Figure 3 - uploaded by Ebrahim Mulla
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Bilateral X-rays of the hands and wrists of a patient with RA. The arthritis is particularly severe in the hand at right, with several joint deformities.
Source publication
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease. It is characterised by symmetrical joint involvement and extra-articular manifestations. Joint and periarticular tissue destruction occurs as a result of inflammation of the synovial joints, leading to functional impairment. Early diagnosis and treatment are the key to minimisi...
Contexts in source publication
Context 1
... investigations are not required in primary care. Negative investigations do not rule out inflammatory arthritis such as RA. Waiting for investigation results should not delay referral if there is a clinical suspicion of RA. To speed up the diagnostic process, consideration should be given to the following investigations (see Table 3 and Fig. 3). Local protocols may recommend these after a referral has been made, but only while awaiting specialist ...
Context 2
... show soft tissue swelling, periarticular osteopenia, loss of joint space, erosions and deformity. Helps with both diagnosis and determination of disease severity (see Fig. 3). coxib-type medication (such as celecoxib or etoricoxib) should be considered to improve symptoms. Of these, naproxen is the NSAID of choice, due to its efficacy and safety profile. The side-effect profile of this class of medication includes dyspepsia, cardiovascular disease, stomach ulcers and bleeding. It is recommended to ...
Citations
... 11 Prevalence of early rheumatoid arthritis have been reported as 0.7%. in a suburb of Colombo in Sri Lanka. 12 Thus, the prevalence of RA in the present study (4.8%) which is much greater than the global prevalence of RA may suggest that COVID-19 acts as a strong triggering factor for development of rheumatoid arthritis. ...
Introduction and objectives: Musculoskeletal symptoms of myalgia and arthralgia after recovery of COVID-19 is a pressing issue. Objective of this study was to assess the prevalence of persistent myalgia and arthralgia and likelihood of developing rheumatoid arthritis (RA), six weeks following COVID-19. Methods: A descriptive longitudinal study was conducted in selected private sector hospitals in Colombo, Sri Lanka. PCR positive COVID-19 patients were recruited by consecutive sampling until required sample size of 333 was fulfilled. They were contacted over the phone six weeks after the discharge. Interviewer administered questionnaire was used to evaluate the presence of symptoms of myalgia and arthralgia. Those with positive symptoms were invited for a consultation to conduct further investigations. Results: Of the 333 patients, 96 (28.8%) had persistent arthralgia, myalgia or both, six weeks after recovery from COVID-19. Among them, 56.3% had only arthralgia, 10% had only myalgia and 33% had both myalgia and arthralgia. Two patients (4.8%; 95% CI: 0.6-16.2%) were confirmed of having RA. Conclusions: More than one fourth of patients, suffered with persistent symptoms of myalgia and arthralgia six weeks following COVID-19 and 2 patients (4.8%) were confirmed to have rheumatoid arthritis.
Articular syndrome is often the presentation of a person’s various rheumatic or related diseases. It includes both arthralgia and arthritis, with objective signs of joint inflammation defining the latter. This syndromic approach to joint pain enables a scientific method for early diagnosis of common rheumatic conditions without compromising the recognition of uncommon conditions. This review explores common rheumatic conditions associated with articular syndrome, including osteoarthritis, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE). It supports the early differentiation of uncommon but emerging entities such as reactive arthritis (ReA). The aim of the review is to comprehensively overview various forms of articular syndrome to update rheumatologists’ and allied health specialists’ knowledge. Epidemiology, clinical presentations, diagnostic approaches, and therapeutic strategies are discussed in the context of articular syndrome. The challenges emerging in the peri-pandemic COVID-19 era are highlighted. The improved understanding of the spectrum of clinical conditions and disease states presenting with articular syndrome may facilitate early diagnosis, optimal management, and enhanced patient outcomes within the realm of rheumatology.
Rheumatoid arthritis (RA) is a chronic autoimmune disease, which is compared to "immortal cancer" in industry. Currently, SYK, BTK, and JAK are the three major targets of protein tyrosine kinase for this disease. According to existing research, marketed and research drugs for RA are mostly based on single target, which limits their efficacy. Therefore, designing multitarget or dual-target inhibitors provide new insights for the treatment of RA regarding of the specific association between SYK, BTK, and JAK from two signal transduction pathways. In this study, machine learning (XGBoost, SVM) and deep learning (DNN) models were combined for the first time to build a powerful integrated model for SYK, BTK, and JAK. The predictive power of the integrated model was proved to be superior to that of a single classifier. In order to accurately assess the generalization ability of the integrated model, comprehensive similarity analysis was performed on the training and the test set, and the prediction accuracy of the integrated model was specifically analyzed under different similarity thresholds. External validation was conducted using single-target and dual-target inhibitors, respectively. Results showed that our model not only obtained a high recall rate (97%) in single-target prediction, but also achieved a favorable yield (54.4%) in dual-target prediction. Furthermore, by clustering dual-target inhibitors, the prediction performance of model in various classes were proved, evaluating the applicability domain of the model in the dual-target drug screening. In summary, the integrated model proposed is promising to screen dual-target inhibitors of SYK/JAK or BTK/JAK as RA drugs, which is beneficial for the clinical treatment of rheumatoid arthritis.
