Seminarios de la Fundación Espa?ola de Reumatología最新文献_第3页

Mentorización Mentorización

Seminarios de la Fundación Espa?ola de Reumatología Pub Date : 2013-04-01 DOI: 10.1016/j.semreu.2013.01.001

Alejandro Olivé Marques

引用次数: 0

Tratamiento del lupus cutáneo con talidomida 沙利度胺治疗皮肤狼疮

Seminarios de la Fundación Espa?ola de Reumatología Pub Date : 2013-04-01 DOI: 10.1016/j.semreu.2013.03.001

Josep Ordi-Ros , Francisco Javier Cosiglio , Josefina Cortés-Henández

{"title":"Tratamiento del lupus cutáneo con talidomida","authors":"Josep Ordi-Ros , Francisco Javier Cosiglio , Josefina Cortés-Henández","doi":"10.1016/j.semreu.2013.03.001","DOIUrl":"10.1016/j.semreu.2013.03.001","url":null,"abstract":"<div><p>Thalidomide, a glutamic acid derivative, has been used successfully in a variety of chronic refractory inflammatory dermatological conditions with underlying autoimmune or infectious pathogenesis. This drug was first used in the treatment of systemic lupus erythematosus (SLE) in 1975. Since then, there has been renewed interest and increased use of this drug, with a reported effectiveness of up to 80-90%. First line therapy has traditionally been antimalarial agents and/or topical steroids, together with sun protection. For refractory cases, there is no consensus algorithm and a trial and error approach using multiple systemic agents has yielded a variable response. The lack of effective treatment, together with the chronic and relapsing course of this disease, contribute to delaying resolution of the inflammatory lesions and to consequent scarring. Although the mechanism of action of thalidomide is not completely known, its efficacy seems to be mediated by its immunomodulatory and antiinflamatory properties. <em>In vitro</em> studies have demonstrated that thalidomide inhibits neutrophil chemotaxis and phagocytosis, angiogenesis, and the production of tumor necrosis factor alfa and that it interacts with the T-helper response and the regulation of transcription factor nuclear kB. Despite its proven effectiveness, the use of thalidomide is still limited by its notorious adverse effects such as teratogenicity, neurotoxicity and thrombosis.</p></div>","PeriodicalId":101152,"journal":{"name":"Seminarios de la Fundación Espa?ola de Reumatología","volume":"14 2","pages":"Pages 60-66"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.semreu.2013.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116405298","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}

引用次数: 2

Inmunización y quimioprofilaxis en pacientes con artritis reumatoide 类风湿性关节炎患者的免疫和化学预防

Seminarios de la Fundación Espa?ola de Reumatología Pub Date : 2013-04-01 DOI: 10.1016/j.semreu.2013.02.001

Alejandra G. Begazo Cruz

{"title":"Inmunización y quimioprofilaxis en pacientes con artritis reumatoide","authors":"Alejandra G. Begazo Cruz","doi":"10.1016/j.semreu.2013.02.001","DOIUrl":"10.1016/j.semreu.2013.02.001","url":null,"abstract":"<div><p>The incidence of severe infections has been estimated to be higher in patients with rheumatoid arthritis. In particular, respiratory infections are up to twice as frequent in these patients as in the general population, which often increases mortality due to immune disorders related to the disease itself and to the immunosuppressive treatment. Nowadays, some of these infections can be prevented by vaccines, which provide a window of opportunity for prophylaxis and for the prevention of complications arising from infection.</p><p>The most widely used vaccines in rheumatic diseases are the pneumococcal and influenza vaccines, which are recommended in vaccination guidelines. The data accumulated on the safety and efficacy of these vaccines support their use in patients with chronic autoimmune or inflammatory diseases. Immunization recommendations for this population should be applied in our daily clinical practice, as the evidence is sufficiently strong to encourage general vaccination against influenza, pneumococcus and hepatitisB in patients with rheumatic diseases. Screening strategies for tuberculosis, with the use of chemoprophylaxis if required, should also be applied in rheumatoid arthritis patients receiving immunosuppressive therapy.</p></div>","PeriodicalId":101152,"journal":{"name":"Seminarios de la Fundación Espa?ola de Reumatología","volume":"14 2","pages":"Pages 36-42"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.semreu.2013.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125545770","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}

引用次数: 7

Recambio plasmático en las enfermedades autoinmunes sistémicas 全身自身免疫性疾病的血浆置换

Seminarios de la Fundación Espa?ola de Reumatología Pub Date : 2013-04-01 DOI: 10.1016/j.semreu.2013.02.002

Guillermo J. Pons-Estel , Rosa Serrano , Miguel Lozano , Joan Cid , Ricard Cervera , Gerard Espinosa

{"title":"Recambio plasmático en las enfermedades autoinmunes sistémicas","authors":"Guillermo J. Pons-Estel , Rosa Serrano , Miguel Lozano , Joan Cid , Ricard Cervera , Gerard Espinosa","doi":"10.1016/j.semreu.2013.02.002","DOIUrl":"10.1016/j.semreu.2013.02.002","url":null,"abstract":"<div><p>Therapeutic apheresis encompasses a large number of techniques whose main purpose is to process patients’ blood through an extracorporeal device. The aim is to remove antibodies and preformed immune complex to avoid tissue damage, eliminate inflammatory mediators – such as complement and cytokines, which could contribute to further damage – restore deficiencies, and stimulate lymphocyte clones to improve the response to immunosuppressive therapy.</p><p>Among the different types of apheresis, the most commonly used for the treatment of autoimmune diseases are plasma exchange and immunoadsorption.</p><p>To aid the correct use of these procedures, the American Society for Apheresis has established more than 65 indications classified into different categories according to the level of evidence. In this review, we analyze the distinct therapeutic indications for the treatment of different autoimmune diseases.</p><p>This review indicates that plasma exchange is a safe and effective therapeutic option for treating the serious manifestations of systemic autoimmune diseases and is a valid option for those patients with diseases refractory to conventional treatments.</p></div>","PeriodicalId":101152,"journal":{"name":"Seminarios de la Fundación Espa?ola de Reumatología","volume":"14 2","pages":"Pages 43-50"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.semreu.2013.02.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129581355","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}

引用次数: 8

Osteoporosis en los pacientes infectados por el virus de la inmunodeficiencia humana 人类免疫缺陷病毒感染患者的骨质疏松症

Seminarios de la Fundación Espa?ola de Reumatología Pub Date : 2013-01-01 DOI: 10.1016/j.semreu.2012.11.001

Alejandra Gullón Ojesto , Jesús Alberto García Vadillo

{"title":"Osteoporosis en los pacientes infectados por el virus de la inmunodeficiencia humana","authors":"Alejandra Gullón Ojesto , Jesús Alberto García Vadillo","doi":"10.1016/j.semreu.2012.11.001","DOIUrl":"10.1016/j.semreu.2012.11.001","url":null,"abstract":"<div><p>Osteoporosis and osteopenia are highly prevalent in the HIV-infected population due to increased life expectancy since the introduction of antiretroviral therapy. The present article reviews the main pathogenic mechanisms involved in the development of these entities and the currently-recommended strategies for their clinical management, diagnosis and treatment.</p><p>Patients with HIV infections have a higher risk of fracture than the general population because of the interaction among nutritional deficiencies, toxic habits, antiretroviral therapy and the viral infection itself. Three of the fundamental mechanisms involved in the physiopathology of these bone diseases are the activation of osteoclastogenesis — mediated by the RANK system — increased osteoblast apoptosis, and deregulation of the vitaminD-PTH axis. Early diagnosis is essential. Screening for reversible secondary causes of osteoporosis, which are highly prevalent in this population, should always be performed and treated appropriately if necessary. Management and treatment should include lifestyle-correction strategies and antiresorptive drugs in individuals at high fracture risk. The only drugs with proven efficacy in HIV-infected patients infected are alendronate and zoledronate.</p></div>","PeriodicalId":101152,"journal":{"name":"Seminarios de la Fundación Espa?ola de Reumatología","volume":"14 1","pages":"Pages 18-23"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.semreu.2012.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115841994","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}

引用次数: 0

Diez razones para ser reumatólogo 成为风湿病学家的十个理由

Seminarios de la Fundación Espa?ola de Reumatología Pub Date : 2013-01-01 DOI: 10.1016/j.semreu.2012.10.001

Alejandro Olivé Marquès

引用次数: 0

Óptima utilización del metotrexato 甲氨蝶呤的最佳使用

Seminarios de la Fundación Espa?ola de Reumatología Pub Date : 2013-01-01 DOI: 10.1016/j.semreu.2013.01.004

Rafaela Ortega Castro, Alejandro Escudero Contreras, Jerusalén Calvo Gutiérrez, Maria del Carmen Castro Villegas, Eduardo Collantes Estévez

引用次数: 1

Seguridad de los tratamientos antirreumáticos en la paciente gestante 孕妇抗风湿治疗的安全性

Seminarios de la Fundación Espa?ola de Reumatología Pub Date : 2013-01-01 DOI: 10.1016/j.semreu.2013.01.002

Inmaculada Chalmeta Verdejo

引用次数: 0

Eficacia y efectividad de los tratamientos reductores de la uricemia 减少尿酸血症治疗的疗效和有效性

Seminarios de la Fundación Espa?ola de Reumatología Pub Date : 2013-01-01 DOI: 10.1016/j.semreu.2013.01.003

Cesar Diaz-Torne, Cesar Diaz-Lopez

引用次数: 0

Enfermedad sistémica relacionada con inmunoglobulina G4: ¿por qué interesa al reumatólogo? 与免疫球蛋白G4相关的全身性疾病:风湿病学家为什么感兴趣?

Seminarios de la Fundación Espa?ola de Reumatología Pub Date : 2013-01-01 DOI: 10.1016/j.semreu.2012.09.003

José Campos Esteban, Clara Méndez Perles, Juan Mulero Mendoza

{"title":"Enfermedad sistémica relacionada con inmunoglobulina G4: ¿por qué interesa al reumatólogo?","authors":"José Campos Esteban, Clara Méndez Perles, Juan Mulero Mendoza","doi":"10.1016/j.semreu.2012.09.003","DOIUrl":"https://doi.org/10.1016/j.semreu.2012.09.003","url":null,"abstract":"<div><p>Immunoglobulin G<sub>4</sub>-related systemic disease is a recently defined emerging disorder characterized by a <em>diffuse mass-forming</em> inflammatory reaction. The mass can be solitary or multiple. This entity affects the exocrine glands, lymph nodes and extranodal tissue, with a lymphoplasmacytic infiltrate rich in IgG<sub>4</sub>-positive cells, fibrosclerosis and obliterative phlebitis affecting medium and small caliber veins. Elevation of serum IgG<sub>4</sub> is often present, but not always. The clinical features are highly variable, as this entity can affect single or multiple organs, with a synchronous or metachronous pattern. Two of the most frequent characteristics are the presence of a mass or localized inflammation, and a past history of allergic disease. Diagnosis requires integration of clinical, serological, imaging, histopathological and immunohistological data. Treatment is based on high-dose corticosteroids with subsequent de-escalation. This treatment is usually effective initially but disease flares are frequent. Rheumatologists should suspect IgG<sub>4</sub>-related systemic disease in patients referred to exclude connective tissue disease because of repeated inflammatory processes in distinct sites of localization.</p></div>","PeriodicalId":101152,"journal":{"name":"Seminarios de la Fundación Espa?ola de Reumatología","volume":"14 1","pages":"Pages 2-7"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.semreu.2012.09.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92345304","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}

引用次数: 2