Revista Colombiana de Reumatología (English Edition)最新文献

{"title":"Central tolerance in T cells, what’s new?","authors":"Alex Imbachí-Salamanca ,&nbsp;Gloria Vásquez","doi":"10.1016/j.rcreue.2024.09.001","DOIUrl":"10.1016/j.rcreue.2024.09.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Random somatic recombination of T cell receptors facilitates the variability of response to foreign antigens. Then, central tolerance occurs, a mechanism designed to avoid exit of autoreactive T cells from the thymus. However, failures in this process can induce the appearance of autoimmunity.</div></div><div><h3>Materials and methods</h3><div>This narrative review was conducted through a literature search focused on describing relevant and recent concepts of central tolerance of T cells.</div></div><div><h3>Results</h3><div>Multiple cell groups are part of the thymic microenvironment, among them, thymic epithelial cells are responsible for directing development of thymocytes, especially medullary thymic epithelial cells that direct the negative selection process.</div></div><div><h3>Conclusions</h3><div>Factors that affect thymocytes, the thymic microenvironment, or interaction between them, can lead to development of immunodeficiencies and/or autoimmunity.</div></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"31 4","pages":"Pages 480-488"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing inflammation and adverse effects of glucocorticoids in clinical practice","authors":"Juan Sebastián Peinado-Acevedo ,&nbsp;Tatiana Rivera-Bustamante ,&nbsp;Jairo Rivera ,&nbsp;Yeison Santamaría-Alza","doi":"10.1016/j.rcreue.2023.08.004","DOIUrl":"10.1016/j.rcreue.2023.08.004","url":null,"abstract":"<div><div>Corticosteroids play a vital role in enabling the body to tolerate stressful situations and regulate the inflammatory process. Excessive or persistent inflammation can lead to tissue damage and the development of diseases. Glucocorticoids are crucial in modulating the impact of inflammatory disorders, such as allergies, autoimmune diseases, and sepsis. These disorders can be life-threatening and benefit from glucocorticoid administration. Natural and synthetic glucocorticoids are utilized for the diagnosis and treatment of adrenal function disorders and various inflammatory, immune, and neoplastic conditions. The discovery of glucocorticoids is a testament to the ingenuity and collaboration of researchers. For over 70 years, glucocorticoids have revolutionized medicine and are widely employed in various medical conditions. This article provides a comprehensive review of the critical considerations for the clinical application of glucocorticoids, aiming to strike a balance between their benefits and potential risks. Understanding its history, chemical structure, pharmacology, and mechanisms of action provides the foundation for achieving proper use of this type of medication.</div></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"31 4","pages":"Pages 498-510"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of core muscle endurance of females with fibromyalgia versus healthy females: An observational study","authors":"Dewanshu Sindwani,&nbsp;Manjyot Kaur","doi":"10.1016/j.rcreue.2024.08.001","DOIUrl":"10.1016/j.rcreue.2024.08.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the numerous benefits of core muscle strengthening in improving symptoms of fibromyalgia (FM), limited studies have quantified core muscle function in FM patients.</div></div><div><h3>Objective</h3><div>To compare the core muscle endurance of FM females with age-matched healthy females and determine whether a correlation exists between core muscle endurance and FM severity.</div></div><div><h3>Materials and methods</h3><div>Pre-diagnosed female FM patients (<em>n</em> <!-->=<!--> <!-->7) and age-matched healthy females (<em>n</em> <!-->=<!--> <!-->19) were assessed using McGill's core endurance tests in four positions – flexion, extension, and bilateral side-bridge. The longest contraction holding time (in seconds) in each position was noted and compared in both groups. Additionally, patient-reported Fibromyalgia Impact Questionnaire (FIQ) scores were obtained to determine disease severity.</div></div><div><h3>Results</h3><div>The mean holding time for trunk extensors (26.14<!--> <!-->±<!--> <!-->7.7<!--> <!-->s), right lateral flexors (20.14<!--> <!-->±<!--> <!-->8.3<!--> <!-->s), and left lateral flexors (20.86<!--> <!-->±<!--> <!-->5.3<!--> <!-->s) was significantly lower in the FM females than the healthy females (trunk extensors<!--> <!-->=<!--> <!-->55.21<!--> <!-->±<!--> <!-->17.1<!--> <!-->s; right lateral flexors<!--> <!-->=<!--> <!-->36.05<!--> <!-->±<!--> <!-->13.2<!--> <!-->s; left lateral flexors<!--> <!-->=<!--> <!-->35.11<!--> <!-->±<!--> <!-->13.8<!--> <!-->s). The endurance of trunk flexors was statistically similar in both groups (FM females<!--> <!-->=<!--> <!-->52.14<!--> <!-->±<!--> <!-->27.9<!--> <!-->s; healthy females<!--> <!-->=<!--> <!-->74.37<!--> <!-->±<!--> <!-->37.7<!--> <!-->s). Lastly, core muscle endurance was not correlated with the FIQ scores in FM patients (<em>p</em> <!-->&gt;<!--> <!-->0.05).</div></div><div><h3>Conclusion</h3><div>The results of this preliminary study revealed that core extensor and lateral flexor endurance in FM females was lower than their healthy female counterparts. Larger sample studies are needed to further substantiate our findings.</div></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"31 4","pages":"Pages 473-479"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical manifestations, laboratory features, and evolution in patients with autoimmune/autoinflammatory syndrome induced by adjuvants (ASIA)","authors":"Javier A. Cavallasca ,&nbsp;Jorge L. Musuruana ,&nbsp;María del Rosario Maliandi","doi":"10.1016/j.rcreue.2024.08.006","DOIUrl":"10.1016/j.rcreue.2024.08.006","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Autoimmune/autoinflammatory syndrome induced by adjuvants (ASIA) suggests that contact with different adjuvants such as silicones or aluminium used as excipient in some vaccines can cause the appearance of different symptomatology.</div></div><div><h3>Materials and methods</h3><div>A retrospective analysis of the clinical manifestations, laboratory parameters, treatment, and evolution of a case series of 13 patients with ASIA syndrome related to silicone implants and vaccines was performed.</div></div><div><h3>Results</h3><div>In 10 (77%) of the patients there was a history of silicone implants, in the rest of the patients there was a history of vaccination. The most frequent symptom in patients with silicone prostheses was Raynaud's phenomenon (72%), while in patients with a history of vaccination, arthralgias and myalgias were the most frequent symptoms. One patient met the criteria for primary Sjögren's syndrome while another patient had limited systemic sclerosis and associated Sjögren's syndrome. Most of the patients had elevated acute phase reactants (61%), while in the group of patients with a history of silicone prosthesis 60% presented positivity for antinuclear antibodies.</div></div><div><h3>Conclusion</h3><div>Raynaud's phenomenon and skeletal muscle symptoms were the most common manifestations in patients with breast prosthesis and vaccination history, respectively.</div></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"31 4","pages":"Pages 457-462"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of patients under 18 years of age with lupus nephritis at the Pablo Tobón Uribe Hospital and at the San Vicente Fundación Hospital in the city of Medellín between 2008 and 2017","authors":"Lorena Quiñones-Ríos ,&nbsp;Mayra Alejandra Estévez Capacho ,&nbsp;Laura Fernanda Niño Serna ,&nbsp;Lady Johana Hernández Zapata ,&nbsp;Ruth María Eraso Garnica ,&nbsp;Catalina Vélez Echeverri ,&nbsp;Richard Baquero Rodríguez","doi":"10.1016/j.rcreue.2024.08.004","DOIUrl":"10.1016/j.rcreue.2024.08.004","url":null,"abstract":"<div><h3>Introduction</h3><div>The kidney is one of the organs frequently affected in systemic lupus erythematosus (40–60%); the manifestations are variable, from a silent pattern to the irreversible impairment of renal function.</div></div><div><h3>Materials and methods</h3><div>Descriptive study with retrospective information in a group of patients under 18 years of age with a diagnosis of lupus nephritis, attended in two referral centres of the city of Medellin between 2008 and 2017. Clinical records of patients who met the inclusion criteria were reviewed.</div></div><div><h3>Results</h3><div>The median age was 13 years, with predominance in females. The majority had renal involvement at the time of diagnosis of lupus. Histological class IV was the most frequent (48%). Age under 10 years, absence of response to induction therapy, and histological class IV, were related to the development of chronic kidney disease (&gt;60 ml/min/1.73 m²).</div></div><div><h3>Conclusions</h3><div>Renal involvement was higher in this study. Age, class IV, and non-response to induction were associated with impaired renal function.</div></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"31 4","pages":"Pages 463-472"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive health assessment based on ICF components using the WOMAC index in patients with osteoarthritis","authors":"Elif Gu Kabul ,&nbsp;Berna Cagla Caglayan ,&nbsp;Bilge Basakci Calik ,&nbsp;Serdar Kaymaz ,&nbsp;Ugur Karasu","doi":"10.1016/j.rcreue.2022.08.003","DOIUrl":"10.1016/j.rcreue.2022.08.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Osteoarthritis (OA) is a common degenerative disease associated with functional impairment, activity limitation, participation restriction, and poor quality of life. Therefore, comprehensive assessment is important to determine how complex problems affect patients with OA.</p></div><div><h3>Objectives</h3><p>The first aim of this study was to link and allocate items of The Western Ontario and McMaster Universities (WOMAC) OA index with the ICF Comprehensive Core Set for OA. The second aim was to examine the relationship between quality of life and each ICF component score based on WOMAC clinical data in OA.</p></div><div><h3>Materials and methods</h3><p>Health status was evaluated with WOMAC and quality of life with the Nottingham Health Profile (NHP). The WOMAC items were linked with codes of the ICF Comprehensive Core Set for OA and allocated with the ICF components by three researchers. The relationship between WOMAC scores and the NHP was determined by Pearson correlation analysis.</p></div><div><h3>Results</h3><p>87 patients with OA were included. As distinguished by the researchers, 7 items of WOMAC covered body function and 17 covered activity-participation. Body function and activity-participation had a moderate correlation with the pain subtest of the NHP and low correlation with the energy level subtest and total score of the NHP. Activity-participation had a high correlation with the physical abilities subtest of the NHP.</p></div><div><h3>Conclusion</h3><p>Although WOMAC does not cover environmental factors, it is a comprehensive tool to assess health status and quality of life. Our results showed that in OA physical abilities can lead to limitations in activity and participation, and these limitations are associated with the individual's pain, energy level, and quality of life.</p><p>Clinical trial registration number: NCT04956510.</p></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"31 3","pages":"Pages 356-364"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic evaluations in rheumatology. New learnings","authors":"Juan Manuel Bello Gualtero","doi":"10.1016/j.rcreue.2024.07.004","DOIUrl":"10.1016/j.rcreue.2024.07.004","url":null,"abstract":"","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"31 3","pages":"Pages 281-282"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASIA syndrome (autoimmune/inflammatory syndrome induced by adjuvants): Narrative literature review","authors":"Fabio Andrés Torres-Saavedra ,&nbsp;Lina Paola León-Sierra ,&nbsp;Julián Rondón-Carvajal","doi":"10.1016/j.rcreue.2024.07.002","DOIUrl":"10.1016/j.rcreue.2024.07.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Adjuvant-induced autoimmune/inflammatory syndrome (ASIA) comprises a spectrum of clinical manifestations associated with exposure to diverse adjuvants that have in common the generation of non-specific autoantibodies and loss of immune tolerance.</p></div><div><h3>Objective</h3><p>This study aimed to develop a narrative review of the literature about the pathogenesis underlying ASIA syndrome, its differentiation from other defined autoimmune diseases, and prospects for future research in this field.</p></div><div><h3>Materials and methods</h3><p>A narrative review of the literature was conducted using Pubmed, Embase, and LILACS. All publications on the subject were included, with no time limit in English and Spanish. Finally, 25 articles published since 1990 were included, from which we reviewed the pathogenesis, diagnostic criteria, and its differentiation from other defined autoimmune processes.</p></div><div><h3>Results</h3><p>The appearance of ASIA syndrome seems to be linked to an individual’s genetic predisposition (HLA-DRB1*01 or HLA-DRB4) and is the result of the interaction of external and endogenous factors that trigger autoimmune phenomena. In recent years, physicians have become more aware of the relationship between exposure to adjuvants and the development of underlying signs and symptoms that may correspond to ASIA syndrome. The current evidence supporting its existence is still contradictory. A timely diagnosis requires a multidisciplinary approach and could require immunosuppressive treatment in particular cases.</p></div><div><h3>Conclusions</h3><p>In recent years a relationship between exposure to adjuvants and the appearance of autoimmunity phenomena has been recognized. In clinical practice, physicians can find cases of ASIA syndrome. However, the evidence is still debated on the relationship between adjuvants and autoimmune clinical manifestations. ASIA syndrome classification criteria require validation in various populations before being applied to select patients for clinical studies. It is necessary to identify the risk factors for ASIA syndrome to understand its pathophysiology and make a timely diagnosis.</p></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"31 3","pages":"Pages 380-389"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antinuclear antibody staining patterns by indirect immunofluorescence assay observed in patients from a tertiary health center in Latin America","authors":"Valeria Erazo-Martínez ,&nbsp;Daniela Peñaloza ,&nbsp;Julián Rosero ,&nbsp;Iván Posso-Osorio ,&nbsp;Carmen Manuela Castillo ,&nbsp;Helen Johana Ortiz-Rojas ,&nbsp;Gabriel J. Tobón","doi":"10.1016/j.rcreue.2023.05.003","DOIUrl":"10.1016/j.rcreue.2023.05.003","url":null,"abstract":"<div><h3>Introduction/Objective</h3><p>This study aimed to describe the frequency of antinuclear antibody (ANA) staining patterns by indirect immunofluorescence assay observed in patients from a tertiary health center in Latin America.</p></div><div><h3>Materials and methods</h3><p>This retrospective, descriptive, and observational study evaluated data from all patients undergoing antinuclear antibody indirect immunofluorescence assay from a single-tertiary center (University Hospital Fundación Valle del Lili, Cali-Colombia) in 2020.</p></div><div><h3>Results</h3><p>One thousand and eight patients met the inclusion criteria. The median patient age was 47 (34–59.2) years, and most were female (769, 75.3%). A positive ANA immunofluorescence assay was observed in approximately two-thirds of patients (664, 65.8%). ANA test results were primarily used to exclude a suspected diagnosis in approximately half of the patients (466, 46.2%). Thirty-seven percent (250/664) of the cohort with ANA-positive titers had a systemic autoimmune rheumatic disease (SARD). The most prevalent SARDs included rheumatoid arthritis (RA) (55, 8.2%) followed by systemic lupus erythematosus (SLE) (37, 5.5%). The vast majority of ANA-positive patients had a reported speckled pattern (anti-cell [AC]-2,4,5; 269; 40.5%) followed by homogenous (AC-1; 266; 40%), nucleolar (AC-8,9,10; 46; 6.9%), and centromere (AC-3; 16; 2.4%). The most frequent patterns observed among SLE patients included homogenous (AC-1) patterns in 17 (45.9%) patients, speckled (AC-2,4,5) nuclear patterns in 11 (29.7%) patients, mixed patterns in 7 (18.9%) patients, and reticular/anti-mitochondrial antibody (AMA, AC-21) cytoplasmic patterns in 2 (5.4%) patients.</p></div><div><h3>Conclusion</h3><p>This study is the first to describe ANA patterns in a Colombian population. Speckled and homogenous patterns were predominant in patients with SARDs.</p></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"31 3","pages":"Pages 296-303"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What it means to live with fibromyalgia for Peruvian women: A phenomenological study","authors":"Consuelo Matilde Rivera-Miranda Giral ,&nbsp;Rosa Jeuna Díaz-Manchay ,&nbsp;Franco Ernesto León-Jiménez","doi":"10.1016/j.rcreue.2023.07.008","DOIUrl":"10.1016/j.rcreue.2023.07.008","url":null,"abstract":"<div><h3>Introduction</h3><p>Patients with fibromyalgia experience pain at a constant and incapacitating pace. It is still a complex entity yet to be fully understood but meanwhile affects patients in every aspect of their lives.</p></div><div><h3>Objective</h3><p>The purpose of this study is to describe what living with fibromyalgia means for Peruvian women and how it affects their family, work, and social lives in 2021.</p></div><div><h3>Materials and methods</h3><p>The study has a qualitative design with a phenomenological approach; snowball sampling and theoretical saturation sample size; 10 patients were interviewed through semi-structured in-depth interviews. An ideographic and a nomothetic analysis were conducted, divergences and convergences in the statements were sought and units of analysis were obtained.</p></div><div><h3>Results</h3><p>There were 12 categories: meaning of fibromyalgia, clinical picture, complications and sequelae, diagnostic process, impact on work, impact on family life, impact on social life, experience with health personnel, lessons learned from fibromyalgia, ecclesiastical support, and myths, misinformation, and prejudices about fibromyalgia.</p></div><div><h3>Conclusion</h3><p>The experiences and the clinical picture are diverse, the family remains an active and reliable support network for patients, unlike social and work lives, where there is a lack of initiative or empathy towards patients. In light of our findings, we expect healthcare workers and the public in general to learn and see beyond “just histrionics” or “attention seekers” and thus improve the patient's quality of life.</p></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"31 3","pages":"Pages 339-348"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}