Integrating point-of-care ultrasound into rheumatology practice.

A scenario‑based probability approach integrating point‑of‑care rheumatology ultrasound (POCRUS) into rheumatology practice has recently been proposed as a teaching methodology to encourage greater awareness of US among practicing clinicians, especially with respect to the management of overlapping clinical conditions. This article reviews the rheumatological areas where application of POCRUS substantially enhances clinical reasoning to confirm or exclude target conditions. It highlights the definitions of US‑detected pathologies in rheumatoid arthritis, spondylarthritis, gout and crystal arthritis, osteoarthritis, and polymyalgia rheumatica, and discusses the added value of POCRUS in diagnosing these conditions.

Vitamin D deficiency: concern for rheumatoid arthritis and COVID-19?

Vitamin D is an immunomodulatory hormone with an established role in calcium and phosphate metabolism and skeletal mineralization. Evidence showing its immunological benefits by regulating essential components of the innate and adaptive immune system is prevalent. Vitamin D deficiency is reported worldwide and is thereby found to be associated with various immune-related diseases.

Deficiency of Adenosine Deaminase 2 in Adults and Children: Experience From India.

Objective: Deficiency of adenosine deaminase 2 (DADA2) is a potentially fatal monogenic syndrome characterized by variable manifestations of systemic vasculitis, bone marrow failure, and immunodeficiency. Most cases are diagnosed by pediatric care providers, given the typical early age of disease onset. This study was undertaken to describe the clinical phenotypes and treatment response both in adults and in children with DADA2 in India.

Physicians Perception of Rheumatology Practice and Training in India.

Objective: To assess physicians' perception and their felt competence in dealing with patients with rheumatic complaints.

Methods: We assessed the quantum of rheumatological disorders seen by physicians in India, their felt competency in dealing with such patients, and their perceived adequacy of undergraduate and postgraduate medical training in Rheumatology by means of an anonymized questionnaire conducted at the annual national conference of internal medicine specialists.

Results: Our analysis of 333 respondents revealed that while they saw an average of 10 patients with rheumatic complaints every month, the felt competence in dealing with such cases was only a median of 6/10 (interquartile range 5-7).

Evaluation of reticulocyte hemoglobin for assessment of anemia in rheumatological disorders.

Objective: The aim of this study was to evaluate the role of reticulocyte hemoglobin (Ret He) estimation in subtyping of anemia and to find the correlation of Ret He with the severity of anemia.

Methods: Ninety-four patients with rheumatic diseases with anemia were enrolled. Blood samples were taken to determine various parameters.

Medical arthroscopy: A tool for diagnosis and research in rheumatology.

Arthroscopy is an important diagnostic procedure which can be used in rheumatology practice to provide direct visualization of the joint cavity, permitting macroscopic evaluation of the synovium, sampling for histopathologic and microbiologic examination and the potential therapeutic benefit of lavage. The term 'medical arthroscopy' is used here to refer to arthroscopy performed by rheumatologists for these purposes. This term differentiates arthroscopy performed by orthopedic surgeons for structural interventions such as meniscal debridement and ligament repair.

Musculo-skeletal ultrasound in rheumatology practice.

In rheumatology ultrasound is a relatively new but rapidly developing field, and now forms an important part of curriculum of rheumatology training programs in European countries. Ultrasound is now an accepted procedure to differentiate between arthralgia and arthritis, to look for erosions in early arthritis which is otherwise not visible on plain radiographs, to scan tendons in enthesopathies and to image blood vessels. It is particularly useful in early undifferentiated arthritis, where presence of synovitis by ultrasound can predict development of rheumatoid arthritis.

Expression of TNF-alpha and related signaling molecules in the peripheral blood mononuclear cells of rheumatoid arthritis patients.

We examined the role of tumor necrosis factor (TNF-alpha) and its related signaling intermediates leading to apoptosis/proliferation in the peripheral blood mononuclear cells (PBMCs) of RA patients. The constitutive expression of mRNA for TNF-alpha receptors (TNFR-I and TNFR-II) and the adapter molecules, such as the TNF receptor-associated death domain protein (TRADD), Fas-associated death domain protein (FADD), receptor interacting protein (RIP), and TNF receptor-associated factor 2 (TRAF-2) were analyzed by reverse transcriptase-PCR (RT-PCR) in PBMCs from control and RA cases. PBMCs of RA patients showed a significant increase in TNF-alpha and TNFR-I expression as compared with that from control subjects along with significantly increased constitutive expression of TRADD, RIP, and TRAF-2 mRNA.

Anti-MBL autoantibodies in patients with rheumatoid arthritis: prevalence and clinical significance.

Occurrence of autoantibodies in patients' sera is the characteristic feature of autoimmune disorders. We assessed the presence of anti-mannose binding lectin (MBL) autoantibodies in the sera of 107 rheumatoid arthritis (RA) patients and 121 control subjects by enzyme immunoassay. Elevated levels of anti-MBL autoantibodies in the sera of RA patients (P<0.

Altered expression and glycosylation of plasma proteins in rheumatoid arthritis.

Altered glycosylation of plasma proteins has been directly implicated in the pathogenesis of rheumatoid arthritis (RA). The present study investigated the changes in the Concanavalin-A (Con-A)-bound plasma proteins in the RA patients in comparison to that of the healthy controls. Two proteins (MW approximately 32 kDa and approximately 62 kDa) showed an alteration in expression while an altered monosaccharide profile (high mannose) was observed in the approximately 62 kDa protein in the samples collected from RA patients.

Association of mannose-binding lectin gene (MBL2) polymorphisms with rheumatoid arthritis in an Indian cohort of case-control samples.

Single nucleotide polymorphisms in the mannose-binding lectin (MBL2) gene, as well as the serum MBL2 level, have been associated with various autoimmune diseases. We investigated whether such polymorphisms and/or the serum MBL2 level were associated with rheumatoid arthritis (RA) in an Indian population. The frequency of the B variant (codon 54) of the MBL2 gene was quite frequent in the healthy Indian population and was significantly (P=6.

Tumor necrosis factor-alpha microsatellite polymorphism association with rheumatoid arthritis in Indian patients.

Background: Level of TNF-alpha increases significantly in synovial fluid of rheumatoid arthritis (RA) patients. It is proposed that tumor necrosis factor (TNF) microsatellite alleles may influence its expression and presumably can contribute to the disease severity. However, there is a lack of such study to predict any such association with RA in an Indian population.