Wojciech Romanowski

Thermal effectiveness of different IR radiators employed in rheumatoid hand therapy as assessed by thermovisual examination.

We conducted a thermovisual comparison of mean hand surface temperature changes upon local heating with two different IR sources. Sixty‐six patients with rheumatoid arthritis (47 women and 19 men; average age, 56.1 ± 8.6 years) were subjected to topical heat therapy for one hand with either the standard IR radiator (SIR) or the water filter IRA (wIRA). The surface temperature of the dorsal side of both hands was measured, and thermal images were taken before and up to 2 h after treatment. At 1 min after treatment, SIR application increased the surface skin temperature of the heated hand from 31.5 ± 1.9 to 35.0 ± 1.9°C (P < 0.05), while wIRA increased it from 32.1 ± 1.6 to 34.2 ± 1.1°C (P < 0.05). Constant decline in temperature was observed immediately after treatment, with the temperatures reaching baseline in about 30 and 120 min after wIRA and SIR treatment, respectively. Similar temperature changes were observed in the heated hands for wIRA and SIR, except at 1 min after treatment. Changes in the untreated hands indicated contralateral reaction. The temperature of the warmed hand showed a correlation to the body mass index.

Effects of Whole-Body Cryotherapy in Comparison with Other Physical Modalities Used with Kinesitherapy in Rheumatoid Arthritis

Whole-body cryotherapy (WBC) has been frequently used to supplement the rehabilitation of patients with rheumatoid arthritis (RA). The aim of this study was to compare the effect of WBC and traditional rehabilitation (TR) on clinical parameters and systemic levels of IL-6, TNF-α in patients with RA. The study group comprised 25 patients who were subjected to WBC (−110°C) and 19 patients who underwent a traditional rehabilitation program. Some clinical variables and levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were used to assess the outcomes. After therapy both groups exhibited similar improvement in pain, disease activity, fatigue, time of walking, and the number of steps over a distance of 50 m. Only significantly better results were observed in HAQ in TR group (p < 0.05). However, similar significant reduction in IL-6 and TNF-α level was observed. The results showed positive effects of a 2-week rehabilitation program for patients with RA regardless of the kind of the applied physical procedure.

High-magnitude whole-body vibration effects on bone resorption in adult rats.

INTRODUCTION Optimal parameters of whole-body vibration (WBV), effective in increasing bone mass or preventing bone loss, are always being sought. We investigated effects of a 6-mo WBV program, consisting of brief daily vibratory sessions, on the bone mass and bone metabolic markers. METHODS There were 10 male Wistar rats (3 mo old) that were subjected to the 6-mo WBV (frequency 50 Hz, acceleration 4.92 g, peak-to-peak displacement 2.5 mm) composed of 4 30-s bouts per day, performed 5 d per week. There were 10 not vibrated, age-matched rats that served as controls. RESULTS After completion of the WBV program the concentrations of C-terminal telopeptide of type I collagen in the WBV treated animals were significantly lower in comparison to the controls. There were no effects of the WBV on areal bone mineral density, osteocalcin, and sRANKL levels. DISCUSSION High-frequency high-magnitude WBV applied for 6 mo decreases bone resorption, but does not affect bone formation and bone mineral density.

Is Osteocalcin Implicated in the Regulation Of Energy Metabolism in Active Rheumatoid Arthritis

The purpose of this study was to determine the relationship of osteocalcin with insulin resistance, insulin-like growth factor-1 (IGF-1) and inflammatory markers in women with RA. The study population comprised of 35 postmenopausal women with RA. The significant negative correlations were noted between the osteocalcin and resistin levels (P <0.05), glucose and resistin levels (P ≤ 0.01), glucose and interleukin-6 levels (P ≤ 0.01), interleukin-6 and insulin-like growth factor binding protein-3 (IGFBP-3) levels (P < 0.05). The positive correlations were found between insulin level and disease duration (P < 0.05), index of insulin resistance (HOMA-IR) level and disease duration (P < 0.05), IGF-1 and IGFBP-3 levels (P ≤ 0.01), the IGF-1/IGFBP-3 ratio and erythrocyte sedimentation rate (P ≤ 0.01), and the IGF-1/IGFBP-3 ratio and C-reactive protein levels (P < 0.05). The present study suggests that inflammatory factors may modify in distinct ways the relationship between osteocalcin and carbohydrate metabolism in patients with RA. However, limitations of this study are: lack of control group, small sample size and that we did not measure uncarboxylated OC.

Satisfaction and discontent of Polish patients with biological therapy of rheumatic diseases: results of a multi-center questionnaire study

Objectives Biologics are medications widely applied in the management of inflammatory rheumatic diseases. The drugs were found to be effective but their application is associated with some disadvantages. Medication with biologics is relatively expensive, and in Poland, it is carried out in specialized centers. The study was designed to evaluate various aspects of satisfaction and dissatisfaction of Polish patients treated with biologics. Material and methods An anonymous questionnaire was distributed in 23 Polish rheumatological centers involved in the treatment; 1212 returned questionnaires were used for analysis. Responses were received from 606 patients with rheumatoid arthritis, 427 with ankylosing spondylitis, 117 psoriatic arthritis, and 62 adult patients with juvenile idiopathic arthritis (in whom administration of the drugs had been introduced before they were 18 years old). The investigated group constituted about one-fifth of all rheumatic patients on biologics in Poland. Results A beneficial or very beneficial influence of the medication on the state of physical health was found mostly in patients with rheumatoid arthritis (51.3 and 30.5%) and ankylosing spondylitis (51.0 and 36.8%). Family life was improved by the treatment especially in patients with ankylosing spondylitis (40.7 and 35.6% beneficial and very beneficial, respectively), sleep quality and sexual life mostly in those with ankylosing spondylitis (beneficial/very beneficial influence 41.5/38.4, and 38.7/23.9, respectively). There was a rather small influence of biological treatment on the financial situation of the patients. In general, satisfaction with the treatment was evaluated as positive or very positive in 88% of all investigated patients. In a significant part of the patients, transportation to the medical center was considered as a disadvantage of the treatment. About one-third of the patients considered laboratory and imaging tests to be done before initiation of the medication as a difficulty, and for about 40% waiting time for qualification for the medication was a significant disadvantage. The route of drug administration was without importance for 4/5 of the patients. Conclusions Summing up, the results were similar in the patients suffering from various diseases although those with psoriatic arthritis felt the highest satisfaction (possibly due to the positive aesthetic effect), and those with ankylosing spondylitis had significant improvement in sexual life (probably due to younger age). Relatively low satisfaction was found in patients with juvenile idiopathic arthritis. There was a small influence of medication on financial status of the patients. Application of biologics has few disadvantages and most of them are associated with the organization of health services (waiting time for the tests, transportation to the medical centers).

The Effect of Whole-Body Cryotherapy at Different Temperatures on Proinflammatory Cytokines, Oxidative Stress Parameters, and Disease Activity in Patients with Ankylosing Spondylitis

Purpose Patients with ankylosing spondylitis (AS) have increased production of proinflammatory cytokines, increased oxidants, and decreased antioxidant capacity. The aim of this study was to determine the effect of whole-body cryotherapy (WBC) at −110°C and −60°C, on disease activity, selected proinflammatory cytokines, and oxidative stress in patients with AS. Methods Sixty-five patients with AS were recruited to one of three study procedures: WBC at −110°C, −60°C, or exercise therapy (non-WBC). The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP), concentration of C-reactive protein (CRP), and the concentrations of interleukin 8 and 17 (IL-8, IL-17) were measured at the beginning of the study and at the end of the intervention. The concentration of thiobarbituric acid reactive substances (TBARS), as a lipid peroxidation result, and total antioxidant status, an antioxidant organism potential, were measured. Results All the studied groups showed significantly decreased posttherapy disease activity expressed as a function of the BASDAI, ASDAS-CRP, and the IL-8 concentration. We found that the TBARS concentration after therapy was significantly increased in the WBC at −110°C group. A comparison of the therapeutic effects between the treatment groups showed a significantly lower BASDAI after therapy in the WBC at −110°C group compared to the non-WBC group. Conclusion WBC at −110°C had a positive effect on lowering AS clinical activity as measured by the BASDAI.