Revista Colombiana de Reumatologia最新文献

{"title":"Tolerancia central de las células T, ¿qué hay de nuevo?","authors":"","doi":"10.1016/j.rcreu.2023.08.002","DOIUrl":"10.1016/j.rcreu.2023.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Random somatic recombination of T<!--> <!-->cell receptors facilitates the variability of response to foreign antigens. Then, central tolerance occurs, a mechanism designed to avoid exit of autoreactive T<!--> <!-->cells from the thymus. However, failures in this process can induce the appearance of autoimmunity.</div></div><div><h3>Materials and methods</h3><div>This narrative review was conducted through a literature search focused on describing relevant and recent concepts of central tolerance of T<!--> <!-->cells.</div></div><div><h3>Results</h3><div>Multiple cell groups are part of the thymic microenvironment, among them, thymic epithelial cells are responsible for directing development of thymocytes, especially medullary thymic epithelial cells that direct the negative selection process.</div></div><div><h3>Conclusions</h3><div>Factors that affect thymocytes, the thymic microenvironment, or interaction between them, can lead to development of immunodeficiencies and/or autoimmunity.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135606267","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 comparison of core muscle endurance of females with fibromyalgia versus healthy females: An observational study","authors":"","doi":"10.1016/j.rcreu.2023.10.001","DOIUrl":"10.1016/j.rcreu.2023.10.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the numerous benefits of core muscle strengthening in improving symptoms of fibromyalgia (FM), limited studies have quantified core muscle function in FM patients.</div></div><div><h3>Objective</h3><div>To compare the core muscle endurance of FM<span> females with age-matched healthy females and determine whether a correlation exists between core muscle endurance and FM severity.</span></div></div><div><h3>Materials and methods</h3><div><span>Pre-diagnosed female FM patients (</span><em>n</em> <!-->=<!--> <!-->7) and age-matched healthy females (<em>n</em> <!-->=<!--> <!-->19) were assessed using McGill's core endurance tests in four positions – flexion, extension, and bilateral side-bridge. The longest contraction holding time (in seconds) in each position was noted and compared in both groups. Additionally, patient-reported Fibromyalgia Impact Questionnaire (FIQ) scores were obtained to determine disease severity.</div></div><div><h3>Results</h3><div>The mean holding time for trunk extensors (26.14<!--> <!-->±<!--> <!-->7.7<!--> <!-->s), right lateral flexors (20.14<!--> <!-->±<!--> <!-->8.3<!--> <!-->s), and left lateral flexors (20.86<!--> <!-->±<!--> <!-->5.3<!--> <!-->s) was significantly lower in the FM females than the healthy females (trunk extensors<!--> <!-->=<!--> <!-->55.21<!--> <!-->±<!--> <!-->17.1<!--> <!-->s; right lateral flexors<!--> <!-->=<!--> <!-->36.05<!--> <!-->±<!--> <!-->13.2<!--> <!-->s; left lateral flexors<!--> <!-->=<!--> <!-->35.11<!--> <!-->±<!--> <!-->13.8<!--> <!-->s). The endurance of trunk flexors was statistically similar in both groups (FM females<!--> <!-->=<!--> <!-->52.14<!--> <!-->±<!--> <!-->27.9<!--> <!-->s; healthy females<!--> <!-->=<!--> <!-->74.37<!--> <!-->±<!--> <!-->37.7<!--> <span>s). Lastly, core muscle endurance was not correlated with the FIQ scores in FM patients (</span><em>p</em> <!-->&gt;<!--> <!-->0.05).</div></div><div><h3>Conclusion</h3><div>The results of this preliminary study revealed that core extensor and lateral flexor endurance in FM females was lower than their healthy female counterparts. Larger sample studies are needed to further substantiate our findings.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433364","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":"Balancing inflammation and adverse effects of glucocorticoids in clinical practice","authors":"","doi":"10.1016/j.rcreu.2023.08.004","DOIUrl":"10.1016/j.rcreu.2023.08.004","url":null,"abstract":"<div><div>Corticosteroids play a vital role in enabling the body to tolerate stressful situations and regulate the inflammatory process. Excessive or persistent inflammation can lead to tissue damage and the development of diseases. Glucocorticoids are crucial in modulating the impact of inflammatory disorders, such as allergies, autoimmune diseases, and sepsis. These disorders can be life-threatening and benefit from glucocorticoid administration. Natural and synthetic glucocorticoids are utilized for the diagnosis and treatment of adrenal function disorders and various inflammatory, immune, and neoplastic conditions. The discovery of glucocorticoids is a testament to the ingenuity and collaboration of researchers. For over 70 years, glucocorticoids have revolutionized medicine and are widely employed in various medical conditions. This article provides a comprehensive review of the critical considerations for the clinical application of glucocorticoids, aiming to strike a balance between their benefits and potential risks. Understanding its history, chemical structure, pharmacology, and mechanisms of action provides the foundation for achieving proper use of this type of medication.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433365","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":"Comprehensive health assessment based on ICF components using the WOMAC index in patients with osteoarthritis","authors":"","doi":"10.1016/j.rcreu.2022.08.003","DOIUrl":"10.1016/j.rcreu.2022.08.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Osteoarthritis (OA) is a common degenerative disease associated with functional impairment, activity limitation, participation restriction, and poor quality of life. Therefore, comprehensive assessment is important to determine how complex problems affect patients with OA.</p></div><div><h3>Objectives</h3><p>The first aim of this study was to link and allocate items of The Western Ontario and McMaster Universities (WOMAC) OA index with the ICF Comprehensive Core Set for OA. The second aim was to examine the relationship between quality of life and each ICF component score based on WOMAC clinical data in OA.</p></div><div><h3>Materials and methods</h3><p>Health status was evaluated with WOMAC and quality of life with the Nottingham Health Profile (NHP). The WOMAC items were linked with codes of the ICF Comprehensive Core Set for OA and allocated with the ICF components by three researchers. The relationship between WOMAC scores and the NHP was determined by Pearson correlation analysis.</p></div><div><h3>Results</h3><p>87 patients with OA were included. As distinguished by the researchers, 7 items of WOMAC covered body function and 17 covered activity-participation. Body function and activity-participation had a moderate correlation with the pain subtest of the NHP and low correlation with the energy level subtest and total score of the NHP. Activity-participation had a high correlation with the physical abilities subtest of the NHP.</p></div><div><h3>Conclusion</h3><p>Although WOMAC does not cover environmental factors, it is a comprehensive tool to assess health status and quality of life. Our results showed that in OA physical abilities can lead to limitations in activity and participation, and these limitations are associated with the individual's pain, energy level, and quality of life.</p><p>Clinical trial registration number: NCT04956510.</p></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47440354","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":"Fe de errores del artículo «Complicación hematológica con impacto pulmonar en una paciente con síndrome de Sjögren» [Rev Colomb Reumatol. 2024;31(2):259-263]","authors":"","doi":"10.1016/j.rcreu.2024.04.006","DOIUrl":"10.1016/j.rcreu.2024.04.006","url":null,"abstract":"","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0121812324000550/pdfft?md5=3cdb0eb9eb53f98b30d3330767ce7292&pid=1-s2.0-S0121812324000550-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951555","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":"A retrospective study of neonatal and pregnancy outcomes in pregnant women suffering from inflammatory arthropathy treated with adalimumab","authors":"","doi":"10.1016/j.rcreu.2023.05.002","DOIUrl":"10.1016/j.rcreu.2023.05.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Anti-tumor necrosis factor-alpha (TNF-α) treatments have been available for over two decades to treat inflammatory arthropathies (IA). Most of these disorders are common among women of reproductive age, which emphasizes the need to evaluate their safety in pregnancy.</p></div><div><h3>Objective</h3><p>This study aims to scrutinize neonatal and pregnancy outcomes in pregnant IA patients treated with adalimumab.</p></div><div><h3>Materials and methods</h3><p>The current cross-sectional work was conducted by reviewing the medical files of pregnant IA patients (<em>n</em> <!-->=<!--> <!-->30) receiving adalimumab referred to Golestan Hospital in Ahvaz (Iran) from 2014 to 2017, followed by extracting demographic profiles as well as neonatal and pregnancy outcomes.</p></div><div><h3>Results</h3><p>Noteworthy among the findings were PsA (<em>n</em> <!-->=<!--> <!-->13), RA (<em>n</em> <!-->=<!--> <!-->5), IBD (<em>n</em> <!-->=<!--> <span>4), AS (</span><em>n</em> <!-->=<!--> <!-->3), uveitis (<em>n</em> <!-->=<!--> <!-->2), Behcet's disease (<em>n</em> <!-->=<!--> <!-->2), and panuveitis (<em>n</em> <!-->=<!--> <!-->1). The mean age of subjects, duration of illness, and duration of treatment were estimated at 29.53<!--> <!-->±<!--> <!-->5.88, 2.85<!--> <!-->±<!--> <!-->1.15, and 1.96<!--> <!-->±<!--> <!-->.90 years, respectively. No delivery outcome was found for 27 (90%) cases, and delivery outcomes observed in three (10%) patients were abortion (<em>n</em> <!-->=<!--> <!-->2) and preterm complications (<em>n</em> <!-->=<!--> <!-->1). No neonatal complication was found for 28 (93.3%) cases and neonatal IUGR outcome was reported in 2 (6.7%) cases. Cesarean section was a delivery method in 7 (23.3%) cases and natural method in 21 (70%) cases. There were no significant differences for the prevalence of cesarean section and neonatal outcomes based on the type of disease, but differences were observed for the outcome of delivery based on the type of disease.</p></div><div><h3>Conclusion</h3><p>According to our findings, definitive conclusions on the safety of adalimumab during pregnancy were impossible and there is a need for further research with a larger sample size.</p></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48934309","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":"Evaluating the efficacy and safety of sodium thiosulfate in calcific tendinitis of the rotator cuff – Data from an ongoing randomized clinical trial","authors":"","doi":"10.1016/j.rcreu.2023.12.003","DOIUrl":"10.1016/j.rcreu.2023.12.003","url":null,"abstract":"","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466410","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":"Evaluaciones económicas en reumatología. Nuevos aprendizajes","authors":"","doi":"10.1016/j.rcreu.2024.05.001","DOIUrl":"10.1016/j.rcreu.2024.05.001","url":null,"abstract":"","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951618","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":"Antinuclear antibody staining patterns by indirect immunofluorescence assay observed in patients from a tertiary health center in Latin America","authors":"","doi":"10.1016/j.rcreu.2023.05.003","DOIUrl":"10.1016/j.rcreu.2023.05.003","url":null,"abstract":"<div><h3>Introduction/Objective</h3><p>This study aimed to describe the frequency of antinuclear antibody (ANA) staining patterns by indirect immunofluorescence assay observed in patients from a tertiary health center in Latin America.</p></div><div><h3>Materials and methods</h3><p>This retrospective, descriptive, and observational study evaluated data from all patients undergoing antinuclear antibody indirect immunofluorescence assay from a single-tertiary center (University Hospital Fundación Valle del Lili, Cali-Colombia) in 2020.</p></div><div><h3>Results</h3><p>One thousand and eight patients met the inclusion criteria. The median patient age was 47 (34–59.2) years, and most were female (769, 75.3%). A positive ANA immunofluorescence assay was observed in approximately two-thirds of patients (664, 65.8%). ANA test results were primarily used to exclude a suspected diagnosis in approximately half of the patients (466, 46.2%). Thirty-seven percent (250/664) of the cohort with ANA-positive titers had a systemic autoimmune rheumatic disease (SARD). The most prevalent SARDs included rheumatoid arthritis (RA) (55, 8.2%) followed by systemic lupus erythematosus (SLE) (37, 5.5%). The vast majority of ANA-positive patients had a reported speckled pattern (anti-cell [AC]-2,4,5; 269; 40.5%) followed by homogenous (AC-1; 266; 40%), nucleolar (AC-8,9,10; 46; 6.9%), and centromere (AC-3; 16; 2.4%). The most frequent patterns observed among SLE patients included homogenous (AC-1) patterns in 17 (45.9%) patients, speckled (AC-2,4,5) nuclear patterns in 11 (29.7%) patients, mixed patterns in 7 (18.9%) patients, and reticular/anti-mitochondrial antibody (AMA, AC-21) cytoplasmic patterns in 2 (5.4%) patients.</p></div><div><h3>Conclusion</h3><p>This study is the first to describe ANA patterns in a Colombian population. Speckled and homogenous patterns were predominant in patients with SARDs.</p></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44500770","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":"Análisis de costo-efectividad del abordaje clínico en fase temprana vs. fase establecida en una cohorte de pacientes con artritis reumatoide de una institución prestadora de servicios de salud de cuarto nivel en Colombia","authors":"","doi":"10.1016/j.rcreu.2023.06.004","DOIUrl":"10.1016/j.rcreu.2023.06.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Rheumatoid arthritis (RA) is a high-cost disease, which allows patients to be classified into early or established phase approaches.</p></div><div><h3>Objective</h3><p>The purpose of this work was to perform a cost-effectiveness analysis comparing both phases with patient data at a 6-month time horizon from a third-party payer perspective.</p></div><div><h3>Materials and methods</h3><p>The population was delimited. The costs and effectiveness of each of the phases were estimated. A decision tree-type economic evaluation model was developed, and the Incremental Cost-Effectiveness Ratio (ICER) was calculated with the respective sensitivity analyses, both deterministic and probabilistic.</p></div><div><h3>Results</h3><p>In terms of costs, it was found that for effectiveness in goals, the cost was 85% higher in the established than in the early phase. Similarly, for non-target effectiveness, the cost was 77% higher in the established than in the early phase. On the other hand, the effectiveness results were better in the early phase compared to the established phase. Regarding the ICER, it was determined that the early phase approach saves $2,326,389 COP_cte (colombian pesos current currency) per patient in goals at 6 months of treatment, compared to the established phase approach.</p></div><div><h3>Conclusion</h3><p>The clinical approach to early-stage rheumatoid arthritis is a less costly and more effective alternative vs. the established phase, as it generates savings for the third-party payer over a 6-month time horizon, from a third-party payer perspective.</p></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135606984","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}