International Journal of Clinical Rheumatology最新文献

{"title":"Chikungunya arthritis: an emerging rheumatologic problem","authors":"Fernando Da, R. Araújo","doi":"10.4172/1758-4272.1000190","DOIUrl":"https://doi.org/10.4172/1758-4272.1000190","url":null,"abstract":"For the rheumatologist, the main interest in the disease is the possibility of progressing with chronic debilitating arthritis. By the way, in the Makonde language of Tanzania, where the disease was first described, chikungunya means “that which bends up”, because of intensity of the pain, in a clear reference to the musculoskeletal involvement of the disease. From the public health point of view, the disease burden can be high, with an estimated cost of Chikungunya outbreaks in the Americas around US$185 billion, which is associated with a loss of 23.8 million disability adjusted life years (DALYs) [2].","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"13 1","pages":"226"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83102671","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":"Spondyloarthropathies: are there any differences between Caucasians and southeast Asians living in north-east London interms of disease onset and progression subject to cultural, social and treatment applications","authors":"A. Bouraoui, E. Roussou, Sree Sakthibalan Khalifa Boukadida","doi":"10.4172/1758-4272.1000174","DOIUrl":"https://doi.org/10.4172/1758-4272.1000174","url":null,"abstract":"Objective: To compare PSpo patients with those with predominantly peripheral disease. Method: Retrospective cross-sectional analysis of 155 patients with PsA. Results: 127 patients (81.9%) had peripheral and 28 patients (18%) had axial disease. PSpo patients had greater HLAB27 and Uveitis percentages (32%, 14% successively) than those with peripheral disease. 64% of patients subsequently developed peripheral joint involvement predominantly oligo-arthritis pattern (72%). Conclusion: further prospective observational studies comparing peripheral and axial PsA are required to elucidate our observation.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"11 1","pages":"121"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78090105","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":"Application of treat-to-target principles in patients with early rheumatoid arthritis in routine clinical practice in Central-EasternEurope","authors":"C. Codreanu, D. Andersone, A. Baranauskaitė, N. Damjanov, H. Dalle, M. Hojnik, H. Mann, Orsolya Nagy Gyula Poor","doi":"10.4172/1758-4272.1000181","DOIUrl":"https://doi.org/10.4172/1758-4272.1000181","url":null,"abstract":"Objective: Understanding the extent to which treat-to-target (T2T) recommendations are applied by rheumatologists in patients with rheumatoid arthritis (RA) may identify gaps or issues in disease management. This study evaluated application of key T2T principles in routine management of RA patients in selected Central-Eastern European countries. Methods: This prospective, single-arm, observational study was conducted in seven countries. Patients with early RA (<1 year since diagnosis) were observed for 12 months. Primary endpoint was the percentage of patients who had a treatment target set at any time between RA diagnosis and last study visit. Disease activity (Disease Activity Score 28-joint count [DAS28]), functional status (Health Assessment Questionnaire Disability Index [HAQ-DI]), target attainment, work productivity/activity impairment (Work Productivity and Activity Impairment-Specific Health Problem [WPAI–SHP] questionnaire), and work-related outcomes were also assessed. Results: At least one treatment target was set in 507 of 514 patients (98.6%). Disease activity targets were set for 507 patients (100%) and functional targets for 335 patients (66.1%). Mean number of treatment targets per patient was 4.3 (standard deviation [SD] 2.4). At last attended visit, 218 patients (43.5%) had achieved their treatment target. Proportions of patients in remission (DAS28 <2.6) or low disease activity (DAS28 <3.2) increased from baseline to last attended visit (0.8% to 54.2% and 2.7% to 78.0%, respectively). Mean HAQ-DI scores improved from 1.3 (SD 0.6) at baseline to 0.7 (SD 0.6) at last attended visit. In patients with available data, all WPAI–SHP parameters improved from baseline to last attended visit. Outcomes for presenteeism, total activity impairment, and days with impairment were significantly (p<0.05) better in patients with remission versus low disease activity. Conclusion: Treatment targets were commonly set for early RA patients in rheumatology centers in Central-Eastern Europe. Clinical, functional, and work-related outcomes improved during 1 year’s follow-up, suggesting benefit from a T2T approach.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"1 1","pages":"162"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73242587","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":"Knee OA management: A cost-effectiveness analysis of platelet-rich-plasma versus hyaluronic acid for the intra-articular treatment of knee OA in France","authors":"L. Stefano, L. Paolo, A. Russo","doi":"10.4172/1758-4272.1000202","DOIUrl":"https://doi.org/10.4172/1758-4272.1000202","url":null,"abstract":"Objectives: The aim of this work is to carry out an economic evaluation of the intra-articular (i.a.) use of the platelet-rich plasma (PRP) therapy in the short period treatment for knee osteoarthritis (OA). Recently the scientific literature has shown the effectiveness of this treatment. The comparator adopted is the Hyaluronic acid (HA) which represents the standard i.a. therapy. Methods: A cost-effectiveness analysis was performed using a decision tree model. The effectiveness outcomes are reported in terms of Quality Adjusted Life Year (QALY). The costs are reported in Euro (€) currency evaluated in 2016. Deterministic and probabilistic sensibility analyses are reported in order to evaluate the robustness of the results and account for the different sources of uncertainty. Results: The PRP therapy results more costly but also more effective than HA. Using a Willingness to pay thresholds of € 10,000/QALY, the PRP is cost-effective with respect to HA, for patient with moderate to severe knee OA, presenting an Incremental Cost Effectiveness Ratio (ICER) of €760 per QALY.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"87 1","pages":"307"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79427936","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":"Epidemiology and awareness of osteoporosis: a viewpoint from the Middle East and North Africa","authors":"T. Hammam","doi":"10.4172/1758-4272.1000177","DOIUrl":"https://doi.org/10.4172/1758-4272.1000177","url":null,"abstract":"Background: Osteoporosis (OP) is defined by low bone mass and microstructural deterioration. It is an escalating public health problem due to increase life expectancy and the resulting bone fractures represent a significant burden for both the individual and the society in terms of morbidity, mortality and cost. Osteoporosis, a multifactorial disease, results from the interaction between genetic and environmental risk factors. Currently, the data available regarding OP epidemiology and predisposing risk factors differ greatly between regions and within population ethnicities. Proper estimation of the epidemiology of OP and its health related outcomes can help identity those at risk and permit prophylactic treatment before its occurrence. The main barrier towards disease prevention strategies is the impaired awareness of the disease and its risk. Enhanced understanding of the OP disease may influence personal behaviors and reduce its prevalence. Objectives: This review was undertaken to wrap-up and throw-light on the published literatures related to the epidemiology of osteoporosis in the Middle East and North Africa (MENA) region, and expose the extent of awareness in the corresponding populations. Describing and discussing key points on the current state of knowledge on these hot issues are well thought-out. Conclusion: Osteoporosis prevalence is variable among MENA populations. Limited reports regarding the established prevalence of osteoporotic fractures among those populations and therefore, lack of guidelines for prevention and management were noticed. In order to improve bone health, preventive measures against OP should be considered. Increase OP awareness and preventive practices in the societies as part of the prophylactic strategy need to be initiated.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"37 12 1","pages":"134"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90981352","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":"Epidemiology of orthopedic trauma admissions over year 2017 in the General Hospital H+ in Queretaro Mexico","authors":"J. G. Martínez-Flores","doi":"10.4172/1758-4272.1000172","DOIUrl":"https://doi.org/10.4172/1758-4272.1000172","url":null,"abstract":"Background: The dynamics of demography in MA©xico is changing and its population is aging. Osteoporotic and fragility fractures are diseases associated with aging and therefore its incidence is expected to grow accordingly. Methods: We conducted a retrospective study of epidemiological data contained on medical records of 50 years and older patients with fracture admitted over a 12-month period at the Orthopedic Service from the General Hospital H+ in Queretaro Mexico. Descriptive and inferential statistics methods for distribution of patients according to gender and age group were used. Qualitative variables were presented by distributions of absolute and relative frequencies and distributions assessed by chi-square method. Results: From 150 patients presented in the Emergency Unit, 32 patients were admitted in Orthopedic Service. Data of 32 medical records showed the most common age groups was 50 to 59 (male 44.4% - female 34.8%). The more frequent factures were in upper limbs (male 33.3% - female 47.8%), hip (male 11.1% - female 21.7%) and spinal bone (male 11.1% - female 4.3%). Most common mechanism of trauma was fall (male 44.4% - female 56.5%) where no less than 50% of patients had pre-existing illness (systemic arterial hypertension, Diabetes Mellitus II, Obesity, Smoking and alcoholism) as predisposition factors to factures. Only one patient was diagnosed with OP using BMD and only one patient received treatment for OP. Conclusion: The frequency of patients with the most common type and trauma mechanism of fractures admitted in the Orthopedic Unit was consistently increased in female than male gender and correlates with previous reports. It was noticed that exists a medical management of patients related to reliable diagnosis and timely treatment of fracture fragility and OP, not according to criteria issued by international health entities.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"31 1","pages":"114"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90538545","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":"IL-17 in primary knee osteoarthritis and its relation with severity of the disease","authors":"S. Mohamed, N. O. Neseem, Shereen E Farag","doi":"10.4172/1758-4272.1000212","DOIUrl":"https://doi.org/10.4172/1758-4272.1000212","url":null,"abstract":"Objective: Is to measure serum level of interleukin 17 and correlate its level with disease severity in patients with primary knee OA. Methods: Serum was collected from patients with primary knee osteoarthritis and age- and sex-matched healthy control subjects. IL-17 was quantified by enzyme-linked immunosorbent assay. Osteoarthritis severity and grade were assessed using the Lequesne index and Kellgren and Lawrence (KL) grading system, respectively. Results: Serum IL-17 concentrations are significantly higher in patients (1039.5 pg/ml) than in controls (55 pg/ml) with p value<0.001. This is significantly positively correlated with degree of WOMAC, pain scale, Lequesne index, KL grade and with MRI grades. Conclusions: According to the results of the present study we can conclude that there is a strong relation between serum level of IL-17 and primary knee osteoarthritis and this may reflect the degree of severity of the disease to some extent","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"29 1","pages":"361"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85893743","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":"Rheumatologic manifestations of HIV/AIDS","authors":"M. G. Blackmore","doi":"10.4172/1758-4272.1000205","DOIUrl":"https://doi.org/10.4172/1758-4272.1000205","url":null,"abstract":"There was a profound increase in undifferentiated spondylarthritis is associated with the AIDS epidemic of the 1980’s. The presentation tends to be predominantly arthritis (lower extremity) and enthesitis with less spondylitis. Psorasis and psoriatic arthritis can be severe, but improve with ant-HIV therapy. Treatment is similar to that for noninfected individuals. TNF inhibitors have been used successfully in many patients.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"1 1","pages":"331"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86311730","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":"Rheumatology to hepatology cross talk: An evidence based update on the treat to target strategy in hepatitis-C related extrahepatic autoimmune syndromes","authors":"R. Mohammed","doi":"10.4172/1758-4272.1000187","DOIUrl":"https://doi.org/10.4172/1758-4272.1000187","url":null,"abstract":"Hepatitis C virus (HCV) is a universally identified major epidemiological health problem with an estimated reservoir of almost 200 million or 3% of the global population. In the year 2013, the WHO declared viral hepatitis as “a leading cause of death worldwide 1.46 million deaths, a toll higher than that from HIV, tuberculosis or malaria, and on the increase since 1990” with more than 90% of these deaths being related to the sequelae of the infection with either forms of hepatitis viruses (HBV-HCV). HCV is classically a hepatotropic virus with the liver cells providing the primary bed for viral replication with clinical evidences supporting an additionally significant viral lymphotropism. HCV is a linear single stranded RNA retrovirus, member of the genus hepacivirus of the flaviviridae family. It is a small virus comprised of a positive-sense 9.6 Kb single-stranded RNA genome embodied in a double layered glycosylated protein envelope, the viral genome protein is basically made up of structural and non-structural proteins. The viral enzymes- NS2-3 and NS3-4A proteases, NS3 helicase and NS5BRdRp— are essential contributors for HCV replication, the HCV serine protease NS3, and its cofactor NS4A, constitute a complex that directs polyprotein cleavage. HCV infected individuals are capable of producing 10-13 trillion virions/day with the majority coming primarily from viral replication within the hepatocytes with an unpredictable yet significant extrahepatic contributions that may lead to the development and modulation of systemic extrahepatic disease. The use of conventional antiviral therapy PEGylated interferon (Peg-IFN) and ribavirin (RBV) practically contributed to the disease burden with less than a 50% sustained viral response rates. A major challenge for interferon therapy comes from the Hepatitis C viral genome itself. The challenging draw backs to interferon based regimen in patients with autoimmune extrahepatic disease EHD demanded an evidence based revisit to the classic recommendations on the use of conventional antivirals with immunomodulatory drugs in this indication. It wasn’t until spring of 2011 when the FDA approved the first two directly acting antiviral drugs that the hepatologists experienced a revolutionary shift in Hepatitis C virus (HCV) treatment paradigm. Directly acting antiviral drugs (DAAs are drugs that target some of the main molecular components of HCV, including NS3/4A protease (first and second generation protease inhibitors), NS5B polymerase (nucleoside and non-nucleoside analogs) and NS5A protein. The recent era of DAAs established an additional need to modify treatment regimens in extrahepatic disease. In the year 2017 the international study group of HCV extrahepatic disease published evidence based recommendations on the use of antivirals for control of EHD. The treatment armamentarium in chronic HCV viremia with and without extrahepatic disease has experienced a revolution with the establishment of directly act","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"18 1","pages":"202"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87397462","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":"The test/retest reliability of physical performance measures in osteoarthritis patients","authors":"F. Humby, Alice J. Hughes, A. Jawad","doi":"10.4172/1758-4272.1000160","DOIUrl":"https://doi.org/10.4172/1758-4272.1000160","url":null,"abstract":"Objectives: There is limited data examining the reliability and consistency of objective measures of osteoarthritis (OA) function. Therefore the aim of this study was to assess their test/retest reliability. Methods: 21 postmenopausal women over the age of 50 diagnosed with bilateral knee OA were recruited from a single centre. Endpoints assessed included time to walk 20 m, 40 m, ascend and descend 11 stairs, pain scores, standard WOMAC questionnaires and range of motion of the knee with assessments repeated at a follow up visit. Results: Time to walk 20 m, 40 m, and climb and descend stairs and total WOMAC scores between the two visits was highly reliable. There was no reliability for the range of motion of the knee. Conclusions: The high degree of reliability for the endpoints of walking and stair climbing within patients and across visits supports the use of these as outcome measures within clinical trials of OA.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"13 1","pages":"43"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88332253","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}