Reumatologia最新文献

{"title":"Machine learning analysis of treatment and complication patterns in rheumatoid arthritis case reports (1995-2025).","authors":"Naruaki Ogasawara","doi":"10.5114/reum/220541","DOIUrl":"10.5114/reum/220541","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to identify research trends and thematic structures in case reports related to rheumatoid arthritis (RA) and complications published between 1995 and September 2025. By applying unsupervised machine learning (ML), the study sought to uncover longitudinal patterns and cross-domain relationships that may not be fully captured in traditional reviews or large-scale epidemiological studies.</p><p><strong>Material and methods: </strong>Bibliographic data were collected from the Web of Science Core Collection using the search term \"rheumatoid arthritis and complications,\" limited to case reports published between 1995 and 2025. Titles, key words, and abstracts were combined into unified text documents and processed with natural language processing (NLP) techniques. Term Frequency-Inverse Document Frequency was applied for text vectorization. Topic extraction employed non-negative matrix factorization, and clustering was performed using K-means. The optimal number of clusters was determined based on the highest Silhouette Score (0.636). Analyses were conducted in Python (Version 3.10.5) within the PyCharm environment (Version 2022.1.3).</p><p><strong>Results: </strong>The unsupervised ML framework identified two major and stable clusters among 1,200 case reports: a pharmacological and immunological management cluster and a surgical and postoperative complications cluster. Cluster 1 included 890 reports characterized by pharmacological and immunological terms such as \"TNF,\" \"therapy,\" and \"anti,\" while cluster 2 contained 310 reports dominated by orthopedic terms such as \"arthroplasty,\" \"knee,\" and \"revision.\" Reproducibility tests across five runs demonstrated consistent clustering patterns, supporting methodological reliability.</p><p><strong>Conclusions: </strong>This NLP and ML-based analysis revealed a dual structure in RA complication literature, reflecting immunological treatment-related complications and surgical outcomes. Beyond confirming known domains, the study provides a data-driven characterization of their evolution and overlap, offering insights into the evolution of research themes in RA management. This approach demonstrates the potential of unsupervised ML for longitudinal mapping of clinical research domains.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"64 3","pages":"166-173"},"PeriodicalIF":2.5,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic Crohn's disease as a granulomatous bridge between gastroenterology, rheumatology and dermatology.","authors":"Raman Nitskovich, Konrad Lewandowski, Irena Walecka","doi":"10.5114/reum/225373","DOIUrl":"10.5114/reum/225373","url":null,"abstract":"","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"64 3","pages":"163-165"},"PeriodicalIF":2.5,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening and management of systemic sclerosis-associated pulmonary complications in Iraq: insights from a national survey of rheumatologists and pulmonologists.","authors":"Asal Adnan Ridha, Nabaa Ihsan Awadh, Faiq Isho Gorial, Nizar Jassim","doi":"10.5114/reum/215233","DOIUrl":"10.5114/reum/215233","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated the screening and management approaches of Iraqi rheumatologists and pulmonologists regarding systemic sclerosis interstitial lung disease (SSc-ILD) and pulmonary hypertension (PHT), identifying key gaps and areas for improvement.</p><p><strong>Material and methods: </strong>An internet-based survey was distributed to Iraqi rheumatologists and pulmonologists from August to October 2024. The survey collected demographic data, screening methods, treatment initiation criteria, and therapeutic preferences. Descriptive statistics were used to analyse the responses, and trends were identified on the basis of physician speciality and experience level.</p><p><strong>Results: </strong>A total of 116 participants responded (75.9% rheumatologists, 24.1% pulmonologists). Routine screening for ILD was reported by 88.8% of respondents, with 62.1% screening at diagnosis. High-resolution computed tomography (HRCT) was the preferred screening tool (61.7%), followed by pulmonary function tests (52.2%). However, only 31% of patients are routinely screened for PHT, with most relying on unexplained dyspnoea or annual assessments. Mycophenolate mofetil was the preferred first-line treatment for SSc-ILD (87.5%), whereas rituximab and azathioprine were less commonly used. Treatment decisions were guided primarily by HRCT findings and pulmonary function trends. Despite 89.3% reporting multidisciplinary collaboration, variability in screening and treatment approaches suggests inconsistencies in guideline adherence.</p><p><strong>Conclusions: </strong>This study revealed inconsistencies in the screening and management of SSc-ILD and PHT among Iraqi specialists. While ILD screening is commonly performed via HRCT, PHT screening remains suboptimal. Mycophenolate mofetil is the preferred treatment, but adherence to international guidelines varies. Strengthening standardised protocols and multidisciplinary collaboration is essential to improve patient care. Future research should prioritise the identification of barriers to the effective implementation of clinical guidelines and the evaluation of the effects of standardised care practices on patient outcomes.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"64 3","pages":"209-217"},"PeriodicalIF":2.5,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orbital pseudotumor and skull base infiltration as the sole manifestation of granulomatosis with polyangiitis.","authors":"Nicole Kivelä, William Karlsen, Karolina Markiet, Anna Masiak","doi":"10.5114/reum/219888","DOIUrl":"10.5114/reum/219888","url":null,"abstract":"<p><p>Granulomatosis with polyangiitis (GPA) is a vasculitis affecting small and medium-sized blood vessels. It typically presents with upper respiratory tract, lung, and kidney involvement. However, the disease may involve multiple other organs, and not all cases present with these classic manifestations. Periocular lesions are described in the GPA and, especially in the case of isolated, single-site disease, require extensive differentiation from other diseases, such as IgG4-related disease or myofibroblastic tumor. However, periocular lesions and coexisting symptoms suggesting changes in the central nervous system without other organ changes are undoubtedly a diagnostic challenge. Such situations are described in the literature mainly as case reports, not as a rule in connection with GPA. The impetus for writing this article and analyzing the literature was a case of GPA manifesting as infiltration of the skull base presenting as multiple cranial nerve palsies. A review of atypical cases of GPA in the literature suggests that skull-based involvement is an important yet easily overlooked presentation. Through this case-based review, we aim to raise awareness that GPA may present with isolated cranial nerve palsies.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"64 3","pages":"242-251"},"PeriodicalIF":2.5,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in hematological indices during adalimumab therapy in ankylosing spondylitis: a one-year retrospective study.","authors":"Dominika Szlichta, Magdalena Dryglewska, Ewa Łyś-Toporowska, Maria Majdan","doi":"10.5114/reum/214444","DOIUrl":"10.5114/reum/214444","url":null,"abstract":"<p><strong>Introduction: </strong>Ankylosing spondylitis (AS) is a chronic inflammatory disease that can be managed with tumor necrosis factor (TNF) inhibitors. This study evaluated the effects of adalimumab, a TNF inhibitor, on inflammatory markers, including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Monitoring disease activity during therapy is important for assessing treatment response.</p><p><strong>Material and methods: </strong>We analyzed the medical history of 28 patients with confirmed AS, treated with adalimumab. The inflammatory markers neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), CRP, ESR, and the Bath Ankylosing Spondylitis Disease Activity Index were assessed at the beginning of the observation (month 0) and after 3, 6, and 12 months of therapy.</p><p><strong>Results: </strong>The mean NLR value after 3 months of treatment was 1.48 (95% confidence interval, CI: 0.92-2.03, <i>p</i> < 0.001), after 6 months was 1.48 (95% CI: 0.92-2.12, <i>p</i> < 0.001), and after 12 months was 1.67 (95% CI: 1.08-2.30, <i>p</i> < 0.001). Mean MLR value after 3 months of treatment was 0.07 (95% CI: 0.03-0.13, <i>p</i> = 0.005), after 6 months was 0.05 (95% CI: 0.00-0.11, <i>p</i> = 0.101), and after 12 months was 0.06 (95% CI: 0.01-0.11, <i>p</i> = 0.047), showing statistical significance only after 3 and 12 months. The mean PLR value after 3 months of treatment was 52.8 (95% CI: 30.1-79.60, <i>p</i> < 0.001), after 6 months was 65.50 (95% CI: 31.60-83.90, <i>p</i> < 0.001), and after 12 months was 68.80 (95% CI: 42.70-93.70, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Neutrophil-lymphocyte ratio may be a useful marker of inflammation in patients with AS. Monocyte-lymphocyte ratio and PLR require further investigation. Peripheral blood tests are simple and inexpensive to perform, making hematological markers promising tools for monitoring inflammatory diseases.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"64 3","pages":"174-180"},"PeriodicalIF":2.5,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of hyperbaric oxygen therapy for women with fibromyalgia: a systematic review and meta-analysis of randomized controlled trials.","authors":"Maggie Liberty, Andi Raga Ginting, Dewi Masyithah Darlan, Peggy Liberty, Satria Gohtama","doi":"10.5114/reum/217148","DOIUrl":"10.5114/reum/217148","url":null,"abstract":"<p><strong>Introduction: </strong>The use of currently recommended treatments for fibromyalgia (FM), combining pharmacological and exercise-based therapies, is often challenging in clinical practice. Poor efficacy and adverse effects of the available drugs and low adherence to exercise-based therapies resulting from physical fatigue have often led to inadequate FM-related chronic pain relief. Hyperbaric oxygen therapy (HBOT) has been reported to be a potential emerging therapy for FM, offering pain relief with minimal physical burden and adverse effects. This review aims to evaluate the efficacy and safety of HBOT in managing FM, explicitly in female populations.</p><p><strong>Material and methods: </strong>A systematic review and meta-analysis was performed in accordance with the PRISMA flowchart in three databases, PubMed/MEDLINE, Cochrane Library, and ScienceDirect, to identify studies published up to the year 2025. The Cochrane risk of bias 2.0 tool was used to assess the quality of the included studies. Statistical analyses were conducted using RevMan 5.4.1 software on studies that reported the required numerical outcomes.</p><p><strong>Results: </strong>This review included 5 eligible studies with a total of 227 female participants with FM. The results indicated that HBOT was associated with a significantly greater reduction in pain compared to the control (mean difference [MD] = -3.41, 95% CI: from -6.24 to -0.59). Patients treated with HBOT showed reduced symptom severity compared to the control (MD = 5.27, 95% CI: 2.11-8.44). Quality of life was enhanced in HBOT, though it was not statistically significant. Furthermore, HBOT was well tolerated, with no serious adverse events reported.</p><p><strong>Conclusions: </strong>HBOT appears to be a promising adjunctive treatment for FM, demonstrating significant pain reduction, with no serious adverse events reported. However, the current evidence is limited, and further high-quality studies are needed to confirm its effects on quality of life and long-term outcomes.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"64 3","pages":"181-191"},"PeriodicalIF":2.5,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of <i>ANO6</i> gene polymorphism and expression with ankylosing spondylitis in a Chinese Han population.","authors":"Mingcan Yang, Xianghui Wen, Xinyu Wu, Yanli Zhang, Jieruo Gu","doi":"10.5114/reum/213485","DOIUrl":"10.5114/reum/213485","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigated genetic polymorphisms and aberrant expression of anoctamin-6 (<i>ANO6</i>) in ankylosing spondylitis (AS) patients to clarify the role of <i>ANO6</i> in AS pathogenesis.</p><p><strong>Material and methods: </strong>Genetic sequencing was performed to identify disease-associated single nucleotide polymorphisms (SNPs) within the exonic and transcriptional regulatory regions of <i>ANO6</i> in 417 AS patients and 541 healthy controls (HCs). Linkage disequilibrium (LD) and haplotype analyses were conducted to assess the association of the candidate SNPs with disease susceptibility. A cohort of 2,144 AS patients was stratified based on the presence or absence of risk-associated haplotypes, and clinical phenotypes were compared between the 2 groups. Reverse transcription-polymerase chain reaction was employed to quantify messenger RNA (mRNA) expression levels in peripheral blood mononuclear cells (PBMCs) from 40 AS patients and 32 HCs. Immunohistochemistry was used to evaluate ANO6 protein expression in tendon tissues from 9 AS patients and 5 control subjects.</p><p><strong>Results: </strong>Five SNP loci (rs79662606, rs76186361, rs17095830, rs80224086, and rs75712006) exhibited significant associations with AS susceptibility, with strong LD observed between pairwise loci. Haplotype analysis revealed a higher prevalence of GTGCG, ATGTA, and ACGTA haplotypes in AS patients (<i>p</i> < 0.001). No significant differences in clinical phenotypes were observed between AS patients with or without risk-associated haplotypes. The mRNA expression in PBMCs was significantly lower in AS patients (0.49 ±0.21) compared to HCs (0.86 ±0.38, <i>p</i> < 0.001). Conversely, ANO6 protein expression was significantly elevated in tendon tissues of AS patients, with an average histoscore of 182.22 ±30.732 compared to 62.00 ±35.637 in controls (<i>p</i> = 0.001).</p><p><strong>Conclusions: </strong><i>ANO6</i> may represent a novel AS susceptibility gene, with GTGCG, ATGTA, and ACGTA as risk-associated haplotypes. Dysregulated <i>ANO6</i> expression in PBMCs and tendon tissues suggests its potential role in AS pathogenesis.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"64 3","pages":"192-199"},"PeriodicalIF":2.5,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pleuropericardial effusion as a first presentation of systemic lupus erythematosus.","authors":"Raja Bakhsh, Khaled Saleh Dairi, Zaher Althaqafi, Shifaa Sharaf Aljefri, Ward Hisham Skaik, Sheren Ismail Saleh, Enas Ali AlRubayyi","doi":"10.5114/reum/209914","DOIUrl":"10.5114/reum/209914","url":null,"abstract":"<p><p>Systemic lupus erythematosus is a multisystem autoimmune disease with varied manifestations involving pulmonary features of pleuritis and pericarditis. These complications may be difficult to diagnose in early stages, as they mimic infectious symptoms. The paper sheds light on diagnostic and treatment challenges associated with lupus pleuropericardial effusions. Glucocorticosteroids (GCs) are usually the first-line treatment, but some patients do not respond to this therapy and require escalation to immunosuppressants or biologics. This is review based on studies published in peer-reviewed journals within past 20 years. The case of a patient with pleural effusion included in the article, in whom the diagnosis of SLE was made through the diagnosis of infection, as well as the cases from the available literature presented in the discussion, well illustrate the problem of symptoms that are part of the picture of SLE, but are non-specific and require differential diagnosis. Early diagnosis and treatment with immunosuppressive, immunemodulating drugs and biologics may lead to better outcomes; further research is needed to explore therapeutic options in difficult cases.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"64 3","pages":"252-261"},"PeriodicalIF":2.5,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological treatment of idiopathic retroperitoneal fibrosis.","authors":"Adrianna Niksińska, Robert Kruszewski, Witold Tłustochowicz","doi":"10.5114/reum/211560","DOIUrl":"10.5114/reum/211560","url":null,"abstract":"<p><p>Idiopathic retroperitoneal fibrosis (IRF) is a rare disease characterized by inflammatory infiltration around the aorta, which can lead to clinical symptoms and complications, the most common of which is ureteral obstruction, potentially resulting in secondary renal failure. A search of medical databases was conducted to compile a review article summarizing the immunosuppressive treatment options for IRF. In addition to urological treatment, immunosuppressive drugs are used in the treatment of retroperitoneal fibrosis. The cornerstone of therapy remains glucocorticosteroids (GCs), whose effectiveness and relatively rapid effect have been proven. However, the issue of frequent disease relapses after discontinuation of GCs still remains, prompting clinicians to investigate the effectiveness of other immunosuppressive agents. The efficacy of numerous immunosuppressive and biological medications in the treatment of IRF has been demonstrated in several studies; however, studies involving larger patient groups are still needed.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"64 4","pages":"313-321"},"PeriodicalIF":2.5,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambiguities in the effect of physical activity on bone remodelling in spondyloarthritis.","authors":"Agnieszka Alicja Kowalczyk, Mateusz Wilk, Mariusz Korkosz","doi":"10.5114/reum/213511","DOIUrl":"10.5114/reum/213511","url":null,"abstract":"<p><p>Spondyloarthritis (SpA) is characterized by inflammation of joints and entheses, leading to structural damage and loss of bone mineral density. The goal of this narrative review was to analyse the impact of physical activity on bone remodelling in patients with SpA. Two investigators searched the PubMed, Scopus, Directory of Open Access Journals, and Web of Science bibliographic databases (May 20, 2024; October 4, 2024; and May 19, 2025), then screened the articles for compliance with the inclusion criteria. Six related articles were included. No studies directly assessed the impact of physical activity on bone density in SpA. Prior research showed that short-term exercise does not affect ultrasound or magnetic resonance imaging findings, while repeated activities, such as certain job types, may worsen structural damage. Data regarding the effect of physical activity on bone remodelling are scarce, and results are divergent. More research regarding biomechanical stress and bone remodelling is needed.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"64 3","pages":"218-229"},"PeriodicalIF":2.5,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}