbia/crescimento & desenvolvimento , Animais , Feminino , Fíbula/diagnóstico por imagem , Articulação do Quadril/diagnóstico por imagem , Articulações/diagnóstico por imagem , Masculino , Pelve/diagnóstico por imagem , Tíbia/diagnóstico por imagemRESUMO
The elbow is a complex joint and has great clinical relevance in small animal medicine. Previous research in this area has been performed using radiographic and tomographic methods; however, there are limited studies on ultrasonography. The aims of this study was suggesting an evaluation protocol for elbow scan and describe the ultrasonographic anatomy of the elbow joint in dogs. Ten cross-breed dogs weighing 5-15kg underwent radiography and were selected for this ultrasonographic study. The protocol was established for the ultrasonographic description dividing the articular areas in the proximal, middle, and distal, lateral, cranial, medial, and caudal faces. The approach was performed in the longitudinal, transverse and oblique planes and the musculoskeletal structures were described according to the architecture, echogenicity and echotexture. Computed tomography and magnetic resonance imaging scans were obtained for one animal for comparison. Ultrasonography was effective in visualizing and analyzing muscles, tendons and ligaments. Bone contours and regions that have clinical significance such as the medial coronoid process and anconeus process were identified, but with limited access. Prior knowledge of the normal sonographic anatomy of the elbow joint, as well as its technical advantages and limitations will allow further studies related to the identification of musculoskeletal disorders.(AU)
O cotovelo é uma articulação complexa e tem grande relevância clínica na medicina veterinária de pequenos animais. Pesquisas prévias nesta área foram realizadas utilizando radiografias e tomografia computadorizada, entretanto há limitados estudos com ultrassonografia. O objetivo desse estudo é sugerir um protocolo de avaliação da articulação do cotovelo e descrever sua anatomia ultrassonográfica. Dez cães sem raça definida, pesando 5-15kg foram submetidos à radiografias e foram selecionados para o estudo ultrassonográfico. O protocolo foi estabelecido para a descrição anatômica ultrassonográfica dividindo as articulações em proximal, média e distal, faces lateral, cranial, medial e caudal. A abordagem foi realizada nos planos longitudinal, transverso e oblíquo e as estruturas foram descritas de acordo com a arquitetura, ecogenicidade e ecotextura. Tomografia computadorizada e ressonância magnética foram realizadas em um animal para comparação. A ultrassonografia foi efetiva na visualização e análise de músculos, tendões e ligamentos. Os contornos ósseos e regiões com significado clínico como o processo coronóide medial e o processo ancôneo foram identificados, mas com acesso limitado. Conhecimento prévio da anatomia ultrassonográfica normal da arquitetura do cotovelo, bem como suas vantagens e limitações, irão permitir estudos adicionais relacionados à identificação de desordens musculoesqueléticas.(AU)
Assuntos
Animais , Cães , Ultrassonografia/veterinária , Cães/anormalidades , Articulações/anormalidades , Articulações/diagnóstico por imagemRESUMO
The elbow is a complex joint and has great clinical relevance in small animal medicine. Previous research in this area has been performed using radiographic and tomographic methods; however, there are limited studies on ultrasonography. The aims of this study was suggesting an evaluation protocol for elbow scan and describe the ultrasonographic anatomy of the elbow joint in dogs. Ten cross-breed dogs weighing 5-15kg underwent radiography and were selected for this ultrasonographic study. The protocol was established for the ultrasonographic description dividing the articular areas in the proximal, middle, and distal, lateral, cranial, medial, and caudal faces. The approach was performed in the longitudinal, transverse and oblique planes and the musculoskeletal structures were described according to the architecture, echogenicity and echotexture. Computed tomography and magnetic resonance imaging scans were obtained for one animal for comparison. Ultrasonography was effective in visualizing and analyzing muscles, tendons and ligaments. Bone contours and regions that have clinical significance such as the medial coronoid process and anconeus process were identified, but with limited access. Prior knowledge of the normal sonographic anatomy of the elbow joint, as well as its technical advantages and limitations will allow further studies related to the identification of musculoskeletal disorders.(AU)
O cotovelo é uma articulação complexa e tem grande relevância clínica na medicina veterinária de pequenos animais. Pesquisas prévias nesta área foram realizadas utilizando radiografias e tomografia computadorizada, entretanto há limitados estudos com ultrassonografia. O objetivo desse estudo é sugerir um protocolo de avaliação da articulação do cotovelo e descrever sua anatomia ultrassonográfica. Dez cães sem raça definida, pesando 5-15kg foram submetidos à radiografias e foram selecionados para o estudo ultrassonográfico. O protocolo foi estabelecido para a descrição anatômica ultrassonográfica dividindo as articulações em proximal, média e distal, faces lateral, cranial, medial e caudal. A abordagem foi realizada nos planos longitudinal, transverso e oblíquo e as estruturas foram descritas de acordo com a arquitetura, ecogenicidade e ecotextura. Tomografia computadorizada e ressonância magnética foram realizadas em um animal para comparação. A ultrassonografia foi efetiva na visualização e análise de músculos, tendões e ligamentos. Os contornos ósseos e regiões com significado clínico como o processo coronóide medial e o processo ancôneo foram identificados, mas com acesso limitado. Conhecimento prévio da anatomia ultrassonográfica normal da arquitetura do cotovelo, bem como suas vantagens e limitações, irão permitir estudos adicionais relacionados à identificação de desordens musculoesqueléticas.(AU)
Assuntos
Animais , Cães , Ultrassonografia/veterinária , Cães/anormalidades , Articulações/anormalidades , Articulações/diagnóstico por imagemRESUMO
OBJECTIVE: To analyse a set of morphological features from digital radiographs (RX) and bone mineral density (BMD) values estimated from quantitative computerized tomography scans (QCT scans) of the knee joint of an osteoporotic rabbits, and to determine the relationship and correlation of these variables to be considered as an alternative diagnosis method. METHODS: The knee joint of rabbits (N = 9 ovariectomized and injected with of methylprednisolone sodium succinate (OVX + MPSS) and 3 sham operated healthy controls) were subjected to radiographic examination before the beginning of the study and after 6 weeks; after sacrifice, they were immediately scanned with a 64-channel CT. A set of morphological features was extracted from RX images and then subjected to Principal Component Analysis (PCA); BMD-values were calculated at different depths from the articular surface of the femur and the tibia. The selected morphological variables and the BMD values were correlated in order to determine useful information in medical diagnostics. RESULTS: Ten morphological variables explained 80.39% of the total variability, but only some of them demonstrated significant differences between baseline and OVX + SSMP states and between OVX + SSMP and control. Spearman analysis showed higher positive and negative correlation of these parameters among them (r = 0.67, 0.81, 0.83 and 1); and a moderate correlation with the BMD values (r = 0.50, 0.52, 0.52 and 0.55) during the progression of osteoporosis (OP). CONCLUSION: The Spearman's rank test supported the overall significant correlation between both, the morphological features and BMD values, making them as a reliable alternative option to the diagnosis of osteoporosis.
Assuntos
Densidade Óssea , Osteoporose/diagnóstico por imagem , Malha Trabecular/diagnóstico por imagem , Animais , Medula Óssea/diagnóstico por imagem , Feminino , Fêmur/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador , Articulações/diagnóstico por imagem , Ovariectomia , Imagens de Fantasmas , Análise de Componente Principal , Coelhos , Tíbia/diagnóstico por imagem , Tomografia Computadorizada por Raios XAssuntos
Hemartrose/diagnóstico , Hemofilia A/diagnóstico , Hemofilia B/diagnóstico , Articulações/diagnóstico por imagem , Dor/diagnóstico , Ultrassonografia/métodos , Doença Aguda , Adolescente , Adulto , Hemartrose/epidemiologia , Hemofilia A/epidemiologia , Hemofilia B/epidemiologia , Humanos , Dor/epidemiologia , Percepção , Estudos Retrospectivos , Índice de Gravidade de Doença , Adulto JovemRESUMO
OBJECTIVE: To assess potential associations among serum cytokines and microRNA (miR) levels with ultrasound (US) findings suggestive of urate deposits in chronic asymptomatic hyperuricemia and gout. METHODS: All participants underwent musculoskeletal US and measurements of serum interleukin-1ß (IL-1ß), IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, IL-13, interferon-γ, tumor necrosis factor, monocyte chemoattractant protein 1, and epithelial neutrophil-activating peptide 78, as well as miR-146a, miR-155, and miR-223 levels. RESULTS: Thirty individuals with asymptomatic hyperuricemia, 31 normouricemic controls, and 30 patients with gout were included. The frequency of synovitis and double contour sign using US was similar between asymptomatic hyperuricemia (67% and 27%, respectively) and patients with gout (77% and 27%, respectively), and each had a higher frequency than controls (45% and 0%, respectively). Serum IL-6 and IL-8 levels were similar between patients with asymptomatic hyperuricemia (mean ± SD 69.7 ± 73.4 and 18.5 ± 25.6 pg/ml, respectively) and gout (mean ± SD 75.8 ± 47.6 and 24.4 ± 31.7 pg/ml, respectively), and higher than controls (mean ± SD 28.2 ± 17.6 and 7.4 ± 6.0 pg/ml, respectively). A similar distribution was observed for miR-155 levels in asymptomatic hyperuricemia, patients with gout, and controls (mean ± SD 0.22 ± 0.18, 0.20 ± 0.14, and 0.08 ± 0.04, respectively). Associations between morphostructural abnormalities suggestive of urate deposits (regardless of clinical diagnosis) and serum markers were assessed. Subjects with urate deposits had higher IL-6 (257.2 versus 47.0 pg/ml; P = 0.005), IL-8 (73.2 versus 12.0 pg/ml; P = 0.026), and miR-155 (0.21 versus 0.16; P = 0.015) levels than those without deposition findings. CONCLUSION: In individuals with chronic asymptomatic hyperuricemia, the presence of synovitis and double contour sign by US may represent a subclinical manifestation of monosodium urate crystal nucleation, capable of triggering inflammatory pathways (IL-6 and IL-8) and mechanisms of intercellular communication (miR-155), similar to what is observed in patients with gout.