Browsing by Author "Veličković, Zoran (58261319300)"

Introduction Adult-onset Still’s disease (AOSD), a systemic inflammatory disorder, often represents a heterogeneous entity and diagnosis requires the exclusion of mimicking disorders, including autoinflammatory diseases. We present a patient who meets the diagnostic criteria for AOSD and Muckle–Wells syndrome (MWS). Case outline A 35-year-old male presented with lymphadenopathy and a chronic nonspecific rash, fever spikes, widespread arthralgia, and joint effusions. Laboratory results showed increased inflammation, leukocytosis, neutrophilia, thrombocytosis, and elevated liver enzymes, accompanied by negative immunoserological tests. Patient was diagnosed with AOSD and prednisone (15 mg/d), methotrexate (10 mg/w) and chloroquine (250 mg/d) are introduced in therapy. Due to refractory course, patient was introduced with anti IL-6 biological agent tocilizumab in 2014 (8 mg/kg monthly). However, after three doses, the drug is stopped due to disease exacerbation. In 2015, there was suspicion that there was another underlying disease from the autoinflammatory spectrum, but DNA analysis of the most common mutations in the NLRP3 gene was negative. In 2017, an ear, nose, and throat specialist confirmed bilateral sensorineural hearing loss, and in 2019, amyloidosis was confirmed after biopsy of the duodenum. Patient fulfilled a new-proposed diagnostic criteria for MWS and confirmation of mutation in NLRP3 gene is not obligatory according to Eurofever registry. Conclusion The symptoms of AOSD and MWS partly overlap, as well as their diagnostic criteria. In chronic refractory cases of AOSD, evaluation of diagnosis should be performed and autoinflammatory syndromes must be kept in mind. © 2024, Serbia Medical Society. All rights reserved.

Background: The aim of the study was to assess gait pattern of patients diagnosed with fibromyalgia (FM) while performing demanding motor and/or cognitive dual tasks while walking. Further, idea was to explore possible correlations of dual task gait pattern alterations to patients’ functional status and presence or absence of clinical symptoms associated with FM. Methods: Twenty-four female FM patients and 24 healthy female subjects performed a basic walking task, a dual motor, a dual mental (cognitive) and a combined, dual motor and cognitive task simultaneously. Quantitative spatial (stride length) and temporal (cycle time, swing time and double support time) gait parameters were measured using GAITRite walkway system and their variability was assessed. Patients underwent clinical examination including assessment of functional status, pain and fatigue level, psychiatric and cognitive manifestations. Results: The motor, cognitive and combined dual tasks affect gait performance in FM patients. Difference in tasks between FM and healthy subjects was found as double support time prolongation. Comparison of tasks showing that cycle time in FM was longer than controls and stride length was shorter in patients for all conditions, while no changes were found in any of the gait parameters variability. Further, mental/cognitive dual tasks had a larger effect than motor tasks. Correlations were also found between depression and functional status of the patients and the gait parameters. Conclusions: Gait is affected in FM patients while dual task walking. No changes in stride-to-stride variability point that patients preserve stability in complex walking situations. Analysis of gait may provide additional information for the FM identification based on presence of clinical features and cognitive status. Correlation of dual task gait alterations with occurrence of clinical symptoms and influence of cognitive changes on gait pattern could additionally define FM subgroups. © 2021, The Author(s).

Objectives: This study aimed to investigate the efficacy of glucosamine-sulfate (GS), nonanimal chondroitin-sulfate (naCS), and S-adenosylmethionine (SAMe) combination on ultrasound findings, inflammation, pain, and functionality in knee osteoarthritis. Patients and methods: In the prospective, randomized, double-blind, placebo-controlled pilot study conducted between August 2019 and November 2019, 120 par ticipants (28 males, 92 females; mean age: 66.4±7.9 years; range, 42.4 to 74. 5 years) were randomized at a 1:1:1 ratio to the placebo group, the first experimental group (a combination of GS, naCS, and SAMe was administered to the experimental groups. The first experimental group received 375 mg of GS, 300 mg of naCS, and 100 mg of SAMe, whereas the second experimental group received 750 mg of GS, 600 mg of naCS, and 200 mg of SAMe). Laboratory (erythrocyte sedimentation rate, C-reactive protein, tumor necrosis factor alpha, interleukin [IL]-1β, IL-6, IL-17), clinical (Visual Analog Scale [ VAS], short form health survey [SF-36], the Western Ontario and McMaster Universities Arthritis Index [WOMAC], and the Tegner Lysholm Knee Scoring Scale [ TLKS]), and musculoskeletal ultrasound (MSUS) assessments were performed at baseline and af ter three and six months. Results: A minor increase was observed in the second experimental group af ter six months using ultrasonography to evaluate articular cartilage thickness (p<0.05). The investigational product's superiority in reducing osteoarthritis ultrasonographic findings was not proven. A moderately negative association was found between cartilage thickness and VAS scores at baseline (ρ=-0. 36, p<0.01), while the presence of massive osteophytes on MSUS showed a low to moderate association with all clinical outcomes. There was no dif ference in the delta changes between groups for the VAS, TLKS, WOMAC, and SF-36. The only serum inflammatory marker outside the reference range was IL-1β, but no significant changes were observed af ter six months. Conclusion: According to the results of our investigation, treatment for knee osteoarthritis should be evaluated using more objective outcomes. The most important conclusion of our study is that IP may result in a slight increase in articular cartilage thickness, which was associated with a decrease in pain intensity at baseline. Clarification of the potential influence of this combination on radiographic progression and laboratory markers of inflammation requires further exploration. © 2023, Turkish League Against Rheumatism (TLAR). All rights reserved.