Rheumatology Advances in Practice最新文献

{"title":"Diagnosis and management of gout: are the British Society for Rheumatology and National Institute for Health and Care Excellence guidelines both needed?","authors":"Edward Roddy, Kelsey M Jordan, Ian Giles","doi":"10.1093/rap/rkae007","DOIUrl":"10.1093/rap/rkae007","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 1","pages":"rkae007"},"PeriodicalIF":2.1,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10809909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139563982","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":"Exploration of adverse consequences of total knee arthroplasty by patients and knee specialists: a qualitative study","authors":"Malou E. M. te Molder, J. Vriezekolk, Stefaan Van Onsem, J. Smolders, Petra J C Heesterbeek, Cornelia H van den Ende","doi":"10.1093/rap/rkad111","DOIUrl":"https://doi.org/10.1093/rap/rkad111","url":null,"abstract":"\u0000 \u0000 \u0000 A successful outcome according to the knee specialist is not a guarantee for treatment success as perceived by patients. This study explored outcome expectations and experiences of patients with osteoarthritis (OA) before and after total knee arthroplasty (TKA) surgery and knee specialists that may contribute to the negative appraisal of its effect, and differences in views between patients and knee specialists.\u0000 \u0000 \u0000 \u0000 Semi-structured interviews were held in Belgium and the Netherlands. Twenty-five patients (2 without TKA indications, 11 on the waiting list for TKA and 12 postoperative TKA), and fifteen knee specialists (9 orthopaedic surgeons, 1 physician assistant, 1 nurse practitioner, and 4 physiotherapists) were interviewed. Conversations were audio recorded, transcribed verbatim, and analysed using thematic analysis following the grounded theory approach. Separate analyses were conducted for patients and knee specialists.\u0000 \u0000 \u0000 \u0000 Patients were focused on the arduous process of getting used to the prosthesis, lingering pain, awareness of the artificial knee and limitations they experience during valued and daily activities, while knee specialists put emphasis on surgical failure, unexplained pain, limited walking ability and impairments that limit patients’ physical functioning.\u0000 \u0000 \u0000 \u0000 This study provides a comprehensive overview of potential adverse consequences from the perspective of both patients and knee specialists. Improving patients’ awareness and expectations of adaptation to the knee prosthesis needs to be considered.\u0000 \u0000 \u0000 \u0000 What does this mean for patients?\u0000 Many people with serious complaints due to knee osteoarthritis benefit from knee replacement surgery. This is not the case for approximately 20% of the people. “No benefit” or “not happy” can mean: too much pain, not able to bend the knee, limited walking ability, or a rehabilitation that takes too long. There are many different opinions and the view of the orthopaedic surgeon can be different of that of the patient. We interviewed patients and knee specialists on the negative consequences of a knee replacement surgery and described whether these views differed. We found that patients were more focused on the difficult process of getting used to the prosthesis, lingering pain, awareness of the prosthetic knee and limitations they experience during valued daily activities, while knee specialists were more focused on surgical failure (ie infections, prosthetic loosening), unexplained pain, and impaired physical functioning. We concluded that the difficult process of adapting to the knee prosthesis should be better discussed with patients during preoperative consultation.\u0000","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"116 3‐4","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138976822","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":"Evidencing the clinical and economic burden of musculoskeletal disorders in Tanzania: paving the way for urgent rheumatology service development","authors":"Emma Laurie, Stefan Siebert, Nateiya M. Yongolo, Jo Halliday, S. Biswaro, Stefanie J. Krauth, K. Kilonzo, B. Mmbaga, Emma McIntosh, S. Biswaro, Christopher Bunn, Edith Chikumbu, Jo Coast, Mia Crampin, M. Deidda, Eleanor Grieve, Jo Halliday, Viktor Katiti, Clive Kelly, K. Kilonzo, Emma Laurie, Emma McIntosh, B. Mmbaga, Gloria Moshi, Elizabeth Msoka, Febronia Shirima, Stefan Siebert, J. Virhia, Richard Walker, S. Wyke","doi":"10.1093/rap/rkad110","DOIUrl":"https://doi.org/10.1093/rap/rkad110","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"38 3","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139008297","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":"Renal pelvic involvement in multicentric Castleman disease","authors":"Yoshitaka Ueda, Ryohei Nagata, Keigo Setoguchi","doi":"10.1093/rap/rkad108","DOIUrl":"https://doi.org/10.1093/rap/rkad108","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"7 5","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138585062","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":"A Sjögren's syndrome patient rapidly progressed to scleroderma renal crisis after COVID-19 infection","authors":"Shenyi Yu, Fangling Yao, Fang Li, Zhaohui Deng, Li Deng","doi":"10.1093/rap/rkad107","DOIUrl":"https://doi.org/10.1093/rap/rkad107","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"2 4","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138586061","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":"Acute hot joints on the medical take: tapping into the skills of our workforce","authors":"K. Kouranloo, Jennifer Christie","doi":"10.1093/rap/rkad098","DOIUrl":"https://doi.org/10.1093/rap/rkad098","url":null,"abstract":"D EAR E DITOR , Acute oligoarthritis is a common presentation to secondary care, with septic arthritis the most serious cause. The inpatient mortality from septic arthritis is 7–15%, despite antibiotics use [1]. Bacterial arthritis in the UK has an incidence of 1 in 49 000/100 000 person-years [2]. Arthrocentesis remains the gold standard in differentiating septic from non-septic causes. Prompt diagnosis of acute oli-goarthritis remains fundamental in avoiding unnecessary antibiotics and reducing hospital admissions [3]. Acute oli-goarthritis is managed by medical teams in many National Health Service (NHS) hospitals. Additionally, more common causes of acute hot joints, e.g. gout and pseudogout, often arise in elderly and multimorbid patients, in whom an important differential is septic arthritis, highlighting the need for urgent arthrocentesis.","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138585155","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":"First contact physiotherapists: are they able to reduce the burden on rheumatology services? A critical review of the evidence base","authors":"Sarah R Golding, Jo Jackson","doi":"10.1093/rap/rkad109","DOIUrl":"https://doi.org/10.1093/rap/rkad109","url":null,"abstract":"\u0000 \u0000 \u0000 First Contact Practitioners have emerged over recent years in response to growing pressures within the National Health Service (NHS) and are now central to primary care musculoskeletal (MSK) services. Within the musculoskeletal field these allied health professionals may be from a range of disciplines including Physiotherapy, Podiatry and Osteopathy. Early referral to rheumatology is key to successful long-term management of many inflammatory musculoskeletal conditions but presents challenges to overburdened services. Evidence supporting the recognition and referral of patients with rheumatological disorders by First Contact Practitioners is lacking, however physiotherapists have been shown to successfully substitute the role of a doctor within the MSK field. This review investigates the value of First Contact Physiotherapists (FCPs) within primary care and their role in early recognition and referral of rheumatological MSK disorders in line with national guidance. FCPs are best placed to fulfil the role of MSK ‘champions’, positively impacting the whole MSK pathway, with the potential to reduce burden on rheumatology services. Planned rapid upscale of FCPs over the next few years will support sustainability of MSK NHS services.\u0000 \u0000 \u0000 \u0000 First Contact Practitioner (FCP) is a relatively new role within GP practices in the NHS whereby physiotherapists manage patients with musculoskeletal problems such as arthritis. In patients with inflammatory conditions such as rheumatoid arthritis (RA), recognising signs and symptoms as early as possible and referring these patients to rheumatology for treatment is essential, giving the best long-term outcomes. Rheumatology services in the UK are under pressure due to staffing levels not meeting current demands, so it is essential that the right patients are referred. Physiotherapists have been shown to successfully undertake similar roles to a doctor in diagnosing and managing patients with musculoskeletal problems. However, there is no research into the relatively new FCP role in diagnosis and referral of patients with inflammatory musculoskeletal conditions to rheumatology. This review presents the value of FCPs in GP practices and their role in referring the right patients early to rheumatology as advised by national guidelines. FCPs are best placed to first assess patients with arthritis, providing best care and helping to reduce pressure on rheumatology NHS services. Numbers of FCPs are planned to increase over the next few years.\u0000","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"4 6","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138585673","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":"Management and treatment of children, young people and adults with systemic lupus erythematosus: British Society for Rheumatology guideline scope.","authors":"Md Yuzaiful Md Yusof, Eve M D Smith, Sammy Ainsworth, Kate Armon, Michael W Beresford, Morgan Brown, Lindsey Cherry, Christopher J Edwards, Kalveer Flora, Rebecca Gilman, Bridget Griffiths, Caroline Gordon, Paul Howard, David Isenberg, Natasha Jordan, Arvind Kaul, Peter Lanyon, Philip M Laws, Liz Lightsone, Hanna Lythgoe, Christian D Mallen, Stephen D Marks, Naomi Maxwell, Elena Moraitis, Clare Nash, Ruth J Pepper, Clarissa Pilkington, Antonios Psarras, Heather Rostron, Jade Skeates, Sarah Skeoch, Dalila Tremarias, Chris Wincup, Asad Zoma, Edward M Vital","doi":"10.1093/rap/rkad093","DOIUrl":"10.1093/rap/rkad093","url":null,"abstract":"<p><p>The objective of this guideline is to provide up-to-date, evidence-based recommendations for the management of SLE that builds upon the existing treatment guideline for adults living with SLE published in 2017. This will incorporate advances in the assessment, diagnosis, monitoring, non-pharmacological and pharmacological management of SLE. General approaches to management as well as organ-specific treatment, including lupus nephritis and cutaneous lupus, will be covered. This will be the first guideline in SLE using a whole life course approach from childhood through adolescence and adulthood. The guideline will be developed with people with SLE as an important target audience in addition to healthcare professionals. It will include guidance related to emerging approved therapies and account for National Institute for Health and Care Excellence Technology Appraisals, National Health Service England clinical commissioning policies and national guidance relevant to SLE. The guideline will be developed using the methods and rigorous processes outlined in 'Creating Clinical Guidelines: Our Protocol' by the British Society for Rheumatology.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"7 3","pages":"rkad093"},"PeriodicalIF":3.1,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10695902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499338","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":"Current and future advances in practice: a practical approach to the diagnosis and management of primary central nervous system vasculitis.","authors":"Mats Junek, Kanjana S Perera, Matthew Kiczek, Rula A Hajj-Ali","doi":"10.1093/rap/rkad080","DOIUrl":"https://doi.org/10.1093/rap/rkad080","url":null,"abstract":"<p><p>Primary CNS vasculitis (CNSV) is a rare, idiopathic autoimmune disease that, if untreated, can cause significant morbidity and mortality. It is a challenging diagnosis due to multiple mimics that can be difficult to differentiate, given that the CNS is an immunologically privileged and structurally isolated space. As such, diagnosis requires comprehensive multimodal investigations. Usually, a brain biopsy is required to confirm the diagnosis. Treatment of CNSV involves aggressive immunosuppression, but relapses and morbidity remain common. This expert review provides the reader with a deeper understanding of presentations of CNSV and the multiple parallel diagnostic pathways that are required to diagnose CNSV (and recognize its mimics), highlights the important knowledge gaps that exist in the disease and also highlights how we might be able to care for these patients better in the future.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"7 3","pages":"rkad080"},"PeriodicalIF":3.1,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809144","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":"Stem cell-based therapy for systemic sclerosis.","authors":"Maryam Zare Moghaddam, Mohammad Javad Mousavi, Somayeh Ghotloo","doi":"10.1093/rap/rkad101","DOIUrl":"https://doi.org/10.1093/rap/rkad101","url":null,"abstract":"<p><p>Autoimmune diseases, including SSc, are prevalent, affecting autologous connective tissues and caused by the breakdown of self-tolerance mechanisms of the immune system. During the last 2 decades, stem cell therapy has been increasingly considered as a therapeutic option in various diseases, including Parkinson's disease, Alzheimer's disease, stroke, spinal cord injury, multiple sclerosis, inflammatory bowel disease, liver disease, diabetes, heart disease, bone disease, renal disease, respiratory disease and haematological abnormalities such as anaemia. This is due to the unique properties of stem cells that both divide and differentiate to the specialized cells in the damaged tissue. Moreover, they impose immunomodulatory properties affecting the diseases caused by immunological abnormalities such as SSc. In the present review, the efficacy of stem cell therapy with two main types of stem cells, including mesenchymal stem cells and hematopoietic stem cells, will be reviewed. Moreover, other related issues, including safety, changes in immunological parameters, suitable choice of stem cell origin, conditioning regimen and complications of stem cell treatment will be discussed.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"7 3","pages":"rkad101"},"PeriodicalIF":3.1,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10701795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809120","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}