{"title":"From clots to cuts in antiphospholipid syndrome","authors":"Abihai Lucas Hernández , Yehuda Shoenfeld","doi":"10.1016/j.reuma.2023.10.005","DOIUrl":"https://doi.org/10.1016/j.reuma.2023.10.005","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 5","pages":"Page 286"},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140824105","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}
Rodrigo Lozano-Lozano , David Vega-Morales , Macarena del Rosario Sifuentes-Martinez , Denisse Ornelas-Balcazar
{"title":"Prevalence of polypharmacy and drug interaction in older adults with rheumatic disease","authors":"Rodrigo Lozano-Lozano , David Vega-Morales , Macarena del Rosario Sifuentes-Martinez , Denisse Ornelas-Balcazar","doi":"10.1016/j.reuma.2024.02.006","DOIUrl":"10.1016/j.reuma.2024.02.006","url":null,"abstract":"<div><h3>Introduction/Aim</h3><p>Older people with rheumatic diseases tend to have a greater number of associated comorbidities, which will require the use of more drugs, increasing the risk of hospitalizations, complications, and drug interactions. In Mexico, there has been an estimated prevalence of polypharmacy of up to 55%, however there are scarce reports on the topic in our elderly population with rheumatic diseases. We aimed to determine the prevalence of polypharmacy and the association of drug interactions in patients treated for rheumatic disease.</p></div><div><h3>Methods</h3><p>A retrospective observational study was conducted on patients undergoing treatment for rheumatic diseases who were treated in geriatrics and rheumatology clinics from January to December 2021. The presence of polypharmacy and drug interactions was evaluated using the BOT Plus Pharmacological Surveillance System. The prevalence of polypharmacy and the association of drug interactions were estimated.</p></div><div><h3>Results</h3><p>We evaluated 320 patients, with a mean age of 67.05<!--> <!-->±<!--> <!-->5.8 years, predominantly female (85%). The prevalence of polypharmacy was 68.1% (<em>n</em> <!-->=<!--> <!-->218), of which 214 (98.1%) patients had related drug interactions; 27.1% were severe and 53.2% as moderate interactions. Factors related with increased risk of drug interactions were being exposed to hypertension increased the risk of drug interactions (POR 1.75, 95% CI 1.44–2.14; <em>P</em> <!--><<!--> <!-->0.001), having osteoarthritis (POR 1.21, 95% CI 1.04–1.42; <em>P</em> <!-->=<!--> <!-->0.032) and thyroid disease (POR 1.45, 95% CI 1.28–1.65; <em>P</em> <!-->=<!--> <!-->0.001). The most prevalent serious interactions were leflunomide–methotrexate in 27 (46.5%) patients and buprenorphine–tramadol in 8 (13.7%).</p></div><div><h3>Conclusions</h3><p>A high prevalence of polypharmacy and drug interactions was observed in elderly patients with rheumatic diseases. The main associated factors were comorbidities, particularly high blood pressure, osteoarthritis and thyroid diseases.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 5","pages":"Pages 249-253"},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140760215","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}
Cristiana Sieiro Santos , Maria Miguel Oliveira , Paulo Ney Solari , Pedro Mateus , Maria José Santos , Hector Corominas , Carolina Álvarez Castro , Elvira Díez Álvarez
{"title":"Cardiovascular disease in patients with systemic autoimmune diseases: The relationship between self-perceived risk and actual risk","authors":"Cristiana Sieiro Santos , Maria Miguel Oliveira , Paulo Ney Solari , Pedro Mateus , Maria José Santos , Hector Corominas , Carolina Álvarez Castro , Elvira Díez Álvarez","doi":"10.1016/j.reuma.2024.01.002","DOIUrl":"10.1016/j.reuma.2024.01.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Autoimmune diseases are known to be associated with an elevated risk of cardiovascular diseases; however, there exists a lack of awareness regarding this increased risk among patients.</p></div><div><h3>Objective</h3><p>This study aimed to assess the prevalence of cardiovascular risk factors and events in various systemic autoimmune diseases, including Systemic Sclerosis (SSc), Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA), and Sjögren's syndrome (SS), matched by age, sex, and disease duration. Additionally, the study aimed to evaluate the perceived and actual risks of cardiovascular disease among patients.</p></div><div><h3>Methods</h3><p>A cross-sectional self-reported survey on the patient's perspective of cardiovascular risk was conducted between January and June 2023. Sociodemographic and clinical data, including disease activity, were collected through medical records and questionnaires. Traditional cardiovascular risk factors and events were assessed, alongside the perceived cardiovascular risk. The SCORE calculation and Charlson Comorbidity Index (CCI) were employed for cardiovascular risk assessment.</p></div><div><h3>Results</h3><p>Survey responses from 180 patients (45 patients each with SSc, SLE, RA, and SS) with systemic autoimmune diseases revealed that 20% perceived a low risk, 23% perceived neither lower nor higher, and 56% perceived a higher risk of developing cardiovascular diseases in the next ten years. Only 45% agreed that their autoimmune disease could increase the risk of a heart attack, even in the absence of other risk factors, and 46.7% were unaware that NSAIDs pose a cardiovascular risk. An association between cardiovascular risk measured by SCORE, comorbidities, and risk perception was observed in RA, SSc, and SS patients, with no association found in SLE patients (<em>p</em> <!-->=<!--> <!-->0.27). Except for SS patients (<em>p</em> <!-->=<!--> <!-->0.02), no association between CCI and disease activity level was found. Regarding the influence of age, working status, and education in CVD risk perception, an association between CVD risk perception and age was observed (<em>p</em> <!-->=<!--> <!-->0.01), with patients over 40 years exhibiting a higher perception of CVD risk. No differences were found regarding working status (<em>p</em> <!-->=<!--> <!-->0.19) nor education level (<em>p</em> <!-->=<!--> <!-->0.06).</p></div><div><h3>Conclusions</h3><p>Patients with SS, RA, and SSc displayed a heightened perception of cardiovascular risk, correlating with their actual risk and preexisting comorbidities. However, patients exhibited unawareness of certain cardiovascular risk behaviors. This underscores the need for tailored education programs on cardiovascular risk for autoimmune disease patients, to be implemented at the time of diagnosis and during follow-up in outpatient clinics.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 5","pages":"Pages 229-236"},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140763732","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":"Cytokine storm in Chikungunya: Can we call it multisystem inflammatory syndrome associated with Chikungunya?","authors":"Zoilo Morel , Tamara Martínez , Fernando Galeano , Judith Coronel , Lorena Quintero , Rolando Jimenez , Jorge Ayala , Sara Amarilla , Dolores Lovera , Celia Martínez de Cuellar","doi":"10.1016/j.reuma.2023.10.003","DOIUrl":"10.1016/j.reuma.2023.10.003","url":null,"abstract":"<div><p>Paraguay is currently facing a new outbreak of Chikungunya virus. This report summarizes two severe cases of Chikungunya (CHIKV) infection, confirmed by real-time reverse transcription polymerase chain reaction. We present the cases of patients with acute CHIKV infection and multisystem involvement, with fever, rash, abdominal pain, vomiting, myocarditis, and coronary artery anomalies, very similar to the cases described in MIS-C related to SARS-CoV-2 during the COVID-19 Pandemic. Both patients received IVIG and methylprednisolone, with good clinical response. In this setting of cytokine storm in Chikungunya, can we call it “Multisystem inflammatory syndrome associated with Chikungunya”?.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 4","pages":"Pages 223-225"},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139293529","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":"Does sacroiliitis is a mandatory criterion for enthesitis-related arthritis diagnosis?","authors":"Hanene Lassoued Ferjani , Lobna Kharrat , Dorra Ben Nessib , Dhia Kaffel , Kaouther Maatallah , Wafa Hamdi","doi":"10.1016/j.reuma.2023.12.005","DOIUrl":"10.1016/j.reuma.2023.12.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Magnetic resonance imaging (MRI) sensitivity and specificity seem to be less studied in enthesitis-related arthritis (ERA).</p><p>We aimed to determine the ability of sacroiliac MRI to diagnose ERA patients.</p></div><div><h3>Materials and methods</h3><p>We conducted a retrospective study including 44 patients with juvenile idiopathic arthritis (JIA). Each patient had a sacroiliac joint MRI. We divided patients into two groups: G1 patients with ERA and G2 patients with non-ERA subtype.</p></div><div><h3>Results</h3><p>ERA was noted in 61% of the cases. Sacroiliac joints were painful in 15 patients (34%). MRI was normal in 25 patients (57%) (G1:11 versus G2:14) and showed bone marrow edema in the sacroiliac joints in 19 patients (34%) (G1<!--> <!-->=<!--> <!-->16 versus G2<!--> <!-->=<!--> <!-->3, <em>p</em> <!-->=<!--> <!-->0.005).</p><p>Sacroiliac joints MRI's sensitivity and specificity in the ERA diagnosis were 61.54% and 82.35%, respectively. Positive and negative predictive values were 84.21% and 58.33%, respectively. Furthermore, sacroiliac joint pain in the clinical examination was able to predict sacroiliac bone edema in MRI with an odds ratio of 6.8 (95% CI 1.68–28.09; <em>p</em> <!-->=<!--> <!-->0.006).</p></div><div><h3>Conclusion</h3><p>Our study showed that sacroiliac joint MRI has good specificity and positive predictive value in the diagnosis of ERA patients among JIA patients. This underlines the usefulness of sacroiliac joint MRI in the early diagnosis of ERA patients.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 4","pages":"Pages 187-192"},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139538619","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}
Francisco José Nicolás-Sánchez , Lluis Eleuteri Pons I Ferré , Francesc Josep Nicolás-Sarrat , Alberto González Barranquero
{"title":"La p.(Tyr135His), una nueva variante asociada a la fiebre mediterránea familiar","authors":"Francisco José Nicolás-Sánchez , Lluis Eleuteri Pons I Ferré , Francesc Josep Nicolás-Sarrat , Alberto González Barranquero","doi":"10.1016/j.reuma.2023.09.010","DOIUrl":"10.1016/j.reuma.2023.09.010","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 4","pages":"Pages 226-227"},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135850287","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}