F. Sensi

Ultrasound transmission velocity of the proximal phalanxes of the non-dominant hand in the study of osteoporosis

SummaryThe aim of our study was to evaluate a quantitative ultrasound technique for measuring bone tissue at the proximal phalanxes of the non-dominant hand. We correlated the mean value of the amplitude-dependent speed of sound (AD-SoS) measured at the distal metaphysis of the last four proximal phalanxes with age, months since menopause and bone mineral density (BMD) of the lumbar spine in 264 women. We further assessed the ability of the AD-SoS to discriminate between normal and osteoporotic subjects with documented vertebral fractures. We found a positive correlation between the AD-SoS and the lumbar spine BMD, where-as the AD-SoS negatively correlated with age and months since menopause. The AD-SoS showed a higher correlation with age changes and months since menopause than BMD. The AD-SoS was significantly higher in healthy females than in osteoporotic ones (p<0.001). Multiple logistic regression analysis showed for age-adjusted values that AD-SoS decrease is significantly associated to the presence of fracture. Our results suggest that AD-SoS is valuable in assessing age and menopause related bone loss and is useful for diagnosing osteoporosis.

Impact of Fasting Glycemia and Regional Cerebral Perfusion in Diabetic Subjects A Study With Technetium-99m-Ethyl Cysteinate Dimer Single Photon Emission Computed Tomography

Background and Purpose— Diabetes mellitus increases the risk of ischemic stroke. The aim of this study was to investigate the correlation between fasting plasma glucose (FPG) and changes in regional cerebral perfusion (CP) in subjects with DM. Methods— CP was assessed in 24 subjects (mean age 44±2.5 years) with type 1 diabetes mellitus by single photon emission computed tomography. Results— Analysis of CP during elevated FPG (224±24 mg/dL) showed 3 or more deficits in 42% of the subjects. A positive relationship between the number of CP deficits and FPG was observed (P<0.01), but not with age, sex, body mass index, or duration of diabetes mellitus. Regional deficits were reduced (P<0.001) with improvement in FPG (119±5 mg/dL). This reduction remained significant after adjustment for age, sex, and body mass index. Plasma levels of P-selectin, intercellular adhesion molecule-1, and vascular cell adhesion molecule-1, established markers of endothelial dysfunction, were significantly decreased with lower FPG. Furthermore, thiobarbituric acid reactive substance plasma levels, an index of oxidative stress, were also reduced (P<0.01). Conclusions— The present study demonstrates that changes in FPG are associated with functional changes in regional CP. Hyperglycemia-induced endothelial dysfunction may be implicated in the impaired regional CP of diabetic subjects.

Ultrasound Measurements at the Proximal Phalanges in Male Patients with Psoriatic Arthritis

Abstract: Bone ultrasound parameters at the proximal phalanges of the hands were measured in 55 male patients with psoriatic arthritis (PA) (39 with peripheral radiologic involvement and 16 with axial involvement), comparing the findings with those in 16 rheumatoid arthritis (RA) patients, 20 ankylosing spondylitis (AS) patients and 55 age- and sex-matched normal controls. Mean values of amplitude-dependent speed of sound (Ad-SoS) and ultrasound bone profile score (UBPS) were significantly lower in RA (p<0.001 and p<1×10–5) and PA (p<0.03 and p<1×10–6) patients than in controls, while there was no statistically significant difference between AS patients and healthy subjects. Ultrasound parameters showed a significant negative correlation with age in all groups. In each patient group ultrasound values were unrelated either to disease duration or to inflammatory indices such as erythrocyte sedimentation rate and C-reactive protein. Moreover no significant differences were observed between ultrasound parameters of the dominant and the nondominant hand. PA patients with and without axial radiologic changes did not show any differences in ultrasound parameters. However, PA subjects with peripheral involvement only had significantly higher Ad-SoS (p<0.04) and UBPS (p<0.04) values than RA patients. PA patients with axial lesions had significantly lower (p<0.04 and p<0.01) ultrasound values than AS patients. These findings suggest that PA ultrasound techniques performed at the peripheral level are of value to speculate on bone involvement, although we think that ultrasound measurements cannot yet be recommended for monitoring bone involvement in these patients.

Soluble interleukin-2-receptor and interleukin-6 changes during low-dose methotrexate treatment in rheumatoid arthritis.

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Soluble interleukin-2 receptor and interleukin-6 levels: evaluation during cyclosporin A and methotrexate treatment in psoriatic arthritis.

In patients with psoriatic arthritis (PsA) presenting different patterns of articular involvement, high levels of soluble interleukin-2 receptor (sIL-2R) [1,2] and interleukin-6 (IL-6) [1,3,4] have been reported. In PsA patients with peripheral polyarthritis, slL-2R and IL-6 levels correlated with each other and also with some disease-activity parameters [1]. IL-6 levels also correlated with the main clinical indices as well as with the erythrocyte sedimentation rate (ESR) and levels of Creactive protein (CRP); sIL-2R correlated only with the number of swollen joints, the physicians assessment and the ESR [1]. Although a 1-year prospective trial showed that low-dose cyclosporin A (CsA) and methotrexate (MTX) are both effective in the therapy of PsA [5], to our knowledge a comparison of the effects of these drugs on sIL-2R and IL-6 levels has not been reported. The aim of this study was to investigate the effect of CsA and MTX on sIL-2R and IL-6 levels and the relationship between changes of these molecules and changes of the main clinical and laboratory parameters in PsA patients with peripheral polyarthritis.