RESUMEN
OBJECTIVES: Adenosine deaminase (ADA) is an enzyme being involved in purine metabolism and plays a significant role in the immune system. The aim of this study was to investigate the use of adenosine deaminase levels in differentiating between rheumatoid arthritis and osteoarthritis. MATERIAL AND METHODS: Thirty patients with rheumatoid arthritis and 30 osteoarthritis patients enrolled the study. They were matched in sex and age. Using the ROC curve, we determined the optimal serum and synovial cutoff for rheumatoid effusion. RESULTS: The results showed a statistically significant difference between ADA levels in joint effusion and serum of patients with rheumatoid arthritis and osteoarthritis (p<0.001). Synovial fluid cutoff value for diagnosing rheumatoid arthritis was 20 with a sensitivity of 90% and specificity of 80% and the serum cutoff value was 15 with a sensitivity of 93% and specificity of 53.3%. Area under ROC curve for synovial ADA, ESR and CRP co-linearity was 99%. CONCLUSION: We concluded that synovial total ADA assay can be a sensitive and specific test, being suitable for rapid diagnosis of rheumatoid effusions.
RESUMEN
BACKGROUND: About 50,000 new cancer cases occur annually in Iran, of which gastrointestinal (GI) cancers are the most common. Colorectal cancers (CRC) account for the third and fourth most prevalent cancers amongst Iranian men and women, respectively. Since CRC has some well-known hereditary forms with differences in their prevalence according to regional heterogeneity, we designed a study to assess familial aspects of this cancer in subjects who reside in Mazandaran Province, Iran. METHODS: We interviewed all CRC patients who attended a private GI clinic during 1999-2007, with histologically confirmed diagnoses of colorectal adenocarcinoma, about their family histories of CRC and age at diagnosis. Pedigrees were drawn up to second-degree relatives. RESULTS: A total of 293 CRC cases enrolled in the study, of which 152 were male and 141 were female. The mean age of patients was 52.6±15.2 years. Of these, 98 patients (33.5%) were under the age of 45. A total of 66 cases (22.5%) had familial histories of CRC, being significantly more prevalent in younger subjects (11.2% vs. 44.9%, P<0.0001). Thirty-two patients (10.9%) fulfilled the criteria for hereditary non-polyposis colon cancer. In addition, right-sided colon cancers were more prevalent in those with positive familial histories (P<0.05). CONCLUSION: Due to the frequency of early-onset CRC and familial syndromes, a more intense screening protocol for early detection of CRC should be developed for this population.