Mediterranean Journal of Rheumatology最新文献

{"title":"Diffuse Idiopathic Skeletal Hyperostosis, beyond the Axial Skeleton: Extra-spinal DISH.","authors":"Eleftherios Pelechas, Aliki I Venetsanopoulou, Paraskevi V Voulgari, Alexandros A Drosos","doi":"10.31138/mjr.211024.bas","DOIUrl":"10.31138/mjr.211024.bas","url":null,"abstract":"","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"36 1","pages":"144-146"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486319","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":"Physical Modalities for the Treatment of Pain in Patients with Fibromyalgia.","authors":"Ilke Coskun Benlidayi","doi":"10.31138/mjr.041124.pht","DOIUrl":"10.31138/mjr.041124.pht","url":null,"abstract":"<p><p>Generalised pain is the major symptom in patients with fibromyalgia. The management of pain includes both pharmacological and non-pharmacological options. Exercise, meditative movement therapies and mindfulness-based stress reduction are examples of non-pharmacological treatments. Over the last decades, there is growing evidence regarding the role of physical modalities in the management of fibromyalgia-related pain. Physical modalities demonstrate their effects by using several energy types such as electrical, thermal, acoustic, or radiant energy. They may act through the alteration of blood flow, cellular activity, and nerve excitability. By reviewing the recent literature, the current article aimed to provide a comprehensive insight to the potential effects of physical modalities in the treatment of fibromyalgia-related pain. Evidence regarding the potential therapeutic role of transcutaneous electrical nerve stimulation, interferential current, therapeutic ultrasound, non-invasive brain stimulation techniques (e.g. transcranial direct current stimulation, transcranial magnetic stimulation), photobiomodulation therapy [e.g. Light Amplification by Stimulated Emission of Radiation (LASER)], the use of therapeutic cold (e.g. whole-body cryotherapy) was discussed.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"36 1","pages":"12-27"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486323","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":"Prevalence of Anti-Synthetase Syndrome in Patients of Interstitial Lung Disease with Connective Tissue Diseases and Autoimmune Features: A Cross-Sectional Study.","authors":"Indu Mb, Desh Deepak, Ajay Bhatta, Gunjan Lalwani, Brijesh Sharma, Vardhini Somayya, Mala Chhabra, Nandini Duggal","doi":"10.31138/mjr.180324.dtc","DOIUrl":"10.31138/mjr.180324.dtc","url":null,"abstract":"<p><strong>Objective: </strong>Anti-synthetase syndrome (ASS) is a rare autoimmune disease with heterogenous manifestations. Interstitial lung disease (ILD) is one among its common manifestations. The aim of this study was to evaluate the prevalence of ASS in cases of ILD associated with autoimmune features and describe the clinical, serological, and radiological profile in them.</p><p><strong>Methods: </strong>This cross-sectional study included a total of 100 patients: 50 cases each of connective tissue disease-related ILD (CTD-ILD) and interstitial pneumonia with autoimmune features (IPAF).</p><p><strong>Results: </strong>Four cases of CTD-ILD and 7 cases of IPAF had anti-ARS auto-antibodies. All eleven of them fulfilled Connor's criteria for ASS. The classic triad of arthritis, myositis, and ILD was present only in two cases. Anti-nuclear antibody (ANA) was positive in 63.6%. Anti-Jo1 (54.56%), Anti-PL12(27.3%), anti-PL7(18.2%), and anti-EJ(18.2%) were the anti ARS autoantibodies. Though generally considered to be mutually exclusive, anti-PL12 and anti-EJ antibodies were found together in two cases. Myalgia was associated with all four ARS antibodies. Anti-Jo1 antibody was associated with Raynaud's phenomenon, polyarthralgia, polyarthritis, and myopathy. Anti-PL7 antibody was associated with myopathy and mechanic's hands. Anti-PL12 and anti-EJ antibodies were associated with inflammatory poly-arthritis, polyarthralgia, and unexplained fever. Non-specific interstitial pneumonia (NSIP) was the most common radiologic pattern of ILD (81.8%). The remaining two had Usual interstitial pneumonia (UIP) pattern and were positive for anti-Jo1 antibody.</p><p><strong>Conclusion: </strong>ASS can present in many ways, often incomplete at the onset without the classic clinical triad. Anti-ARS autoantibodies can be found in established CTDs. Anti-cytoplasmic antibodies (not ANA) must be used to screen for ASS in suspected cases.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"36 1","pages":"107-115"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486326","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":"Weight Loss, but Not at Any Cost: Risks and Challenges in Patients with Osteoarthritis.","authors":"Tsvetoslav Georgiev, Plamena Kabakchieva","doi":"10.31138/mjr.121224.wlc","DOIUrl":"10.31138/mjr.121224.wlc","url":null,"abstract":"<p><p>Osteoarthritis (OA) is a prevalent joint disorder characterised by the deterioration of the entire joint. Among its primary risk factors, obesity significantly contributes to OA onset and progression. Weight reduction in individuals with OA can alleviate pain, enhance joint function, and potentially delay or prevent the need for surgical interventions. However, despite these benefits, the potential risks and detriments associated with weight loss in OA patients warrant careful evaluation. This review synthesises available data on the multifaceted effects of weight loss interventions in OA patients, including risks of weight regain, malnutrition, sarcopenia, joint instability, bone density reduction, and psychoemotional stress due to fluctuating weight. A comprehensive search was conducted across major databases, identifying studies that assessed the physical, mental, and quality of life impacts of weight loss in knee and hip OA populations. Rapid weight loss may destabilise joints, lead to muscle and bone loss, and increase the risk of malnutrition and osteoporosis. Additionally, psychological distress from weight loss failures or fluctuations can adversely affect mental health and quality of life, underscoring the need for balanced weight management strategies. Long-term weight loss maintenance remains a challenge, with high rates of weight regain observed in OA patients. Emerging anti-obesity drugs hold potential for more sustained outcomes, albeit with uncertainties remaining. By adopting a holistic approach that addresses both physical and mental aspects, healthcare providers can improve outcomes and quality of life for OA patients, tailoring strategies to reduce the potential harms associated with aggressive or unsupervised weight reduction efforts.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"36 1","pages":"28-35"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486330","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":"Dietary Recommendations from the Moroccan Society for Rheumatology (SMR) for Patients with Chronic Inflammatory Rheumatic Diseases.","authors":"Hind El-Kasmi, Samira Rostom, Salma Zemrani, Bouchra Amine, Latifa Tahiri, Nessrine Akasbi, Kawtar Nassar, Soumiya Mehdioui, Sara Wakrim, Racha Lahlou, Nada Bensaoud, Rachina Bahiri","doi":"10.31138/mjr.030624.dra","DOIUrl":"10.31138/mjr.030624.dra","url":null,"abstract":"<p><p>This work was conducted under the auspices of the Moroccan Society of Rheumatology (SMR) with the aim of developing best practice medical guidelines for the dietary management of patients with Chronic Inflammatory Rheumatic Diseases (IRDs). A working group composed of rheumatology experts and two nutritionists was formed. This group relied on a synthesis of the literature and expert opinions. These guidelines were then validated by a group of rheumatology experts. The methodology followed the procedure proposed by the European League Against Rheumatism (EULAR). Five general principles and eleven recommendations were established. These principles emphasise that diet should complement, rather than replace, pharmacological treatment and should be integrated into the overall management of patients with IRDs. Additionally, it should be associated with appropriate physical activity and take cultural and socio-economic context into account. These recommendations highlight the importance of weight loss for overweight or obese patients and advocate for the Mediterranean diet as well as a diet rich in omega-3. However, exclusion diets such as gluten-free, vegetarian, and dairy-free diets, as well as supplementation with probiotics or spices, are currently not recommended for patients with IRDs. Supplementation with vitamins or trace elements is not systematically recommended, and the data concerning Ramadan fasting or intermittent fasting are limited or contradictory. Furthermore, two specific recommendations for the Moroccan diet were proposed. These recommendations standardise dietary management in IRDs, making it accessible for practitioners and patients.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"36 1","pages":"36-49"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486318","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":"Comparing Mannitol and Hypertonic Dextrose Injections for Knee Osteoarthritis Pain and Function: A Randomised Trial.","authors":"Nasrin Barzegar, Rezvan Ghaderpanah, Hamid Reza Farpour, Mohammad Esmaeil Ghorbani Nejad","doi":"10.31138/mjr.280224.cmd","DOIUrl":"10.31138/mjr.280224.cmd","url":null,"abstract":"<p><strong>Introduction: </strong>Knee osteoarthritis is a chronic and age-related disease that causes joint stiffness, pain, and biomechanical changes in the joint, resulting in decreased activity and performance. Prolotherapy is one of the methods of injection therapy in the management of this disease. Drugs such as hypertonic dextrose and mannitol have been introduced as prolotherapy drugs. The aim of this study is to evaluate the efficacy of intra-articular injection of mannitol compared to prolotherapy with hypertonic dextrose in terms of pain relief and functional improvement in patients with knee osteoarthritis.</p><p><strong>Patients and methods: </strong>A total of 48 patients with KOA were randomly divided into two groups: hypertonic dextrose (24 patients) and mannitol (26 patients). All patients received three intra-articular injections of either hypertonic dextrose or mannitol at two-week intervals. Visual Analogue Pain Scale (VAS), Oxford Knee Scale (OKS), and Western Ontario McMaster University Osteoarthritis Index (WOMAC) questionnaire scores were the outcome measures assessed before and 2, 4, and 8 weeks after the injections.</p><p><strong>Results: </strong>There were no statistically significant differences in pre-injection demographic characteristics between the two groups (p > 0.05). Results showed that VAS and OKS scores decreased over time (p < 0.001). Both interventions significantly improved the mean scores of WOMAC pain, WOMAC stiffness, WOMAC function, and WOMAC total score. There were not any serious side effects in any of the groups.</p><p><strong>Conclusion: </strong>The results showed that prolotherapy is an effective and safe treatment. Although both groups had improvements in outcome measures during follow-up up to 8 weeks after the intervention, no statistically significant difference was found between the two groups.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"36 1","pages":"100-106"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486316","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":"Pregnancy and Fibromyalgia and their Interrelationships: A Systematic Review.","authors":"Jozélio Freire de Carvalho, Thelma L Skare","doi":"10.31138/mjr.220424.pam","DOIUrl":"10.31138/mjr.220424.pam","url":null,"abstract":"<p><strong>Background: </strong>Fibromyalgia (FM) occurs frequently in women of childbearing age. These patients may become pregnant, and it is essential to know the influence of pregnancy on this disease.</p><p><strong>Aim: </strong>To review the studies of pregnancy in FM.</p><p><strong>Methods: </strong>To systematically search for articles on pregnancy and FM between 1966 and April 2024. No language limitation was used. Scielo, PubMed, and Embase databases were analysed.</p><p><strong>Results: </strong>Twelve articles with 8,833 patients were found. Patients' ages varied from > 18 to 65 years old. FM patients had a lower number of children and more nulliparity than controls. Studies that analysed FM symptoms during pregnancy found symptom worsening, mainly pain, anxiety, depression, and gestational diabetes, were found to be more common than in controls in 2 papers. Regarding neonatal outcomes, only four studies evaluated these data: two of them found that FM had no adverse effect on the neonate's health. In contrast, the other two found that these babies were more likely to be premature, to have intrauterine growth restriction, and to have low Apgar.</p><p><strong>Conclusion: </strong>This systematic review demonstrates that pregnancy in FM usually has a bad prognosis since obstetric and FM outcomes are worse during this period. Results of repercussions on the offspring are controversial.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"36 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486325","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":"Detection of Auto-Immune Disease using Deep Learning Techniques.","authors":"B Subramanya, Divya B Shivanna, Nithin Raj G, Pratham S Prabhu, Mohammed Yaseer, Roopa S Rao","doi":"10.31138/mjr.060624.doa","DOIUrl":"10.31138/mjr.060624.doa","url":null,"abstract":"<p><strong>Objective: </strong>The diagnosis of autoimmune disorders, particularly through the Anti-Nuclear Antibodies (ANA) Indirect Immunofluorescence (IIF) test utilising human epithelial type-2 (HEp-2) cells, presents a formidable challenge due to the subjective nature of pathologists' analysis. In response, this study proposes an innovative automated approach that integrates deep learning, advanced image processing, guided Hep-2 Cell, and mitotic cell instance segmentation.</p><p><strong>Methods: </strong>Leveraging the ICPR 2016 dataset for training and evaluation, this research encountered an initial challenge of dataset imbalance, with a significantly lower number of mitotic cells compared to HEp-2 Homogenous cells. To overcome this, data augmentation techniques were strategically employed to ensure a balanced representation.</p><p><strong>Results: </strong>In Experiment 1, the Detectron2 model achieved an overall mean Average Precision of 54% for segmentation masks and 55% for bounding boxes. In Experiment 2, the YOLOv8n model demonstrated an impressive overall Mean Average Precision score of 94% for bounding boxes and 93% for segmentation masks, showcasing its exceptional efficacy in detecting HEp-2 cells and mitotic cells. The instance segmentation provided a more granular analysis, revealing the count of cells in each class, further highlighting the model's proficiency in diagnosing autoimmune diseases.</p><p><strong>Conclusion: </strong>This study establishes a reliable and automated method for HEp-2 Homogenous cell detection, addressing the ongoing challenges in autoimmune disease diagnosis and contributing significantly to the ongoing revolution in this critical field.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"36 1","pages":"50-62"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486317","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":"HLA DRB1* Allele Lupus Erythematosus, Rheumatoid Arthritis, and other Autoimmune Disorders with Skin Involvement.","authors":"Eleni Klimi","doi":"10.31138/mjr.111024.oad","DOIUrl":"10.31138/mjr.111024.oad","url":null,"abstract":"<p><strong>Objective: </strong>A narrative short review has been made aiming to identify the most important immune disorders associated with the HLA DRB1*allele.</p><p><strong>Material and methods: </strong>Data have been taken from PubMed, and 36 articles have been retrieved.</p><p><strong>Results: </strong>It has been found that DRB1*16:02 is associated with autoimmune diseases with production of autoantibodies, mainly systemic lupus erythematosus and myasthenia gravis. DRB1*04 is associated with lupus erythematosus, bullous pemphigoid, and pemphigus vulgaris. DRB1*is also associated with dermatitis herpetiformis, alopecia areata, acute generalised exanthematous pustulosis, and systemic sclerosis. No association of DRB1 has been found either with psoriasis or with psoriatic arthritis, while the association of Cw6 and DRB1*07 confers less severe joint damage in patients with psoriatic arthritis.</p><p><strong>Conclusion: </strong>DRB1* is associated with lupus erythematosus rheumatoid arthritis and with most immune disorders with skin involvement.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"36 1","pages":"8-11"},"PeriodicalIF":0.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486321","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":"Lower Heart Rate Variability is Associated with High Disease Activity, Functional Disability and Inflammation in Rheumatoid Arthritis: A Cross-Sectional Study.","authors":"Suchitra Lakshmi Goda, Madhumitha Haridoss, Krishnamurthy Venkataraman, Bhavani Shankara Bagepally","doi":"10.31138/mjr.290524.lhv","DOIUrl":"10.31138/mjr.290524.lhv","url":null,"abstract":"<p><strong>Introduction: </strong>Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterised by persistent inflammation that negatively impacts cardiovascular health, often leading to cardiac autonomic neuropathy. Heart Rate Variability (HRV), a non-invasive measure, reveals compromised autonomic regulation in RA, as evidenced by reduced HRV and increased sympathetic control in RA. Despite existing evidence, the relationship between HRV and RA remains inconclusive, prompting this study to examine HRV in RA disease activity.</p><p><strong>Methods: </strong>Study involved 320 individuals with RA, aged ≥18 years, attending an outpatient clinic at a tertiary care multispecialty hospital in south India. Sociodemographic, clinical, and laboratory data, and HRV parameters, were obtained. RA disease-specific parameters such as Health-Related Quality of Life, Disease activity and Functional status were assessed using EuroQol-5D, Disease Activity Score-28 (DAS-28) and Health Assessment Questionnaire (HAQ) respectively. Spearman's correlation and linear regression analyses were performed to examine the association between HRV and RA disease-specific parameters. A statistical significance level of p<0.05 was considered.</p><p><strong>Result: </strong>We observed a significant negative correlation between HRV parameters and RA disease-specific parameters such as DAS-28, HAQ and Erythrocyte sedimentation rate. The linear regression analysis indicated that a lower Standard Deviation rate Beats Per Minute was linked to higher functional ability scores according to the HAQ Scale.</p><p><strong>Conclusion: </strong>Reduced HRV in individuals with RA is linked to higher disease activity, functional disability and inflammation. This underscores the significance of HRV as a potential tool for assessing cardiovascular autonomic function in RA patients, with implications for their management and prognosis.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"36 1","pages":"116-121"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486322","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}