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JRPMS 2023

Original Article JRPMS, Vol 7, No 1, March 2023, p.1-7
A Comparative Study of Patients with Seropositive and Seronegative Rheumatoid Arthritis
Chetan Saner, Archana Sonawale, Alhad Mulkalwar, Kshitij Sonawale, Ravi Keswani
Keywords: EULAR classification, Polyarthritis, Remission, Rheumatoid factor
Objectives: The aim of this study was to analyse and compare the clinical profile, disease activity, extent of disabilities and response to treatment in patients with seropositive and seronegative Rheumatoid Arthritis (RA). Methods: A prospective observational study was conducted among 46 patients of RA at the General medicine and Rheumatology OPDs of a tertiary care hospital over a period of 18 months. The clinical profile, disease activity, extent of disabilities and response to treatment of patients with seropositive and seronegative RA was analysed and compared. Results: The number of joints involved as well as the outcome indicators (DAS 28 score, HAQ score, SDAI and CDAI) were significantly higher for the seronegative group of patients, indicating more inflammation, higher disease activity and slower response to treatment in the group. Rate of radiological progression of the disease was also higher in seronegative RA. Conclusion: Contrary to what was previously believed, patients with seronegative RA have a relatively later disease onset and more active disease at presentation. Physicians should be aware of the considerable clinical burden of seronegative RA, especially at the time of disease onset. However, given the small sample size of this study, these results require validation from larger cohorts.
Review Article JRPMS, Vol 7, No 1, March 2023, p.8-17
A dental approach to hereditary and congenial metabolic bone diseases
Afroditi A. Rallatou, Sophia D. Sakka, Christos Zafeiris
Keywords: Congenial, Hereditary, Metabolic bone disease, Oral manifestation, Teeth
Bone growth requires a balance of minerals such as calcium, phosphorus, and factors of bone biomineralization. The difference between jaws’ bones and the rest of the bones is the existence of teeth. Although the development of teeth has no similarities with bones, the biomineralization of both is happening at the same time. Consequently, the disturbances in the metabolism of minerals and peptides which participate in osteogenesis, have an impact on teeth, jaws, periodontal tissues, and oral mucosa. The hereditary and congenial metabolic bone diseases are being analysed and classified based on their genetic profile and oral manifestations. Regarding the categories, there are metabolic bone diseases caused by genetic mutations, like hereditary rickets, and others caused by chromosomal abnormalities, such as Down syndrome. In addition, many disorders are provoked by enzymatic dysfunction, disturbances of creation of polypeptide chain, while others have an unknown explanation. Many oral manifestations are related with problems in the dentition, oral mucosa, periodontal tissues, and jaws. Especially some syndromes present with cleft lip and palate. To conclude, there is a big variety of dental symptoms of these disorders, while the most frequent are the delayed eruption of teeth, oligodontia, a dysplastic enamel and dentine.
Review Article JRPMS, Vol 7, No 1, March 2023, p.18-25
Hyperparathyroidism-jaw tumor syndrome: A rare disorder with significant clinical features
Dimitrios Kourkouliotis
Keywords: CDC73 gene, Genetic testing, Hyperparathyroidism-jaw tumor syndrome, Jaw tumors, Parathyroid carcinoma
Hyperparathyroidism-jaw tumor syndrome is a rare disorder that is inherited in an autosomal dominant manner and predisposes to the development of parathyroid adenomas and carcinoma, ossifying jaw tumors, uterine neoplasms and renal cysts. It is caused by inactivating mutations in the gene CDC73 that it was first identified in 2002. The purpose of this narrative review is to highlight the genetic background of the syndrome and its clinical manifestations as well as to emphasize the significance of genetic testing in diagnosis from an early age. The clinical and familial features of the syndrome were collected by searching on electronic database PubMed/Medline using the MeSH terms “Hyperparathyroidism-jaw tumor syndrome” or “HPT-JT syndrome”. 246 articles were returned of which, 44 were reviews and 59 case reports. Two nationwide retrospective studies were found. This article is focused mainly on data from the last decade, as there seems to be a better understanding of the genetic basis due to the evolution of DNA sequencing techniques. To date, there have been over 200 patients reported in approximately 50 families carrying a germline mutation of CDC73 gene, suggesting that there should be an augmented awareness of identifying both patients and their relatives.
Review Article JRPMS, Vol 7, No 1, March 2023, p.26-32
The role of miRNAs in titanium implants-molecular and pathophysiological mechanisms
Ioannis Ioakeimidis, George I. Lambrou
Keywords: Titanium implants, miRNAs, osseointegration, peri-implantitis
Implants are structures made of alloplastic materials. They are widely implemented in both orthopedics and dentistry in order to rehabilitate different parts of the body with predictable outcomes. Although plenty materials have been introduced, titanium still remains the gold standard in Implantology. MiRNAs constitute a group of small non-coding RNA sequences composed of approximately 22 nucleotides. It is a well-known fact that they play a significant role in various biological processes such as osseointegration and peri-implant health maintenance, promoting the differentiation of mesenchymal stem cells into osteoblast cells. They regulate bone remodeling and signaling pathways of bone formation as well. Moreover, miRNAs can be utilized as activators of implant surfaces, biomarkers in the diagnostic process and finally occupy a prominent place in the therapeutic approach in Implantology. Even though the importance of miRNAs in Implantology is obvious, more studies are needed for a complete comprehension of the effects triggered by miRNAs.
Mini Review JRPMS, Vol 7, No 1, March 2023, p.33-37
The effect of kyphoplasty and vertebroplasty on denosumab discontinuation rebound fractures
Paraskevas-Asimakis Velitsikakis, Stylianos Kopanos, Georgios Giovanidis, Aikaterini Manta, Christos Zafeiris
Keywords: Kyphoplasty, Vertebroplasty, Denosumab, Rebound fractures
Denosumab is an antiresorptive agent that significantly reduces bone turnover markers, increases mineral density and as a result, decreases the risk of vertebral fractures. The drug holiday effect on denosumab is associated with a high risk of multiple vertebrae fractures soon after the withdrawal. Discontinuation reasons may vary, but common reasons are the patient’s will, discontinuation due to an upcoming dental procedure and long treatment period. Treatment of these fractures can be either surgical augmentation or conservative with the use of antiresorptive drugs. The purpose of this scientific paper is to review current data on the effect of either kyphoplasty or vertebroplasty on these types of fractures. Several studies showed that surgical augmentation is associated with a higher risk of multiple vertebrae fractures in comparison with conservative treatment and thus, it is not recommended, though more research is needed.