Inflammation assessment in patients with arthritis using a novel in vivo fluorescence optical


Posted On Nov 2 2017 by

The declines in plasma baseline concentration during treatment interruptions clearly showed that the half-lives of the MTX-HSA conjugate were close to 3 weeks. If administered in 2-3-week intervals, steady-state conditions were achieved during poststudy treatment. MTX-HSA injections every 2-4 weeks. No toxicity was observed.

Nonhematological Toxicity

In the remaining 200 patients, a clinical diagnosis by history had a sensitivity of 78% and specificity of 60%. A discriminant analysis of symptoms was inferior to a history taken by an experienced gastroenterologist. Use of antireflux medication, Gastroesophageal Reflux Disease Activity Index (GRACI) scores, grade of esophagitis, frequency of treatment of esophageal stricture, frequency of subsequent antireflux operations, 36-item Short Form health survey (SF-36) scores, satisfaction with antireflux therapy, survival, and incidence of esophageal adenocarcinoma, compared between the medical antireflux therapy group and the fundoplication surgery group. Information on cause of death was obtained from autopsy results, hospital records, and death certificates. Our aim in the present study was to compare patients presenting with gastroesophageal reflux disease in the presence or absence of mild-grade esophagitis (grade I or II according to the Savary-Miller classification).

Severe gastroesophageal reflux disease (GERD) is a lifelong problem that can be complicated by peptic esophageal stricture and adenocarcinoma of the esophagus. This was a post hoc analysis of a multicenter prospective cohort study. A total of 5,279 GERD patients with Frequency Scale for the Symptoms of GERD (FSSG) scores ≥ 8 points at baseline were analyzed. Correlations between HRQOL and FSSG were investigated and logistic regression analysis was performed. The pathogenesis of chronic rejection still remains uncertain.

Fat-saturated coronal proton-density (FS-PD-TSE), non-enhanced and enhanced T1-TSE with subtraction, coronal and axial fat-saturated postintravenous gadolinium (Dotarem, 0.2 ml/kg/body weight) (FS-T1-TSE) sequences of the clinically dominant hand were performed in 25 patients (1.5 T MRI; Siemens Magnetom Symphony, Erlangen, Germany). MRI findings (MCP 1-5, interphalangeal joint finger 1 (IP), PIP 2-5, DIP 5 and wrist as a whole) were scored according to the OMERACT (Outcome Measures in Rheumatoid Arthritis Clinical Trials) criteria.19, -, 21 The RAMRI score was calculated. We report the results of the first comparative study of this commercially available FOI system with CE, US and contrast-enhanced MRI in two major cohorts of patients with arthritis and allied conditions and controls. Careful clinical examination (CE) is a prerequisite but may miss subclinical inflammation in early disease as well as in clinical remission under treatment.3, -, 5 Conventional radiography is commonly used as an indicator of prognosis and represents the standard outcome measure of disease progression in clinical studies but is displaying the result of previous inflammatory processes rather than presenting current disease activity.

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A higher specificity and a lower sensitivity were seen for P1 (GSUS 95% and 22%; PDUS 90% and 33%) and P3 (GSUS 78% and 51%; PDUS 69% and 60%). AR was up to 82% with PDUS.

Our initial results suggest that this questionnaire is valid and should be applicable in population-based studies to assess gastroesophageal reflux disease. To develop a questionnaire to measure gastroesophageal reflux disease in the community and to test its reliability and validity. Two hundred thirty-nine (97%) of the original 247 study patients were found (79 were confirmed dead). Among the 160 survivors (157 men and 3 women; mean [SD] age, 67 [12] years), 129 (91 in the medical treatment group and 38 in the surgical treatment group) participated in the follow-up.

FOI was compared with GSUS and PDUS findings of the clinically dominant hand in 962 joints. Four hundred and fifty-three joints were positive in GSUS, 148 in PDUS and 136 in GSUS and PDUS (including tenosynovitis).

In this case report we present a 32-year old female patient with Crohn’s disease. The coexisting extraintestinal symptoms such as mucocutaneous apthous lesions of the mouth and vulva, the erythema nodosa of the lower extremities and recurrent arthralgias made the correct diagnosis even more difficult. The patient was treated with a combination of systemic corticosteroids and azulfidine enema, under which she recovered. Ultrasonography, magnetic resonance imaging, radiography, and clinical assessment of inflammatory and destructive changes in fingers and toes of patients with psoriatic arthritis .

Quantitative assessment of synovitis in patients with rheumatoid arthritis using fluorescence optical imaging

With MRI or US as reference, FOI was more sensitive than CE. In the present study, FOI was compared to CE, MRI and US in two larger cohorts of patients with arthritis and in healthy controls. The major findings were comparable in both centres. We found that FOI agreed well with CE, MRI and US. FOI was more sensitive for detecting synovitis and tenosynovitis than CE.

FOI showed a higher rate of positive findings than the other compared modalities. In an FOI sequence, three phases could be distinguished, with different sensitivity and specificity as well with different AR. FOI scores correlated significantly with assessment of disease activity (DAS28, US score, RAMRIS). In healthy subjects, FOI was negative in almost all joints. In 12 controls (6 healthy and 6 with arthralgia without any sign of inflammatory rheumatic disease; median age 30 years, range 21-56 years, 3 women), 360 joints were evaluated.

In a comparative study30 with MRI as reference, US revealed a sensitivity of 40-70% for synovitis and an agreement (73-100%) comparable to our findings for FOI. Especially for the inflammatory changes, the sensitivity and agreement of US were lower than those for destructive changes. Similar results were obtained in other studies.31 32 US and MRI display both morphological changes (eg, pannus, erosions) and dynamic changes (eg, hyperaemia, hypervascularity, hyperperfusion). FOI only displays the dynamic changes.

The growing importance of symptom assessment is evident from the numerous clinical studies on gastroesophageal reflux disease (GERD) assessing treatment-induced symptom relief. However, to date, the a priori selection of criteria defining symptom relief has been arbitrary.

Reliable prospective data may be obtained from the large European Multicenter Trial o FK506 vs cyclosporin A in which ductopenic rejection occured in 1.4% and 6.4% of cases, respectively [5]. Chronic rejection has been diagnosed between 1 month and 1 year following liver transplantation [36]. The process of chronic rejection with FK506 treatment could not be confirmed by recent studies [5]. Therefore, retransplantation remains the principal treatment fot ductopenic rejection.

A strategy for the assessment of QoL in patients with upper gastrointestinal symptoms is presented here. The QoL evaluation was based on a battery of questionnaires, covering both general and specific aspects of life. General well-being was evaluated with the Psychological General Well-being Index (PGWB), and subjective symptoms with two specific questionnaires, the Gastrointestinal Symptom Rating Scale (GSRS) and the Ulcus Esophagitis Subjective Symptoms Scale (UESS). This new strategy was applied clinically in a study including 146 outpatients with suspected peptic ulcer. Initially, the patients reported a low degree of general well-being as evaluated with the PGWB, but the values returned to those found in normal populations within 4 weeks.

gerd bahner

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