10 14 microbial cells, which have 100- fold more genes than the human native genome [ 1 ]. In the past decade, multiple studies demonstrated that the disruption of microbial ecosystems within human body might trigger medical disorders, particularly rheumaticdiseases [ 1 ].
The role of gut microbiota in rheumaticdiseases
There are three main roles of the gut microbiota in rheumaticdiseases. First, the microbes can act on an immune defense mechanism by competing with potential pathogens for space and food [ 1 ]. The commensal bacteria exhaust the
therapies (e.g., chiropractic, massage, reflexology), mind-based interventions and spiritual medicine (e.g., prayer, hypnotherapy, yoga, Tai Chi, Qi Gong), biologically based therapy (e.g., diet supplement and Herbs), energy therapies (e.g., magnets, Reiki, pulsed electric field), procedures (e.g., acupuncture, colon cleansing, mineral baths, chelation, hydrotherapy), and miscellaneous (e.g., copper bracelets, snake oil, leech therapy, dimethyl sulfoxide, venoms, exercise). A few of them are based on evidence. The manuscript reviewed evidence on CAM in various rheumatic
option for rheumaticdiseases.
There are various sources of MSCs. They can be obtained from both infant and adult tissues. Infant tissues mainly include umbilical cord (UC) tissues, cord blood cells and developing tooth buds of the mandibular third molar. MSCs can be derived from adult tissues as well, most commonly from the bone marrow, others from the umbilical cord, placenta, adipose tissue, muscles, peripheral blood, synovial fluid and articular cartilages. Infant tissues MSCs contain more multipotent primitive MSCs compared with adult tissues. They are able to
The main goal of treating rheumaticdiseases is to achieve rapid and effective suppression of inflammation. More and more drugs have been proven to be able to achieve these goals nowadays. The current practice is to give a recommended dose of drugs to our patients according to the body weight, risk factors and tolerance, etc. However, all our patients are different individuals who have different pharmacokinetics, and this difference in pharmacokinetics can affect the true drug concentration that is working inside them. This may create
Patient with rheumaticdiseases are at increased risk of malignancies. The most widely known malignancies associated with rheumaticdiseases other than inflammatory myositis include lymphoproliferative disorders and skin cancer. Treatment options of rheumaticdiseases such as disease-modifying anti-rheumatic drugs (DMARDs) and biologics may also increase the risks of different malignancies. It is important to be aware of the association of malignancy with rheumaticdiseases and anti-rheumatic agents, in order to guide our decision of
.[ 14 , 15 , 16 , 17 , 18 , 19 , 20 ] In one study on ANA patterns in healthy subjects versus patients with ANA related autoimmune rheumaticdisease conditions, nuclear fine speckled (45.8%) and nuclear dense fine speckled (DFS) (33.1%) were the two most commonly encountered patterns in healthy subjects. In contrast, fine speckled (42%) and coarse speckled (26.1%) were the two most common patterns in patients. It’s interesting that certain ANA patterns are exclusively found in the patients’ ANA test results, including coarse speckled, nuclear homogeneous and
in the health cost.[ 10 ] Recommendations for the management of RA from academic and administrative bodies around the world have been published for the practicing rheumatologists. One of these recommendations, the European League of Associations of Rheumatology (EULAR), has been widely adopted in many European and non-European countries. Regular update of the recommendations is being published by the EULAR RA task force. The latest version of the EULAR RA recommendations was finalized and published recently in the journal Annals of the RheumaticDiseases. [ 11 ] In
International Commission on Radiation Protection [ 35 ]. But the age of exposure should also be taken into account and that younger age will have higher cumulative risk. One Hong Kong study suggested that the associated lifetime cancer incidence for patients who are 20 years of age was estimated to be up to 0.622%. This is not negligible from the view of public [ 36 ]. Thus, ordering a PET-CT should be clinically justified.
PET-CT is useful for diagnosing the rheumaticdisease especially when the presentation, serology, and clinical pattern are
1. Cortes S, Cutolo M. Capillaroscopic patterns in rheumaticdiseases. Acta Reum Port 2007;32:29-36.
2. Ho M, Belch JJ. Raynaud’s Phenomenon: State of the Art 1998. Scand J Rheumatol 1998;27:319-22.
3. Carrol GJ, Withers K, Bayliss CE. The prevalence of Raynaud’s syndrome in rheumatoid arthritis. Ann Rheum Dis 1981;40:567-70.
4. Müller-Ladner U. Raynaud’s phenomenon and peripheral ischemic syndromes. 1st ed, Bremen: UNI-MED Verlag AG; 2008, pp. 36-41.
5. Wigley FM