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Introduction Methods Results Discussion COVID‐19 survivors are at greater risk for new medical conditions. Among older adults, where multimorbidity and functional impairment are common, frailty measurement provides a tool for understanding how infection impacts future health beyond a one‐disease‐at‐a‐time approach. We investigated whether COVID‐19 was associated with change in frailty among older Veterans.Data were from the Veterans Affairs (VA) COVID‐19 Observational Research Collaboratory, which extracted VA medical record data. We included Veterans who had COVID‐19 from March 1, 2020, to April 30, 2021 and matched uninfected controls. We excluded those <50 years at index or did not survive 12 months after. Frailty was assessed at the index date and 12 months using the VA Frailty Index (VA‐FI).We assessed the number of new VA‐FI deficits over 12 months. Analysis was done by negative binomial regression adjusted for age, gender, race, ethnicity, and BMI. Coefficients are given as the ratio of the mean number of new deficits in COVID‐19 cases versus controls during follow‐up.We identified 91,338 COVID‐19‐infected Veterans and an equal number of matched controls. Median (IQR) age was 68.9 years (60.3–74.2), 5% were female, 71% were White, and baseline VA‐FI was 0.16 (0.10, 0.26). Median (IQR) number of new deficits at 1 year was 1 (0–2) for infected and 0 (0–1) for uninfected controls. After adjustment, those with COVID‐19 accrued 1.54 (95% CI 1.52–1.56) times more deficits than those who did not. The five most common new deficits were fatigue (9.7%), anemia (6.8%), muscle atrophy (6.5%), gait abnormality (6.2%), and arthritis (5.8%).We found a greater increase in frailty among older Veterans with COVID‐19 compared with matched uninfected controls, suggesting that COVID‐19 infection has long‐term implications for vulnerability and disability among older adults. Functional impairments such as fatigue, impaired mobility, and joint pain may warrant specific attention in this population. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion Recent studies supported the presence of a relationship between pain and frailty, but more research is needed to highlight the pain–frailty association. The study aimed to investigate the prevalence and the influence of different pain indicators on frailty while controlling for age, sex and country.This observational study used data from the sixth wave of the SHARE survey. A sample of 22 356 community‐dwelling individuals aged >60 years from six European countries (Spain, Estonia, France, Greece, Czech Republic and Sweden) was analyzed. The pain was measured through assessment of medication used for joint pain or other types of pain, pain location, polypharmacy and pain level. Frailty was assessed with the modified Fried Frailty phenotype.Pain indicators, especially widespread pain and pain severity, were significantly associated with prefrailty (odds ratio 3.30, 95% CI 2.40, 4.55; and odds ratio 0.61, 95% CI 0.51, 0.72) and frailty status (odds ratio 4.69, 95% CI 3.31, 6.67; and odds ratio 0.37, 95% CI 0.30, 0.44). Advancing age and female sex consistently correlated with increased prefrailty (odds ratio 1.06, 95% CI 1.05, 1.07; and odds ratio 1.36, 95% CI 1.22, 1.53) and frailty risk (odds ratio 1.11, 95% CI 1.10, 1.12; and odds ratio 1.71, 95% CI 1.48, 1.96). Country‐specific differences emerged, with Spaniards showing higher odds ratios of prefrailty and frailty compared with Swedish, French and Czech individuals, whereas Greeks showed elevated odds ratios compared with Spaniards. The factors associated jointly explained 27.5% of the variance in frailty categories.Significant associations were identified, particularly with widespread pain and pain severity, highlighting their impact on frailty. Country‐specific variations in frailty prevalence were observed, alongside consistent associations with advancing age and female sex. These findings provide valuable insights into the intricate interplay between pain and frailty, offering the potential for targeted interventions in older adults' care through tailored pain management strategies. Geriatr Gerontol Int ••; ••: ••–••. Geriatr Gerontol Int 2024; ••: ••–••. [ABSTRACT FROM AUTHOR]

The article discusses the potential role of colchicine in treating Oral Mucous Membrane Pemphigoid (MMP), an autoimmune disease affecting the oral cavity. While corticosteroids are the first-line treatment, colchicine showed promising results in patients resistant to other therapies. A retrospective study at Bordeaux University Hospital found that colchicine led to remission in oral MMP lesions, with fewer adverse effects compared to dapsone. Further research is needed to confirm these findings and establish colchicine as a viable second-line treatment option for MMP. [Extracted from the article]

Background: In the randomized, phase 3, SUSA‐301 trial, celecoxib‐tramadol co‐crystal (CTC) provided significantly greater analgesia compared with celecoxib, tramadol, or placebo in adults with acute, moderate‐to‐severe, postoperative pain. This post hoc, secondary analysis further evaluated the use of rescue medication and the incidence of treatment‐emergent adverse events (TEAEs). Methods: Patients (N = 637) were randomized 2:2:2:1 to receive oral CTC 200 mg twice daily (BID; n = 184), tramadol 50 mg four times daily (QID; n = 183), celecoxib 100 mg BID (n = 181), or placebo QID (n = 89). Post hoc analyses were conducted on the use of rescue medications up to 4 and 48 h post‐study drug dose, stratified by baseline pain intensity (moderate/severe), and on the incidence of TEAEs, stratified by rescue medication use. Results: A significantly lower proportion of patients received any rescue medication within 4 h post‐study dose with CTC (49.5%) versus tramadol (61.7%, p = 0.0178), celecoxib (65.2%, p = 0.0024), and placebo (75.3%, p = 0.0001); this was also seen for oxycodone use. Fewer patients in the CTC group received ≥3 doses of rescue medication compared with the other groups, irrespective of baseline pain intensity. In patients who did not receive opioid rescue medication, CTC was associated with a lower incidence of nausea and vomiting TEAEs versus tramadol alone. In patients who received rescue oxycodone, the incidence of nausea was similar in the CTC and tramadol groups, and higher versus celecoxib and placebo. Conclusion: Celecoxib‐tramadol co‐crystal was associated with reduced rescue medication use and an acceptable tolerability profile compared with tramadol or celecoxib alone in adults with acute, moderate‐to‐severe, postoperative pain. [ABSTRACT FROM AUTHOR]

Arthroscopic treatments of hip synovial osteochondromatosis are mostly performed under traction, resulting in neurovascular injury or iatrogenic damage to the labrum or cartilage. This study aimed to assess the effectiveness of outside‐in hip arthroscopy without traction in treating hip synovial osteochondromatosis. This retrospective study was conducted on a series of patients with hip synovial osteochondromatosis treated using outside‐in hip arthroscopy without traction in our hospital between 2018 and 2020. Plain radiography and magnetic resonance imaging (MRI) scans were obtained. The Harris hip score (HHS), hip range of motion (ROM), and visual analog scale (VAS) scores were analyzed. The preoperative scores and last follow‐up scores were compared with a paired‐sample t test. The complications and recurrence postsurgery were recorded. This study included five patients (three male and two female) with an average age of 41 years (range 28–54 years). The mean follow‐up time was 25.2 months (range 18–36 months). All patients experienced groin pain relief and improved ROM. The mean VAS score was significantly lower postoperatively (0.4 ± 0.5) than preoperatively (3.2 ± 0.8) (p < 0.001). The mean HHS improved from 58.6 ± 12.7 (range 43–73) to 89.8 ± 5.26 (range 81–95) (p < 0.001). No major complications, including infection, perineal numbness and swelling, neurotrosis, thromboembolism, or severe persistent pain, were reported. Synovial osteochondromatosis recurred in one patient after 2 years of follow‐up without any obvious symptoms such as hip pain or joint locking. Therefore, no further treatment was necessary. This study showed that outside‐in hip arthroscopy without traction might be a viable option for treating hip synovial osteochondromatosis, effectively and safely relieving symptoms with minimal complications, especially in patients without lesions in the central compartment. [ABSTRACT FROM AUTHOR]

Background: Collagen, a key protein in the body maintains hair, skin and bone health and its production tends to decrease in synthesis as humans age. The demand for vegan collagen‐builder has increased worldwide due to increased adaptability to vegan diet. Objective: This clinical study was designed aim to evaluate the safety and efficacy of vegan collagen builder (VEGCOL™️) at different dosages (2.5, 5, and 10 g) in adult participants. Methods: Total 66 subjects (22 subjects/dose) aged 30 to 50 years were enrolled, and 63 subjects completed the study. Duration of study was 60 days. Evaluations included change in skin elasticity, hydration, crow's feet area wrinkles, fine lines, skin, Glogau skin age, change in pain scale score, muscle strength and subject perception assessment about test treatment use. Results: After 60 days of treatment, there was significant improvement in hair growth rate by 45.01%, 38.54% and 50.37% with p < 0.01 for doses 2.5, 5, and 10 g respectively. Additionally, 19.64% (p < 0.0001) and 20.51% (p < 0.0001) increase in hair density and hair thickness respectively was observed with 10 g dose. 2.5 g dose resulted in 33.03% (p < 0.01) increase in skin smoothness and 49.94% (p < 0.0001) decrease in crow's feet area wrinkles, decreased retraction time by 21.71 milliseconds (p < 0.05). 52.54% reduction in pain score (p < 0.001). No any adverse events were reported. Conclusion: Vegan collagen‐builder effectively improved multiple age‐related concerns such as wrinkles, fine lines, joint pain, muscle strength and hair growth. All respondents perceived the product as beneficial in improving the aesthetics of the skin, hair, and nails. The findings support the use of vegan collagen‐builder as safe and efficacious in promoting healthier skin, stronger muscles, and improved hair and nail conditions. [ABSTRACT FROM AUTHOR]

Background: Brodalumab, a fully human monoclonal immunoglobulin IgG2 antibody that binds the human interleukin 17 receptor subunit A, is available for the treatment of moderate‐to‐severe plaque psoriasis in Europe since September 2017, but so far there are only a few studies on its use in real‐world conditions. Objectives: To assess the management of moderate‐to‐severe psoriasis with brodalumab 210 mg in daily practice after 12 and 52 weeks (W). In addition, patient profiles and treatment pathways are described. Methods: LIBERO is a prospective, multicenter, non‐interventional study including adult patients with plaque psoriasis treated with brodalumab 210 mg. Results: In total, 638 patients (65% male, mean age: 49.3 ± 14.4 years) from 148 sites in Germany were enrolled. The majority suffered from severe (51.1%) or very severe (13.1%) psoriasis according to physician global assessment (PGA0‐5). When starting with brodalumab, 58.5% were biologic naïve and 41.5% were previously treated with another biologic, mainly adalimumab (18.5%) and secukinumab (17.9%). About 74.0% of patients met the primary endpoint of an absolute PASI ≤3 at ~W12 (n = 618, LOCF). The mean PASI was reduced significantly as of ~W2 from 17.2 (±11.7) to 9.7 (±8.8) and improved further to 3.3 (±6.3) at ~W12 (p < 0.001). At ~W52 85.5% of patients reached a PGA0/1‐response (primary endpoint) and 54.1% patients were assessed as completely clear (PGA0) (both n = 399, as observed). Effectiveness of brodalumab was confirmed in relevant subgroup analysis by previous treatment regimen. Most frequently reported adverse events were nasopharyngitis (4.6%), psoriasis (4.6%) and arthralgia (4.1%), new safety signals were not detected. Conclusions: This representative, non‐interventional study confirms the short‐ and long‐term effectiveness and safety profile of brodalumab in the management of psoriasis in daily practice as well as in relevant treatment pathways. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is a systemic autoimmune disease driven by highly active autoantibody‐producing B cells. Activation of B cells is maintained within ectopic germinal centres found in affected joints. Fibroblast‐like synoviocytes (FLS) present in inflamed joints support B‐cell survival, activation, and differentiation. CD27+ memory B cells and naive B cells show very different responses to activation, particularly by CD40 ligand (CD40L). We show that FLS‐dependent activation of human B cells is dependent on interleukin‐6 (IL‐6) and CD40L. FLS have been shown to activate both naive and memory B cells. Whether the activating potential of FLS is different for naive and memory B cells has not been investigated. Our results suggest that FLS‐induced activation of B cells is dependent on IL‐6 and CD40L. While FLS are able to induce plasma cell differentiation, isotype switching, and antibody production in memory B cells, the ability of FLS to activate naive B cells is significantly lower. [ABSTRACT FROM AUTHOR]

Objective: Observational studies have associated glucosamine, used to treat joint pain and osteoarthritis, with reductions in cancer incidence, although their study design was affected by selection bias. We assessed this association using a study design that mitigates this selection bias. Methods: We used the UK Clinical Practice Research Datalink to identify a cohort of patients diagnosed with osteoarthritis during 1995 through 2017. The prevalent new‐user cohort design was employed to match glucosamine initiators with non‐users on time‐conditional propensity scores, who were observed until cancer incidence. Hazard ratios (HRs) and 95% confidence intervals (CIs) of cancer incidence were estimated to compare glucosamine initiators with non‐users. Results: The study cohort of patients with osteoarthritis included 20,541 glucosamine initiators who were matched to 20,541 non‐users. Over an average follow‐up of eight years, the overall incidence rate of any cancer was 16.4 per 1,000 per year. The HR of any cancer incidence with glucosamine treatment was 0.97 (95% CI 0.91–1.02) compared with non‐users. For lung cancer, the HR with glucosamine treatment was 0.99 (95% CI 0.83–1.18), whereas it was 1.11 (95% CI 0.93–1.33) for colorectal cancer, 1.07 (95% CI 0.93–1.23) for breast cancer in women, and 1.03 (95% CI 0.88–1.22) for prostate cancer. Conclusion: In this large, real‐world study of patients with osteoarthritis, designed to emulate a trial, treatment with glucosamine did not reduce the incidence of cancer. This finding reinforces that previous studies, not based on glucosamine initiators, were affected by selection bias. Our study does not support the prescription of glucosamine to prevent cancer in patients with osteoarthritis. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions International registration number The development of haemophilic arthropathy causes joint damage that leads to functional impairment that limits the performance of activities in patients with haemophilia. The aim was to identify the best predictive model for performing instrumental activities of daily living in adult patients with haemophilia arthropathy.Cross‐sectional cohort study. 102 patients were recruited. The dependent variable was the performance of instrumental activities of daily living (Lawton and Brody scale). The dependence on the performance of activities of daily living was the dependent endpoint (Barthel scale). The secondary variables were joint damage (Hemophilia Joint Health Score), pain intensity, and clinical, anthropometric, and sociodemographic variables.The degree of dependence, joint damage, pain intensity, and marital status (Cp = 5.60) were the variables that best explain the variability in the performance of instrumental activities of daily living (R2adj = 0.51). Loss of predictive capacity is acceptable with good mean internal (R2 mean = 0.40) and external (R2‐r2 = 0.09) validation. According to the predictive pattern obtained, patients with haemophilia, who were married, without joint pain or damage, and independent in their day‐to‐day lives, had a score of 7.91 points (95% CI: 7.42; 8.39) in the performance of instrumental activities of daily living.The predictive model for the functional capacity of instrumental activities of daily living in haemophilia patients encompasses factors such as level of autonomy, joint impairment, pain severity, and marital status. Notably, despite the presence of joint damage, individuals with haemophilia exhibit a significant level of independence in carrying out both basic daily tasks and instrumental activities of daily living.Id NCT04715100. [ABSTRACT FROM AUTHOR]

Rationale Aims and Objectives Method Results Conclusion Patients with rheumatoid arthritis (RA) experience a range of symptoms including joint pain and inflammation, stiffness, fatigue, anxiety, and low mood. Similar to patients with other long‐term conditions, they may have periods of time when their disease is under control, and times when their condition is less stable, requiring treatment adjustments. The REMORA2 feasibility study explored the implementation of an integrated symptom‐tracking system using a smartphone application (app), enabling patients to track day‐to‐day symptoms. The data was available in the electronic health record to be viewed at subsequent consultations.This paper explores patients' comments on living with RA, and how patient‐reported symptom data supports informed interactions as patients and clinicians work together to coproduce meaning from the data.Individual semi‐structured interviews were conducted with 21 patients and 7 clinicians, supplemented by nonparticipant observations of 5 clinical appointments. Thematic analysis was used to analyse data from the interviews, with an ethnographic approach used to analyse the observational data.Both clinicians and patients reported the benefits of reviewing the data in the clinic together. This helped inform decisions about pain management and identified patients who might otherwise have dismissed symptoms such as pain, because of their natural inclination to be stoical.Improved insights on the care of RA were generated as patients and clinicians discuss symptom tracking data. This can assist the patient‐clinician dyad in the process of two‐way learning and shared decision‐making on the management of a long‐term condition. [ABSTRACT FROM AUTHOR]

Background: Congenital insensitivity to pain with anhidrosis (CIPA) (OMIM 256800) is a rare autosomal‐recessive condition, also known as hereditary sensory and autonomic neuropathy type IV (HSAN‐IV). The most commonly reported features include anhidrosis, intellectual disability, self‐mutilation, febrile episodes, impaired temperature perception, recurrent infections and/or autonomic nervous system impairment. Major joint destruction and joint deformity known as Charcot (neuropathic) joints are also seen in CIPA patients attributed to insensitivity to joint pain. Methods: We present a case of a 46‐year‐old female affected with CIPA with a known NTRK1 variant and previously unidentified variant. Minigene reporter constructs were generated encompassing the exon 8 to exon 13 of the NTRK1 gene using the reference sequence and one harboring c.1483 + 5G > A variant identified in our proband. Minigene constructs were transfected into HEK293T cells, and the transcript was analysed for splicing to evaluate the effect of this variant in splicing. Results: The patient (46‐year‐old female) exhibited right ankle joint deformity around 5 years of age. Patient also experienced lumbar compression and knee damage in adulthood. She had undergone a significant number of evaluations without clear diagnosis. Her presentation lacked many of the common clinical presentations of CIPA, and therefore, the focus of her evaluation was directed towards her unexplained joint deformities. Exome sequencing revealed a known pathogenic variant in NTRK1 (c.851 ‐ 33T > A:p.? [Intron 7]) and a novel NTRK1 variant (c.1483 + 5G > A:p.? [Intron 11]), which was later re‐classified as likely pathogenic. The patient was started on a biologic disease‐modifying anti‐rheumatic medication (bDMARD) due to a possible inflammatory etiology of her joint deformity. Molecular diagnosis allowed for modification of her treatment and surveillance strategies. Our minigene splicing assay demonstrated that the presence of the c.1483 + 5G > A variant has a negative effect on splicing, supporting the pathogenicity of this novel variant. [ABSTRACT FROM AUTHOR]

Background: Painful temporomandibular disorder (TMD) is the common cause of chronic oro‐facial pain, which may interfere with sleep. Previous studies have documented an association between sleep and TMD. Objectives: This study aimed to further explore the association of night‐time sleep and daytime napping with painful TMD. Methods: A total of 419 patients (aged 31.88 ± 11.54 years with women forming 85.4%) from a TMD/Orofacial Pain center were enrolled. Patients' sleep conditions were evaluated with the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and information on night‐time sleep duration, napping duration and napping frequency was interviewed. TMD was diagnosed according to the Diagnostic Criteria for TMD protocol and stratified into myalgia (muscle pain), arthralgia (joint pain) and combined (muscle and joint pain) subgroups. The severity of TMD was measured with the Fonseca Anamnestic Index (FAI) questionnaire. Restricted cubic spline (RCS) regression models were established to explore relationships between sleep and painful TMD subgroups. Results: Patients with poor sleep quality (PSQI≥6) had higher FAI scores (median 60, p <.001) and higher proportions of painful TMDs. The myalgia subgroup had higher PSQI scores (median 8, p <.001) than the arthralgia subgroup. The RCS models indicated a non‐linear relationship between night‐time sleep duration and myalgia (p <.001), which was not observed in arthralgia. However, there were no significant findings concerning napping and painful TMD subgroups. Conclusion: This study found that the association between sleep and TMD is mainly related to painful TMD conditions, which are associated with night‐time sleep duration. [ABSTRACT FROM AUTHOR]

Background: Somatosensory tinnitus (ST) is associated with activation of the auditory pathway by trigeminal or cervical afferents. Objective: This is a cross‐sectional observational study that aims to verify the association of ST with TMD, bruxism, migraine and psychosocial aspects. Methods: This study was conducted at the Tinnitus Outpatient Clinic of the Clinical Hospital Complex of the Federal University of Paraná. Specific ST characteristics, were evaluated according to the last consensus for the diagnosis of ST. Two groups with 39 individuals each one were formed, the ST group (STG) and the comparison group (CG). TMD was classified according to the Diagnostic Criteria for Temporomandibular Disorders and migraine by the International Classification of Headaches. The presence of probable sleep and awake bruxism was associated with individual's reports and clinical inspections. The applied questionnaires investigated oral behaviours (OB), sleep quality (SQ), psychosocial aspects (PA), central sensitization (CS), tinnitus impact on quality of life (TIQF), and graded chronic pain scale (GCPS). Results: The STG showed a significant association with modulation manoeuvres and trigger points; myalgias and arthralgia; disc displacement with and without reduction; subluxation; bruxism; and presence of migraine. For the same group, we found a significant association with OB, PA, CS, TIQF and GCPS. There was no significant difference between groups regarding SQ. Conclusion: There is a significant association between the presence of ST and the occurrence of TMD, probable sleep and awake bruxism, and migraine. There is also a greater impairment of OB, PA, CS and TIQF. [ABSTRACT FROM AUTHOR]

Background: Biologic therapies approved for treating chronic rhinosinusitis with nasal polyps (CRSwNP) have well‐established safety profiles but reports of rheumatic adverse events (AEs) are increasing and not well defined. This review aims to assess the risk and incidence of rheumatic AEs associated with biologic therapy in CRSwNP and summarize current reported management strategies. Methods: A protocol was registered in PROSPERO [CRD42024525663]. A search was conducted in four electronic databases: Medline (Ovid), Embase, Scopus, and Cochrane CENTRAL from inception until January 4, 2024. Two reviewers independently screened citations and extracted data. Methodological quality was assessed using the Joanna Briggs Institute's critical appraisal tool. Data were pooled using a random effects model to calculate overall incidence and relative risk. Results: Twenty‐one studies met the final inclusion criteria, totaling 3434 patients of which 2763 (80%) received either dupilumab (n = 2257; 82%), mepolizumab (n = 372; 13%), or omalizumab (n = 134; 5%) for treatment of CRSwNP. The overall incidence rate for any on‐treatment rheumatic AE was 0.05 per person–year (95% CI, 0.03–0.09, I2 = 75%). Biologic therapy increased the risk of developing a rheumatic AE (RR = 2.53; 95% CI, 1.29–4.94) compared with placebo. The most frequently reported rheumatic AE was arthralgia or joint pain (n = 94; 95%), followed by lupus‐like syndrome or lupus erythematosus‐like reaction (n = 2; 2.5%). Discontinuation of treatment was the most common intervention (n = 21, 39%). Conclusion: Biologic therapy increases the risk of rheumatic AEs in CRSwNP patients by over twofold. Healthcare providers should remain vigilant in monitoring rheumatic AEs and apply appropriate management strategies on a case‐by‐case basis. [ABSTRACT FROM AUTHOR]

Summary Avascular necrosis (AVN) is a prevalent and progressive complication in young patients with sickle cell disease (SCD), but no study evaluated the long‐term subjective and objective outcome measures. Oxford hip score (OHS) and Oxford shoulder scores (OSS) are validated joint‐specific patient‐reported outcome measures (PROMs). In this prospective multicentre study, 47 SCD patients with pre‐existing diagnosis of AVN occurred at a median age of 35.9 (24.2–47.6) filled out the OHS and OSS at median follow‐up of 9.4 years (4.5–12.9). No patient died after diagnosis of AVN. Hip AVN was present in 34 (72%) patients, with bilateral involvement in 25 (74%); 26 (59%) underwent total hip arthroplasty (THA) at a median age of 34.6 (22.6–49.5); and 4 (15%) required re‐surgery. OHS revealed moderate to severe impairment both in patients underwent THA and no hip surgery. Shoulder AVN was present in 13 (6%) patients and OSS revealed mild to moderate impairment. A high rate of compromised joint function and pain was observed 10 years after diagnosis of AVN regardless of the type of treatment, outlying the need to improve the management of this sickle‐related complication. OHS and OSS are validated joint‐specific PROMs easy to use in all SCD centres. [ABSTRACT FROM AUTHOR]

Background and Purpose Experimental Approach Key Results Conclusions Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation and painful joint destruction. Current treatments are helpful in RA remission, but strong immunosuppressive activity and patient resistance are clinical issues. This study explores a dual‐action inhibitor, possessing both anti‐inflammatory and anti‐resorptive properties, as a novel treatment for RA.Therapeutic efficacy and mechanisms of ectosteric (tanshinone IIA sulfonate [T06]) and active site‐directed (odanacatib [ODN]) inhibitors of cathepsin K (CatK) were evaluated in RA mouse models. Pathology was assessed through biochemical analyses and histopathological examination. Flow cytometry analysis was performed to characterize immune cells. Anti‐inflammatory effects of T06 on nuclear factor kappa beta (NF‐κB) pathway were studied in macrophages.T06 effectively lowered the number of joint‐resident immune cells, accompanied by significantly reduced production of inflammatory cytokines and collagenolytic proteases. This also included the suppression of Th17 cells and IL‐17, resulting in the reduction of osteoclasts in arthritic joints and amplification of the overall anti‐resorptive effect of T06, which has been attributed to its selective inhibition of the collagenolytic activity of CatK by preventing its oligomerization. The anti‐inflammatory mechanism of T06 was based on blocking the phosphorylation of IκBα in the NF‐κB pathway, resulting in reduced activation and expression of inflammatory cytokines. In contrast, ODN had no effect on inflammation and disease progression and was limited to the inhibition of CatK.The combined anti‐resorptive and anti‐inflammatory activities characterize T06 as a novel therapeutic agent for RA. [ABSTRACT FROM AUTHOR]

Chronotherapy of arthritis that is to reduce the early morning pain in the joints using pH sensitive hydrogel microspheres for colon targeting is a novel approach. Novel ketoprofen‐loaded pH‐sensitive Gellan gum‐Sodium alginate (Gg‐NaAlg) microspheres were developed by emulsion crosslinking method using Ethylene glycol dimethacrylate (EGDMA) as a crosslinker. The formulations were characterized by Scanning Electron Microscopy (SEM), Fourier Transforms Infrared Spectroscopy (FT‐IR), and Thermogravimetry. The influence of process parameters such as particle size distribution, drug encapsulation efficiency and matrix swelling has been investigated. The average particle size of microspheres varied from 50 to 100 μm giving an encapsulation efficiency of 70 %. Due to the pH‐sensitive swelling nature of microspheres, the drug was released in the colonic medium of pH of 7.4, but almost no release in acidic media. The kinetics of drug release was analyzed using empirical equations to understand the transport of drugs through polymeric matrices. Drug release was extended up to 10 hr and pulsatile release was observed depending upon the variation in the pH from stomach to colon region. [ABSTRACT FROM AUTHOR]

This article discusses a case report and literature review on the treatment of relapsing polychondritis with inverse psoriasis using tofacitinib and risankizumab. Relapsing polychondritis is an inflammatory condition that primarily affects cartilaginous tissues, while inverse psoriasis is a form of psoriasis that occurs in skin folds. The patient in the case study had a history of Hashimoto's thyroiditis and presented with symptoms such as chest pain, recurrent swelling of the nose and ears, joint pain, and psoriatic lesions. The patient was initially treated with methotrexate and systemic steroid therapy but did not respond well. Tofacitinib and risankizumab were then added to the treatment regimen, resulting in significant clinical improvement. The article also discusses the challenges of treating relapsing polychondritis and the effectiveness of different treatment options. [Extracted from the article]

Key Clinical Message: It is important to recognize and manage gastrointestinal symptoms in patients with BD, as they are linked to high rates of mortality and morbidity. BD can affect any part of the gastrointestinal tract, and prompt diagnosis and appropriate treatment are essential to prevent complications. Additionally, the diagnosis of BD is primarily based on clinical factors due to the lack of pathognomonic laboratory tests. Behçet's disease (BD) is an idiopathic, chronic, and relapsing multi‐systemic vasculitis characterized by recurrent skin lesions and eye disease. There is no pathognomonic laboratory testing; the diagnosis is made mainly on clinical factors. BD symptoms affecting the gastrointestinal (GI) system are particularly important as they are linked to high rates of mortality and morbidity. Although ileocecal involvement is most frequently mentioned, BD can affect any part of the GI tract. There are techniques for keeping track of disease activity during treatment, but they are not ideal. We present a case of a 38‐year‐old male patient admitted to the ICU with a history of black tarry stools of 1‐month duration, fresh blood per rectum 5 to 7 times a day associated with fever, chills, and back and nonspecific joint pain for five days. The patient also experienced left eye episcleritis while being hospitalized, which was later confirmed to be BD. [ABSTRACT FROM AUTHOR]

The primary aim of this article is to propose an effective dengue disease monitoring system by integrating deep learning models with Internet of Things (IoT) and fog computing. In this context, the disease related parameters are collected using IoT devices and further, the reports are securely transmitted to the healthcare facilities utilizing fog computing. In this article, the misdiagnosis error is reduced utilizing attention based long short term memory (ALSTM) network with coati optimization algorithm (COA). The Attention model allocates higher weight to significant parameters and pay additional consideration while training the model. Therefore, the conventional LSTM network is combined with a self‐attention mechanism for enabling this model to focus on relevant parts of the input sequences for precise dengue disease prediction. The Attention Model differs from the conventional model since it delivers higher amount of data into the decoder and improves additional stages to the attention decoder before making its output. Furthermore, the COA is integrated with the ALSTM network for optimal hyper‐parameter selection. The ALSTM‐COA model evaluates the dengue related parameters like nausea, vomiting, skin rash, joint pain, muscle pain, soft bleeding, temperature of water‐sites, humidity of water‐sites, and so forth, for timely dengue disease diagnosis and clinical decision‐making. The experiments performed on a real time dataset state that the ALSTM‐COA model achieves significant prediction results by utilizing different performance measures like recall, accuracy, fall‐out, miss rate, training time, and testing time. The ALSTM‐COA model obtains an accuracy of 99.27%, latency of 0.03 s, and time complexity of 8 s for 500 health records, which are superior to the comparative deep learning models. [ABSTRACT FROM AUTHOR]

Background: The use of communication technologies has allowed a substantial improvement in telediagnosis. Objectives: To evaluate the feasibility and diagnostic agreement of synchronous teleconsultation compared to physical standard examination for temporomandibular disorders (TMD) and orofacial pain. Methods: Sixty‐one patients (50 women, 11 men) with a mean age of 46.07 years referred to the Orofacial Pain Ambulatory Service (SAMDOF —UFPR) were evaluated remotely. They were then examined in person by another evaluator, blinded for the first evaluation. Data on the experience and level of satisfaction with the teleconsultation were also collected. Results: For each type and subtype of TMD, diagnostic agreement values, sensitivity, specificity, positive predictive values and negative predictive values were calculated with a 95% confidence interval. 'Almost perfect' agreement was found for Myalgia (k = 0.915), Arthralgia (k = 0.863), disc displacement without reduction without limited opening (k = 0.955) and no TMD (k = 1.00). 'Substantial' agreement for the subtypes headache attributed to TMD (k = 0.761), disc displacement without reduction with limited opening (k = 0.659) and subluxation (k = 7.82). The diagnoses of local myalgia (k = 0.573), myofascial pain with referral (k = 0.524) and disc displacement with reduction (k = 0.563) obtained 'moderate' agreement. Degenerative joint disease (k = 0.170) and disc displacement with reduction with intermittent locking (k = 0.000) obtained 'weak' and 'no agreement', respectively. More than 90% of the participants were satisfied and reported no discomfort during the assessment, agreeing to participate in another teleconsultation. Conclusion: Synchronous teleconsultation proved to be feasible and presented adequate diagnostic agreement for the main painful TMDs, especially for the diagnosis of myalgia and arthralgia. This format was also well accepted among patients. [ABSTRACT FROM AUTHOR]

The article explores the semiotics of argan phytodiplomacy, focusing on the endangered argan trees in Morocco and their significance to the marginalized Tachelhit Amazigh community. It discusses the gender-and-development model that capitalizes on argan's potential, as well as the diplomatic relations between Morocco, Israel, and the United States regarding agricultural research and argan domestication. The narrative also delves into the global commercial aspects of argan oil, highlighting the role of Moroccan women, a phytochemist, and the challenges of semiotic appropriation and exploitation in the industry. [Extracted from the article]

Summary: Background: Osteoarthritis (OA) is a common disease in equine patients that causes joint pain and loss of function. The aetiology of OA is assumed to be multifactorial. A range of medical treatments are on the market for symptomatic treatment of OA in equine patients, both biological and conventional options. Today, no true disease‐modifying osteoarthritis drug (DMOAD) is available. Objective: To summarise the current evidence of the clinical effect of commonly used intra‐articular treatments of equine OA, specifically the use of intra‐articular glucocorticosteroids (IA‐GCs), intra‐articular hyaluronic acid (IA‐HA), intra‐articular platelet‐rich plasma/autologous‐conditioned plasma (IA‐PRP), intra‐articular interleukin‐1 receptor antagonist protein/autologous‐conditioned serum (IA‐IRAP) and intra‐articular mesenchymal stem cells (IA‐MSCs). Study design: Systematic review. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines, a comprehensive search identified 22 clinical studies where horses with OA, naturally occurring or induced, were treated with one of the mentioned intra‐articular treatments. The studies were reviewed to collect all in vivo studies with clinical follow‐up on horses with OA. Results: IA‐GCs seem to have a beneficial short‐term clinical outcome. Treatment with IA‐HA shows varying clinical results and provides uncertain evidence for a beneficial clinical effect. IA‐PRP shows overall promising clinical results for a significant improvement. IA‐IRAP shows promising significant clinical effect, but most of the studies lack a control group for comparison. IA‐MSCs show varying clinical results, but a majority of the included studies show evidence for a significant improvement in clinical effect. Conclusion: To provide stronger evidence of the clinical effect of the five chosen treatments, further blinded, randomised and placebo‐controlled studies are needed. [ABSTRACT FROM AUTHOR]

The abnormal fluctuation of temperature in vivo usually reflects the progression of inflammatory diseases. Noninvasive, real‐time, and accurate monitoring and imaging of temperature variation in vivo is advantageous for guiding the early diagnosis and treatment of disease, but it remains difficult to achieve. Herein, we developed a temperature‐activated near‐infrared‐II fluorescence (NIR‐II FL) and surface‐enhanced Raman scattering (SERS) nanoprobe for long‐term monitoring of temperature changes in rat arthritis and timely assessment of the status of osteoarthritis. The thermosensitive polymer bearing NIR‐II FL dye was grafted onto the surface of nanoporous core‐satellite gold nanostructures to form the nanoprobe, wherein the nanoprobe contains NIR‐II FL and Raman reference signals that are independent of temperature change. The ratiometric FL1150/FL1550 and S1528/S2226 values of the nanoprobe exhibited a reversible conversion with temperature changes. The nanoprobe accurately distinguishes the temperature variations in the inflamed joint versus the normal joint in vivo by ratiometric FL and SERS imaging, allowing for an accurate diagnosis of inflammation. Meanwhile, it can continuously monitor fluctuations in temperature over an extended period during the onset and treatment of inflammation. The tested temperature change trend could be used as an indicator for early diagnosis of inflammation and real‐time evaluation of therapeutic effects. [ABSTRACT FROM AUTHOR]

Nano‐delivery systems hold great promise for the treatment of rheumatoid arthritis (RA). Current research efforts are primarily focused on enhancing their targeting capabilities and efficacy. Here, this study proposes a novel viral‐mimicking ternary polyplexes system for the controlled delivery of the anti‐inflammatory drug Cyclosporin A (CsA) to effectively treat RA. The ternary polyplexes consist of a nanogel core loaded with CsA and a hyaluronic acid shell, which facilitates CD44‐mediated targeting. By mimicking the Trojan Horse strategy employed by viruses, these polyplexes undergo a stepwise process of deshielding and disintegration within the inflamed joints. This process leads to the release of CsA within the cells and the scavenging of pathogenic factors. This study demonstrates that these viral‐mimicking ternary polyplexes exhibit rapid targeting, high accumulation, and prolonged persistence in the joints of RA mice. As a result, they effectively reduce inflammation and alleviate symptoms. These results highlight the potential of viral‐mimicking ternary polyplexes as a promising therapeutic approach for the targeted and programmed delivery of drugs to treat not only RA but also other autoimmune diseases. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) is a degenerative disease caused by a variety of factors with joint pain as the main symptom, including fibrosis, chapping, ulcers, and loss of cartilage. Traditional treatment can only delay the progression of OA, and classical delivery system have many side effects. In recent years, microspheres have shown great application prospects in the field of OA treatment. Microspheres can support cells, reproduce the natural tissue microenvironment in vitro and in vivo, and are an efficient delivery system for the release of drugs or biological agents, which can promote cell proliferation, migration, and differentiation. Thus, they have been widely used in cartilage repair and regeneration. In this review, preparation processes, basic materials, and functional characteristics of various microspheres commonly used in OA treatment are systematically reviewed. Then it is introduced surface modification strategies that can improve the biological properties of microspheres and discussed a series of applications of microsphere functionalized scaffolds in OA treatment. Finally, based on bibliometrics research, the research development, future potential, and possible research hotspots of microspheres in the field of OA therapy is systematically and dynamically evaluated. The comprehensive and systematic review will bring new understanding to the field of microsphere treatment of OA. [ABSTRACT FROM AUTHOR]

The clinical data from 118 CTD patients with bronchiectasis were collected and categorized into two groups: pulmonary infection present (n = 67) and absent (n = 51), for comparative analysis of characteristics and risk factors. Then, we analyzed and compared their demographics, disease characteristics, and risk factors for infection. Among the whole cohort (n = 118), the incidence of pulmonary infections was 56.78%. The occurrence of rheumatoid arthritis, systemic lupus erythematosus, and vasculitis was found to be associated with an increased risk of pulmonary infection. Sputum culture identified Pseudomonas aeruginosa and Klebsiella pneumoniae as the predominant pathogens in the infected group. Notably, symptoms such as joint pains (p = 0.018) and morning stiffness (p = 0.017) were significantly more common in the infected group compared to the noninfected group. Moreover, our findings revealed that elevated levels of C‐reactive protein and complement C3, along with bronchial expansion observed on high‐resolution computed tomography (HRCT), were significant independent factors in the infection group. Conversely, pulmonary interstitial changes identified through HRCT (OR: 0.135, 95% CI: 0.030–0.612, p = 0.009) were significantly associated with the non‐infection group. Overall, this study provides valuable insights into managing CTD patients with bronchiectasis, emphasizing early detection and tailored approaches to prevent and treat pulmonary infections for better outcomes. [ABSTRACT FROM AUTHOR]

Objective: The management of the infrapatellar fat pad (IPFP) during total knee arthroplasty (TKA) remains controversial. This study aimed to evaluate a novel IPFP preservation technique—"the medially pedicled IPFP flap"—for reducing postoperative pain, wound complications, and improving functional recovery after TKA. Methods: A retrospective analysis was conducted on TKA cases at our institution from 2018 to 2021, including those with IPFP preservation (medially pedicled flap) versus IPFP complete resection. Patient demographics, perioperative parameters (blood loss, operative time, length of hospital stay, visual analogue scale [VAS] score, white cell count [WBC], C‐reactive protein [CRP], erythrocyte sedimentation rate [ESR], and wound oozing), and postoperative follow‐up data (VAS, Knee Society [KSS], or Knee Society functional assessment [KSFA] scores) were compared between groups. Independent sample t‐tests were used to compare continuous data and chi‐squared tests were used to compare categorical data between groups. Results: Six hundred thirty patients were included, with 278 in the medial pedicled IPFP flap group (preservation group) and 352 in the IPFP resection group (resection group). The operative time was significantly shorter in the preservation versus resection group (125.5 ± 23.2 vs 130.3 ± 28.7 mins, p = 0.03), as was the length of hospital stay (8.4 ± 2.7 vs 9.2 ± 2.3 days, p < 0.01). Regarding pain, the preservation group had significantly lower VAS scores on postoperative day 2 (2.0 ± 0.8 vs 2.4 ± 1.2, p < 0.001) and day 3 (1.5 ± 0.5 vs 1.8 ± 1.0, p < 0.001). CRP and ESR levels on postoperative day 5 were also significantly lower in the preservation group. Wound oozing rates were significantly lower in the preservation versus resection group (0.7% vs 2.8%, p = 0.04). No significant differences existed in VAS, KSS, or KSFA scores at the last follow‐up. Conclusion: The novel IPFP preservation technique significantly improved surgical exposure, shortened operative time and length of hospital stay. It also reduced wound pain and oozing compared to IPFP resection. [ABSTRACT FROM AUTHOR]

Background: The effect of dietary modifications on pain and joint function in adults with osteoarthritis (OA) is an emerging area of study. This systematic review aimed to evaluate if adults with OA who consume diets with a higher proportion of plant phenols and omega‐3 fatty acids would have less pain and improved joint function than those with a higher proportion of saturated fatty acids, omega‐6 fatty acids and refined carbohydrates. Methods: Database searches of CINAHL (EBSCO), Clinical Trials (NIH‐NLM), Cochrane Library (Wiley), Dissertation & Thesis Global (ProQuest), Embase (Elsevier), Medline (OVID), PubMed (NLM), Scopus (Elsevier), Web of Sciences (Clarivate) for clinical trials identified 7763 articles published between January 2015 and May 2023. After an independent review of the articles, seven randomised clinical trials and one nonrandomised clinical trial were included in the analysis. Because of the heterogeneity of the outcome measures, a meta‐analysis was not possible. Results: Participants who were instructed to consume high‐phenol/high‐omega‐3 fatty acid diets reported significant improvements in pain and physical function scores. The greatest improvement was reported by those who consumed a diet that had the most omega‐3 fatty acids. Conclusion: Because of the high risk of bias, the strength of the evidence is limited. However, there is evidence that counselling adults with OA to replace refined grains and processed foods with whole plant foods, fish and plant oils may have a favourable effect on pain and physical function. Routine follow‐up care regarding these diet modifications may be necessary to ensure adherence to this therapy. Key points: A systematic review of the literature identified eight clinical trials that studied the effects of diet interventions on pain and physical function in adults with osteoarthritis (OA).The diet interventions used in the clinical trials were categorised based on their varying levels of fatty acids and polyphenols.Instructing adults with OA to consume diets high in omega‐3 fatty acids and polyphenols may have a favourable effect on pain and physical function. [ABSTRACT FROM AUTHOR]

Minimally invasive sacroiliac joint fusion has become increasingly prevalent and is described to reduce pain and improve function. In some patients, pain can recur several months after primary surgery. Lack of early implant osseointegration might be a cause of pain and hence an indication for revision surgery. Triangular titanium implants are the most documented implant for minimally invasive sacroiliac joint fusion. There is, however, no knowledge of how triangular titanium implants osseointegrate in humans and whether fusion is induced over the sacroiliac joint. During planned revision surgery due to recurrent pain, six triangular titanium implants were retrieved from six different patients at median 9 months from primary surgery. All six implants were scanned using microcomputed tomography. The presence or absence of bone in‐growth, on‐growth, and through‐growth of the implants was evaluated as an indication of implant osseointegration. Three of six implants showed no or minor signs of osseointegration. Of the three remaining implants, one showed partial osseointegration and two implants showed high degrees of osseointegration. This study showed that triangular titanium implants can osseointegrate into host bone in humans. When osseointegration occurs, triangular titanium implants can give fusion across the sacroiliac joint. [ABSTRACT FROM AUTHOR]

This article, published in the International Journal of Rheumatic Diseases, provides a comprehensive analysis of the clinical application of JAK inhibitors in SAPHO syndrome. SAPHO syndrome is a rare autoimmune inflammatory disease characterized by skin lesions, bone and joint lesions, and peripheral tissue damage. The study includes a retrospective analysis of 10 SAPHO syndrome patients, detailing their clinical data and treatment outcomes. The most common symptoms observed in these patients were sternoclavicular pain and swelling, joint pain in limbs, palmoplantar pustulosis, and severe acne. The article also includes clinical scores and radiographic images to support the findings. The study suggests that JAK inhibitors may be an effective treatment option for SAPHO syndrome, but emphasizes the importance of personalized treatment for optimal outcomes. [Extracted from the article]

Key Clinical Message: Pauci‐immune necrotizing glomerulonephritis (PING) is a small vessel renal vasculitis usually associated with the presence of antineutrophil cytoplasmic antibodies (ANCA) against myeloperoxidase or proteinase. A small proportion of PING patients do not have ANCA antibodies. A condition known as Pauci‐immune necrotizing glomerulonephritis, or PING for short, is a type of kidney inflammation that affects small blood vessels. This condition is typically linked with the existence of certain antibodies, specifically antineutrophil cytoplasmic antibodies or ANCA, which target myeloperoxidase or proteinase. However, it's worth noting that a minor percentage of individuals diagnosed with PING do not possess these ANCA antibodies. A 24‐year‐old woman with no previous medical history arrived at the ER due to various symptoms including joint pain, fever, difficulty swallowing, and shortness of breath. Despite multiple symptoms suggesting systemic lupus erythematosus (SLE), this diagnosis was ruled out based on the EULAR/ACR 2019 classification criteria and laboratory tests. Other potential diagnoses such as rheumatoid arthritis (RA) and eosinophilic garnulomatosis with polyaniitis (EGPA) were also excluded based on respective criteria. The patient was treated with a 3‐day course of methylprednisolone, followed by prednisolone, which improved her creatinine levels. Subsequent tests for P‐ANCA and C‐ANCA were negative. A kidney biopsy confirmed necrotizing glomerulonephritis, consistent with pauci‐immune vasculitis. A bronchoscopy revealed bleeding and hemorrhage in her lungs, but bacterial culture analysis was negative. The patient was given piperacillin, tazobactam, and vancomycin for septic coverage, as well as intravenous immunoglobulin (IVIg), which led to symptom improvement. [ABSTRACT FROM AUTHOR]

Background: Psychosocial function of Chinese temporomandibular disorders (TMD) pain patients and the correlation with somatosensory function has not been sufficiently studied. Objective: The study aims at assessing the psychosocial function of Chinese TMD pain patients by visualisation method and evaluating the correlations with somatosensory function quantitatively. Methods: The Symptom Checklist 90 (SCL‐90) questionnaire and standardised quantitative sensory testing (QST) were administered to 70 Chinese TMD pain patients and age‐ and gender‐matched healthy controls (HCs). Of these, 40 TMD arthralgia patients received QST before and after medication. Psychosocial and somatosensory parameters were transformed into standardised scores. Differences within groups were assessed through t tests. Correlations between psychosocial and somatosensory profiles were explored through correlation analyses with Bonferroni correction for multiple comparisons. Results: 100% of the Chinese TMD pain patients exhibited psychosocial distress in contrast to HCs. Anger and hostility showed negative correlation with the thermal nonnociceptive parameter (thermal sensory limen, p =.002) and nociceptive parameters (cold pain threshold and pain pressure threshold, p<.001). Correlation analysis indicated that cold detection threshold was negatively correlated with somatization and mechanical pain sensitivity had a negative correlation with anger and hostility through medical treatment (p <.001). Conclusions: Visual psychosocial profiles provided an easy overview of psychosocial function in Chinese TMD pain patients. Anger and hostility was associated with increased thermal nonnociceptive and nociceptive sensitivity to stimuli. Psychosocial distress might be negatively associated with TMD treatment response which indicated a possible need for psychological intervention during treatment. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate the use of high‐frequency sonography as a tool for detecting inflammatory and destructive changes in the hand and foot joints of patients with early and long‐term RA. Methods: This study employs a prospective cohort design involving 162 patients diagnosed with Rheumatoid arthritis (RA) who meet the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria. Patients were divided into two groups based on disease duration: Group 1 (n = 74) included patients with a disease duration of up to 2 years, or early РА (ERA;), Group 2 (n = 88) consisted of patients with a disease duration exceeding 2 years, or long‐term persistent РА (LtRA). All patients underwent a clinical assessment of their joints, as well as radiography and arthrosonography, at the beginning of the study and again at 6 and 12 months later. Results: In the general group of patients, ultrasound examination revealed signs of synovitis in the joints of the hands more frequently (66%) compared with clinical examination (56% by a number of swollen joints [NSJ] and 55% by a number of painful joints [NPJ], P <.01). After 6 months of treatment, 12% of the patients achieved full US remission and 24% achieved partial US remission. Conclusions: Within the scope of comprehensive RA diagnostics, arthrosonography of the joints of the hands and feet, utilizing a combination of greyscale and power Doppler, may surpass radiography in detecting early RA. This method allows for a more accurate assessment of disease activity and progression rates. Access the CME test here and search by article title. [ABSTRACT FROM AUTHOR]

Objectives: This randomized clinical trial study aims to compare ultrasound‐guided versus non‐guided Dextrose 10% injections in patients suffering from internal derangement in the temporomandibular joint (TMJ). Material and Methods: The study population included 22 patients and 43 TMJs suffering from unilateral or bilateral TMJ painful clicking, magnetic resonance imaging (MRI) proved disc displacement with reduction (DDWR), refractory to or failed conservative treatment. The patients were divided randomly into two groups (non‐guided and ultrasound (US)‐guided groups). The procedure involved injection of 2 mL solution of a mixture of 0.75 mL 0.9% normal saline solution, 0.3 mL 2% lidocaine and 0.75 mL dextrose 10% using a 25G needle in the joint and 1 mL intramuscular injection to the masseter muscle at the most tender point. The Visual Analogue Score (VAS) was used to compare joint pain intensity over four different periods, beginning with pre‐injection, 1‐, 2‐, and 6‐months postinjection. Results: Twenty‐two patients 5 males (n = 5/22, 22.7%) and 17 females (n = 17/22, 77.2%) were included in this study. The mean age was 27.3 ± 7.4 years (30.2 ± 7.0) for the non‐guided group and 24.3 ± 6.9 for the US‐guided group. The dextrose injection reduced intensity over time in both groups with statistically significant improvement (P value <.05) at 2 and 6 months in both groups. There was no statistically significant difference in VAS assessment between both groups. Conclusion: Intra‐articular injection of dextrose 10% for patients with painful clicking and DDWR resulted in reduced pain intensity in both US‐guided and non‐guided groups with significant symptomatic improvement over time in both groups. US guidance allowed accurate anatomical localization and safe procedure with a single joint puncture. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is an autoimmune disorder characterized by chronic inflammation of the synovial joints and the dysfunction of regulatory T cells (Tregs) in the peripheral blood. Therefore, an optimal treatment strategy should aim to eliminate the inflammatory response in the joints and simultaneously restore the immune tolerance of Tregs in peripheral blood. Accordingly, we developed an efferocytosis‐mimicking nanovesicle that contains three functional factors for immunomodulating of efferocytosis, including "find me" and "eat me" signals for professional (macrophage) or non‐professional phagocytes (T lymphocyte), and "apoptotic metabolite" for metabolite digestion. We showed that efferocytosis‐mimicking nanovesicles targeted the inflamed joints and spleen of mice with collagen‐induced arthritis, further recruiting and selectively binding to macrophages and T lymphocytes to induce M2 macrophage polarization and Treg differentiation and T helper cell 17 (Th17) recession. Under systemic administration, the efferocytosis‐mimicking nanovesicles effectively maintained the pro‐inflammatory M1/anti‐inflammatory M2 macrophage balance in joints and the Treg/Th17 imbalance in peripheral blood to prevent RA progression. This study demonstrates the potential of efferocytosis‐mimicking nanovesicles for RA immunotherapy. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion This study aimed to investigate the clinical and laboratory characteristics of salivary gland ultrasonography (SGUS)‐positive patients with primary Sjögren's syndrome (pSS) compared to SGUS‐negative patients and to analyse the diagnostic value of SGUS and labial salivary gland biopsy (LSGB) grading in pSS.A retrospective analysis of patients admitted to the Affiliated Hospital of Yangzhou University between May 2019 and November 2023 was conducted. According to the OMERACT scoring system, patients with pSS were divided into an SGUS‐negative group (score <2) and an SGUS‐positive group (score ≥2). The patient's age, gender, clinical symptoms, laboratory parameters and diagnostic examinations were compared and analysed, and Spearman correlation analysis was used to analyse the correlation between SGUS, LSGB and influencing factors.There was no significant difference in dry mouth, dry eyes, tooth loss, fever, joint pain, fatigue, interstitial lung disease or renal tubular acidosis between the two groups, although there were more patients with salivary gland enlargement in the SGUS‐positive group (p < 0.05). In terms of high levels of immunoglobulin G (IgG), high levels of rheumatoid factor (RF), anti‐nuclear antibody ≥1:320, anti‐Sjögren's syndrome A‐52KD and anti‐Sjögren's syndrome B, the number of cases in the SGUS‐positive group was greater than that in the SGUS‐negative group (p < 0.05). LSGB samples were graded per the Chisholm–Mason system with significant differences between multiple groups. SGUS score negatively correlated with age and positively correlated with LSGB grade.This study showed that the SGUS score positively correlated with LSGB grade in pSS patients and negatively correlated with patient age. Thus, SGUS and LSGB are consistent in the diagnosis of pSS to reflect the degree of salivary gland involvement, and patients who are SGUS positive have high RF and IgG levels, a variety of autoantibodies positive and a tendency toward salivary gland enlargement. [ABSTRACT FROM AUTHOR]

Summary: An 8‐year‐old Warmblood cross mare was presented for further investigation of an acute‐onset lameness of the right hindlimb. Three weeks prior to presentation, the horse was found markedly lame at walk following a fall during exercise. The horse was initially managed with field rest, but the lameness persisted. A marked right hindlimb lameness at trot graded 5/10 was confirmed. Atrophy of the right gluteal musculature was evident, and palpation over the region of the right coxofemoral joint provoked a pain reaction. Nuclear scintigraphy revealed a diffuse area of increased radiopharmaceutical uptake in the right femoral head, neck and greater trochanter. Radiographs identified a complete, slightly displaced fracture of the base of the greater trochanter of the right femur. Ultrasound examination of the proximal femur demonstrated an irregularity of the caudolateral bone surface of the greater trochanter, extending along its attachment to the femur; this was consistent with the radiological findings. On re‐examination, after 9 months of stable rest, the horse was found to be sound when trotted in a straight line on the hard surface. Follow‐up two and a half years after the initial incident reported the horse to be nonlame and at its previous level of work. [ABSTRACT FROM AUTHOR]

Objective: This study examined the racial and ethnic differences in individuals with self‐reported and doctor‐diagnosed arthritis, severe joint pain, and provider counseling for physical activity among US adults with arthritis. Methods: We estimated prevalence by race and ethnicity among 31,997 adults aged ≥18 years in the 2019 National Health Interview Survey. We used multiple logistic regression models to investigate associations between outcomes and race and ethnicity. Results: Compared with non‐Hispanic White adults (22.9%), we found a significantly higher age‐adjusted prevalence of arthritis among American Indian/Alaska Native adults (30.3%). Among adults with arthritis, higher age‐adjusted prevalence of severe joint pain among American Indian/Alaska Native (39.1%), non‐Hispanic Black (36.4%), and Hispanic adults (35.7% vs 22.5% [White]) and higher provider counseling for physical activity among non‐Hispanic Black adults (58.9% vs 52.1% [White]) were observed and could not be fully explained by differences in socioeconomic factors, body mass index, depression history, and comorbid conditions. Additional models also containing inability to pay medical bills and food insecurity did not explain racial and ethnic differences. Conclusion: Our findings highlight a need for multilevel interventions to mitigate social and environmental barriers to physical activity and eliminate disparities in individuals with arthritis and severe joint pain. [ABSTRACT FROM AUTHOR]

Objective: Interferon regulatory factor 1 (IRF1) is a transcriptional regulator conventionally associated with immunomodulation. Recent molecular analyses mapping DNA binding sites of IRF1 have suggested its potential function in DNA repair. However, the physiologic significance of this noncanonical function remains unexplored. Here, we investigated the role of IRF1 in osteoarthritis (OA), a condition marked by senescence and chronic joint inflammation. Methods: OA progression was examined in wild‐type and Irf1−/− mice using histologic assessments and microcomputed tomography analysis of whole‐joint OA manifestations and behavioral assessments of joint pain. An integrated analysis of assay for transposase‐accessible chromatin with sequencing and whole transcriptome data was conducted for the functional assessment of IRF1 in chondrocytes. The role of IRF1 in DNA repair and senescence was investigated by assaying γ‐H2AX foci and senescence‐associated beta‐galactosidase activity. Results: Our genome‐wide investigation of IRF1 footprinting in chondrocytes revealed its primary occupancies in the promoters of DNA repair genes without noticeable footprint patterns in those of interferon‐responsive genes. Chondrocytes lacking IRF1 accumulated irreversible DNA damage under oxidative stress, facilitating their entry into cellular senescence. IRF1 was down‐regulated in the cartilage of human and mouse OA. Although IRF1 overexpression did not elicit an inflammatory response in joints or affect OA development, genetic deletion of Irf1 caused enhanced chondrocyte senescence and exacerbated post‐traumatic OA in mice. Conclusion: IRF1 offers DNA damage surveillance in chondrocytes, protecting them from oxidative stress associated with OA risk factors. Our study provides a crucial and cautionary perspective that compromising IRF1 activity renders chondrocytes vulnerable to cellular senescence and promotes OA development. [ABSTRACT FROM AUTHOR]

Background: The burden of musculoskeletal (MSK) pain and disabilities is high in health facilities but remains unknown in the community due to a lack of community‐level studies. The community‐oriented program for control of rheumatic diseases (COPCORD) is focused on determining MSK pain and disabilities through epidemiological surveys. This study adopted the COPCORD stage I protocol to determine the prevalence of rheumatic MSK pain and disability and its associated factors in the Pyuthan district of Nepal. Methodology: A cross‐sectional community‐based study using the quantitative method was conducted in Pyuthan municipality as per COPCORD stage I protocol. COPCORD stage I (phase I and phase II) questionnaires were used to collect data through the interview technique. Populations aged 18 years and above were included in the study. A multistage sampling technique was used, and the total sample size was 2145. The collected data from phase I and phase II were entered in Epidata version 3.1. Descriptive and analytical analysis was done in SPSS. The Chi‐square test was used to find the association between dependent and independent variables. Findings: The overall prevalence (past and current MSK pain/swelling) was 26.81% (95% CI 24.9–28.7). Current MSK pain/swelling was found in 19.53% of the participants, and past MSK pain/swelling was found in 25.87%. Among self‐reported chronic diseases, joint pain was reported by the majority of the participants (17.86%). Age, sex, education, nature of work, current smoking, tobacco use, and alcohol use were found to be associated with past and current MSK pain/swelling. Conclusions: More than one‐fourth of the participants had MSK pain/swelling. The prevalence of MSK pain/swelling was higher in elderly participants, females, illiterates, heavy workers, smokers, tobacco users, and alcohol users. Similar studies should be conducted in other regions of the country, and this study should also be expanded to COPCORD Stages II and III to identify the risk factors and to improve the management of MSK pain and disorders. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) is one of the most common degenerative diseases characterised by joint pain, swelling and decreased mobility, with its main pathological features being articular synovitis, cartilage degeneration and osteophyte formation. Inflammatory cytokines and chemokines secreted by activated immunocytes can trigger various inflammatory and immune responses in articular cartilage and synovium, contributing to the genesis and development of OA. A series of monocyte/macrophage chemokines, including monocyte chemotaxis protein (MCP)‐1/CCL2, MCP2/CCL8, macrophage inflammatory protein (MIP)‐1α/CCL3, MIP‐1β/CCL4, MIP‐3α/CCL20, regulated upon activation, normal T‐cell expressed and secreted /CCL5, CCL17 and macrophage‐derived chemokine/CCL22, was proven to transmit cell signals by binding to G protein–coupled receptors on recipient cell surface, mediating and promoting inflammation in OA joints. However, the underlying mechanism of these chemokines in the pathogenesis of OA remains still elusive. Here, published literature was reviewed, and the function and mechanisms of monocyte/macrophage chemokines in OA pathogenesis were summarised. The symptoms and disease progression of OA were found to be effectively alleviated when the expression of these chemokines is inhibited. Elucidating these mechanisms could contribute to further understand how OA develops and provide potential targets for the early diagnosis of arthritis and drug treatment to delay or even halt OA progression. [ABSTRACT FROM AUTHOR]

Background and Aims: The primary objective of this systematic review and meta‐analysis was to assess the impact of dextrose prolotherapy on individuals diagnosed with knee osteoarthritis (KOA). Methods: To conduct a thorough investigation, a variety of leading international databases were checked, including PubMed (Medline), Scopus, Web of Sciences, EMBASE (Elsevier), ClinicalTrials.gov, and the Cochrane Library. The search covered a period from January 2000 to the end of June 2023, which facilitated the collection of relevant studies. Results: The findings of the study revealed that when the studies utilizing the Western Ontario McMaster Universities Index tool (WOMAC) were combined, patients with KOA who received prolotherapy experienced an improvement in function compared with those who received other treatments (SMD: 0.20; 95% Confidence Interval [1]: −0.11, 0.51; p value SMD = 0.221; I2: 78.49%; pheterogeneity < 0.001). Additionally, there was a decrease in mean pain and stiffness among patients who received prolotherapy compared with those who received other treatments or a placebo [(SMD: −0.95; 95% CI: ‐1.14, −0.76; p value SMD < 0.001; I2: 59.35%; pheterogeneity = 0.070) and (SMD: −0.21; 95% CI: −0.32, −0.10; p value SMD < 0.001; I2: 88.11%; pheterogeneity < 0.001)]. Furthermore, based on the Visual Analog Scale (VAS) score, there was a reduction of 0.81 units out of 10 in mean pain for patients with KOA who received prolotherapy (SMD: −0.81; 95% CI: −5.63, 4.10; p value SMD = 0.693; I2: 48.54%; pheterogeneity = 0.08). Conclusion: Drawing from the data analysis performed in this meta‐analysis, it is apparent that dextrose prolotherapy exhibits promising effectiveness in reducing joint pain and stiffness, as well as improving functional performance in individuals suffering from KOA. Furthermore, it is recommended that forthcoming studies incorporate follow‐up periods to guide decisions concerning the duration of prolotherapy's effects. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is a well‐known autoimmune disorder related with joint pain, joint swelling, cartilage and bone degradation as well as deformity. Fibroblast growth factor 23 (FGF23) is an endocrine factor of the FGF family primarily produced by osteocytes and osteoblasts, involves an essential effect in pathogenesis of RA. IL‐1β is a vital proinflammatory factor in the development of RA. However, the role of FGF23 on IL‐1β synthesis in RA has not been fully explored. Our analysis of database revealed higher levels of FGF23 and IL‐1β in RA samples compared with healthy controls. High‐throughput screening demonstrated that IL‐1β is a potential candidate factor after FGF23 treatment in RA synovial fibroblasts (RASFs). FGF23 concentration dependently promotes IL‐1β synthesis in RASFs. FGF23 enhances IL‐1β expression by activating the PI3K, Akt, and NF‐κB pathways. Our findings support the notion that FGF23 is a promising target in the remedy of RA. [ABSTRACT FROM AUTHOR]

Haemophilic arthropathy (HA), a common comorbidity in haemophilic patients leads to joint pain, deformity and reduced quality of life. We have recently demonstrated that a long non‐coding RNA, Neat1 as a primary regulator of matrix metalloproteinase (MMP) 3 and MMP13 activity, and its induction in the target joint has a deteriorating effect on articular cartilage. In the present study, we administered an Adeno‐associated virus (AAV) 5 vector carrying an short hairpin (sh)RNA to Neat1 via intra‐articular injection alone or in conjunction with systemic administration of a capsid‐modified AAV8 (K31Q) vector carrying F8 gene (F8‐BDD‐V3) to study its impact on HA. AAV8K31Q‐F8 vector administration at low dose, led to an increase in FVIII activity (16%–28%) in treated mice. We further observed a significant knockdown of Neat1 (~40 fold vs. untreated injured joint, p = 0.005) in joint tissue of treated mice and a downregulation of chondrodegenerative enzymes, MMP3, MMP13 and the inflammatory mediator‐ cPLA2, in mice receiving combination therapy. These data demonstrate that AAV mediated Neat1 knockdown in combination with F8 gene augmentation can potentially impact mediators of haemophilic joint disease. [ABSTRACT FROM AUTHOR]

The article discusses the association between kidney function and relapse risk in antineutrophil cytoplasmic antibody–associated vasculitis (AAV). Various studies have evaluated kidney function at different stages of treatment and found conflicting results regarding its impact on relapse risk. While some studies suggest a link between kidney function and relapse risk, others found no association. Future research is needed to validate novel predictors and biomarkers to improve relapse-risk prediction and guide treatment strategies for AAV patients. [Extracted from the article]

The editorial discusses the role of the mechanosensitive ion channel Piezo 1 in osteoarthritis (OA) pathogenesis and its potential as a therapeutic target. Piezo 1 is crucial in transducing mechanical stimuli into cellular responses that exacerbate joint degradation in OA. Targeting Piezo 1 and its associated pathways could offer a novel therapeutic approach for more effective treatments of OA, as it regulates chondrocyte biomechanical signaling and inflammatory responses. Continued research is necessary to translate these findings into clinical therapies for patients with OA. [Extracted from the article]

This document provides a collection of articles on various topics related to dermatology. The first article discusses the complex relationship between allergic contact dermatitis (ACD) and atopy or atopic dermatitis (AD), highlighting the shared inflammatory pathways and clinical presentations between the two conditions. The second article focuses on systemic therapy for atopic dermatitis in children and adolescents, emphasizing the use of biologics such as dupilumab to reduce symptoms and improve quality of life. Other articles cover subjects such as angioedema, urticaria, health literacy in hand eczema and atopic dermatitis, cosmetic sensitization, and allergic contact cheilitis. The document provides valuable insights and information for researchers and individuals interested in these dermatological topics. [Extracted from the article]

This article discusses the long-term use of canakinumab in patients with mevalonate kinase deficiency (MKD), also known as hyperimmunoglobulin D syndrome. The authors share their experiences with canakinumab treatment at a hospital in Italy. They describe several case studies of patients with MKD who have been treated with canakinumab for varying lengths of time. The article highlights the effectiveness of canakinumab in controlling symptoms and managing inflammation in these patients. The authors also discuss the challenges in managing MKD and the need for biological drugs like canakinumab when conventional treatments fail. They conclude that canakinumab is safe and effective for long-term use in MKD patients. [Extracted from the article]