Reumatologia最新文献

{"title":"Oculomotor nerve palsy, an unusual onset of polyarteritis nodosa.","authors":"Ana Martins,&nbsp;Filipe Oliveira Pinheiro,&nbsp;Sofia Vedor,&nbsp;Daniela Oliveira,&nbsp;Maria Seabra Rato,&nbsp;Diogo Fonseca,&nbsp;Pedro Madureira,&nbsp;Luís Braz,&nbsp;Sofia Pimenta,&nbsp;Lúcia Costa","doi":"10.5114/reum/161085","DOIUrl":"https://doi.org/10.5114/reum/161085","url":null,"abstract":"<p><strong>Introduction: </strong>Cranial nerve involvement in polyarteritis nodosa(PAN) is underrecognized and rarely reported. The aim of this article is to review the available literature and present an example of oculomotor nerve palsy in the course of PAN.</p><p><strong>Material and methods: </strong>Evaluation of texts describing the analyzed problem using the terms \"polyarteritis nodosa\", \"nerve\", \"oculomotor\", \"cranial nerve\" and \"cranial neuropathy\" for searching the PubMed database was done. Only full-text articles in English language with titles and abstracts were included in the analysis. As a guideline for the analysis of articles, the methodology described in the Principles of Individual Patient Data systematic reviews (PRISMA-IPD) was used.</p><p><strong>Results: </strong>After screening articles only 16 reported cases of PAN with cranial neuropathy were included in the analysis. In 10 the cranial neuropathy was reported as the initial manifestation of PAN with optic nerve involvement as the most frequent (62.5%); among these cases the oculomotor nerve was involved in 3 cases. Treatment with glucocorticosteroids and cyclophosphamide was the most common.</p><p><strong>Conclusions: </strong>Although cranial neuropathy, especially oculomotor nerve palsy is a rare first neurological manifestation of PAN, this clinical problem should be considered in the differential diagnosis.Especially patients with peripheral neuropathy, general symptoms, skin lesions and hepatitis B virus infection should be evaluated for cranial nerve involvement in the course of vasculitis.In the case of unclear involvement of the cranial nerves, PAN should also be considered in the differential diagnosis as the cause of symptoms and the first manifestation of the disease.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a8/5a/RU-61-161085.PMC10044037.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9230521","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":"The influence of growth hormone deficiency on bone health and metabolisms.","authors":"Arnika Wydra,&nbsp;Izabella Czajka-Oraniec,&nbsp;Jakub Wydra,&nbsp;Wojciech Zgliczyński","doi":"10.5114/reum/170244","DOIUrl":"https://doi.org/10.5114/reum/170244","url":null,"abstract":"<p><p>Growth hormone (GH) is a key peptide hormone in the regulation of bone metabolism, through its systemic and paracrine action mediated directly as well as by insulin-like growth factor-1 (IGF-1). Growth hormone exerts pleiotropic effects leading to an increase in linear bone growth, accumulation of bone mineral content and preservation of peak bone mass. Furthermore, it influences protein, lipid, and carbohydrate metabolism.Growth hormone deficiency (GHD) causes a low bone turnover rate leading to reduced bone mineral density (BMD) and increased bone fragility. The results of GH insufficiency are the most pronounced among children as it negatively affects longitudinal bone growth, causing short stature and in adolescents, in whom it hinders the acquisition of peak bone mass. Most studies show that treatment with recombinant human growth hormone (rhGH) in GHD patients could improve BMD and decrease fracture risk. This review aims to summarize the pathophysiology, clinical picture and management of bone complications observed in GHD.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a6/62/RU-61-170244.PMC10515129.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41165745","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":"Approach to prediction and receiver operating characteristic analysis of a regression model for assessing the severity of the course Lyme borreliosis in children.","authors":"Svetlana Oleksiivna Nykytyuk, Andriy Stepanovych Sverstiuk, Serhiy Ivanovich Klymnyuk, Dmytro Stepanovych Pyvovarchuk, Yuri Bogdanovich Palaniza","doi":"10.5114/reum/173115","DOIUrl":"https://doi.org/10.5114/reum/173115","url":null,"abstract":"<p><strong>Introduction: </strong>Lyme borreliosis (LB) is a multisystemic zoonotic disease transmitted by the bite of infected tick vectors.The aim of the study is to develop a mathematical model for predicting the risk of severity of Lyme disease by the risk factor of the disseminated form of LB in children who have had a tick attack. To test the effectiveness of the formula for predicting the development of the disseminated stage of LB, we built a receiver operating characteristic (ROC) curve and determined the specificity and sensitivity of our model. The results of the examination of 122 patients with the confirmed local and disseminated stages of LB were taken as a basis.</p><p><strong>Material and methods: </strong>To build a prognostic model for prediction of the risk of the developing of the stage in LB predicting the risk of severity of course in Lyme borreliosis (PRSCLB), 122 children (aged 13 ±3 years) with LB were examined using multivariate regression analysis, including 52 boys and 70 girls. Groups of patients: 79 children with erythema migrans, 16 with Lyme arthritis, and 27 with nervous system involvement by LB. The quality of the prognostic model was checked by the Nagelkerke R Square (Nagelkerke R2) and the acceptability of this model was assessed using ROC analysis.</p><p><strong>Results: </strong>The method of multivariate regression analysis for predicting severe course and organ and system damage in LB in children, taking into account the factors and variants of the disease itself, makes it possible to develop a mathematical model for predicting the relative response factors (RRF) of severe forms of Lyme disease and will improve the effectiveness of treatment. This will create all the prerequisites for high-quality preventive measures and reduce the relative response factors rate.The initial data for predicting the severity of LB were 28 factors. According to the results of regression analysis, 24 factors were included in the model for predicting the severity of LB.</p><p><strong>Conclusions: </strong>The results of the study showed that the multifactorial model predicts the severity and organ and system damage in LB in children with an accuracy of 95%. The ROC curve, which was built on the basis of the results, has an area under the curve of 0.94, which indicates the high efficiency of the model.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10634403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134649584","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":"The 4DBODY system as a new tool for chest mobility assessment in patients with ankylosing spondylitis.","authors":"Teresa Sadura-Sieklucka, Daniel Szewczyk, Paweł Liberacki, Sławomir Paśko, Piotr Wojdasiewicz, Tomasz Targowski","doi":"10.5114/reum/173022","DOIUrl":"https://doi.org/10.5114/reum/173022","url":null,"abstract":"<p><strong>Introduction: </strong>Ankylosing spondylitis (AS) is a chronic inflammatory, progressive disease, which leads to deterioration of chest and spine mobility and decrease of physical capacity with abnormal chest movement patterns. We aimed to assess the usefulness of the 4DBODY technology for evaluation of the effectiveness of AS treatment.</p><p><strong>Material and methods: </strong>The 4DBODY technology was assessed on single AS patient with axial involvement. The patient was examined twice, before and after 14 days of rehabilitation. Physiotherapeutic and plethysmographic examinations were used, as well as angular measurement of spine curvatures and measurement of chest mobility. Chest activity measured using the 4DBODY system and the quality of movement were visualized.</p><p><strong>Results: </strong>There was observed an increase of chest mobility from 18 mm to 27.9 mm (up 55%) in the 4DBODY system measurement. The quality of the chest movement also improved, the required phases of inspiration were synchronized. The angular position of the spine has also changed. The chest expansion improved from 25 mm to 50 mm measured on the level of the fourth intercostal space and from 30 mm to 50 mm at the Th10 level. Inspiratory and expiratory muscle strength increased respectively from 80% to 93% and from 46% to 86% of the predicted values. Total airway resistance (Rtot) - increase from 59% to 67%, whereas functional residual capacity (FRC) and total lung capacity (TLC) did not change significantly.</p><p><strong>Conclusions: </strong>The new 4DBODY technology was found to be an effective method of examination and assessment of the effectiveness of rehabilitation of patients with AS.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10634404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134650852","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":"Jagiellonian University and allied rheumatology centers across the country have launched Poland's first registry on inflammatory rheumatic diseases: How the Real World Evidence Registry in Rheumatic Diseases in Poland has finally become a fact. A long, steep road successfully completed.","authors":"Mariusz Korkosz","doi":"10.5114/reum/161940","DOIUrl":"https://doi.org/10.5114/reum/161940","url":null,"abstract":"Dear Editor, It was in early 2019 when a group of rheumatologists at Jagiellonian University Medical College had a vision of having Polish real world data instead of constantly quoting data from other countries. Such real world data are needed not only for scientific work, but also for improving the health care system and health care outcomes – our colleagues from the West have already seen this. Also big pharma listens to such data, which helps them set the pace for research and development of new drugs and improvement of drugs already in use by the rheumatology community. So, why do we not have our own registry in Poland? We have a lot of patients with rheumatic chronic inflammatory diseases, and current worldwide progress in medicine has been established on two pillars – randomized controlled trials (RCTs) and real world evidence (RWE). These two are a bridge to joint research and improvement of clinical achievements. Since RCTs are the domain of pharmaceutical companies, RWE remains attractive for us. Doesn’t such a large country deserve its own real world data in that case? Yes, of course – so that is why we decided to start. We did not want to duplicate the scheme – “we have an idea of a RWE Registry and once you give us money we will arrange it”. No, we adopted a different approach – we wrote a project application with Norwegian partners and received funding of PLN 7 million from Norway Grants via the National Centre for Research and Development in POLNOR Call 2019. The grant focused on improving health care and health outcomes of patients with inflammatory rheumatic diseases, both adults and children. Thus we got access to all Norwegian experience in RWE and their know-how in recording and navigating data flow for scientific but also practical purposes. Importantly, one of the key tasks was to create a high-quality register that would meet the requirements of data collection according to the philosophy of real world evidence that would be the basis for further scientific investigations and progress in clinical practice in Poland. So, all hands on deck, two clinical departments – Jagiellonian University Medical College Department of Rheumatology and Immunology and Sorlandet Hospital Division of Rheumatology from Norway and two IT companies – KAMBU from Krakow and DiagraphIT from Kristiansand, and the work began in early 2021 as PolNor Rheuma Project (www.polnorrheuma.com). The main undertaking at the beginning was to adapt a tool – the Norwegian IT program GoTreatIT (www. diagraphit.no) – for structured clinical data collection to the Polish environment. Once we had done this, we started enrolling patients in our database, and now we have more than 800 patients enrolled. For some, visits and data have been collected since the beginning of 2021. In the database we have evidence on the activity of the disease, imaging, treatment, side effects, accompanying diseases, and much more. In addition, we have a huge amount of data reported by the pa","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/e4/RU-61-161940.PMC10044039.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9214323","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":"Clinical characteristics of ankylosing spondylitis patients depending on neuropathic pain.","authors":"Ivan Kedyk,&nbsp;Mykola Stanislavchuk","doi":"10.5114/reum/163223","DOIUrl":"https://doi.org/10.5114/reum/163223","url":null,"abstract":"<p><strong>Introduction: </strong>Neuropathic pain (NP) in ankylosing spondylitis (AS) is an important factor that complicates patients' everyday activities and leads to a decrease of life quality. Detection and diagnosis of NP can be facilitated by the use of screening instruments, and the comparative assessment of the sensitivity of different scales is important for improving the diagnosis and personalizing the treatment of AS.The aim of the study was to analyze prevalence of NP in patients with AS and clinical features of AS patients depending on the presence of NP.</p><p><strong>Material and methods: </strong>We examined 94 patients with NP and 48 patients without pain in AS using the following questionnaires: LANSS, DN4, StEP, BASFI, BASMI, BASDAI, HAQ, ASAS HI/EF and BAS-G.</p><p><strong>Results: </strong>The prevalence of NP according to LANSS was 51.7% in women and 32.7% in men (<i>p</i> = 0.048); according to DN4 - 58.6% and 32.7%, respectively (<i>p</i> = 0.010). Disease activity and functional disability of the patients were higher in the group of patients with NP than in the group of patients without NP according to the BASDAI, BASFI, BASMI, HAQ, ASAS HI/EF and BAS-G. Significance of differences between groups was at the level of <i>p</i> < 0.01.</p><p><strong>Conclusions: </strong>The prevalence of NP in AS is alarmingly high. Even with low scores on screening scales, patients showed signs of NP, which may indicate higher prevalence of NP. Neuropathic pain is more associated with the activity of the disease, greater loss of functional capacity and a decrease in indicators of the general state of health, which allows it to be considered as an aggravating factor regarding these manifestations.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/cb/RU-61-163223.PMC10201386.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9888096","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":"Comparison of the efficacy and safety of methotrexate alone or in combination with leflunomide in the treatment of juvenile idiopathic arthritis: a double-blind, placebo-controlled, randomized trial.","authors":"Zahra Rezaieyazdi,&nbsp;Sahar Ravanshad,&nbsp;Mandana Khodashahi,&nbsp;Maliheh Bokaeian,&nbsp;Hassan Mehrad Majd,&nbsp;Masoumeh Salari","doi":"10.5114/reum/161317","DOIUrl":"https://doi.org/10.5114/reum/161317","url":null,"abstract":"<p><strong>Introduction: </strong>Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disorder in children. Although methotrexate (MTX) is the first line disease-modifying antirheumatic drug for JIA, many patients do not respond well or cannot tolerate MTX. The aim of this study was to compare the effect of combination therapy of MTX and leflunomide (LFN) with MTX in patients who do not respond to MTX.</p><p><strong>Material and methods: </strong>Eighteen patients (2-20 years old) with polyarticular, oligoarticular or extended oligoarticular subtypes of JIA who did not respond to conventional JIA therapy participated in this double-blind, placebo-controlled, randomized trial. The intervention group received LFN and MTX for 3 months while the control group received oral placebo and MTX at a similar dose to the intervention group. Response to treatment was assessed every 4 weeks using the American College of Rheumatology Pediatric criteria (ACRPed) scale.</p><p><strong>Results: </strong>Clinical criteria, including number of active joints and restricted joints, physician and patient global assessment, Childhood Health Assessment Questionnaire (CHAQ38) score, and serum erythrocyte sedimentation ratelevel, did not differ significantly between groups at baseline and at the end of the 4^th and 8^th weeks of treatment. Only the CHAQ38 score was significantly higher in the intervention group at the end of the 12^th week of treatment. Analysis of the effect of treatment on study parameters revealed that only the global patient assessment score differed significantly between groups (<i>p</i> = 0.003).</p><p><strong>Conclusions: </strong>The results of this study showed that combining LFN with MTX does not improve clinical outcomes of JIA and may increase side effects in patients who do not respond to MTX.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/6e/RU-61-161317.PMC10044028.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9230522","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":"Emotional and cognitive states of geriatric patients during the COVID-19 pandemic - an observational study.","authors":"Teresa Sadura-Sieklucka,&nbsp;Joanna Szczuka,&nbsp;Tomasz Targowski","doi":"10.5114/reum/168344","DOIUrl":"https://doi.org/10.5114/reum/168344","url":null,"abstract":"<p><strong>Introduction: </strong>The authors of the study assessed the emotional and cognitive state of geriatric patients during the COVID-19 pandemic and tried to answer the question: were there any differences in this state in geriatric patients at different stages of the pandemic?</p><p><strong>Material and methods: </strong>The study included 518 patients of 60 years old and above of the Department of Geriatrics in Warsaw. To collect data, the following tools of psychological measurement were applied: the Mini-Mental State Examination scale and Geriatric Depression Scale. In order to test the differences in the means between the groups, a Chi-square test (with Yates's correction for continuity when the class size did not exceed 8 items) was used. For the comparison of the three groups, the Kruskal-Wallis (ANOVA) test was performed.</p><p><strong>Results: </strong>It was found that the majority of geriatric patients (73% of respondents) do not show symptoms of depressed mood. But there are statistically significant differences in the results of the patients' cognitive state tests depending on the time of examination. Patients examined before the pandemic tended to demonstrate a better cognitive state than patients at the beginning of the pandemic and in its later stages. Nevertheless, there are no significant differences in the cognitive functioning of patients examined at the beginning and later in the pandemic.</p><p><strong>Conclusions: </strong>The number of geriatric patients with symptoms of depression significantly increased when visits of relatives prohibition were introduced. However, the number of patients with depression returned to its previous level later in the pandemic.This phenomenon may indicate psychological adaptation to the situation. The presented results of observation suggest that the introduction of limitations is less important than the particular perception of one's situation and adaptation to that.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d0/87/RU-61-168344.PMC10373168.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286348","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":"Diagnostic role of minor salivary glands biopsy in Sjögren's syndrome: correlations between histology and autoimmunity in a large, monocentric cohort.","authors":"Edoardo Conticini,&nbsp;Marco Bardelli,&nbsp;Antonio Vitale,&nbsp;Renato De Stefano,&nbsp;Paolo Falsetti,&nbsp;Enrico Selvi,&nbsp;Maria Romana Bacarelli,&nbsp;Roberto D'Alessandro,&nbsp;Luca Cantarini,&nbsp;Bruno Frediani,&nbsp;Stefano Gentileschi","doi":"10.5114/reum/163213","DOIUrl":"https://doi.org/10.5114/reum/163213","url":null,"abstract":"<p><strong>Introduction: </strong>Based on ACR/EULAR classification criteria, minor salivary glands biopsy (MSGB) is a useful diagnostic tool for the diagnosis of primary Sjögren's syndrome (SS). The main objective of our study was to evaluate the diagnostic role of MSGB, as well as to highlight correlations between histological findings and autoimmune profiles.</p><p><strong>Material and methods: </strong>We retrospectively evaluated histological and autoimmunity data from patients who underwent MSGB in our department in cases of suspected SS, from March 2011 to December 2018. Salivary gland samples were evaluated using Chisholm and Mason (CM) grading and the focus score (FS).</p><p><strong>Results: </strong>A total of 1,264 patients (108 males, 1,156 females) were included. The median age was 55.22 ±13.51 years (range: 15-87). In univariate binary logistic regression, CM ≥ 3 and FS ≥ 1 were significantly predicted by antinuclear antibodies (ANA), anti-extractable nuclear antigens (ENA) and anti-Ro/SSA titer as well as anti-La/SSB, anti-Ro/SSA, rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA) positivity. In multivariate analysis, CM ≥ 3 and MSGB positivity were significantly associated with ANA titer; FS ≥ 1 was not associated with laboratory findings. A positive biopsy was associated with laboratory findings, as ANA and ENA titers, anti-Ro/SSA, anti-La/SSB, RF and ACPA positivity may discriminate patients with SS-related histological findings.</p><p><strong>Conclusions: </strong>Minor salivary glands biopsy is a useful tool to diagnose SS in cases of highly suggestive clinical symptoms but in the absence of a specific autoimmunity.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c1/5b/RU-61-163213.PMC10201380.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9888092","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":"Update on neuromonitoring procedures applied during surgery of the spine - observational study.","authors":"Przemysław Daroszewski,&nbsp;Anna Garasz,&nbsp;Juliusz Huber,&nbsp;Katarzyna Kaczmarek,&nbsp;Piotr Janusz,&nbsp;Paweł Główka,&nbsp;Marek Tomaszewski,&nbsp;Tomasz Kotwicki","doi":"10.5114/reum/160209","DOIUrl":"https://doi.org/10.5114/reum/160209","url":null,"abstract":"<p><strong>Introduction: </strong>Motor evoked potentials (MEPs) are currently considered as a more useful method for neurophysiological intraoperative monitoring than somatosensory evoked potentials in cases of surgery applied to patients with adolescent idiopathic scoliosis. The non-invasive approach is preferred to modify MEP recordings, criticizing, in many cases, the fundamentalism for neurophysiological monitoring based only on needle recordings. The aim of the review is to provide our own experience and practical guidelines with reference to neuromonitoring innovations.</p><p><strong>Material and methods: </strong>Recordings of MEPs with surface electrodes instead of needle electrodes including nerve instead of muscle combinations during neurophysiological monitoring associated with surgical interventions to the spine have become more relevant for pediatric purposes, avoiding the anesthesiology-related influences. Observations on 280 patients with Lenke A-C types of spine curvature are presented before and after the surgical correction.</p><p><strong>Results: </strong>The MEPs recorded from nerves do not undergo fluctuations at different stages of scoliosis corrections and the anesthesia effect more than MEPs recorded from muscles. The use of non-invasive surface electrodes during neuromonitoring for MEP recordings shortens the total time of the surgical procedure without diminishing the precision of the neural transmission evaluation. The quality of MEP recordings during intraoperative neuromonitoring from muscles can be significantly influenced by the depth of anesthesia or administration of muscle relaxants but not those recorded from nerves.</p><p><strong>Conclusions: </strong>The proposed definition of \"real-time\" neuromonitoring comprises the immediate warning from a neurophysiologist about the changes in a patient's neurological status during scoliosis surgery (especially during pedicle screws' implantation, corrective rods' implantation, correction, distraction and derotation of the spine curvature) exactly during the successive steps of corrective procedures. This is possible due to the simultaneous observation of MEP recordings and a camera image of the surgical field. This procedure clearly increases safety and limits financial claims resulting from possible complications.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/8a/RU-61-160209.PMC10044034.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9225976","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}