The aim of this study was to investigate possible differences in the frequencies of alleles at the HLA loci and at microsatellite loci within the HLA region among patients suffering from psoriatic arthritis (PsA) and healthy controls. Fifty-eight Croatian PsA patients (28 male and 30 female) and 157 healthy unrelated controls were typed for HLA alleles (A, B, Cw and DRB1) by the polymerase chain reaction-sequence-specific primers (PCR-SSP) method, while microsatellite alleles (D6S265, D6S273, MHC class I chain-related gene (MICA) and MIB) were analysed by electrophoresis in an ALFexpress sequencer (Pharmacia Biotech, Uppsala, Sweden). The findings from this study were: (1) the frequencies of B*39 and B*57 were significantly increased in PsA patients; (2) differences in the frequencies of B*13 and B*27 were not statistically significant after correction; (3) the B*0702, B*18, and B*38 alleles were decreased in patients only before correction; (4) none of the alleles at other HLA loci tested were associated with PsA in Croatia; (5) polymorphism at D6S265, D6S273, and MIB microsatellites in patients did not show any statistically significant differences when compared to controls; (6) the increase in the MICA-A4 allele frequency in PsA patients was independent of the B*39 and B*57 alleles.

Atlantoaxial (AA) instability is frequent radiological finding in patients with rheumatoid arthritis (RA). Mostly no serious neurological disorders are expected in such patients. The purpose of the study was to assess the sagittal spinal canal diameter according to Steel's rule of third and its relationship to clinical symptoms. Radiological and clinical evaluation was performed in 65 in-patients with RA. Fifty four patients complained of neck pain, 39 had vertebrobasilar symptoms, and 25 mild neurological disorders. Hyperreflexy tendon responses were registered in 16 patients. Only 1 patient had extensor plantar response. Forward AA dislocation was verified in 28 (43%) cases with a mean value of 8.3mm (4-17 mm). Still free space for spinal cord in spinal canal was obtained in 62 (95%) of patients, which can explain such a low incidence of serious neurological disorders. Our results suggest an association among duration of disease, atlantodental distance, and sagittal spinal canal diameter. We consider that it is important to detect early the most jeopardized patients on the basis of radiological analysis at C1 level according to Steel's rule of third and recognize when rising dbl quote, left (low)safe zone" has exceeded and enters the area of impending spinal cord compression.

The objective of the present study was to investigate possible changes in granulysin (GNLY)-mediated cytotoxicity of peripheral blood lymphocytes in psoriatic arthritis (PsA) patients with respect to different phases of the disease. We prospectively enrolled 25 PsA patients in the active phase, 26 PsA patients in remission and 24 healthy controls. The simultaneous detection of intracellular GNLY and cell surface antigens (CD3 and CD56) was performed with flow cytometry. GNLY apoptotic protein was visualised by immunocytochemistry. Natural killer (NK) cell cytotoxicity was analysed with a cytotoxicity assay against human erythroleukaemia K-562 cells. The percentage of GNLY(+) cells did not differ significantly between PsA patients in the acute phase and those in remission; however, it was always higher than in healthy examinees due to the increased percentage of GNLY(+) cells within T cells, NKT cells, and both, and in the CD56(+dim) and CD56(+bright) NK subsets. The mean fluorescence intensity for GNLY was higher in all lymphocyte subpopulations in the acute phase than in remission and in healthy controls. Accordingly, GNLY-mediated NK cell cytotoxicity against K-562 cells of active phase PsA patients was significantly higher than that in patients in remission or in healthy controls. These findings demonstrated the involvement of GNLY in the worsening of PsA and suggested that GNLY mediated the development of joint lesions.

Polymyalgia rheumatica (PMR) is relatively common disorder in elderly.When the relationship between polymyalgia rheumatica and giant cell arteritis (GCA) is weel recognized there is still controversy about PMR and malignancy. We are presenting a patient with the PMR and adenocarcinoma of the sygmoid colon and hypothesize a paraneoplastic relationship.

Objective: Long-term treatment of osteoporosis is required for optimal efficacy, but adherence to therapy is suboptimal with daily and weekly oral bisphosphonates. The aim of this study was to assess real-world persistence (long-term adherence) with weekly alendronate. Patients and methods:Persistence data were collected according to World Health Organization criteria for the prior month and year for 102 consecutive patients with osteoporosis at three outpatient clinics in Croatia. Persistence was assessed using medication possession ratios (MPR). Adequate persistence was defined as sufficient medication supply to ensure antifracture efficacy (MPR ≥80 %). Self-reported persistence data were compared with resupply prescription data from primary care physicians (PCPs). The effect of patient age, co-therapy, co-morbidity, and time since osteoporosis was diagnosed were evaluated. Conclusions:In Croatia, persistence was superior with weekly administered alendronate than has been reported elsewhere, perhaps due to socio-cultural factors.Larger, longitudinal studies are needed to confirm these results.