Nature Reviews Rheumatology最新文献_第4页

The management of adult and paediatric uveitis for rheumatologists 风湿免疫科医生对成人和儿童葡萄膜炎的管理

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2024-11-06 DOI: 10.1038/s41584-024-01181-x

Sarah L. N. Clarke, Panagiotis Maghsoudlou, Catherine M. Guly, Andrew D. Dick, Athimalaipet V. Ramanan

{"title":"The management of adult and paediatric uveitis for rheumatologists","authors":"Sarah L. N. Clarke, Panagiotis Maghsoudlou, Catherine M. Guly, Andrew D. Dick, Athimalaipet V. Ramanan","doi":"10.1038/s41584-024-01181-x","DOIUrl":"10.1038/s41584-024-01181-x","url":null,"abstract":"Uveitis encompasses multiple different conditions that are all characterized by intra-ocular inflammation. Uveitis occurs in the context of many different rheumatological conditions and carries a substantial risk to vision. Uveitis can develop both at the early stages of rheumatic diseases, sometimes even preceding other clinical features, and at later stages of disease. Uveitis can also occur as either a direct or an indirect complication of therapies used to treat patients with rheumatic disease. Conversely, patients with uveitis of non-rheumatic aetiology sometimes require immunosuppression, a treatment option that is not readily accessible to ophthalmologists. Thus, collaborative working between rheumatologists and ophthalmologists is critical for optimal management of patients with uveitis. This Review is written with rheumatologists in mind, to assist in the care of patients with uveitis. We collate and summarize the latest evidence and best practice in the diagnosis, management and prognostication of uveitis, including future trends and research priorities. This Review provides an overview of the pathogenesis, classification and diagnosis of and treatment strategies for adult and paediatric rheumatology patients with uveitis. The authors highlight the importance of collaborations between ophthalmologists and rheumatologists to provide optimal treatment of uveitis, improve patient care and enhance future research.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"20 12","pages":"795-808"},"PeriodicalIF":29.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142588532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dupuytren contracture treatments compared 杜普伊特伦挛缩症治疗方法比较

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2024-11-05 DOI: 10.1038/s41584-024-01186-6

Sarah Onuora

引用次数: 0

Novel autoantigen in idiopathic lung disease 特发性肺病中的新型自身抗原

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2024-11-04 DOI: 10.1038/s41584-024-01187-5

Maria Papatriantafyllou

引用次数: 0

Rheumatology in the digital health era: status quo and quo vadis? 数字医疗时代的风湿病学：现状与未来？

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2024-10-31 DOI: 10.1038/s41584-024-01177-7

Johannes Knitza, Latika Gupta, Thomas Hügle

{"title":"Rheumatology in the digital health era: status quo and quo vadis?","authors":"Johannes Knitza, Latika Gupta, Thomas Hügle","doi":"10.1038/s41584-024-01177-7","DOIUrl":"10.1038/s41584-024-01177-7","url":null,"abstract":"Rheumatology faces a critical shortage of health-care professionals, exacerbated by an ageing patient population and escalating costs, resulting in widening gaps in care. Exponential advances in digital health technologies (DHTs) in the past 5 years offer new opportunities to address these challenges and could contribute to overall improved health care. However, keeping pace with innovations and integrating them into clinical practice can be challenging. This Review explores the transformative potential of DHTs for rheumatology in reshaping the entire patient pathway and redefining the roles of patients and providers, and discusses the potential barriers to DHT integration. Key technologies, such as large language models, clinical decision-support systems, digital therapeutics, electronic patient-reported outcomes, digital biomarkers, robots, self-sampling devices and artificial intelligence-based scribes, can be implemented along the patient pathway. A digital-first hybrid stepped-care patient pathway could combine in-person and remote care, enabling personalized and continuous monitoring through a digital safety net. The potential benefits and risks of transforming the traditional patient–provider relationship into a digital health triad with technology are discussed. Collaborative efforts are needed to navigate the evolving digital health landscape and harness the potential of DHTs to improve rheumatology care. Digital health has the potential to improve patient care in rheumatology and alleviate strain on the health-care system. This Review explores the current status of the transition from traditional health care to a model that harnesses the potential of digital health technologies, including discussion of the main benefits and barriers.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"20 12","pages":"747-759"},"PeriodicalIF":29.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk of uveitis in SpA is changing SpA 葡萄膜炎的风险正在发生变化

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2024-10-31 DOI: 10.1038/s41584-024-01185-7

Sarah Onuora

引用次数: 0

Rheumatic diseases and metabolism: where centre and periphery meet 风湿病与新陈代谢：中心与边缘的交汇点

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2024-10-30 DOI: 10.1038/s41584-024-01178-6

Miguel López, Oreste Gualillo

{"title":"Rheumatic diseases and metabolism: where centre and periphery meet","authors":"Miguel López, Oreste Gualillo","doi":"10.1038/s41584-024-01178-6","DOIUrl":"10.1038/s41584-024-01178-6","url":null,"abstract":"Over the past few decades, the connection between metabolism and various inflammatory and rheumatic diseases has been an area of active investigation. Nonetheless, the precise mechanisms underlying these relationships remain a topic of ongoing debate, owing in part to conflicting data. This discrepancy can be attributed to the predominant focus on peripheral mechanisms in research into the metabolic consequences of rheumatic diseases. However, a wealth of evidence supports the notion that the central nervous system, specifically the hypothalamus, has an important influence on metabolic homeostasis. Notably, links have been established between crucial hypothalamic mechanisms responsible for regulating energy balance (including food intake, thermogenesis, and glucose and lipid metabolism), such as AMP-activated protein kinase, and the pathophysiology of rheumatoid arthritis. This Review aims to comprehensively examine the current understanding of central metabolic control in rheumatic diseases and explore potential therapeutic options that target this pathophysiological mechanism. In this Review, López and Gualillo discuss the complex interrelationships between rheumatic diseases and the hypothalamic and autonomic mechanisms that regulate metabolism, and explore the therapeutic potential of targeting central regulators of energy balance.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"20 12","pages":"783-794"},"PeriodicalIF":29.4,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142541697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management strategies in rheumatoid arthritis 类风湿关节炎的管理策略

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2024-10-24 DOI: 10.1038/s41584-024-01169-7

Victoria Konzett, Daniel Aletaha

{"title":"Management strategies in rheumatoid arthritis","authors":"Victoria Konzett, Daniel Aletaha","doi":"10.1038/s41584-024-01169-7","DOIUrl":"10.1038/s41584-024-01169-7","url":null,"abstract":"Management of rheumatoid arthritis (RA) has evolved from simply the direct translation of drug efficacy results from clinical trials to patient care, to a more complex longitudinal process that considers not only drug efficacy but also the safety gestalt of a treatment and patient profiles and preferences, as well as health-economic factors. With numerous DMARDs available to treat RA, knowledge about trial efficacy becomes less important than data that inform an appropriate clinical strategy for their optimal selection and use. Overly ambitious approaches targeting the ‘maximum’ level of success could, for example, be prone to failure and create frustration, and lead to a large number of patients then being considered as ‘difficult to treat’. Safety profiles might be more informative than efficacy profiles for precision medicine approaches. Contemporary RA management strategies might therefore take a more holistic approach, beyond merely efficacy, to the setting of targets that lead to improved compliance rather than aspirational successes, with consideration of each patient’s multimorbidity profile and preferences, as well as the safety profile of each treatment. Ultimately, the goal remains unchanged: maximizing health-related quality of life; however, with a focus on optimal balance rather than superlatives. Despite the availability of numerous treatment options, the management of rheumatoid arthritis remains suboptimal. In this Review, Konzett and Aletaha discuss strategies to advance clinical decision-making from trial-and-error to an informed process that considers more than just drug efficacy, and appropriately balances effort and success.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"20 12","pages":"760-769"},"PeriodicalIF":29.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mito+ RBCs prompt IFN and IL-1β release by SLE monocytes 线粒体+红细胞促使系统性红斑狼疮单核细胞释放 IFN 和 IL-1β

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2024-10-23 DOI: 10.1038/s41584-024-01183-9

Holly Webster

引用次数: 0

Osmo-sensitive anion channels reduce crystal-induced inflammation Osmo 敏感阴离子通道可减少晶体诱发的炎症

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2024-10-16 DOI: 10.1038/s41584-024-01182-w

Holly Webster

引用次数: 0

Erosive cargo from synovial fibroblasts 来自滑膜成纤维细胞的侵蚀性货物