RIT had the advantage in clinical and functional improvement in fibromyalgia patients, while rTMS had better results regarding depression and the cortical component of AEPs. These results might draw attention to the evaluability of a combination of both techniques for a better therapeutic response.
Objectives: To compare the effect of pulsed electromagnetic field (PEMF) extracorporeal shock wave therapy (ESWT) on healing of delayed as well as non-united tibial fractures.
Methods:This study was carried out on 60 adult patients suffering from delayed or non-union tibial fractures in spite of previous conservative treatment by (closed reduction and casting), or operative treatment by: ORIF by (IMN, plate and screws or gliding nail), or external fixation. They were divided according to line of treatment into 2 equal groups. The first group received (PEMF) therapy at the site of fracture of 12 Hz, 3 mT for 60 minutes per session, for 3 months, the patient of the second group were treated by focused (ESWT) at the site of fracture 3 sessions of 2500-3000 impulses each given at 0.25-0.84 mJ/mm 2 , at interval of 48-72 h between sessions, a maximum of 3 cycles of treatment was given at 3 months intervals. Clinical and radiological assessments were done before, after and then 6 months later as follow up. However functional assessment was done after treatment and 6 months later as follow up.
Results:Our results showed better and earlier improvement of clinical, radiological as well as functional scores in group II more than group I.
Conclusion:The best significant as well as more rapid clinical, radiological and functional improvement in cases of delayed or non-united tibial fractures was obtained with ESWT compared to PEMF therapy.
Objective: The main objective of this study is to analyze and evaluate the association of IL6-174 G/C gene polymorphisms with response to interleukin-6 blockade in Egyptian patients with systemic juvenile idiopathic arthritis, and to assess the effect of other factors on treatment response as well as long-term efficacy of treatment with Tocilizumab. Methods: Sixty systemic JIA patients (37 males and 23 females with median age at onset 5.2 years) who received IL-6 blockade (Tocilizumab) were recruited. The overall response to treatment with IL-6 blockade was assessed according to: 1) Clinical response, 2) switch (or no switch) to another biological DMARD therapy following IL-6 blockade, 3) achievement of clinically inactive disease within 6 months of IL-6 blockade, 4) improvement in disease activity measured using the modified JADAS-10, and 5) achievement of a glucocorticoid-free state. In addition, basic demographic, laboratory data, characteristics of the disease course and IL6 polymorphisms were assessed.Results: Three IL6 -174 genotypes, including, GG, GC, and CC were found with higher frequencies of GC genotype. These genotypes had non-significant association with the response of sJIA patients to IL-6 blockade in this cohort study. Moreover, a longer time frame from disease onset to diagnosis was associated with poorer long-term treatment response. Conclusion. No significant impact of IL6 -174 G/C gene polymorphisms on treatment response to IL6 blockade therapy in sJIA Egyptian patients, providing evidence of a “window of opportunity” for improved long-term treatment response with shorter time from the disease onset to diagnosis.
Objective: The main objective of this study was to evaluate the association of IL6-174 G/C gene polymorphisms and the response to tocilizumab (TCZ) in patients with systemic juvenile idiopathic arthritis (s-JIA).
Methods: Sixty patients with s-JIA (37 males and 23 females with median age at onset of 5.2 years) who received TCZ were recruited. Basic demographic, laboratory and clinical data were collected alongside the IL-6 haplotype status. The overall response to treatment with TCZ was assessed according to a number of variables including the extent of disease activity reduction, the achievement of clinically inactive disease, the necessity to switch to another biologic disease modifying anti-rheumatic drug (bDMARD) and the achievement of a glucocorticoid-free state.
Results: Three IL6 -174 genotypes, including, GG, GC, and CC were found with higher frequencies of GC genotype. These genotypes had non-significant association with the response of s-JIA patients to IL-6 blockade in this cohort study. However, a longer time frame from disease onset to diagnosis was associated with poorer long-term treatment response.
Conclusion: We observed no significant impact of IL6 -174 G/C gene polymorphisms on treatment response to TCZ in s-JIA Egyptian patients. The observation that a shorted timeframe between symptom onset and diagnosis is associated with better long-term response to TCZ provides evidence for a therapeutic “window of opportunity” in patients with s-JIA.
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