Objective. Low-level laser therapy (LLLT) and extracorporeal shock wave therapy (ESWT) is applied in the conservative treatment of inflammatory plantar fasciitis, which is also a characteristic feature of spondyloarthritis (SpA) (Gill, 1997 and Roxas, 2005). We determined and compared the effectiveness of LLLT and ESWT using magnetic resonance imaging (MRI). Methods. This study is a prospective, randomized, comparative, single-blind clinical study. Voluntarily followed 40 patients with the diagnosis of SpA and having pain at the heels at least for 6 months. Patients were divided randomly into two treatment groups. One group undertook 14 sessions of infrared Ga-Al-As LLLT, and the other group undertook 3 sessions ESWT. Feet functions of the patients were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) and Roles and Maudsley Scoring; VAS was evaluated for foot pain and function. In clinical assessment, disease activity was carried out by applying the BASDAI, the functional assessment was evaluated through the BASFI, and the patient quality of life was evaluated through the ASQoL; enthesitis was scored according to MASES assessment, performed before and at 1 month after treatment. The thickness of the plantar fascia was measured with MRI before and 1 month after treatment. Results. Compared with the pretherapy, progress in the feet function by AOFAS and Roles-Maudsley scoring and decrease in VAS levels were statistically significant in both groups (p<0.001). Only the VAS exercise score was superior to LLLT (p<0.05). The thickness of the plantar fascia had decreased significantly on MRI in all two groups. Conclusion. The treatment of plantar fasciitis with LLLT and ESWT was more successful in pain improvement and functional outcomes with the dose, frequency, and duration used in our study.
Aim Cardiovascular morbidity is increased in patients with psoriatic
arthritis (PsA) compared to the general population. Several recent studies have
indicated that pentraxin 3 (PTX-3) and cell adhesion molecules (CAMs) might be
independent biomarkers of subclinical atherosclerosis. In this study, we aimed
to determine the relationship of CAMs and PTX-3 with carotid intima media
thickness (CIMT) in patients with PsA and to compare CIMT and serum levels of
these biomarkers in patients with healthy controls (HCs).
Method PsA patients fulfilling the CASPAR (Classification criteria for
Psoriatic Arthritis) criteria without traditional cardiovascular (CV)
comorbidity and HCs without autoimmune and/or CV disease were included
in this cross-sectional study. Carotid artery Doppler ultrasound examinations
were conducted by a single radiologist blinded to the participants’
clinical characteristics. Serum vascular adhesion molecule 1 (VCAM-1),
intercellular adhesion molecule 1 (ICAM-1), E-selectin, and PTX-3 concentrations
were analized.
Results 43 PsA patients (27 females, mean age 42.49±11.70 years,
and a mean disease duration of 9.37±7.96 years) and 37 HCs (28 females,
mean age 42.16±11.38 years) were included. In regression analyses, age
and PTX-3 were found to be the best predictors of CIMT in patients with PsA.
CIMT was significantly higher in PsA patients compared with HCs
(0.63±0.18 vs. 0.49±0.10 mm, p<0.01). In te PsA
group, serum levels of PTX-3, ICAM-1, and VCAM-1 were also significantly higher
than HCs. CIMT correlated positively with age, disease duration, PTX-3, ICAM-1,
and VCAM-1 (p<0.05).
Conclusion In our study, age and serum level of PTX-3 were found to be the
predictors of CIMT in patients with PsA without CV comorbidity. This outcome
highlights the importance of monitoring CIMT and serum level of PTX-3 as CV risk
factors in PsA patients.
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