{"title":"Knee joint dysfunction in the patients immediately before arthroplasty was well reflected by locomotive syndrome, not physical frailty.","authors":"Kentaro Inui, Shingo Maeda, Shuji Yamada, Koji Mandai, Yoshito Minami, Kentaro Ueno, Hirotsugu Ohashi, Tesshu Ikawa","doi":"10.1093/mr/roae093","DOIUrl":"https://doi.org/10.1093/mr/roae093","url":null,"abstract":"<p><strong>Objectives: </strong>We assessed physical function by three different methods in patients with knee osteoarthritis just before total knee arthroplasty (TKA) and investigated the relationship between impairment of mobility and preoperative factors.</p><p><strong>Methods: </strong>All patients scheduled to undergo TKA at our hospital were assessed for basic attributes, clinical assessment, radiography, whole-body mode DXA, knee muscle strength. And frailty, sarcopenia, and locomotive syndrome (LS) were evaluated.</p><p><strong>Results: </strong>Among 204 patients (213 knees),172 women, mean age 75.0 years, the overall distribution in frailty was <no: 14.6%, pre-frailty: 58.5%, and frailty: 26.8%>; in sarcopenia <no: 93.3%, yes: 3.4%, and severe: 3.4%>; and in LS <Stage 0: 0%, Stage 1: 3.3%, Stage 2: 11.4%, and stage 3: 85.3%>. Eighty-seven percent of the patients with frailty and 92% with LS stage 3 did not suffer from sarcopenia. Statistically significant relationships were observed between sarcopenia and frailty, while no relationship between LS and frailty or LS and sarcopenia. Multivariate analysis of related factors with severity level for frailty and LS revealed statistically significant correlations for frailty with gait speed and LS with KSS and muscle strength.</p><p><strong>Conclusion: </strong>In the patients with knee OA immediately before arthroplasty, physical frailty and LS was not related with by sarcopenia. Knee joint dysfunction without sarcopenia was well reflected by LS, not by physical frailty.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The use of biologic disease-modifying anti-rheumatic drugs does not increase surgical site infection or delayed wound healing after orthopaedic surgeries for rheumatoid arthritis.","authors":"Yohei Kiso, Keiichiro Nishida, Ryozo Harada, Yoshihisa Nasu, Ryuichi Nakahara, Yoshifumi Hotta, Shuichi Naniwa, Toshifumi Ozaki","doi":"10.1093/mr/roae089","DOIUrl":"https://doi.org/10.1093/mr/roae089","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of the use of biologic disease-modifying anti-rheumatic drugs (bDMARDs) on surgical site infection (SSI) and delayed wound healing (DWH) in rheumatoid arthritis (RA) patients undergoing orthopaedic surgery.</p><p><strong>Patients and methods: </strong>We retrospectively reviewed the records of 965 elective orthopaedic procedures undertaken in RA patients. The incidences of SSI and DWH were compared between the bDMARDs user and non-user groups. Subsequently, univariate and multivariate logistic regression analyses were performed to evaluate risk factors for SSI and DWH after propensity score (PS) matching. The incidence of postoperative flare-up was also examined.</p><p><strong>Results: </strong>In 965 procedures, SSI and DWH were identified in 12 and 28 cases, respectively. SSI and DWH were identified in 3 and 17 of 414 procedures treated with bDMARDs, respectively. Flare-up occurred in 21 cases. PS matching identified 315 cases in both groups, with no significant difference in incidence between the two groups. No risk factors for SSI were identified, whereas age, diabetes mellitus, foot and ankle surgery and a history of musculoskeletal-related infection were identified as risk factors for DWH.</p><p><strong>Conclusion: </strong>The use of bDMARDs was not associated with an increased incidence of SSI or DWH, with the incidence of flare-up being relatively low.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spondyloarthritis and Tietze’s syndrome: A Re-evaluation","authors":"Yasunori Matsuki, Tadashi Nakamura","doi":"10.1093/mr/roae086","DOIUrl":"https://doi.org/10.1093/mr/roae086","url":null,"abstract":"Spondyloarthritis comprises a number of related but different disorders with distinct phenotypes: psoriatic arthritis, reactive arthritis, arthritis related to inflammatory bowel disease, undifferentiated arthritis, and ankylosing spondylitis (the well-known prototypic subtype). Differentiating rheumatic diseases, such as rheumatoid arthritis, synovitis-acne-pustulosis-hyperostosis-osteitis syndrome, pustulotic arthro-osteitis, gout and spondyloarthritis, is difficult because they all may manifest swelling at the upper anterior chest wall, often involve the sternocostal and/or sternoclavicular joints, and clearly show cutaneous nodular symptoms, so that they may mimic Tietze’s syndrome in the presentation. Tietze’s syndrome is a benign, self-limiting entity with tender, non-suppurative swelling in the upper anterior chest wall, especially at the second and third costosternal junctions and the sternoclavicular joint. Therefore, distinguishing spondyloarthritis from Tietze’s syndrome during an entire disease course is important, even after an initial tentative diagnosis. This article aims to re-evaluate the importance of Tietze’s syndrome in the differential diagnosis of spondyloarthritis, while keeping in mind information about rheumatic diseases affecting the upper anterior chest wall.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy and safety of febuxostat in Japanese paediatric patients with hyperuricaemia including gout: phase 2, single arm, open‑label, multicentre studies.","authors":"Shuichi Ito, Yo Morita, Makoto Nitami, Ryutaro Iwama, Akihiro Nakajima, Hisashi Yamanaka, Masataka Honda","doi":"10.1093/mr/roae056","DOIUrl":"https://doi.org/10.1093/mr/roae056","url":null,"abstract":"<p><strong>Objectives: </strong>Urate-lowering efficacy and safety of febuxostat was evaluated in paediatric patients with hyperuricaemia including gout.</p><p><strong>Methods: </strong>A phase 2 study of febuxostat in paediatric patients aged 6-18 years with hyperuricaemia including gout was conducted. We evaluated the proportion of patients achieving serum uric acid (sUA) level ≤6.0 mg/dL at Week 26, and long-term safety and efficacy at Week 52. We also considered efficacy stratified by renal function.</p><p><strong>Results: </strong>Thirty patients (10 at <40 kg and 20 at ≥40 kg) were enrolled. Twenty-four were male, 29 had asymptomatic hyperuricaemia, and 1 had gout. Age was 8 to 18 years. Of these, 63.3% (95% confidence interval 43.9-80.1%) achieved a sUA level of ≤6.0 mg/dL at Week 26. sUA level (mean ± standard deviation) was 5.55 ± 0.87 mg/dL, reduced from 9.01 ± 1.23 mg/dL at baseline. Febuxostat efficacy appeared similar for mild to moderate renal dysfunction and with normal renal function. There were no major safety issues.</p><p><strong>Conclusions: </strong>In paediatric patients with hyperuricaemia including gout, febuxostat showed long-term, well-controlled urate-lowering efficacy with no major safety issues. Findings suggest that no dose adjustment is required for paediatric patients with mild to moderate renal dysfunction.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rheumatoid arthritis increases complication risks in elderly hip fracture patients.: A Japanese nationwide medical claims database study.","authors":"Yu Mori, Kunio Tarasawa, Hidetatsu Tanaka, Naoko Mori, Ryuichi Kanabuchi, Kiyohide Fushimi, Toshimi Aizawa, Kenji Fujimori","doi":"10.1093/mr/roae088","DOIUrl":"https://doi.org/10.1093/mr/roae088","url":null,"abstract":"<p><strong>Objectives: </strong>Rheumatoid arthritis (RA) is a common autoimmune disorder characterized by chronic inflammation and periarticular bone loss, leading to systemic osteoporosis and heightened fracture susceptibility, especially hip fractures among the elderly. This study aimed to evaluate the outcomes and complications associated with hip fractures in patients with RA relative to those without RA.</p><p><strong>Methods: </strong>Using the Japanese National Administrative Diagnosis Procedure Combination (DPC) database, we examined cases of femoral neck fractures from April 2016 to March 2023. After one to three propensity score matching for age, sex, and complications, we examined the association between RA, complications, and mortality during hospitalization in elderly patients with hip fractures.</p><p><strong>Results: </strong>The findings revealed that elderly Japanese RA patients with hip fractures had significantly higher complications of pneumonia than elderly hip fracture patients without RA, with a ratio of 1.232 (95% CI: 1.065-1.426, p=0.0056), and pulmonary embolism, with a ratio of 1.155 (95% CI: 1.036-1.287, p=0.009) in multivariate logistic regression analyses. Although not significantly elevated, it also found a trend toward higher mortality during hospitalization, with a ratio of 1.179 (95% CI: 0.973-1.429, p=0.096).</p><p><strong>Conclusions: </strong>A substantial study based on the Japanese DPC database revealed a significant association between RA and increased complications, including pneumonia and pulmonary embolism. On the other hand, there was a nonsignificant but higher trend for risk of mortality during hospitalization for hip fracture in elderly RA patients. Implementing preventive strategies is essential to minimizing complications in the treatment of hip fractures in patients with RA.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Challenges Nurses Face in Providing Care to Older Patients with Rheumatoid Arthritis: A Qualitative Study.","authors":"Mie Fusama, Hideko Nakahara, Yukitomo Urata, Kimito Kawahata, Yutaka Kawahito, Masayo Kojima, Takahiko Sugihara, Motomu Hashimoto, Takako Miyamae, Atsuko Murashima, Masaaki Mori, Nobuyuki Yajima, Toshihiro Matsui","doi":"10.1093/mr/roae087","DOIUrl":"https://doi.org/10.1093/mr/roae087","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to identify challenges nurses face in providing care to older patients with rheumatoid arthritis (RA) in Japan. Methods: Nurses certified by the Japan Rheumatism Foundation were requested via mail to describe challenges in providing care to older RA patients. Qualitative content analysis was used.</p><p><strong>Results: </strong>182 issues were identified from 152 responses. Twenty categories were grouped into seven components, five of which focused on patients: (1) lack of patient understanding, (2) lack of understanding and support from surrounding people, (3) numerous comorbidities and complications, (4) challenges related to physical strength, and (5) financial issues. Two focused on nurses: (6) lack of knowledge of nurses, and (7) inadequate systems and environment in the workplace. Various difficulties, such as polypharmacy due to multimorbidity, lifestyle issues due to aged couples or those living alone, as well as inadequate decision-making and informed consent due to cognitive decline were also identified.</p><p><strong>Conclusion: </strong>Nurses experienced numerous medical and non-medical difficulties in providing care to older RA patients. Assessing patients' comprehension and self-management, and grasping their situations at home are necessary. Along with the improvement of nurses' knowledge and skills, support from their workplace and multidisciplinary team care including families is crucial.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Serum creatinine is more strongly associated with hyperuricemia than eGFR in males but not in females.","authors":"Yukana Chihara, Ichiro Wakabayashi, Yuki Kataoka, Tetsuya Yamamoto","doi":"10.1093/mr/roae083","DOIUrl":"https://doi.org/10.1093/mr/roae083","url":null,"abstract":"<p><strong>Objectives: </strong>Serum creatinine and estimated glomerular filtration ratio (eGFR) are factors associated with hyperuricemia, though which is more closely associated with hyperuricemia remains unclear.</p><p><strong>Subjects and methods: </strong>This retrospective cross-sectional study examined the associations of serum creatinine and eGFR with hyperuricemia using health check-up findings. Enrolled were 6020 individuals (3509 males, 2511 females) who underwent health check-ups from 2017 to 2021. The subjects were divided based on serum uric acid level into the normuricemia (males 1.5-7.0 mg/dl, females 1.5-< 6.0 mg/dl) and hyperuricemia (males >7.0 mg/dl, female ≥ 6.0 mg/dl) groups. Matched-pair analysis was used to evaluate the association between hyperuricemia and variables related to serum uric acid.</p><p><strong>Results: </strong>Matched-pair analysis results showed a significant association of serum creatinine with hyperuricemia in male subjects but not in females. Furthermore, propensity score obtained by binominal logistic regression demonstrated that serum creatinine had a greater association with hyperuricemia than eGFR in the males but not in females.</p><p><strong>Conclusions: </strong>The present findings indicate an association of serum creatinine with hyperuricemia in males not only because of reduced renal function but other factors related to greater muscle mass, such as increased intake of protein-rich foods containing purines and increased uric acid production induced by accelerated creatinine metabolism.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Incidence of and predictive factors for lung cancer in patients with rheumatoid arthritis: A retrospective long-term follow-up study.","authors":"Shunsuke Mori, Mizue Hasegawa, Fumikazu Sakai, Kouya Nakashima, Kazuyoshi Nakamura","doi":"10.1093/mr/roae084","DOIUrl":"https://doi.org/10.1093/mr/roae084","url":null,"abstract":"<p><strong>Objective: </strong>To determine the incidence and predictive factors of lung cancer in rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>We conducted a retrospective follow-up study of patients who were diagnosed with RA at our institution between April 2001 and December 2022. Pulmonary complications were evaluated using high-resolution computed tomography at RA diagnosis. Patients were followed until the diagnosis of lung cancer, diagnosis of other malignancies, death, loss to follow-up, or the end of the study.</p><p><strong>Results: </strong>Among 771 RA patients, 3.5% were diagnosed with combined pulmonary fibrosis and emphysema (CPFE), 4.9% with interstitial lung disease (ILD) alone, and 6.0% with emphysema alone. During follow-up (mean of 9.3 years), the crude incidence rates of lung cancer per 1,000 patient-years were 2.9 in all patients, 47.8 in CPFE patients, 10.5 in ILD patients, 11.9 in emphysema patients, and 0.8 in patients without these complications. The standardized incidence ratios (95% confidence intervals [CI]) compared with the general population were 2.53 (1.29-3.77) for male patients and 0.89 (0.57-1.16) for female patients. In Fine-Gray regression analysis, adjusted hazard ratios (95% CI) of lung cancer were 13.48 (3.14-57.85) for CPFE, 6.42 (1.42-29.09) for ILD alone, and 4.65 (1.18-18.30) for emphysema alone versus without these complications, and 1.02 (1.01-1.04) per additional 1 pack-year for smoking history. These factors were not associated with the risk of other malignancies.</p><p><strong>Conclusion: </strong>Close monitoring of lung cancer is needed for RA patients with smoking history and pulmonary complications, especially CPFE.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gamze Ahiskali, Orkun Tüfekçi, Nur Banu Karaca, Mustafa Ekici, Nazli Elif Nacar, Sinan Buran, Mine Kantar, Bilgen Apras Şule, Sedat Kiraz, Edibe Unal
{"title":"A biopsychosocial questionnaire for patients with primer Sjögren's syndrome: The BETY-Biopsychosocial Questionnaire.","authors":"Gamze Ahiskali, Orkun Tüfekçi, Nur Banu Karaca, Mustafa Ekici, Nazli Elif Nacar, Sinan Buran, Mine Kantar, Bilgen Apras Şule, Sedat Kiraz, Edibe Unal","doi":"10.1093/mr/roae085","DOIUrl":"https://doi.org/10.1093/mr/roae085","url":null,"abstract":"<p><strong>Objective: </strong>The BETY-Biopsychosocial Questionnaire (BETY-BQ) is a scale developed to assess the biopsychosocial domains of patients with rheumatic diseases under a single roof. The study aimed to determine the validity and reliability of the BETY-BQ in patients with primary Sjögren's Syndrome (pSS).</p><p><strong>Methods: </strong>At enrollment and one week, 91 patients with pSS completed the BETY-BQ. Construct validity was measured by correlating the BETY-BQ total score responses with the Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale (HADS), 36-Item Short-Form Health Survey (SF-36), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI), Primary Sjögren's Syndrome Quality of Life questionnaire (PSS-QoL), and Euro-QoL 5D (EQ-5D).</p><p><strong>Results: </strong>The BETY-BQ correlated high to moderate with HAQ, bodily pain subscale of SF-36, Euro Qol-5D, PSS-QoL, HADS, and ESSPRI (0.776 to 0.557, p <0.05). Spearman's correlation coefficients between BETY-BQ total scores at baseline and average one week were very high (rho = 0.98, <0.001) and indicated substantial agreement between test-retest scores (ICC = 0.99, <0.001). Internal consistency reliability at baseline was 0.91 for the BETY-BQ.</p><p><strong>Conclusions: </strong>BETY-BQ is valid and reliable for assessing biopsychosocial status in patients with pSS and can be used to measure outcomes in pSS.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}