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Juvenile idiopathic arthritis (JIA) is the most common rheumatologic disorder of childhood. It is a group of diseases characterized by chronic synovitis and associated with many extra-articular manifestations including cardiac and pulmonary involvement. Cardiac involvement as pericarditis, myocarditis and valvular disease is common in JIA. There are, however, few descriptions concerning systolic and diastolic functions of the left ventricle (LV) and the development of lung disease in children with JIA. The study was carried out to detect the cardiac and pulmonary involvement and to study the systolic and diastolic function of the left ventricle in a group of children with juvenile idiopathic arthritis. Forty-five children with JIA without any cardiac or pulmonary symptoms and 30 age- and sex-matched controls were included in the study. M-mode, two-dimensional and pulsed Doppler echocardiography (ECHO) was performed on 36 patients. Tissue Doppler ECHO examination was performed on 24 patients to assess systolic and diastolic functions of left ventricle. Pulmonary function tests: Forced vital capacity (FVC%), the predicted forced expiratory volume in the first second (FEV(1)%) and FEV(1)/FVC ratio and peak expiratory flow (PEF), total lung capacity (TLC) and residual volume (RV), carbon monoxide diffusing capacity of the lung (DLCO) and DLCO/alveolar volume (VA) were evaluated in 32 patients. Informed consent was obtained from all children's parents. The study protocol was approved by ethical committee of Faculty of Medicine, Assiut University. In this study, children with JIA had higher systolic and diastolic blood pressures, resting heart rate, left ventricle systolic size and volume (4.35 ± 0.68 vs. 3.92 ± 0.28, P value = 0.02). On Doppler and tissue Doppler analysis, the JIA group had lower peak early filling velocity (E, m/s), higher peak atrial filling velocity (A, m/s) and prolonged diastolic E and A waves deceleration times and isovolumic relaxation time (IRT) compared to control. Regarding pulmonary function tests, children with JIA showed significant decrease in FVC, PEF, Pimax, Pemax and DLCO compared to normal controls. This decrease was not related to age, height or weight of these patients. There was significant inverse correlation between lung function parameters and the rheumatoid factor titer, erythrosedimentation rate, disease duration and the duration of methotrexate use (P < 0.01). Despite of an asymptomatic cardiopulmonary status, significant systolic and diastolic functional abnormalities exist in children with JIA. Also, both restrictive and obstructive lung impairments were found.

Our data demonstrated that adiponectin and visfatin are related to disease activity in RA patients and might be involved in the progression of RA. The English full-text version of this article is available at SpringerLink (under "Supplemental").

rLMS at 15 Hz may improve urinary dysfunction secondary to lumbosacral nerve injury. Further trials can determine the profile of patients who may benefit and optimal stimulation parameters.

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Background and objective: Patellofemoral joint osteoarthritis (PFJOA) is an under recognized category of arthritis, evident in almost 70% of adults with knee pain. Objective was to evaluate the effect of patellofemoral joint targeted education, and exercise guidelines on outcomes of patients with patellofemoral osteoarthritis.Methods: A quasi experimental (pre/post) design was used. Setting: The study was conducted in the physiotherapy department of a large University Hospital in Egypt. Sample: A randomized 30 adult patients with symptomatic and diagnosed PFJOA. Researchers and Physiotherapists delivered the PFJ-targeted education, and exercise program in 3 sessions over 9 month period.Results: The PFJ-targeted education, and exercise guidelines resulted in a highly statistically significant difference in the Knee Injury and Osteoarthritis Outcome Score (KOOS) pre/posttest in the whole five domains of the questionnaire; Pain (nine items); Symptoms (seven items); ADL Function (17 items); Sport and Recreation Function (five items); and Quality of Life (four items) p < .001**.Conclusions: PFJ-targeted education, and exercise guidelines were more effective in reducing pain, improving physical function, and activities of daily living. Recommendation: Replication of the study using a larger probability sample from different geographical areas to help for generalization of the results.