Background and ObjectiveAxial spondyloarthritis (axSpA) includes thoracic manifestations and changes in respiratory function that require a comprehensive understanding for effective treatment. This ...review aims to investigate these manifestations and evaluate the role of ultrasound in detecting diaphragmatic changes to provide insights for improved diagnosis and treatment strategies in axSpA patients.MethodsA systematic search was conducted in Index Medicus and Scopus from 2003 to 2023. Inclusion criteria included primary and secondary publications, with a focus on high-quality evidence such as randomised controlled trials and systematic reviews with or without meta-analysis. Keywords spondyloarthritis, respiratory, chest, thoracic, diaphragm and ultrasound were used in the search. A total of 22 articles were identified after duplicates, and inadequate papers were removed.Key Content and FindingsThe review included the prevalence, classification and extra-articular manifestations of axSpA, highlighting the impact on respiratory function. Thoracic manifestations and the potential impact of pharmacological interventions were detailed, and various conditions affecting respiratory dynamics were discussed. In addition, the utility of ultrasonography in assessing diaphragmatic function was explained and the techniques, parameters and measurements used to assess diaphragmatic movement, muscle thickness and respiratory mobility were described. The results illustrate the changes in diaphragmatic function in axSpA patients and their correlation with disease activity.ConclusionsThis narrative review highlights the intricate relationship between axSpA and respiratory manifestations and emphasises the significant impact on thoracic function and diaphragmatic dynamics. The utility of ultrasound in assessing diaphragmatic function offers a promising avenue for objective evaluation that provides insight into disease activity and potential therapeutic responses. This review emphasises the critical role of early diagnosis and vigilant monitoring, and advocates a multidisciplinary approach that integrates non-pharmacological interventions, particularly tailored physical activity, to maintain and improve respiratory function in axSpA patients. Increased research initiatives and awareness of pulmonary complications in axSpA are essential to optimise medical care and improve treatment outcomes in this patient group.
Infrared thermography is used for measuring and analyzing physiological functions and pathology related to the body’s thermal homeostasis and temperature. This review provides an overview of the ...technological advantages of infrared imaging, with the focus on new advances in and opportunities for infrared imaging, as a reliable medical diagnostic tool.
The review has four main parts. Firstly, a short history of thermography development in medicine is given. Secondly, an overview on the clinical and biomedical research results and methodological improvements in established applications of infrared thermography is provided. Thirdly, the details of published research and development results and activities of the last 3 years for time and frequency domain analysis of infrared video
thermography recordings to study some vital functions of human physiology are discussed. Analysis of infrared video thermography streams resulted in important information on microvascular (arteriolar) function of the skin and of vital organs when exposed during an operation. This new set of parameters of microvascular function enhances the assessment of the cardiovascular
system in chronic diseases e.g. in hypertension and diabetes. Infrared
thermography provides valuable information when an organ’s suitability for transplantationmust be assessed based on quantifiable parameters of organ function and viability. Fourthly, a brief overview on a separate, exciting area of infrared imaging is provided as well: the development of a touchless polygraph system. It enables the study of the psychophysiological parameters of stress, by the assessment of breathing and pulse wave patterns by noncontact
methodology, for lie detection purposes.
In conclusion, infrared imaging is a non-invasive, non-radiative, low
cost detection tool, and its application area is constantly growing, along with technical improvements and advances.
Vitamin D is beneficial in patients with immune-mediated rheumatic diseases as it has been shown that it lowers the incidence risk and the level of inflammation. To examine the association between ...clinical outcomes and initial 25-hydroxyvitamin D 25(OH)D concentrations in patients with the immune-mediated rheumatic diseases treated with infliximab for 9 months. This study was performed in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) treated with infliximab for at least 38 weeks. Disease activity was assessed using Disease Activity Score (DAS28) for RA and PsA and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for AS, while the global assessment was performed using the Visual Analogue Scale (VAS). Patients were divided into 2 groups according to 25(OH)D concentration which was classified as deficient or non-deficient (below and above 50 nmol/L, respectively). Concentrations of infliximab (IFX) and C-reactive protein (CRP) were measured according to the manufacturer’s instructions.This study was performed in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) treated with infliximab for at least 38 weeks. Disease activity was assessed using Disease Activity Score (DAS28) for RA and PsA and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for AS, while the global assessment was performed using the Visual Analogue Scale (VAS). Patients were divided into 2 groups according to 25(OH)D concentration which was classified as deficient or non-deficient (below and above 50 nmol/L, respectively). Concentrations of infliximab (IFX) and C-reactive protein (CRP) were measured according to the manufacturer’s instructions. The study included 23 patients (14 with RA, 6 with AS and 3 with PsA), median age 54 years, 15 females. Vitamin D deficient and non-deficient groups had median initial concentrations of 38 and 61 nmol/L, respectively. DAS28 and pain on VAS calculated at the 2nd and 38th week showed a statistically significant decrease only in RA and PsA patients with vitamin D deficiency (
P
= 0.02 and 0.06, respectively). Lower initial concentration of 25(OH)D in patients treated with infliximab was associated with better improvement of clinical measures (DAS28 and VAS) of disease after 9 months of therapy.
Sindrom tarzalnog tunela (STT) relativno je rijetka kompresivna mononeuropatija donjih ekstremiteta uzrokovana kompresijom tibijalnog živca ili njegovih ogranaka (medijalnog ili lateralnog plantarnog ...živca) u području tarzalnog kanala. Pripada skupini kanalikularnih sindroma, a iako puno rjeđi, može se smatrati ekvivalentnim sindromu karpalnog tunela. Klinički se očituje pojavom boli, poglavito u medijalnom dijelu tabana te žarenjem i trncima u području prva tri prsta stopala. Uz kliničku procjenu, za dijagnosticiranje ove neuropatije najčešće se koriste elektrodijagnostičke pretrage – elektroneurografija (ENG) i elektromiografija (EMG), te ultrazvučna pretraga. Liječenje STT-a može biti konzervativno i kirurško. Konzervativno liječenje preporučuje se bolesnicima s lakšim do umjerenim tegobama, dok se kirurško liječenje provodi u bolesnika s težim oštećenjima. Cilj je ovog preglednog rada prikazati novije spoznaje vezane za STT s naglaskom na potvrdu kliničke dijagnoze najčešće korištenim dijagnostičkim pretragama kao što su elektroneurografija (ENG) i elektromiografija (EMG) te ultrazvučni pregled.
Tarsal tunnel syndrome (TTS) is relatively rare compressive mononeuropathy of lower extremities caused by compression of tibial nerve and its associated branches (medial and lateral plantar nerve) in tarsal tunnel. It is one of canalicular sindromes, although much less common, and is equivalent of carpal tunnel syndrome. Clinically it is presented with pain in medial foot aspect, numbness and parestesia in the first three toes. Beside clinical assessement, diagnosis of this neuropathy is made by the use of electrodiagnostic procedures of neurography (ENG) and electromiography (EMG) and diagnostic ultrasound imaging. The management of tarsal tunnel syndrome can be conservative or operative. Patients with light to moderate simptoms are treated conservatively while those with severe damage undergo operative treatment. The aim of this systematic narrative review is to scrutinize the literature to date of TTS with emphasis on clinical diagnosis validation via neurography (ENG) and electromiography (EMG), and diagnostic ultrasound.
Neck pain is one of the most prevalent musculoskeletal diseases which results in considerable pain and disability, and has a great impact on individual level, as well as on health-care system, and ...overall society. Causes of neck pain are different, and prevailing aetiology are mechanical reasons associated with degenerative changes of cervical spine. We are witnessing various diagnostic and therapeutic approaches for these patients. The Croatian Society for Vertebrology of the Croatian Medical Association is presenting a comprehensive narrative review and guidelines for the diagnosis and treatment of neck pain, focusing on the most prevalent causes. The guidelines are the result of consensus of experts of different background, based on the best available evidence. Part 1 relates to diagnosis, while the complementary Part 2 relates to treatment. For the diagnostic part (Part 1) the guidelines encompass: clinical features and evaluation (including questionnaires), laboratory tests, imaging, neurophysiology tests, and minimally invasive diagnostic procedures. The management part (Part 2) includes: pharmacology treatment, physical exercise, traction, manual therapies, physical therapy modalities, orthotics, minimally invasive therapeutic interventions, surgical treatment, rehabilitation after surgical procedures, and psychiatric approach. These are the first Croatian guidelines for neck pain intended in the first place for the physicians’ professional community.
Neck pain is one of the most prevalent musculoskeletal diseases which results in considerable pain and disability, and has a great impact on individual level, as well as on health-care system, and ...overall society. Causes of neck pain are different, and prevailing aetiology are mechanical reasons associated with degenerative changes of cervical spine. We are witnessing various diagnostic and therapeutic approaches for these patients. The Croatian Society for Vertebrology of the Croatian Medical Association is presenting a comprehensive narrative review and guidelines for the diagnosis and treatment of neck pain, focusing on the most prevalent causes. The guidelines are the result of consensus of experts of different background, based on the best available evidence. This part (Part 1) relates to diagnosis, while the complementary part (Part 2) relates to treatment. For the diagnostic part (Part 1) the guidelines encompass: clinical features and evaluation (including questionnaires), laboratory tests, imaging, neurophysiology tests, and minimally invasive diagnostic procedures. The management part (Part 2) includes: pharmacology treatment, physical exercise, traction, manual therapies, physical therapy modalities, orthotics, minimally invasive therapeutic interventions, surgical treatment, rehabilitation after surgical procedures, and psychiatric approach. These are the first Croatian guidelines for neck pain intended in the first place for the physicians’ professional community.
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