ARP Rheumatology最新文献

{"title":"A feasibility study of a short lung ultrasound protocol as a screening method for fibrotic interstitial lung disease.","authors":"Sara Braga, André Carvalho, Márcio Rodrigues, Pedro Madureira, Raquel Miriam Ferreira, André Terras Alexandre, Natália Melo, Patrícia Caetano Mota, António Morais, Hélder Novais Bastos","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aims: </strong>Interstitial lung disease (ILD) represents a common complication of connective tissue diseases (CTD). Early detection of ILD is critical since patients often remain asymptomatic during the initial stages. While numerous studies have proposed various ultrasound protocols for ILD evaluation, we find these protocols to be time-consuming in our clinical practice. The aim of this study is to introduce a concise lung ultrasound protocol for the screening of pulmonary fibrosis.</p><p><strong>Methods: </strong>We conducted a prospective observational pilot study involving 28 patients followed in consultation for ILDs. By implementing this streamlined protocol, we established correlations between ultrasound findings at specific locations and their corresponding tomographic patterns. Following the assessment of the protocol's diagnostic accuracy, a multidisciplinary meeting was convened to scrutinize ultrasound images from several patients and evaluate the level of agreement among rheumatologists, pulmonologists, and radiologists.</p><p><strong>Results: </strong>Our simplified protocol revealed significant correlations between ultrasonographic pleural irregularity, discontinuity and the number of B-lines, and the tomographic findings of reticulation and honeycombing in both the upper and lower lung regions. This protocol demonstrated high sensitivity and positive predictive value in identifying reticulation and honeycombing, as well as remarkable specificity and negative predictive value for the latter. The results obtained between the specialties showed strong agreement.</p><p><strong>Conclusion: </strong>Preliminary results suggest a role of ultrasound to detect peripheral manifestations of fibrotic ILDs, such as reticulation and honeycombing. This assessment protocol can be adopted effectively by clinicians, such as rheumatologists, to evaluate lung involvement by CTDs. A larger study is necessary to achieve more robust and generalizable results as a screening tool.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"4 1","pages":"20-28"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765264","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":"Quantification of paravertebral cross-sectional muscle areas and fatty degeneration and their correlation with clinical parameters in ankylosing spondylitis: a comprehensive analysis.","authors":"Selçuk Akkaya, Gonca Sağlam Akkaya, Serpil Demirulus, Hanife Baykal Şahin, Gamze Kılıç, Erhan Çapkın, Murat Karkucak","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aims: </strong>Ankylosing spondylitis (AS) is a chronic disease characterized by inflammation of the spine and joints. This study aimed to examine the multifidus (MF) and erector spinae (ES) muscles in AS patients using magnetic resonance imaging (MRI), and to evaluate the clinical implications of muscle findings.</p><p><strong>Methods: </strong>This study included 43 patients and 40 matched controls. The total (TCSA), functional (FCSA), relative CSAs, and ratios of MF and ES muscles were compared between the groups. The Visual Analog Scale, Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Disease Activity Score with CRP, Ankylosing Spondylitis Disease Activity Score with ESR, Bath Ankylosing Spondylitis Activity Index, and Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) scores of AS patients were recorded. Comparisons between the two groups were made using the Student's t-test and the Mann-Whitney U test.</p><p><strong>Results: </strong>The TCSAs of the MF and ES were similar in the two groups. In contrast, MF relative FCSA (p = 0.003), ES relative FCSA (p < 0.001), ES FCSA (p = 0.017), MF FCSA/TCSA (p < 0.001), and ES FCSA/TCSA (p < 0.001) were decreased in AS patients. ES FCSA/TCSA was negatively correlated with BASMI (r = - 0.369, p = 0.015), while MF FCSA/TCSA was negatively correlated with BASMI, BASFI, and ASQoL (r = - 0.395, p = 0.009; r = - 0.321 p = 0.036; r = - 0.387, p = 0.010, respectively).</p><p><strong>Conclusions: </strong>The paravertebral muscle morphology significantly deteriorates in AS patients, exhibiting decreased functional muscle areas and increased fatty degeneration.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"4 1","pages":"13-19"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765284","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":"Prevalence and risk factors of interstitial lung disease in early systemic sclerosis and systemic sclerosis sine scleroderma: a cross-sectional study.","authors":"Maria Carolina Torres Villarreal, Luis Javier Cajas Santana","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Introduction: Interstitial lung involvement (ILD) is one of the main complications in patients with systemic sclerosis (SSc), representing a significant cause of mortality. According to previous reports, ILD can appear in many patients from early stages (eSSc) to patients with established disease without skin involvement (ssSSc).</p><p><strong>Methods: </strong>Patients were included in the ssSSc group if they met the ACR/EULAR 2013 classification criteria and had a Rodnan skin score 0. In the eSSc group, if they did not meet the former criteria but fulfilled the VEDOSS criteria. Patients must have undergone a high-resolution chest CT scan within the last six months. Experts in this complication reviewed the images, and the percentage of patients with ILD in each group was determined. A univariate and multivariate analysis was performed to determine potential risk factors for ILD, including conventional risk factors and clinical findings in both groups. Odds Ratios and their 95% confidence intervals were estimated. Statistical significance was considered when p was less than 0.05.</p><p><strong>Results: </strong>Data from 353 patients with SSc: 65 (18.4%) with ssSSc, and 75 (21.2%) eSSc (VEDOSS patients) were included in the study. The proportion of patients with ILD was 38% in the ssSSc group and 20% in VEDOSS patients group (p=0.03). Regarding risk factors, anticentromere antibody positivity was found to have a protective effect (OR 0.17, 95% CI 0.03-0.44, p=0.001), and anti-SCL-70 antibody presence was identified as a risk factor for ILD (OR 35.8, 95% CI 2.6-492, p=0.007). No association was found with male gender, digital ulcers, puffy fingers, or capillaroscopic findings.</p><p><strong>Conclusions: </strong>ILD in patients with SSc can occur from early stages or without skin involvement. Thus, an active search for ILD is warranted, as it can be present in 1 out of 5 patients with these disease subsets.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"4 1","pages":"5-12"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765283","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":"Is the association between Immunoglobulin A Nephropathy and Spondyloarthritis real? A case-based review.","authors":"Susana P Silva, Marília Rodrigues, Carolina Ochôa Matos, Rafaela Nicolau, Miguel Bernardes, Margarida Santos Faria, Gisela Eugénio, Anabela Barcelos","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Spondyloarthritis is a group of inflammatory rheumatic diseases characterized by inflammation of the spine and sacroiliac joints. Extra-musculoskeletal manifestations may also occur, although kidney involvement is rarely reported. Immunoglobulin A nephropathy is one of the most common types of glomerulonephritis, and it can be primary or associated with various diseases, such as SpA. Several cases have been reported, mostly through case reports and small case series, pointing to a possible common pathophysiology between these two diseases. However, there is scarce information on the prevalence of renal involvement, particularly Immunoglobulin A nephropathy, among Spondyloarthritis Portuguese patients. We present 5 cases of Immunoglobulin A nephropathy in patients with Spondyloarthritis, resulting from a multicentre Portuguese collaboration, accompanied by a systematic literature review to understand this possible association.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"4 1","pages":"57-62"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765269","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":"Rheumatologists' and Pulmonologists' attitudes and regarding Rheumatoid Arthritis-associated interstitial lung disease: national survey.","authors":"Hugo Parente, Catarina Soares, Sara Dinis, Emanuel Costa, Maria Ferreira, Anita Cunha, Daniela Santos-Faria, Soraia Azevedo, Francisca Guimarães, José Tavares-Costa, Carmo Afonso, Filipa Teixeira","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"4 1","pages":"72-74"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765285","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":"Supervised and non-supervised physical exercises in patients with knee osteoarthritis: a systematic review and meta-analysis.","authors":"Marco Aurélio Schiavon, Jocassia Silva Pinheiro, Rinaldo Roberto Guirro","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Analyzing the high cost of long rehabilitation programs and clinical experiences from the recent pandemic, the aim of the study was to compare the effect of supervised and non-supervised physical exercises in patients with knee osteoarthritis considering pain and function.</p><p><strong>Methods: </strong>Searches were conducted on the database PubMed, EMBASE, PEDro, and Cochrane for randomized clinical trials (RCT) involving adults with knee osteoarthritis. The risk of bias was analyzed using the risk of bias 2 tool and quality of evidence, using the GRADE. Meta-analysis was carried out by applying the differences of means and heterogeneity by the I2 statistics.</p><p><strong>Results: </strong>Regarding the results, 642 studies were checked, out of them 7 were included in the qualitative analysis and 6 on the quantitative analysis, of which 6 for the outcome pain and 5 for the outcome function. Total sample consisted of 903 individuals, mostly female, mean age 63.05 years (SD=4.40), and strengthening and aerobic exercises were the most used. In general, the risk of bias was considered uncertain, the randomization process was effective in most articles and participant blinding was impaired because of the intervention with exercises. According to GRADE, the quality of evidence was moderate for both outcomes. Treatment effect was estimated at -0.67 (CI 95%, -2.09 to 0.74) for pain and -1.07 (CI 95%, -4.30 to 2.16) for function, and heterogeneity was classified as high for both outcomes.</p><p><strong>Conclusions: </strong>In conclusion, no significant differences were observed between supervised and non-supervised physical exercises in terms of pain and function of the osteoarthritis knee.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"4 1","pages":"44-53"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765286","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":"From forgotten to frontline: the new era of crystal diseases?","authors":"Nils Bürgisser, Kim Lauper","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"4 1","pages":"2-4"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765267","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":"Thyroid membrane involvement in rheumatoid nodules: a rare finding.","authors":"Joana Dias, Ana Isabel Pereira, Francisco Alves Sousa, Sandra Sousa Castro, Luís Meireles","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 76-year-old woman with a 19-year history of rheumatoid arthritis (RA) presented with progressive cachexia and constitutional symptoms. Imaging revealed a suspicious hypermetabolic lesion in the cervical region, initially raising concerns of malignancy. Following excision, histopathology identified the lesion as a rheumatoid nodule, a rare extra-articular manifestation of RA in deep tissues like the thyroid membrane. The patient's symptoms were attributed to her autoimmune disease and cognitive decline. This case highlights the importance of considering rheumatoid nodules in the differential diagnosis of cervical masses in RA patients, potentially avoiding unnecessary surgical interventions.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"4 1","pages":"63-64"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765288","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":"Effectiveness of education programs on axSpA patients: a systematic review of randomized controlled trials.","authors":"Luisa Brites, Rita Cunha, Helena Santos, Helena Donato, Fernando Pimentel-Santos","doi":"10.63032/DIBS9955","DOIUrl":"10.63032/DIBS9955","url":null,"abstract":"<p><strong>Introduction: </strong>The current standard of care of patients with spondyloarthritis (SpA), in addition to pharmacological treatment, includes regular exercise and patient education.(1) The primary goal of this systematic literature review (SLR) is to update the evidence of the effectiveness of education programs for patients with axial SpA (axSpA).</p><p><strong>Methods: </strong>We systematically searched three databases, PubMed, Embase and Web of Science Core Collection, from January 2000 to June 2023, using the following terms: \"patient education\", \"patient counselling\", \"patient teaching\", \"patient engaging\", \"patient empowerment\", \"health education\", \"spondyloarthritis\", \"spondyloarthropaties\", \"spondylitis\" and \"ankylosing spondylitis\". The \"Population (P)\", \"Intervention (I)\", \"Comparator (C)\", \"Outcome (O)\", PICO criteria were used. \"P\", defined as axSpA, \"I\" as education, \"C\" as standard of care or physical exercise and \"O\" as disease activity, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS); disease functional repercussion, Bath Ankylosing Spondylitis Functional Index (BASFI); disease metrological repercussion, Bath Ankylosing Spondylitis Metrological Index (BASMI); disease quality of life Ankylosing Spondylitis Quality of Life (ASQoL), EuroQol-5D (EQ-5D) and Short Form 36 Health Survey (SF36); disease economic impact, cost-utility, cost-benefit and incremental cost-effectiveness ratio (ICER). Only randomized clinical trials were included. Two reviewers independently assessed the identified papers according to the established criteria and extracted the data.</p><p><strong>Results: </strong>From the initial 494 studies identified, 6 were selected for data extraction and qualitative analysis. The study sample sizes ranged between 41-65 individuals, all diagnosed with ankylosing spondylitis. The leaders of the programs varied, the intervention period ranged between 4-12 weeks and the follow up ranged between 3-12 months. In three studies, the comparator was standard of care, and in the other three was physical exercise. Overall, there was an improvement in BASDAI, BASFI, BASMI, ASQoL and SF-36, after the application of educational programs. No studies evaluated the economic impact of educational programs.</p><p><strong>Conclusion: </strong>Education appears to be an important adjuvant as non-pharmacological treatment for patients with axSpA, enhancing various disease outcomes, particularly when delivered by Health Professionals using physical materials such as pamphlets. However, there is an ongoing need for additional research to obtain more robust conclusions.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"3 4","pages":"310-319"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927869","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":"Could CGRP mAbs for migraine trigger rheumatoid arthritis? Insights from a case report.","authors":"Catarina Rua, Tiago Beirão, Catarina Silva, Tiago Meirinhos, Patricia Pinto, Romana Vieira, Joana Aleixo-Santos, Flávio Costa, Diogo Fonseca, Ana Sofia Pinto, Beatriz Samões, Taciana Videira","doi":"10.63032/LZFI4171","DOIUrl":"10.63032/LZFI4171","url":null,"abstract":"<p><strong>Background: </strong>Case reports suggest that calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) may trigger inflammatory flares in patients with autoimmune diseases.</p><p><strong>Case description: </strong>A 56-year-old woman with a history of severe migraines, experienced improvement in migraine frequency and intensity after starting fremanezumab 225 mg monthly. However, three months into treatment, she developed symmetric inflammatory polyarthralgias. Physical examination confirmed polyarthritis in the hands, feet, and knees. Laboratory tests showed elevated inflammatory markers and positive anti-cyclic citrullinated peptide antibodies, with baseline X-rays of hands, feet, and knees being normal. Diagnosed with rheumatoid arthritis (RA), she was treated with prednisolone, methotrexate (MTX), folic acid, calcium carbonate, and cholecalciferol, resulting in clinical improvement. Despite recommendations, she continued fremanezumab; her articular symptoms persisted after discontinuation. Later, she switched to leflunomide 20 mg due to gastrointestinal intolerance to MTX and is currently in remission.</p><p><strong>Discussion/conclusions: </strong>CGRP mAbs are effective for migraine prevention, but cases of immune-mediated disease flares are documented. This case suggests a possible association between CGRP mAbs and RA onset. Further research is essential to understand the impact of CGRP modulation in autoimmune diseases.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"3 4","pages":"337-338"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927603","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}