Medicine and Health Sciences Commons^™

Role Of Gut Microbiome In Rheumatoid Arthritis, Varsha Gupta, Jaya Prakash

Research Symposium

Background: Every individual is born with some dosha that determines its ‘Prakriti’. In the Ayurvedic text, ‘Aamvata’ is a joint disorder causing polyarticular pain and swelling like that in RA, which is texted to be the result of imbalances of gut doshas. It says that accumulation of Ama or undigested food is the cause, as they release endotoxins/ other proteins. The father of modern medicine, Hippocrates, says that the “gut is the site of all the diseases”. Traditional medicine also emphasises a balanced fibrous diet, nutrition, digestion, good sleep, yoga, and meditation, which holistically affect the body, mind and soul. …

Associations Of Galectin-3 Levels With Measures Of Vascular Disease In Patients With Rheumatoid Arthritis, Amanda Nussdorf, Elizabeth Park, Isabelle Amigues, Laura Geraldino-Pardilla, Sabahat Bokhari, Jon T. Giles, Joan M. Bathon

Division of Rheumatology Faculty Papers

OBJECTIVES: Galectin-3 is a beta-galactoside-binding lectin and is a marker of cardiovascular disease (CVD) in the general population. It may also play a role in joint inflammation. We asked whether serum galectin-3 is a useful marker of subclinical vascular disease in patients with rheumatoid arthritis (RA).

METHODS: RA patients without clinical CVD underwent assessment of coronary artery calcium (CAC) score, aortic inflammation (using 18Fluorodeoxyglucose positron emission-computed tomography [FDG PET/CT]), and myocardial flow reserve (MFR). Aorta FDG uptake was measured as standardized uptake values (SUV). Generalized linear models were constructed to explore the associations of galectin-3 levels with CAC score, aortic …

A Retrospective Study On The Effect Of Raas Pathway Inhibitors At Decreasing The Risk Of Acute Coronary Syndrome In Hypertensive Patients With Rheumatoid Arthritis As Compared To Other Antihypertensives, Yousuf Sherwani, Asad Risvi, Senthil Thambidorai

North Texas GME Research Forum 2024

Rheumatoid arthritis (RA) is a chronic multi-system inflammatory disease of which is characterized by articular and extra-articular involvement. Patients with RA have a higher risk of mortality when compared with the general population, which is due predominantly to increased cardiovascular disease. Due to the higher incidence of CVD and MI in RA patients it has been postulated that enhanced systemic inflammation plays an important role in the pathogenesis of CVD in RA patients. Previous studies have shown that ant inflammatory medication such as systemic steroids and immune blockers have been shown to decrease the risk of MI in patients with …

Musculoskeletal Ultrasonography In Rheumatic Diseases, Erhan Çapkin

Turkish Journal of Medical Sciences

Ultrasonography is an imaging technique based on sound waves used for the evaluation of soft tissues. Sound waves have been used for a long time in nonmedical fields, including military defense systems, radar systems, and detection of icebergs. Technological advances resulted in new techniques becoming available for medical imaging, including ultrasonography, magnetic resonance imaging, and computed tomography. Nowadays, the use of imaging has become a gold standard protocol in the diagnosis of many diseases, and recently developed diagnosis and therapy options provide more efficient treatment of rheumatic diseases. Thus, it has become possible to prevent structural damage and disability in …

Craniocervical Junction Involvement In Inflammatory Arthritis: A Single-Center Radiologic Study, Fatma Yalçinkaya, Şafak Parlak Sağol, Aynur Azizova, Emre Bi̇lgi̇n, Kader Karli Oğuz, Umut Kalyoncu

Turkish Journal of Medical Sciences

Background/aim: Craniocervical junction (CCJ) can be involved in inflammatory arthritis. We aimed to define types of CCJ involvement in rheumatoid arthritis (RA), spondyloarthritis (SpA), and psoriatic arthritis (PsA) and compare them with patients without inflammatory arthritides. Materials and methods: In this retrospective analysis, cervical CT or MRIs of patients with RA, SpA, or PsA, taken for any reason between 2010 and 2020, according to ICD-10 codes, were scanned. Demographic data of the patients were recorded. CCJ involvements (atlantoaxial, vertical, or subaxial subluxation, odontoid process involvement) were reevaluated by an experienced radiologist. The control group consisted of consecutive patients without inflammatory …

Body Mass Index Does Not Affect Response Of Rituximab In Patients With Rheumatoid Arthritis: Results From The Turkbi̇o Registry, Ahmet Karataş, Rabi̇a Pi̇şki̇n Sağir, Süleyman Serdar Koca, Hüseyi̇n Edi̇z Dalkiliç, Gerçek Can, Yavuz Pehli̇van, Ayten Yazici, Güzi̇de Nevsun İnanç, Ayşe Çefle, Zeynep Ertürk, Servet Akar, Soner Şenel, Ahmet Meri̇h Bi̇rli̇k, Nurullah Akkoç, Fatoş Önen

Turkish Journal of Medical Sciences

Background/aim: Adipose tissue produces several inflammatory mediators. Thus, obesity affects the disease course and the responses to the antirheumatic agents in inflammatory diseases. The aim of the study was to determine whether the body mass index (BMI) is involved in the response to rituximab in rheumatoid arthritis (RA). Materials and methods: This multicenter retrospective study included 206 RA patients who received rituximab from the Turkish Biologic (TURKBIO) registry between 2011 and the end of May 2017. Demographic and clinical data including age, sex, disease type, disease duration, and previous or current treatment with disease-modifying antirheumatic drugs (DMARDs) and biological drug …

Cd39 Expression On Immune Cells Predicts Methotrexate Response In Rheumatoid Arthritis Patients, Bariş Boral, İbrahi̇m Tuncer, Fi̇li̇z Ki̇bar, Sali̇h Çeti̇ner, Suade Özlem Badak, Emrah Salman, Emrah Koç, Eren Erken, Akgün Yaman

Turkish Journal of Medical Sciences

Background/aim: Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting mostly small joints, such as hand and foot joints symmetrically with irreversible joint destruction. In this study, the relationship between CD39 expression and the treatment response of RA patients was examined to investigate its potential as a biomarker that demonstrates treatment response. Materials and methods: This study included 77 RA patients and 40 healthy controls (HC). The RA patients were divided into 2 groups based on their response to RA treatment, those with a good response to methotrexate (MTX) monotherapy and those with an inadequate response based on the American …

Patient's Perspective Of Shared Decision-Making In Rheumatoid Arthritis Treatment: A Grounded Theory Exploration, Isabela Viana Oliveira, Mariana Martins Gonzaga Nascimento, Cristiane P. Rezende Mrs, Carina M. Neves, Hagabo Mathyell Silva, Ana Luiza Mourawad Cesar, Djenane Ramalho De Oliveira

The Qualitative Report

Current guidelines for rheumatoid arthritis (RA) treatment state that all decisions should be shared with the patient. Therefore, it becomes necessary to understand in-depth how patients with RA with different levels of health literacy and activation feel about sharing the decision with the health professional and how they experience this process. Grounded theory was used. Data collection included semi-structured interviews with 14 patients with RA. From the analysis of the patients’ narratives, four categories were built: “Accepting the changes: non-shared decisions”; “The patient's rationale: why not share?”; “Reaching the requirements for sharing the decision: expanding the patient’s autonomy"; and "Experiencing …

Pengaruh Terapi Metotreksat Pada Pasien Artritis Reumatoid Terhadap Penurunan Fungsi Kognitif: Meta-Analisis Berdasarkan Telaah Sistematik, Fara Fauzia, Nurhayati Adnan Prihartono, Rudy Hidayat, Abirianti P. Araminta

Jurnal Penyakit Dalam Indonesia

Introduction. Rheumatoid arthritis (RA) is a systemic and chronic autoimmune disease involving the joints disorder as the main manifestations. Methotrexate (MTX) is currently still the drug of choice for RA treatment due to the good clinical response. However, there was a case reported by the American Geriatric Society in 2015 regarding the presence of reversible dementia after treatment with low-dose oral methotrexate. This study aimed to identify the effect of MTX treatment on cognitive disorder in RA patients.

Methods. The study protocol was registered with PROSPERO (CRD42023414937). A systematic literature search was conducted in Medline Embase database, Scopus, CENTRAL …

The Role Of Clock Genes In Maintaining Circadian Rhythm And Rheumatoid Arthritis Pathophysiology., Arathi Kulkarni, Michelle Demory-Beckler, Marc M. Kesselman

HPD Articles

Rheumatoid arthritis (RA) is a chronic, progressive autoimmune condition that affects up to 1% of the world population and symmetrically affects the joints leading to joint stiffness and decreased mobility. RA patients present with increased pain and chronic inflammation within their joint spaces, which researchers have linked to poorer sleep patterns, including difficulty falling asleep and non-restorative sleep. As such, identifying mediators of poor sleep quality among RA patients may improve their long-term quality of life. More recently, researchers identified an association between chronic inflammation in RA patients and their circadian rhythm. Altered circadian rhythms negatively impact the hypothalamic-pituitary-adrenal (HPA) …

Interstitial Lung Disease Due To Underlying Sjogren's Syndrome, Ryan E. Johnson, Elizabeth Bogaty, Chamonix Kinimaka, Marilian Canals-Rivera

South Atlantic Division GME Research Day 2023

No abstract provided.

Relationship Between Chinese Herbal Medicine Use And Risk Of Sjögren’S Syndrome In Patients With Rheumatoid Arthritis: A Retrospective, Population-Based, Nested Case-Control Study, Hou-Hsun Liao, Hanoch Livneh, Miao-Chiu Lin, Ming-Chi Lu, Ning-Sheng Lai, Hung-Rong Yen, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Background and Objectives: Sjögren’s Syndrome (SS) is a common extra-articular feature among subjects with rheumatoid arthritis (RA). While Chinese herbal medicine (CHM) has been used to treat symptoms of RA for many years, few studies have examined its efficacy in guarding against the SS onset. This study aimed to compare risk of SS for RA patients with and without use of CHM. Materials and Methods: Data obtained for this nested case-control study were retrieved from Taiwanese nationwide insurance database from 2000–2013. Cases with SS claims were defined and matched to two randomly selected controls without SS from the recruited RA …

Rheumatoid Vasculitis Presenting With Incidental Renal Infarcts: Case Report And Literature Review, Fatima Halilu, Howard Hauptman

Journal of Community Hospital Internal Medicine Perspectives

Rheumatoid vasculitis is a rare and late complication of rheumatoid arthritis, affecting small to medium sized vessels. Inflammation in the vessel wall produces an occlusive vasculopathy with downstream infarction. We present the case of a 70-year-old female with long standing stable RA status post recent COVID-19 vaccination admitted with community acquired Legionnaires disease found to have an incidental renal infarct on chest imaging without a clear etiology. She improved from a respiratory standpoint but then had a fever spike with repeat imaging showing a second renal infarct and CT angiography showing extensive beading with aneurysmal dilation in the bilateral hepatic …

Dental And Oral Manifestations Of Rheumatoid Arthritis: Is It Related To General Disease Activity?, Omnia A. Abubakr, Ali M Youssef, Mohamed A Mohamed, Mohamed A Hamdy

Journal of Medicine in Scientific Research

Background: RA is a chronic immune-mediated systemic disorder; its pathogenesis is complex. Genetic, environmental, hormonal, and lifestyle are the main risk factors. The correlation between oral health and RA is rising. Oral manifestations in RA include temporomandibular joint disorder, secondary Sjögren’s syndrome, xerostomia, and periodontal disease. Previous studies suggest a bidirectional relationship between RA and periodontal diseases. This study aims to detect oral mucosal and dental disease in RA patients and its relation to demographic features, disease activity, and extra-articular manifestation. Patients and Methods: This cross-sectional study included 150 patients with RA allocated into two groups, 75 patients in each …

A Spontaneous Subcutaneous Emphysema As A Life Threatening Complication Of Rheumatoid Arthritis Associated Interstitial Lung Disease, Austin Makadia, Vishesh Persaud, Saiara Choudhury, Asad Chohan, Abhay Vakil

Gulf Coast Division GME Research Day 2023

No abstract provided.

A National, Multicenter, Retrospective Study Evaluating Retention Rate And Efficacy Of Tocilizumab Treatment In Patients With Active Rheumatoid Arthritis Who Had An Inadequate Response To Csdmards And/Or Tnf Inhibitors, Güzi̇de Nevsun İnanç, Mustafa Ender Terzi̇oğlu, Yusuf Karabulut, Zevcet Yilmaz, Emi̇ne Fi̇gen Tarhan, Mehmet Emi̇n Eneci̇k, Ali̇ Şahi̇n, Adem Küçük, Ayşe Ayan, Meti̇n Özgen, Uğur Karasu, Servet Yolbaş

Turkish Journal of Medical Sciences

Background/aim: To describe the disease activity and retention rate in rheumatoid arthritis (RA) patients with inadequate response (IR) to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and/or tumor necrosis factor inhibitors (TNFis) who were prescribed tocilizumab (TCZ) as first-line or second-line biologic treatment in real-world setting. Materials and methods: Data gathered from patients' files was used in a multicenter and retrospective context. Retention rates and the Disease Activity Score in 28 joints with CRP (DAS28-CRP) were evaluated at time points. The relationship of drug efficacy with factors such as smoking, obesity, and previous use of TNFis was also examined. Results: One …

Rituximab For Steroid-Resistant Organising Pneumonia In A Woman With Rheumatoid Arthritis, Christine E. Loftis, Emilia C. Dulgheru, Adolfo Kaplan

School of Medicine Publications and Presentations

Organising pneumonia (OP) is a form of interstitial pneumonia characterised by inflammation and scarring leading to obstruction within the small airways and alveoli. Practice guidelines recommend treatment of moderate to severe OP with glucocorticoids; however, there have been cases of steroid-resistant OP successfully treated with rituximab. We describe a case of a woman in her 20s with rheumatoid arthritis who presented with pleuritic chest pain, haemoptysis and dyspnoea on exertion and was diagnosed with OP after multiple radiographic images and biopsies. The patient failed numerous treatment regimens, including corticosteroids, antibiotics and mycophenolate, but was successfully treated with rituximab. This case …

A Rheumatoid Nodule At The Sternoclavicular Joint: An Uncommon Presentation Of A Common Problem, Patrick M. Thomas, Nathan J. Cockerill, Christina M. Arcand, Alan R. Koester, Mark H. Cooper Md, Phd

Marshall Journal of Medicine

Most rheumatoid nodules are found at joints or pressure points. They rarely require medical intervention and even fewer require surgery. A 78-year-old female developed a 7.2 x 3.2 x 2.8 cm rheumatoid nodule originating at the right sternoclavicular joint, a novel site for a common pathology. Management involved a complex differential diagnosis and surgical treatment was resection from adjacent vascular and neural structures. Following surgical excision, the patient maintained good mobility and sensation of the neck and surrounding areas.

Effect Of Rheumatoid Arthritis Treatment On The Posterior Segment Of The Eye, Abdelkawy Moghazy, Ahmed S. Fayed, Heba A. R. Rizk, Moataz El-Sawy

Menoufia Medical Journal

Objective The aim of the study was to evaluate the influence of rheumatoid arthritis (RA) treatment on the posterior segment of the eye using spectral-domain optical coherence tomography. Background RA is a common chronic autoimmune systemic inflammatory disease that primarily affects mainly small joints. It may affect many parts of the eye, such as conjunctiva, cornea, sclera, uvea, choroid, and retina. Patients and methods The study included 44 RA patients (22 on methotrexate and 22 on etanercept), and 21 healthy controls. Results A significant increase in choroidal thickness in the RA group compared with the control group. There were no …

Enhancing Physician Perspectives Of Skilled Occupational Therapy Services For Patients With Rheumatoid Arthritis, Valerie S. Trinidad

Department of Occupational Therapy Entry-Level Capstone Projects

This Capstone Project, with a focus in research, sought to identify a relationship between self-reported functional performance and participation restriction as described by satisfaction with one’s execution or participation in a described occupation. A correlational study design was employed under the mentorship of Dr. Thomas Decker, EdD, OTD, OTR/L who oversaw all IRB processes, documentation, study development and deployment, as well as co-authored and provided mentorship for creation of a publishable manuscript of this project. The established Health Assessment Questionnaire Disability Index (HAQ-DI) and the newer Keele Assessment of Participation (KAP) were the two outcome measures of focus for surveying …

At-Home Aerobic Exercise Improves Functional Ability Of Patients With Rheumatoid Arthritis With Limited Exercise Options, Daniel Harris

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Neuberger GB, Aaronson LS, Gajewski B, et al. Predictors of exercise and effects of exercise on symptoms, function, aerobic fitness, and disease outcomes of rheumatoid arthritis. Arthritis Rheum. 2007;57(6):943-952. https://doi.org/10.1002/art.22903

and its application for a patient with rheumatoid arthritis.

Quality Of Life, Duration Of The Disease And The Level Of Pain In Patients With Rheumatoid Arthritis, Ewa Kupcewicz, Agnieszka Drejer

Baltic Journal of Health and Physical Activity

The aim of the present study is to evaluate life quality of people suffering from RA and determine the influence of illness duration and degree of pain intensity on their quality of life. The group of subjects comprised of 189 people: 104 (55.03%) with diagnosed RA and 85 (44.97%) healthy people as control group. Mean age in the group of ill subjects was 57.66 ±11.30 and 68 ±8.99 in the control group. In the research, self-constructed questionnaire, Visual Analogue Scale (VAS) and shortened version of WHOQoL-Bref were used. Assumed significance level was p < 0.05. Patients with RA received statistically significantly lower scores of life quality in all domains as compared with the control group. In the group of ill subjects, social domain (14.91 ±2.40) obtained highest scores whereas physical domain received lowest scores (11.96 ±1.69). The main somatic issue connected with the illness reported by 95.19% of subjects was experienced joint pain. Mean degree of perceived pain in VAS scale reached 7.37 ±1.86 points and it significantly lowered life quality of ill subjects. The results regarding life quality in four life domains (i.e. physical, psychological, social and environmental) were definitely better than in the control group.

A Review Of Arthritis Diagnosis Techniques In Artificial Intelligence Era: Current Trends And Research Challenges, Maleeha Imtiaz, Syed Afaq Ali Shah, Zia Ur Rehman

Research outputs 2022 to 2026

Deep learning, a branch of artificial intelligence, has achieved unprecedented performance in several domains including medicine to assist with efficient diagnosis of diseases, prediction of disease progression and pre-screening step for physicians. Due to its significant breakthroughs, deep learning is now being used for the diagnosis of arthritis, which is a chronic disease affecting young to aged population. This paper provides a survey of recent and the most representative deep learning techniques (published between 2018 to 2020) for the diagnosis of osteoarthritis and rheumatoid arthritis. The paper also reviews traditional machine learning methods (published 2015 onward) and their application for …

Kikuchi-Fujimoto Disease Complicated By Rheumatoid Arthritis, Type 1 Diabetes Mellitus, And Hypothyroidism, Soroush Shahrokh, Ammar Hasan, Salman Raza Alim, Michelle Hebert, Khulood Rizvi

Gulf Coast Division GME Research Day 2022

No abstract provided.

Egfr Blocker Lapatinib Inhibits The Synthesis Of Matrix Metalloproteinases From Synovial Fibroblasts, Demet Yalçin Kehri̇bar, Hakan Emmungi̇l, Neşe Başak Türkmen, Osman Çi̇ftçi̇, Emi̇ne Şalva, Meti̇n Özgen

Turkish Journal of Medical Sciences

Background/aim: Epidermal growth factor receptor (EGFR) family members and their associated ligands may be related to bone and joint destruction in rheumatoid arthritis. Matrix metalloproteinases are responsible for joint and bone tissue degradation. This study is intended to investigate the effect of epidermal growth factor receptor inhibition by lapatinib on the synthesis of matrix metalloproteinases in in vitro. Materials and methods: Synovial fibroblast cell culture was obtained from a patient with rheumatoid arthritis who underwent knee arthroplasty. Interleukin-1ß (IL-1ß) and tumor necrosis factor-∝ (TNF-∝) were added to the cell culture to stimulate synovial fibroblast cells and create an inflammatory character. …

Outcome Of Solid And Cavitary Pulmonary Nodules In Rheumatoid Arthritis Patients? Case Series, Aysun Aksoy, Derya Kocakaya, Yasemi̇n Yalçinkaya, Emi̇ne Bozkurtlar, Sai̇t Karakurt, Semi̇ha Emel Eryüksel, Güzi̇de Nevsun İnanç

Turkish Journal of Medical Sciences

Background/aim: Rheumatoid pulmonary nodule can be detected in up to 32% of rheumatoid arthritis (RA) patients and approximately one-third of nodules may cavitate. We aimed to evaluate characteristics of patients with RA developing cavitary pulmonary nodular (CPN) lesions under disease-modifying antirheumatic drugs (DMARDs), follow-up of both cavitary and solid nodules, and their outcome with the treatment. Materials and methods: RA patients who presented with CPN lesions during follow-up were recruited retrospectively in this case series analysis. Total numbers and mean diameters of cavitary and solid nodules in each thorax computed tomography (CT) have been determined and followed up by two …

Relation Between Neuropathic Pain And Serum Levels Of Vitamin D In Egyptian Patients With Rheumatoid Arthritis, Enas A. Abdelaleem, Mervat I. Abdelazeem, Rabab A. Mohamed, Shaimaa S. Anwar

Menoufia Medical Journal

Objectives This study aims to measure vitamin D serum levels in Egyptian patients with rheumatoid arthritis (RA) and assess its association with neuropathic pain (NP). Patients and methods The present study was conducted on 70 RA patients. NP was evaluated by the Leeds Assessment of Neuropathic Symptoms and Signs, visual analog scale (VAS) was used to assess the degree of pain, disease activity score (DAS-28) was used to assess activity, and modified health assessment questionnaire (mHAQ) was used to assess quality of life. Serum vitamin D levels were measured for all the patients by ELISA. Results RA patients with NP …

The Efficacy Of Sequential Biologic Agents In Refractory Rheumatoid Arthritis After Failure Of Initial Dmard And Anti-Tumor Necrosis Factor Therapy, Antonio Giovanni Versace, Caterina Oriana Aragona, Daniela La Rosa, Marianna Chiappalone, Maria Concetta Tringali, Alberta De Gaetano, Charles Frederick Moore Jr., Donatella Sangari, William Neal Roberts, Gianluca Bagnato

Internal Medicine Faculty Publications

Introduction/Objective: The efficacy of biologic therapy in the treatment of rheumatoid arthritis (RA) has been well-established but, in practice, a quarter of patients will either not respond to the first biologic agent or will suffer an adverse event requiring a switch to a different drug. While clinical guidelines exist to help guide therapy and previous studies have examined sequential use of anti-TNF agents, there is little data to inform a multiple switch strategy. Our aim was to measure the efficacy of multiple switches of biologic in severe refractory RA. Methods: We enrolled 111 patients whose therapy with one anti-TNF agent …

Outcomes Of Covid-19 In Patients With Rheumatoid Arthritis: A Multicenter Research Network Study In The United States., Rahul Raiker, Charles Deyoung, Haig Pakhchanian, Sakir Ahmed, Chengappa Kavadichanda, Latika Gupta, Sinan Kardeş

Student Papers, Posters & Projects

OBJECTIVES: To investigate outcomes of Coronavirus Disease-2019 (COVID-19) in patients with rheumatoid arthritis (RA) as compared to the general population. Additionally, outcomes were explored among RA patients stratified by sex, race, and medications use through sub-cohort analyses.

METHODS: This comparative cohort study used a US multicenter research network (TriNetX) to extract data on all adult RA patients who were diagnosed with COVID-19, and adults without RA who were diagnosed with COVID-19 (comparative cohort) anytime from January 20, 2020 to April 11, 2021. COVID-19 outcomes were assessed within 30 days after its diagnosis. Baseline characteristics that included demographics and comorbidities were …

Development Of Macromolecular Prodrug Of Sinomenine For The Treatment Of Rheumatoid Arthritis, Roshni Mukundan

Theses & Dissertations

Inflammation is a natural response of the body to infections or any potential threat to the body. But, sometimes the immune system attacks its own body causing persistent inflammation leading to inflammatory diseases. One of the common chronic inflammatory diseases is rheumatoid arthritis (RA) which causes inflammation of the synovial membrane. The current treatments for RA are effective in controlling the symptoms but they come with severe side effects and economic burden. Further, the management of pain is still a problem with these drugs. Sinomenine is a natural alkaloid obtained from the Chinese medicinal plant Sinomenium acutum that has been …