High frequency ultrasonography of the hand versus anti-RA33 evaluation in early rheumatoid arthritis - a pilot study

Abstract

Aim: Accurate diagnosis and early treatment in rheumatoid arthritis (RA) can lead to a good outcome and a correct management of the disease. We aimed toinvestigate the prognostic value of anti-RA33 antibodies, by evaluating the relationship with ultrasonographic (US) findings in patients with early RA.Material and methods: We performed a prospective study which included 29 patients, diagnosed with early RA according to the ACR/EULAR 2010 criteria and 21 sex and age-matched control subjects. All patients underwent clinical and biological assessment, followed by US examination in grayscale (GS) and power Doppler (PD) at baseline and after 12 months [from the second to the fifth metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints and wrists (RCC), in dorsal aspect]. The second and fifth MCP joints were scanned also in lateral aspects.Results: The initial GS evaluation revealed the presence of synovitis in all 29 patients; PD found at least one joint with a PD grade higher than 1 in 23 patients, higher than 2 in 20 patients, and grade 3 in 6 patients; at 12 months, we revealed the presence of GSUS synovitis in 25 patients and PDUS examination found active synovitis in 12 subjects. In those patients, the anti-RA33 titre was significantly lower compared to those without PDUS active synovitis (p=0.031), with a moderately negative correlation (r=-0.519, p=0.0039).Conclusions: The current study shows that anti-RA33 antibodies might constitute an additional tool for diagnosing early RA patients and can help identify patients with mild disease and a low level of activesynovitis.

The Role of Colistin in Urinary Tract Infections in the Neurologic Patient

“…Of 16 Px with multidrug-resistant uropathogens to colistin, the treatment with colistin was indicated only for 12 Px (75%), in all cases it was established depending on the antibiotic results (6 strains were sensitive to colistin bacteriological healing was proven in all cases treated with colistin, a similar aspect to other studies [7,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Colistin resistance of multidrug-resistant bacteria is associated with the increase of mortality [4]; in the paper presented, Px evolution was favourable, which was possibly due to the preserved colistin sensitivity of uropathogens.…”

Diagnostic Challenges and Management Update in Rheumatoid Arthritis

“…US was recently included by EULAR recommendations on the use of imaging, between the techniques with a potential role in RA diagnosis and management [90,91]. The reflection of ultrasound waves by body structures generates US images of those structures in the greyscale (GS) [92].…”

The Relationship between the Acute Confusing State and the Comorbidities of the Elderly Patient

“…Also risk factors for the onset of delirium are considered the metabolic disorders including hypo and hyperglycemia, but more studies are needed in order to support this hypothesis [29][30][31][32][33].…”