Extraarticular manifestations of juvenile idiopathic arthritis and their impact on health-related quality of life.

OBJECTIVES: The objective of this study is to investigate extraarticular manifestations (EAMs) in patients with juvenile idiopathic arthritis (JIA) and assess their impact on health-related quality of life (HRQoL) among these patients. METHODS: This cross-sectional analytic study was carried out on 117 patients with JIA. EAMs were identified clinically by history and examination. Sicca symptoms, peripheral neuropathy, enthesitis, and skin lesions were picked up during clinical examination. Pulmonary involvement was evaluated by high-resolution CT chest. Patients were assessed by abdominal ultrasonography to assess the size of liver and spleen. Atlantoaxial subluxation was evaluated by cervical spine x-rays. Patients were evaluated by Pediatric Quality of Life Inventory-4 (PedsQL-4) and PedsQL-3 arthritis module. RESULTS: The median age of patients was 14 years with a median disease duration 4 years, 82.9% were females. Of the studied 117 JIA patients, 85 patients (72.6%) had at least one EAM. Persistent fatigue (51.3%) was the most prevalent EAM, followed by recurrent skin rash (16.2%), enthesitis (15.4%), recurrent fever (13.7%), and uveitis (12%). Patients with EAMs scored significantly lower in physical functioning (p = 0.001), emotional functioning (p < 0.001), social functioning (p = 0.005), and school functioning (p = 0.001). Regarding PedsQL arthritis module, patients with EAM had also significantly lower scores than did patients without EAM on the domains of pain and hurt (p < 0.001), daily activities (p = 0.008), and worry (p = 0.001). RESULTS: EAMs are prevalent among JIA patients and have a negative impact on their HRQoL. So, early identification and treatment are highly recommended. Key Points • A large percentage of JIA patients experienced at least one extraarticular manifestation (EAM). • Persistent fatigue and recurrent skin rash are the most prevalent EAMs in JIA patients. • JIA patients with EAMs have worse scores in almost all domains of HRQoL.

Clinical and Ultrasonographic Characteristics of the Achilles Tendon in Hemodialysis Patients.

Background and Objectives: The early recognition of tendon alterations in chronic hemodialysis (HD) patients, an awareness of the factors that influence the condition, and active intervention have considerable clinical relevance. The aim of this study was to investigate the musculoskeletal ultrasound (MSUS) features of the Achilles tendon in chronic HD patients and determine the factors associated with tendon abnormalities. Materials and Methods: This study was conducted on 46 HD patients and 24 sex- and age-matched controls. All participants were evaluated clinically for any signs of Achilles tendon abnormalities. Then, the Achilles tendon was scanned bilaterally using MSUS. Results: Among the 92 Achilles tendons in the HD patients, there was tenderness and swelling of only two (2.2%). Regarding MSUS features, there were statistically significant higher thicknesses in the proximal end (p < 0.001), midpoint (p < 0.001), and distal end (p < 0.001) of the Achilles tendons in the HD patients when compared with the healthy controls. Tendinosis was found in 12 (13%) of the HD patients' Achilles tendons, which was statistically significant in comparison to the healthy controls (p = 0.008). There were statistically significant higher scores of structural abnormalities (p = 0.005), bone erosions (p = 0.017), and calcifications (p = 0.015) in the HD patients when compared to the healthy controls. According to the results of a univariate regression analysis, age and male gender were predictive for US abnormalities in HD patients (p = 0.002 and 0.025, respectively). Conclusions: The Achilles tendon in subjects on chronic HD showed frequent US abnormalities. These abnormalities in HD patients appear to be more related to age and gender and may be asymptomatic.

Sustainable multifunctional zinc oxide quantum dots-aided double-layers security paper sheets.

Fluorescence is well-known nowadays as one of the most efficient anti-counterfeiting techniques. Zinc oxide quantum dots (ZnOQds) are exceptionally fluorescence when exposed to ultraviolet (UV) light, which makes them a candidate for anti-counterfeiting printing. The resulting anti-counterfeiting papers are sustainable and resistance against organic dyes. In this work, ZnOQds were prepared via a green method and characterized under UV-visible spectroscopy, along with microscopic observations by transmission electron microscopy (TEM) and crystallography by X-ray diffraction (XRD). Formation of ZnOQds nanocrystals with an average partials size of 7.3 nm was approved. Additionally, double-layers sheets were prepared at two loading concentrations of ZnOQds, namely 0.5 and 1 (wt./v) and underwent characterization using a topographical surface study via field emission scanning electron microscopy (FE-SEM). Hybrid sheets were mechanically more stable compared to single-layer paper and likewise polymer film. Moreover, aging simulation approved a high stability for hybrid sheets. Particularly, the photoluminescence emission affirmed anti-aging character of hybrid paper for more than 25 years. The hybrid sheets also showed a broad range of antimicrobial activity.

Mechanical and antibacterial properties of recycled carton paper coated by PS/Ag nanocomposites for packaging.

Polymer nanocomposites and paper constitute a new class of packaging materials. In this study silver nanoparticles were prepared by novel method as antibacterial additive, where, synthetic takes place with aid of a novel, non-toxic, and eco-friendly biological materials namely rice straw (RS) powder. The prepared Ag nanoparticle was examined by transmission electron microscope (TEM), X-ray diffraction pattern (XRD) and UV-spectroscopy. The silver nanoparticles were then embedded into commercial polystyrene solution. The recycled carton paper was coated by the polystyrene nanocomposites containing different concentration of silver nanoparticles, namely 2, 4, 6 and 8% based on polystyrene. The prepared recycled carton sheets were characterized by scanning electron microscope (SEM). The mechanical properties, water vapor permeability and antibacterial effect of recycled carton sheets were also investigated.