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001-es BibID:	BIBFORM084306
Első szerző:	Oláh Csaba (idegsebész)
Cím:	Assessment of cervical spine involvement in rheumatoid arthritis patients in the era of biologics : a real-life, cross-sectional MRI study / Csaba Oláh, Kardos Zsófia, Kostyál László, Hodosi Katalin, Tamási László, Bereczki Dániel, Szekanecz Zoltán
Dátum:	2020
ISSN:	0172-8172 1437-160X
Megjegyzések:	Cervical spine involvement may lead to severe complications in rheumatoid arthritis (RA). In the era of modern therapies, atlantoaxial subluxation (AAS) may be rare; however, it may still be detected in asymptomatic patients. The onset of myelopathy can occur at any time. Altogether 49 female RA patients were included. Among them, 15 were methotrexate treated, biologic free, while 34 patients received biologics. The patients had no cervical pain or any neurological symptoms. We assessed the first (C1) and second (C2) cervical vertebrae by 3?T magnetic resonance imaging (MRI). In addition to AAS, we also determined odontoid erosion or periodontal soft tissue thickening. We associated our MRI findings with clinical, laboratory parameters, and hand radiography. We detected anterior AAS and soft tissue thickening in one-quarter, while odontoid erosions in eight (16%) of RA patients. There were no significant differences among the therapeutic subgroups. No posterior or vertical AAS was seen. Anterior AAS was associated with higher degree of inflammation, soft tissue thickening was seen at younger age, while odontoid erosions were associated with van der Heijde?Sharp scores of the hand. None of the patients had any lesions requiring surgery. The presence of cervical involvement in RA patients with 10?11?years of disease duration is still an important and frequent phenomenon. Higher disease activity and erosive disease are associated with atlantoaxial involvement. 3?T MRI is a sensitive method to assess AAS, as well as soft tissue lesions and odontoid erosions.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Rheumatoid arthritis Atlantoaxial subluxation Cervical spine involvement Odontoid erosion
Megjelenés:	Rheumatology International. - 40 : 6 (2020), p. 915-921. -
További szerzők:	Kardos Zsófia Kostyál László (1974-) (radiológus) Hódosi Katalin Tamási László Bereczki Dániel (1960-) (neurológus) Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus)
Pályázati támogatás:	TAMOP-4.2.4.A/2-11/1-2012-0001 TÁMOP GINOP-2.3.2-15-2016-00015 GINOP GINOP-2.3.2-15-2016-00050 GINOP
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001-es BibID:	BIBFORM081586
Első szerző:	Oláh Csaba (idegsebész)
Cím:	Assessment of cognitive function in female rheumatoid arthritis patients : associations with cerebrovascular pathology, depression and anxiety / Oláh Csaba, Kardos Zsófia, Andrejkovics Mónika, Szarka Enikő, Hodosi Katalin, Domján Andrea, Sepsi Marianna, Sas Attila, Kostyál László, Fazekas Katalin, Flórián Ágnes, Lukács Katalin, Miksi Ágnes, Baráth Zsuzsanna, Kerekes György, Péntek Márta, Valikovics Attila, Tamási László, Bereczki Dániel, Szekanecz Zoltán
Dátum:	2020
ISSN:	0172-8172 1437-160X
Megjegyzések:	We assessed cognitive function of female rheumatoid arthritis (RA) patients and analyze the determinants, with special focus on cerebrovascular morphology. Sixty methotrexate (MTX-) or biologic-treated RA patients and 39 healthy controls were included in a cross-sectional study. Smoking habits, alcohol intake and time spent in education were recorded. Standard measures were performed to assess cognitive function (Montreal Cognitive Assessment, MOCA; Trail Making Test, TMT; Victoria Stroop Test, VST; Wechsler Adult Intelligence Scale, WAIS; Benton Visual Retention test, BVRT), depression (Beck Depression Inventory, BDI), anxiety (State-Trait Anxiety Inventory, STAIT/S) and general health status (Short Form 36, SF-36). Mean disease activity (28-joint Disease Activity Score, mDAS28; erythrocyte sedimentation rate, mESR; C-reactive protein, mCRP) of the past 12 months was calculated; anti-cyclic citrullinated peptide (CCP) and rheumatoid factor (RF) were assessed. Cerebral vascular lesions and atrophy, carotid intima?media thickness (cIMT) and plaques, as well as median cerebral artery (MCA) circulatory reserve capacity (CRC) were assessed by brain magnetic resonance imaging (MRI), carotid ultrasound and transcranial Doppler, respectively. Cognitive function tests showed impairment in RA vs controls. Biologic- vs MTX-treated subgroups differed in TMT-A. Correlations were identified between cognitive function and depression/anxiety tests. WAIS, STAIS, STAIT and BDI correlated with most SF-36 domains. Numerous cognitive tests correlated with age and lower education. Some also correlated with disease duration, mESR and mDAS28. Regarding vascular pathophysiology, cerebral vascular lesions were associated with VST-A, carotid plaques with multiple cognitive parameters, while MCA and CRC with MOCA, BVRT and BDI. RA patients have significant cognitive impairment. Cognitive dysfunction may occur together with or independently of depression/anxiety. Older patients and those with lower education are at higher risk to develop cognitive impairment. Cognitive screening might be a useful tool to identify subgroups to be further investigated for cerebrovascular pathologies.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Rheumatoid arthritis Cognitive dysfunction Cerebrovascular disease Transcranial Doppler Carotid artery Methotrexate Biological therapy
Megjelenés:	Rheumatology International. - 40 : 4 (2020), p. 529-540. -
További szerzők:	Kardos Zsófia Andrejkovics Mónika (1967-) (klinikai szakpszichológus, neuropszichológus, pszichoterapeuta) Szarka Enikő Hódosi Katalin Domján Andrea (1979-) (jogász, egészségügyi menedzser) Sepsi Marianna Sas Attila Kostyál László (1974-) (radiológus) Fazekas Katalin (orvos) Flórián Ágnes Lukács Katalin Miksi Ágnes Baráth Zsuzsa Kerekes György (1973-) (belgyógyász, kardiológus, angiológus) Péntek Márta Valikovics Attila Tamási László Bereczki Dániel (1960-) (neurológus) Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus)
Pályázati támogatás:	TAMOP-4.2.4.A/2-11/1-2012-0001 TÁMOP GINOP-2.3.2-15-2016-00050 GINOP GINOP-2.3.2-15-2016-00015 GINOP
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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