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The EULAR classification defines the CJA as a systemic manifestation affecting both sexes before 16 years old and registers 3 clinical forms: the systemic disease (Still‘s disease), oligo- and poly-articular. Ultrasonography has remarkable contribution in the diagnosis of musculoskeletal apparatus‘ lesions. Due to the advantages (non-invasive, low cost, no negative effects and contraindications), this method allows the static and dynamic evaluation of the hard and soft structures. The purpose of the paper: to assess TMJ involvement in CJA patients by ultrasonography and to define characteristic patterns of the disease. Material and method: the research was conducted on 2 patients with CJA, hospitalized in Rheumatology Department, Rehabilitation Hospital of Iasi during 01.01.2005-31.07.2006. Assessment was done according to a standard protocol in all patients and included: inflammatory and immune parameters and a complex, both static and dynamic, ultrasound evaluation of TMJ. Descriptive statistical analysis was done using SPSS-11. Results and discussions 86.36% patients featured either inflammatory-destructive or degenerative types ultrasound lesions, the majority of them (59.09%) being inflammatory and destructive. Conclusions a non-invasive, easy, low cost and easily reproducible method, ultrasonography, reconfirmed its diagnostic function in the small joints evaluation, including TMJ.

Background: although the benefits of aerobic training on healthy immune system are widely recognized, data in patients with chronic inflammatory immune-mediated rheumatic disorders are still controversial. Aim: to evaluate the influence of aerobic training on the immune system and disease outcomes in patients with rheumatoid arthritis (RA). Material and methods: prospective observational study on 40 consecutive RA fulfilling the inclusion criteria, classified according to their participation in specific aerobic training program. A standard assessment protocol has been used recording disease activity (Disease Activity Score 28) and functional (Health Assessment Questionnaire-Disability Index) scores, inflammatory and immune parameters (TNF-α, C3 and C4, immunoglubulins A, M and G). Statistical analysis was performed in SPSS 16.0, p<0.05. Results: subgroup analysis has demonstrated a statistical significant improvement in all of the clinical and laboratory parameters defining disease activity (DAS28), in addition to significant effects on TNF-α, C3 complement fraction, IgA and IgM levels in RA undertaking aerobic training as compared to baseline (p<0.05); conversely, irrelevant modifications in disease activity and functional scores, as well as no impact on serum cytokines, immunoglobulins and complement levels have been reported in RA in whom exercise was prohibited (p>0.05); furthermore, major differences have been detected in immune response between RA subgroups at final point. Conclusion: Although patients with RA should be optimistic to perform aerobic training, further research is needed to validate the therapeutic benefit on the immune system, disease activity and functional outcomes, particularly in patients with active disease subsets. [ABSTRACT FROM AUTHOR]

Background : Timely detection and aggressive management of interstitial lung disease (ILD) in systemic sclerosis (SSc) are essential to improving outcomes and reducing risks of irreversible lung injury. Objective : to explore the usefulness of an ultraportable ultrasound device for the management of SSc-related ILD and to compare it with clinical and instrumental data. Methods : A total of 19 consecutive SSc patients underwent a comprehensive pulmonary evaluation: clinical, pulmonary function tests (PFTs) (spirometry, DLCO), lung CT (1.5 mm slice thickness reconstruction; HRCT), and lung ultrasound (LUS). A total score was calculated based on the number of color-coded B-lines recorded for each lung sliding. B-lines were analyzed against dyspnea, cough, Velcro, CT imaging (Warrick's score), and PFTs. Global and subgroup analysis were performed (diffuse versus limited cutaneous SSc, Warrick's < 7 versus >7). Results : Symptomatic lung involvement with varying degrees of dyspnea was reported in about 74% of cases (functional NYHA > 2 in more than half), chronic dry cough in one-third, Velcro rales in 42%. A total of 84.24% were classified as SSc with ILD on CT imaging. Statistically significant mild-to-moderate correlations between B-lines and clinical manifestations were demonstrated, as well as PFTs and Warrick's scores (more B-lines, lower pulmonary function, but higher extent and severity on CT) ( p < 0.05); there were differences between SSc patients without and with ILD in terms of the number and distribution of B-lines ( p < 0.05), as well as different B-lines patterns and numbers in diffuse versus limited SSc ( p < 0.05). Conclusions : Ultraportable handheld LUS is a promising method suitable for the management (screening, early detection, and evaluation) of SSc patients.

(1) Background: Although the association between psoriasis and atopic dermatitis (AD) is reported in the literature, scarce data are known about the efficacy of biologic therapy (including TNF and IL-17 inhibitors) in patients with psoriatic arthritis (PsA) and concomitant AD. (2) Objective: We aimed to explore AD in patients with PsA undergoing biologics for their active disease, focusing on prevalence and clinical and potential therapeutic implications. (3) Material and methods: We performed a retrospective analysis of 64 patients with PsA receiving various biological agents, followed-up in an academic outpatient rheumatology department up to 10 years. (4) Results: Atopic diseases were reported in about one third of cases, with a higher incidence of AD (10 cases; 52.6%) vs. atopic rhinitis (6 cases; 31.6%) and allergic asthma (3 cases; 15.8%). Three morphological patterns of AD were recognized including chronic prurigo (3 cases), a chronic lichen simplex (1 case), and eczemas (6 cases). All PsA with concomitant AD displayed a late onset of skin atopy (in their adult life) and demonstrated a specific profile (younger), from urban settings, equally distributed among genders, and requiring switching to a higher number of biologics to achieve disease control. (5) Conclusion: PsA and AD may coexist, requiring special attention when selecting the optimal biologic agent., Competing Interests: The authors declare no conflicts of interest.

Unlabelled: Breast cancer is the second leading cause of cancer death in women, while in Eastern Europe the most common form of diagnosed cancer. Out of the multiple possibilities of early detection of mammary neoplasia that have been elaborated, only mammography has proved to be a simple, efficient method and of a high sensitivity, almost 90% However, the cytological confirmation of diagnosis allows us to perform the preoperative radiotherapy treatment or poly chemotherapy., Material and Methods: we analyzed the informative value of these diagnosis methods in stage I mammary gland cancer (MGC). In this way, in the present paper we demonstrated that collecting samples through fine-needle aspiration biopsy allows the cytological confirmation of the diagnosis of stage I MGC in 30.7% cases., Results and Discussion: In stage I MGC young patients, under 35 years, the cytological confirmation rate is 22.2% and is lower as compared to the cytological confirmation rate in patients older than 35 years which is 37.9% Also, for a tumor diameter < 0.5 cm, the prevalence of cytological confirmation was only 10.3%, while for the diameter of 0.6-1.0 cm the cytological confirmation was around 40.0%. Therefore, in order to improve the cytological diagnosis confirmation rate the tumor biopsy through the USG of the mammary glands is required. Moreover, the cytological investigation of the smear obtained by the first and second puncture was instrumental in confirming the diagnosis in 41.3% and 17.4% cases; the subsequent repetition of the punctures was not useful as it helped to confirmation of the diagnosis only in 9.3% cases. The frequency of diagnosis cytological confirmation depends on the tumor histopathological form and type of growth., Conclusions: Thus, the lowest prevalence was in the mixed forms--12.5% cases, lobular cancer--24.4% cases, while regarding the type of growth, for the rare forms the cytological confirmation rate was 7.7% and 31.5% cases for the schiros growth type.

Breast cancer is the most common oncology disease in women and is one of the major public health issues. Worldwide, is the second leading cause of cancer death in women and cancer research is a priority in all the laboratories of the world, in terms of uncovering the appearance causes of the malignant process, understanding the mechanisms of development, but most of all, the discovery of early diagnostic methods and effective treatment. Ignorance, fear of diagnosis, lack of health education and of efficient programmes for prevention and screening could cause diagnosis of the disease to be detected in the majority of cases in advanced stages, when treatment remains only palliative and very costly, in this cases the patient's suffering being immense. In this way, regarding the clinical diagnosis in stage I mammary gland cancer, in the 496 stage I MGC patients, during the primary clinical investigation the diagnosis of stage I MGC was established only in 165 (33.3%) patients, and in 232 (46,8%) patients the diagnosis of suspicion MGC was obtained. Also, in terms of instrumental diagnosis, such as mammography, ultrasonography in mammary gland cancer stage I, it seems that in accordance with literature data the pathological process features assessment in the mammary gland is problematic especially in young age. Thus, it seems that MGC represents a polymorphic and pathogenic disease and it cannot be admitted that all subgroups of patients will obtain identical results from one tactic of treatment determined for all the patients with MGC. In this way, the concept of MGC both clinical and patho morphological, combines different cell clones depending on its microstructure and biology. As a result, the evolution of the disease, the prognosis and the effectiveness of the treatment may vary in different patients at the same stage, depending on the degree of malignancy of the tumor, its histopathological structure, the degree of expression of molecular markers identification and also immune resistance.

Unlabelled: Despite recent advances in the immune mechanisms of cervical cancer (CC), the relapse still remains an actual issue and recognition of new predictive biomarkers is essential., Aim: The purpose of this retrospective study was to investigate possible differences in the primary, in situ, cellular immune response between cervical carcinoma with and without relapse., Material and Methods: Paraffin-embedded tissue samples from 61 consecutive women with CC (34 with and 27 without relapse) were immunostained for CD3, CD20 and CD45 cells. Immune cell profile densities were further assessed, assigning scores between 0 and 3: "0" meaning the absence of inflammatory infiltrate, "1+" low, "2+" intense and "3+" intense infiltrate with lymphoid follicles. Statistical analysis was performed in SPSS-13 software, p<0.05., Results: Statistically significant intra- and peri-tumoral low numbers of several immune cell subtypes are strongly associated with relapse of disease within three and five years in patients with CC (p<0.05); moreover, statistical significant correlations between immune cells and both free survival (CD3: r=0.382; CD20: r=0.404; CD45: r=0.376) and relapse (CD3: r=-0.408; CD20: r=-0.355; CD45: r=-0.354) have been demonstrated. Only CD3 was reported as predictive biomarker of relapse in CC (ANOVA, t-Student, p<0.05)., Conclusions: Major differences in the cellular immune response among patients with cervical cancer with and without relapse within three and five years have been demonstrated. CD3 may be used as potential prognostic biomarkers, whereas the results are promising for adjuvant immunotherapy.