Urinary glycosaminoglycans in systemic lupus erythematosus: marker of renal affection and relation to disease activity

To evaluate glycosaminoglycans [GAG], heparan sulphate [HS] and chondroitin sulphate [CS] levels in the urine of systemic lupus erythematosus [SLE] patients. Also, to determine its possible use as a marker for lupus nephritis and its correlation with disease activity. This study was conducted on 30 patients suffering from SLE. They were subdivided according to disease activity and renal affection. Ten apparently healthy subjects were taken as a control group. GAGs were isolated from urine with ion exchange chromatography on DEAE sephacel. Determination of HS and CS levels were done with ELISA. There was a significant increase of GAGs and HS levels in SLE patients than in controls [p<0.05]. There was a highly significant difference [p<0.01] between active and inactive SLE patients as regards CS/HS ratio. GAGs and CS/HS ratio were significantly higher in active patients with lupus nephritis [p< 0.001]. Urinary GAGs may represent an additional, non-invasive diagnostic approach for lupus nephritis. It could be used as a parameter for disease activity and lupus nephritis

Biochemical markers of bone turnover in postmenopausal osteoporosis and relation to female sex hormone estradiol

To evaluate bone turnover in postmenopausal osteoporosis and its relation to female sex hormone estradiol, using biochemical markers of both bone formation and resorption. Thirty females suffering from postmenopausal osteoporosis were studied compared to ten apparently healthy females. Estimation of biochemical markers of bone formation including procollagen type 1 carboxy- terminal propeptide [PICP], osteocalcin and alkaline phosphatase was performed. Hydroxyproline was estimated in the urine as a marker of bone resorption. Also, serum estradiol values were assessed. Our results revealed an increase in the values of biochemical markers of bone formation PICP and osteocalcin, but no change in alkaline phosphatase was detected. Also, there was an increase in the biochemical marker of bone resorption, hydroxyproline. There were decreased estradiol values in our patients that were correlated with the biochemical markers of bone turnover. Regular estimation of biochemical markers of bone turnover may be valuable in early diagnosis, prevention and treatment of postmenopausal osteoporosis. Estradiol strongly affects bone turnover in postmenopausal osteoporosis that reflected on the values of biochemical markers of bone turnover

Standing and kneeling as risk factors in knee disorders

To determine the prevalence of knee disorders in some occupations possibly related to work positions that put strain on the knees. A cross-sectional study has been carried out on 46 floor layers and 38 carpenters who were exposed to knee straining at work as well as 48 clerks whose work does not strain the knees. The members of the study were interviewed using a questionnaire including personal, occupational and past histories and present knee complaints. They were subjected to clinical examination of the knees and workers who reported knee complaints were subjected to radiological imaging. The prevalence of knee complaints was significantly higher among floor layers [47.8%] and carpenters [34.2%] than among clerks [14.6%]. 28.3% of floor layers and 10.5% of carpenters had changed work tasks or working methods because of knee complaints. The prevalence of bursitis was significantly higher in floor layers [17.3%] as compared to clerks [2.08%] while there was no significant difference between carpenters and clerks as regard bursitis. The prevalence of hyperkeratosis was significantly higher in floor layers [58.7%] and carpenters [36.8%] as compared to clerks [14.6%]. The prevalence of knee osteoarthritis was significantly higher in floor layers [77.2%] as compared to clerks [28.5%], while there was no significant difference between carpenters and clerks as regard knee osteoarthritis. Comparison between clinical signs and radiological knee osteoarthritis showed no significant association between radiological knee osteoarthritis and intra-articular and retropatellar crepitation while there was no association with pain caused by knee bending. Risk factors of knee osteoarthritis were found to be occupation, obesity and duration of work. Work in which a considerable amount of time is spent in knee straining positions, as floor layers and carpenters, causes more self reported knee complaints and contributes to the development of knee disorders and osteoarthritis