Ankylosing spondylitis (AS) is an inflammatory autoimmune disease and the most common clinical form of spinal arthritis. Over the past decades, tremendous progress has been made in systematic reviews on AS. This study aimed to conduct a bibliometric analysis of AS-related meta-analyses to visualize the hotspots and trends in the field. A comprehensive search was conducted for publications of AS meta-analyses from 2007 to 2025 using the Web of Science Core Collection database. Bibliometric analysis was performed using the Bibliometrix software package, VOSviewer, and CiteSpace. In total, 507 articles were identified, and the number of relevant publications showed annual growth. China, the USA, and England were the most productive countries. Annals of the Rheumatic Diseases was the most productive journal (54, 10.65%), Pan Faming was the most productive author (23, 4.54%), and Anhui Medical University (45, 8.88%) was the most productive institution. High-frequency keywords were mainly grouped into five themes: complications, biologics, physical therapy exercises, gut microbiota, and analytical methods. This first bibliometric analysis of AS-related EBM research showed a 20-year upward trend in AS meta-analyses, consistent with prior studies. CiteSpace revealed that China (top since 2014) and the USA led in publications (53 countries) but had limited collaboration. Pan Faming (23 articles) was the most active author, and Annals of the Rheumatic Diseases published the most articles. Keyword analysis identified five themes (e.g., AS complications, biologics) and research frontiers: pre-2012 genome-AS links, post-2012 multi-center RCTs, and the recent focus on AS patients' HRQoL. Limitations included database and English-language bias; future meta-analyses should adopt standardized outcomes. In recent years, there has been a remarkable surge in the number of meta-analyses on AS. This significant increase underscores the importance of this research area. Studies in this field have mainly focused on several key aspects: risk factors, network meta-analysis, and quality- of-life studies. These findings are highly valuable for understanding advancements in ASrelated research and can also encourage researchers and clinicians to focus on both effective medical treatments and the well-being of AS patients.

Systemic sclerosis is a rare, progressive, multisystem autoimmune disease that can affect the skin, digestive system, internal organs, joints, and hands. Pharmacological treatment remains the standard of care; however, it does not always adequately address all the distressing symptoms experienced by patients. This study aimed to review and summarise the available surgical options for systemic sclerosis. A comprehensive literature review was conducted using a broad search strategy to encompass the wide-ranging aspects of the disease. Systemic sclerosis is associated with a broad spectrum of clinical manifestations. Surgical interventions have been attempted for many of these, with the goals of improving patients' quality of life, reducing pain, and lowering disability. The most common procedures performed in patients with systemic sclerosis include anti-reflux operations and other gastrointestinal surgeries, various hand surgeries, organ transplantation, and selected orthopaedic or plastic procedures. Available evidence suggests that, although systemic sclerosis presents additional challenges in surgical management, it is not an absolute contraindication when surgery is indicated. Surgical management remains a valuable option in systemic sclerosis, particularly when conservative treatments are insufficient. Organ-specific procedures can improve quality of life and, in selected cases, be life-saving. By comprehensively reviewing the available surgical literature, this study may assist clinicians in considering operative approaches where appropriate. Further research is needed to standardise reporting and define clear surgical indications in patients with systemic sclerosis.

Low back pain is a real public health issue. It is a common musculoskel-etal disorder linked to work among health professionals. The objective of this study is to deter-mine the frequency of low back pain among healthcare workers and to study the associated risk factors. This is a cross-sectional study conducted over a period of 6 months during the year 2022 involving a sample of the healthcare staff at Mahdia University Hospital. An anonymous self-administered questionnaire was completed by the healthcare staff, including anthropometric, socio-economic, professional lifestyle habits, and the characteristics of low back pain. A total of 96 participants responded to the questionnaire. The population was mostly fe-male (75.3%) with an average age of 36.21 ± 8.78 years. The average BMI was 27.7 kg/m2 ± 4.5 kg/m2, with nurses being the most numerous group, followed by midwives. The professional ac-tivities were mainly care activities (76.7%). The frequency of low back pain was estimated at 82.2% (n=79). In univariate analysis, a significant association was observed between the low back pain and age (p < 0.001), marital status (p = 0.027), physical activity (p = 0.03), job seniori-ty (p = 0.001), care activities (p = 0.03), sitting position (p = 0.04) and weight carried (p = 0.003). The prevalence of low back pain in our study was 82.2%. This finding aligns with results from studies conducted in Egypt at Zigazig Hospital (79%) and in Rwanda at Kanombe Military Hospital (78%). In this study, multiple factors linked to low back pain were identified, most of which are modifiable, highlighting the need to implement effective preventive measures to reduce the prevalence of low back pain and limit the socio-economic damage it generates.

Osteoarthritis (OA) is a prevalent joint disorder with a significant global impact. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are commonly used for OA treatment but can have adverse effects. This study aimed to investigate the potential anti-inflammatory and analgesic effects of saffron in patients with OA. A randomized, double-blind, controlled trial was conducted in patients with OA aged 50 to 70 years. The intervention group received saffron tablets (containing 50 mg of saffron extract, administered orally once daily) for 12 weeks, while the control group received a matched placebo. Pain severity, physical activity, and levels of IL-1 beta and TNF-alpha were assessed using validated measures and quantitative methods. NSAID treatment was monitored. The saffron group exhibited a significant decrease in IL-1β levels, indicating an anti-inflammatory effect. Both groups demonstrated improvements in pain severity and physical activity scores. However, the saffron group exhibited a significant reduction in NSAID use over time. This study suggests that saffron may be an effective and safe supplement for managing osteoarthritis by reducing inflammation, improving symptoms, and lowering NSAID use. These results support previous research on saffron's anti-inflammatory properties. However, limitations such as a small, mostly female sample, high dropout in the control group, and self-reported adherence highlight the need for larger, more rigorous studies. Saffron consumption may have potential anti-inflammatory and analgesic effects in OA patients. Furthermore, saffron supplementation may reduce the need for NSAIDs, potentially minimizing associated complications. Further research is needed to explore the full benefits and mechanisms of saffron in OA management. IRCT2016091029777N1.

Adipose-Derived Mesenchymal Stromal Cells (ADMSCs) are a developing area of cell therapy due to their ease of access and differentiation potential. Within in vitro studies, culturing cells at low oxygen tension (< 21%) can modulate the immune function of MSCs, enhance cell proliferation, and reduce cell senescence. This could impact their clinical utility when implanted in vivo. This systematic review examined the effect of hypoxic culture on ADMSCs in vitro and their behaviour when implanted into an in vivo disease model. This systematic review was registered on the PROSPERO database with the identification number CRD42023401755. A literature search was performed across four databases: EMBASE, MEDLINE, PubMed, and Cochrane. 320 studies were extracted from Embase, 122 from Medline via Ovid, and no studies were selected from the Cochrane database. Before screening the abstracts, 50 records were removed as duplicates. Following the abstract screening, 330 records were excluded from the search. Based on the complete text, 62 papers were included according to the applied criteria, as shown in Table 1. The final number of included articles was five. In several selected studies, hypoxic culture (or preconditioning) of ADMSCs has been shown to positively affect motility, promoting cell differentiation and the resolution of ischaemic injury. However, hypoxic culture was not universally successful across the selected in vivo study models. Selected studies indicate that hypoxic preconditioning of ADMSCs improves motility, aiding cell differentiation and the healing of ischaemic injury. While in vivo models suggest enhanced cell function with hypoxic culture, results vary, reflecting differences in culture methods and technical translation issues between in vitro and in vivo models. The limited number of papers reviewed makes it challenging to draw broad conclusions due to the diversity of models and methods. To conclude, a common focus in the studies is VEGFA activation, highlighting its potential as a therapeutic target, especially for retinal disorders that affect angiogenesis. Nonetheless, the influence of conditioned MSCs on VEGF-particularly in musculoskeletal research such as cartilage regeneration-has not been thoroughly examined. Future reviews must focus on this gap as the field progresses.

14-3-3η (eta), an intracellular chaperonin, is elevated in the serum of patients with Rheumatoid Arthritis, a progressive inflammatory "autoimmune" disease that impacts joint function and daily activities. This study aimed to assess 14-3-3η levels in DMARD-naïve Rheumatoid Arthritis patients and analyze its association with TNF-α, MMP-1, RA factor, AC CP, and disease activity. A cross-sectional study was conducted on 90 DMARD-naïve RA patients. The clinical evaluation included the Health Assessment Questionnaire-Disability Index (HAQ-DI) and the Disease Activity Score of 28 joints using ESR (DAS28-ESR). Serum levels of RF, ACCP, 14-3-3η, TNF-α, and MMP-1 were measured using ELISA. Mann-Whitney and Spearman correlation tests were applied, with p < 0.05 considered statistically significant. Among 90 RA patients (76 females, 14 males), 68(75.6%) were seropositive. Serum levels of 14-3-3η and TNF-α differed significantly between seropositive and seronegative groups. TNF- α correlated positively with both 14-3-3η (r = 0.397, p < 0.001) and MMP-1 (r = 0.284, p = 0.007). The correlation between 14-3-3η and TNF-α suggests a possible role for 14-3-3η as an adjunctive biomarker in early RA. While findings are promising, the small sample size and lack of follow-up warrant cautious interpretation. Further longitudinal studies are needed to confirm its clinical utility and integration within composite biomarker models. Serum 14-3-3η may serve as a supportive biomarker for the diagnosis of early rheumatoid arthritis and assessment of disease activity. Its correlation with TNF-α reflects a potential link to inflammatory burden. Further large-scale, longitudinal studies are needed to confirm its clinical utility.

Integrative medicine, which combines complementary and alternative medicine (CAM) with conventional treatments, is increasingly utilized by patients with systemic lupus erythematosus (SLE) to manage their condition. This study aims to review the CAM available for SLE patients. Studies focusing on CAM interventions in patients diagnosed with SLE were identified via PubMed, Scopus, Cochrane Library, and Google Scholar through a systematic search conducted to identify relevant articles published up to May 2024. The potential therapeutic roles of specific micronutrients (vitamins A, C, D, and E), macronutrients (omega-3 fatty acids and probiotics), and supplements (ginger, turmeric) were examined, detailing their mechanisms and emerging evidence supporting their use. Additionally, the roles of dietary changes and mind-body interventions were discussed. Despite the absence of established guidelines for supplementation and other interventions, this review emphasizes the need for personalized approaches tailored to individual characteristics and comorbidities. Healthcare providers are encouraged to enhance their knowledge of these CAM modalities to optimize patient care and improve overall quality of life for SLE patients.

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disorder with flare-ups often triggered by environmental stressors. While stress is a known trigger for lupus exacerbations, the relationship between environmental stressors, lupus flares, and discoid lupus erythematosus remains underexplored. This case report examines a patient whose symptoms worsened after exposure to the Eaton fire. A 57-year-old female with lupus reported a flare following the Eaton fire, which severely damaged her parents' home. Symptoms began 12 hours after the fire. Examination revealed erythema and deformity in both ears, consistent with chondritis. After starting a prednisone taper, her condition improved within two weeks. Environmental stressors, like natural disasters, can trigger lupus flare-ups and conditions, such as discoid lupus erythematosus (DLE). Stress-induced immune dysregulation exacerbates autoimmune responses, making it challenging to differentiate discoid lupus from other lupus manifestations. This case highlights the need for recognizing environmental triggers in lupus management and further research into the role of stress in lupus flare-ups.

Gout is a common form of inflammatory arthritis characterized by the deposition of MSU in the joints and surrounding tissues, which results in inflammation and recurrent painful attacks. Currently, xanthine oxidase inhibitors, i.e., Allopurinol and Febuxostat, are used in the therapy. Recently, nanoparticles (NPs) containing metal oxides and non-metal oxides have also been developed to better manage gout. This comprehensive review summarizes the pathophysiology of gout, currently used drugs in the treatment, followed by emerging therapies for gout.

Obesity is a growing global health crisis intricately connected to various chronic conditions, including arthritis. This paper explores the intricate web of hormonal changes in the context of obesity and their profound influence on the development and progression of arthritis. Hormones, such as leptin, insulin, cortisol, and estrogen, all altered in obesity, play pivotal roles in inflammation, cartilage degradation, mechanical stress, and pain associated with obesity-related arthritis. Additionally, the mechanical stress placed on weight-bearing joints by excess body weight accelerates joint wear and tear, contributing to arthritis. Genetic factors, shared biomarkers, and pathways further link these conditions. Recognizing these connections is vital for healthcare professionals and individuals facing the challenges of obesity and arthritis, offering insights into strategies for prevention, management, and intervention. This comprehensive understanding of the complex interplay between hormonal changes, obesity, and arthritis sheds light on multifaceted mechanisms underlying this intricate relationship.