None of the 360 joints was FOI positive in P1 or P3. Positive findings were in low grade.
FOI agreed well with clinically swollen and tender joints. Disagreement of FOI and CE mainly resulted from the higher rate of positive findings in FOI. The highest agreement was seen for FOI P1 and swollen and tender joints, indicating that P1 displays joints with high clinical activity.
Between 2005 and 2007, 215 patients with gastroesophageal reflux disease (67 with reflux associated with grade I or II esophagitis and 148 without esophagitis) were evaluated at the Department of Surgery, University Hospital Tor Vergata, Rome, and were included in the present study. The evaluations consisted of clinical interviews, endoscopy of the high digestive tract, esophageal manometry and pH monitoring. MTX-HSA in weekly courses. After five injections, MTX-HSA accumulated to 30 Î¼mol/liter MTX-HSA.
Symptom-based evaluative tools should greatly aid the objective evaluation of GERD symptoms, monitor precisely how patients respond to therapy and thereby lead to improvements in GERD management. MTX-HSA is a novel chemotherapeutic prodrug conjugate. Phase I testing revealed an excellent toxicological profile, allowing outpatient treatment and maintaining a high quality of life status for all cancer patients.
The growing importance of symptom assessment is evident from the numerous clinical studies on gastroesophageal reflux disease (GERD) assessing treatment-induced symptom relief. However, to date, the a priori selection of criteria defining symptom relief has been arbitrary.
FOI did not detect any positive findings in 97.8-100% of joints (figure S1), depending on the evaluated image or phase. FOI displayed positive findings in 1 out of 360 joints (0.3%) in CI, 8 out of 360 joints (2.2%, grade 1 changes) in P2 and none in P1 and P3.
In a comparative study30 with MRI as reference, US revealed a sensitivity of 40-70% for synovitis and an agreement (73-100%) comparable to our findings for FOI. Especially for the inflammatory changes, the sensitivity and agreement of US were lower than those for destructive changes. Similar results were obtained in other studies.31 32 US and MRI display both morphological changes (eg, pannus, erosions) and dynamic changes (eg, hyperaemia, hypervascularity, hyperperfusion). FOI only displays the dynamic changes.
Analysing a single FOI sequence, we found that, within each image stack, three phases (P1-P3) may be distinguished as defined by the different time points’ increased signal intensities in the fingertips. Figure 2 shows a typical FOI image of highly active RA, displaying focal increased signal intensity in all three phases. Inflammatory activity in a variety of affected structures was also detected in PsA (figure 3). A triangular, slightly arcuate enhancement from nail bed into DIP was observed in 60 out of 64 (94%) subjects with PsA compared with 8 out of 38 (21%) in patients with definite RA (sensitivity 94%, specificity 79%, positive predictive value 0.88, negative predictive value 0.88; subjects with both RA and psoriasis have been excluded from the calculation). test22 to cover correlations of multiple joints within the same patient.
MTX-HSA at 2-4-week intervals. During week 24, slight stomatitis reoccurred, and treatment was paused again for 4 weeks and then resumed. Until September 1998, the patient had received 35 administrations of MTX-HSA (cumulative MTX dose, 3270 mg or 121 mg MTX/month). No significant toxicity was observed.