Can disease activity in patients with psoriatic arthritis be adequately assessed by a modified Disease Activity index for PSoriatic Arthritis (DAPSA) based on 28 joints?

Objective: To test the psychometric performance of a modified Disease Activity index for PSoriatic Arthritis (DAPSA) using 28 instead of 66 swollen/68 tender joint counts (SJC/TJC).

Methods: We included patients with psoriatic arthritis (PsA) from the Danish national quality registry DANBIO, divided into examination (n=3157 patients, 23987 visits) and validation cohorts (n=3154 patients, 24160 visits). We defined DAPSA28 = (28TJC × conversion factor) + (28SJC × conversion factor) + patient global (0-10VAS) + pain (0-10VAS) + C reactive protein (CRP) (mg/dL).

Acute type A aortic dissection and pregnancy: a population-based study.

Objective: Pregnancy has been reported to be an independent risk factor for 50% of acute aortic dissections recorded in women younger than 45 years of age. The present epidemiologic study aimed to identify whether this putative association of pregnancy and acute type A dissection could be an artifact of selective reporting.

Methods: This population-based study was conducted in the City of Vienna, Austria, Europe, in an average female population of 34,1381 women in the age range of 15-45 years who were followed up between 1994 and 2004 (total of 3755.

Flexor tendon synovitis of the hand as first manifestation of atypical tuberculosis.

We present the case of a 73-year old patient suffering from chronic flexor tendon synovitis of the wrist with carpal tunnel syndrome. He underwent synovectomy and median nerve release. Primary bacteriology was negative.

What should be our treatment goal in rheumatoid arthritis today?

Remission should be the treatment aim in management of rheumatoid arthritis (RA) today because joint damage may progress in RA patients with low disease activity but presumably does not progress in patients in clinical remission. However, stringent criteria are needed to define remission status, as some criteria in current use allow for considerable residual disease activity. Even using stringent criteria, remission is achievable in a sizable proportion of patients in clinical trials and practice.

Proton pump inhibition prevents gastrointestinal bleeding in ultramarathon runners: a randomised, double blinded, placebo controlled study.

Background: Ultra-endurance running is emerging as a popular sport in Western industrialised countries. Gastrointestinal bleeding has been reported to be an adverse effect in these runners.

Objective: To see if the oral administration of a proton pump inhibitor would reduce the incidence of gastrointestinal bleeding in an ultramarathon.

Infliximab treatment maintains employability in patients with early rheumatoid arthritis.

Objective: To evaluate the impact of infliximab therapy on the employment status of patients with early rheumatoid arthritis (RA).

Methods: Methotrexate (MTX)-naive patients with active early RA were randomly allocated to receive MTX plus placebo or MTX plus infliximab (3 mg/kg or 6 mg/kg) at weeks 0, 2, and 6 and then every 8 weeks through week 46. Data for patients younger than age 65 years were included in the analyses.

Predictors of joint damage in patients with early rheumatoid arthritis treated with high-dose methotrexate with or without concomitant infliximab: results from the ASPIRE trial.

Objective: To identify disease characteristics leading to progression of joint damage in patients with early rheumatoid arthritis (RA) treated with methotrexate (MTX) versus those treated with infliximab plus MTX.

Methods: Patients who had not previously been treated with MTX with active RA were randomly assigned to receive escalating doses of MTX up to 20 mg/week plus placebo or infliximab at weeks 0, 2, and 6, and every 8 weeks thereafter through week 46. Radiographic joint damage was assessed using the modified Sharp/van der Heijde score (SHS).

Comparison of 111In-DOTA-DPhe1-Tyr3-octreotide and 111In-DOTA-lanreotide scintigraphy and dosimetry in patients with neuroendocrine tumours.

Purpose: Somatostatin receptor scintigraphy with (111)In-DOTA-D: Phe(1)-Tyr(3)-octreotide ((111)In-DOTA-TOC) and (111)In-DOTA-lanreotide ((111)In-DOTA-LAN) has been used for staging of neuroendocrine tumours (NETs). However, the comparative diagnostic value of these radioligands on a lesion basis has not yet been established. The aim of this study was to compare the diagnostic capacity of (111)In-DOTA-TOC and (111)In-DOTA-LAN scintigraphy in patients with NETs, evaluating whether significant differences exist in lesion imaging with these radioligands.

Functional evaluation of the spine in patients with breast hypertrophy.

The purpose of the study in this article was to evaluate the physical impairment of patients with breast hypertrophy and to justify the medical necessity of reduction mammaplasty. In 50 women, 20 to 40 years old, with a body mass index below 25, breast size was measured by volumetry and correlated to a functional spine score. This score was determined by the presence of scoliosis, deviated head position, shoulder protraction, shortening of the pectoralis muscle, mobility of the cervical spine, and strength of the abdominal and back extensor muscles.

Iatrogenic nerve lesions of the upper extremity.

Thirty-three patients are presented who suffer from iatrogenic nerve injury of the upper extremity. Depending on the nature, duration, and degree of nerve injury, we performed neurolysis (16), direct nerve coaptation (4), and nerve grafting (13). Fourteen (70%) of 20 patients presenting with motor nerve injury achieved motor function against resistance.

Uroflow nomogram for male adolescents.

Purpose: Uroflowmetry is well established for investigating lower urinary tract symptoms. Current nomograms are based on sample sizes limited to 8 men of the same age. We generated percentile curves for the maximum urinary flow rate (Qmax) in relation to voided volume in male adolescents in a large homogenous healthy group.

Surgical treatment modalities for lower-extremity iatrogenic nerve lesions.

Thirty-six patients with lower-extremity iatrogenic nerve injury were treated with neurolysis (23), direct nerve coaption (1), and nerve grafting (12) depending on the nature, duration, and degree of nerve injury. Seventeen (74%) of 23 patients presenting with motor nerve injury achieved motor function against resistance. In 24 (80%) of 30 patients with sensory nerve involvement, at least some superficial sensory function was restored.

Dealing with the uncertain and the unexpected: a report on the first kidney transplantations in Aden, Republic of Yemen.

First kidney transplantations were performed in Aden, Jemen in 2003. A difficult medical environment and unrehearsed decision-making process in a country of scant resources were the background of this undertaking. A brief report is given on the medical situation, training and preparedness of the Yemeni medical community for transplant procedures.

Value of 111In-DOTA-lanreotide and 111In-DOTA-DPhe1-Tyr3-octreotide in differentiated thyroid cancer: results of in vitro binding studies and in vivo comparison with 18F-FDG PET.

Purpose: Radioiodine-negative thyroid cancer presents diagnostic and therapeutic difficulties, warranting the implementation of new imaging and treatment strategies. The purpose of this study was twofold. First, we investigated in vitro the binding characteristics of 111In-DOTA-lanreotide (111In-DOTA-LAN) and 111In-DOTA-D: Phe1-Tyr3-octreotide (111In-DOTA-TOC) to cells derived from differentiated thyroid cancer (DTC).

Evidence of radiographic benefit of treatment with infliximab plus methotrexate in rheumatoid arthritis patients who had no clinical improvement: a detailed subanalysis of data from the anti-tumor necrosis factor trial in rheumatoid arthritis with concomitant therapy study.

Objective: To assess the relationship between inflammation and joint destruction in rheumatoid arthritis (RA) patients who have not responded clinically to treatment.

Methods: Changes from baseline to week 54 in clinical variables and measures of radiographic progression were compared between patients who received infliximab (3 mg/kg or 10 mg/kg every 4 or 8 weeks) plus methotrexate (MTX) and those who received MTX plus placebo in the Anti-Tumor Necrosis Factor Trial in RA with Concomitant Therapy trial.

Results: At week 54, patients who did not show 20% improvement by American College of Rheumatology criteria (ACR20 nonresponders) while receiving infliximab plus MTX exhibited mild but statistically significant improvement in clinical variables, including the 28-joint Disease Activity Score (DAS28) (P < 0.

Aden kidney transplantation.

During the first Yemeni Congress of Uro-Nephrology in Aden, an international team performed the first kidney tranplantations in the region. We report the difficulties encountered and discuss the pros and cons for transplantations in developing countries.

Expression of resistance markers to methotrexate predicts clinical improvement in patients with rheumatoid arthritis.

Background: Methotrexate is transported into the cell by the reduced folate carrier (RFC) and out of the cell by members of the multidrug resistance protein family (MRP). Transport proteins may affect the therapeutic efficacy of this drug in patients with rheumatoid arthritis.

Objective: To investigate the potential benefit of the presence of RFC and the absence of functional MRP for the efficacy of methotrexate treatment.

Intramural left atrial hematoma after aortocoronary artery surgery.

Unlabelled: We report the occurrence of an intraoperative left atrial hematoma during coronary artery bypass grafting surgery. Echocardiography proved to be of great help in diagnosis and monitoring of this patient. After severe hemodynamic impairment the patient recovered and could be transferred on postoperative day eight.

Acupuncture in the treatment of psychogenic erectile dysfunction: first results of a prospective randomized placebo-controlled study.

In a prospective study, we investigated the potentially curative effect of acupuncture in patients with psychogenic erectile dysfunction (pED). A total of 22 patients with pED were randomized into two groups. They were either treated with acupuncture specific against ED (treatment group) or acupuncture specific against headache (placebo group).

Benign breast lesions: minimally invasive vacuum-assisted biopsy with 11-gauge needles patient acceptance and effect on follow-up imaging findings.

Purpose: To evaluate patient acceptance of stereotactic or ultrasonographically (US) guided directional vacuum-assisted 11-gauge needle biopsy of breast lesions and short- and long-term changes at mammography and US resulting from the procedure.

Materials And Methods: For 91 benign lesions that had been sampled at either stereotactic or US-guided directional vacuum-assisted breast biopsy performed with 11-gauge needles, clinical, mammographic, and US changes were evaluated 1 week after biopsy; 6-month follow-up findings were available for 74 lesions. The subjective outcome of the procedure and patient satisfaction were assessed on the basis of a patient-completed questionnaire that incorporated a multistage scoring system.

A simplified disease activity index for rheumatoid arthritis for use in clinical practice.

Objective: The objective of this study was to verify the usefulness of a simple disease activity index (SDAI) for rheumatoid arthritis (RA).

Methods: The SDAI is the numerical sum of five outcome parameters: tender and swollen joint count (based on a 28-joint assessment), patient and physician global assessment of disease activity [visual analogue scale (VAS) 0-10 cm] and level of C-reactive protein (mg/dl, normal <1 mg/dl). Analysis initially focused on MN301, one of the three phase III clinical trials of leflunomide, in order to assess possible correlations between the SDAI and the Health Assessment Questionnaire (HAQ) and Disease Activity Score 28 (DAS 28).