Reumatologia Clinica最新文献

{"title":"Neurological manifestations of rheumatoid arthritis – Nearly 50 years of experience","authors":"Beatriz Samões , Ana Paula Sousa , Raquel Samões , Ernestina Santos","doi":"10.1016/j.reuma.2023.09.005","DOIUrl":"10.1016/j.reuma.2023.09.005","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135568220","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":"Trastornos de la pigmentación como signo guía de enfermedades autoinmunitarias","authors":"Beatriz Clemente Hernández, Itziar Muelas Rives, Adrián Ballano Ruiz, Tamara Gracia Cazaña","doi":"10.1016/j.reuma.2023.09.003","DOIUrl":"10.1016/j.reuma.2023.09.003","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134934271","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":"Comparación de biomarcadores inflamatorios plasmáticos en pacientes con SIM-PedS versus infecciones potencialmente graves en pacientes pediátricos","authors":"Núria Visa-Reñé,&nbsp;Adriana Rubio-Páez,&nbsp;Núria Mitjans-Rubies,&nbsp;Fernando Paredes-Carmona","doi":"10.1016/j.reuma.2023.09.004","DOIUrl":"10.1016/j.reuma.2023.09.004","url":null,"abstract":"<div><h3>Background</h3><p>Inflammatory biomarkers have been used for the diagnosis and management of multisystemic inflammatory syndrome in children (MIS-C). We aimed to compare the clinical and laboratory findings of MIS-C cases versus other febrile cases cataloged as potentially suspected bacterial infection (non-MIS-C).</p></div><div><h3>Methods</h3><p>Unicentric ambispective observational cohort study (June 2020 to February 2022). We analyzed demographics, clinical symptoms and laboratory findings in MIS-C cases and in non-MIS-C cases with febrile processes of patients under 15 years of age admitted to hospital.</p></div><div><h3>Results</h3><p>We enrolled 54 patients with potential suspected bacterial infection and 20 patients with MIS-C for analysis. Fever (100%), gastrointestinal (80%) and mucocutaneous findings (35%) were common in MIS-C patients, also hypotension (36.8%) and tachycardia (55%). Laboratory findings showed significantly elevated proBNP (70%), ferritin (35%), D-dimer (80%) and lymphopenia (55%) and thrombocytopenia (27.8%) in MIS-C cases. IL-6 values were high in non-MIS-C patients (92.6%).</p></div><div><h3>Conclusions</h3><p>In the management of MIS-C patients, the dynamic monitoring of proBNP, ferritin, D-dimer, lymphocytes and platelets could be helpful to pediatricians to effectively evaluate the progress of MIS-C in the early phases, not IL-6 values. The applicability of the IL-6 level as a prognostic biomarker in MIS-C patients may require closer discussion. In addition, the optimal laboratory markers, as stated in our study, can help establish a biomarkers model to early distinguish the MIS-C versus non-MIS-C in patients who are admitted to febrile syndrome.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134934504","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":"Documento de consenso sobre los medicamentos biosimilares en enfermedades inmunomediadas en España","authors":"Emilio Monte-Boquet ,&nbsp;Ángeles Florez ,&nbsp;Guillermo José Alcaín Martínez ,&nbsp;Agustí Sellas","doi":"10.1016/j.reuma.2022.12.001","DOIUrl":"10.1016/j.reuma.2022.12.001","url":null,"abstract":"<div><h3>Objective</h3><p>To improve knowledge about biosimilar medicines and to generate a consensus framework on their use.</p></div><div><h3>Methods</h3><p>Qualitative study. A multidisciplinary group of experts in biosimilar medicines was established (1<!--> <!-->dermatologist, 1<!--> <!-->hospital pharmacist, 1<!--> <!-->rheumatologist, and 1<!--> <!-->gastroenterologist) who defined the sections and topics of the document. A narrative literature review was performed in Medline to identify articles on biosimilar medicines. Systematic reviews, controlled, pre-clinical, clinical, and real-life studies were selected. Based on the results of the review, several general principles and recommendations were generated. The level of agreement was tested in a Delphi that was extended to 66 health professionals who voted from 1 (totally disagree) to 10 (totally agree). Agreement was defined if at least 70% of the participants voted ≥<!--> <!-->7.</p></div><div><h3>Results</h3><p>The literature review included 555 articles. A total of 10 general principles and recommendations were voted upon. All reached the level of agreement established. The document includes data on the main characteristics of biosimilar medicines (definition, development, approval, indication extrapolation, interchangeability, financing, and traceability); published evidence (biosimilarity, efficacy, effectiveness, safety, immunogenicity, efficiency, switch); barriers and facilitators to its use; and data on information for patients.</p></div><div><h3>Conclusions</h3><p>Authorized biosimilar medicines meet all the characteristics of quality, efficacy, and safety. They also significantly help improve patient access to biological therapies and contribute to health system sustainability.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47751357","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":"Utilidad del ultrasonido para el diagnóstico de enfermedad pulmonar intersticial en enfermedades difusas del tejido conectivo","authors":"Bruno Alexander Velazquez Guevara,&nbsp;Carlos Abud Mendoza,&nbsp;Lesly Rocío de Jesús Avilés Ramírez,&nbsp;Eva Santillán Guerrero","doi":"10.1016/j.reuma.2022.12.006","DOIUrl":"10.1016/j.reuma.2022.12.006","url":null,"abstract":"<div><p>Patients with diffuse connective tissue diseases frequently develop interstitial lung disease, which carries a worse prognosis and shortens survival. High-resolution computed tomography is the first-choice test, and is competitive with histopathology, however, the cost and radiation may limit its use, particularly for screening. Lung ultrasound is a rapid, accessible, reproducible, and inexpensive study that is useful for diagnosis of interstitial lung disease. Furthermore, extensive training is not required to identify the alterations associated with these lung diseases. B lines and pleural irregularities compose the ultrasonographic interstitial syndrome, although it must be kept in mind that it is not specific, and it is necessary to rule out haemodynamic, cardiovascular, and infectious abnormalities. This review highlights the elevated prevalence of this lung condition in the main rheumatological diseases, with emphasis on the usefulness of pulmonary ultrasound.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45232126","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":"Assessment of liver fibrosis in patients with rheumatoid arthritis treated with methotrexate: Utility of fibroscan and biochemical markers in routine clinical practice","authors":"Andrea de Diego-Sola ,&nbsp;Agustín Castiella Eguzkiza ,&nbsp;Luis María López Domínguez ,&nbsp;Iratxe Urreta Barallobre ,&nbsp;María José Sánchez Iturri ,&nbsp;Joaquín María Belzunegui Otaño ,&nbsp;Eva María Zapata Morcillo","doi":"10.1016/j.reuma.2022.12.003","DOIUrl":"https://doi.org/10.1016/j.reuma.2022.12.003","url":null,"abstract":"<div><h3>Objectives</h3><p>To study the prevalence of liver fibrosis (LF) measured by FibroScan and APRI index in patients with rheumatoid arthritis (AR) undergoing treatment with methotrexate (MTX).</p></div><div><h3>Methods</h3><p>We included 59 patients with RA on MTX. Medical records, FibroScan measures and serological markers of liver damage were compared on the basis of cumulative methotrexate dose.</p></div><div><h3>Results</h3><p>Mean treatment duration was 82.4<!--> <!-->±<!--> <!-->65.1 months and mean cumulative dose was 5214.5<!--> <!-->±<!--> <!-->4031.9<!--> <!-->mg. Five patients met LF criteria by fibroscan, while only one patient had a suggestive APRI score. No statistically significant differences were found in terms of LF measured by both APRI and fibroScan between patients with cumulative doses above and below 4000<!--> <!-->mg. There was also no relationship between LF and treatment duration.</p></div><div><h3>Conclusions</h3><p>The occurrence of LF in patients with RA on MTX is a multifactorial process that does not seem directly related to its cumulative dose. FibroScan may be a useful technique in clinical practice to screen for this complication.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49906445","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":"Implementation of the recommendations for the psychological management of patients with spondyloarthritis and inflammatory bowel disease","authors":"Ana Urruticoechea-Arana ,&nbsp;Jesús Sanz ,&nbsp;Daniel Ginard ,&nbsp;Yago González-Lama ,&nbsp;Xavier Juanola ,&nbsp;Miriam Almirall ,&nbsp;Natalia Borruel ,&nbsp;Jordi Gratacós ,&nbsp;Estíbaliz Loza","doi":"10.1016/j.reuma.2023.03.003","DOIUrl":"https://doi.org/10.1016/j.reuma.2023.03.003","url":null,"abstract":"<div><h3>Objective</h3><p>To assess and improve the level of implementation of the recommendations for the psychological management of patients with spondyloarthritis (SpA) and associated inflammatory bowel disease (IBD).</p></div><div><h3>Methods</h3><p>Qualitative study. We performed a narrative literature review to identify the recommendations for the psychological management of SpA and associated IBD and to explore their level of implementation. Based on the findings, we developed a national survey to assess: (1) current level of knowledge and implementation of the recommendations; (2) attitudes towards the recommendations; and (3) barriers and facilitators to their implementation. The results of the review and survey were discussed by a multidisciplinary group of 9 expert rheumatologists and gastroenterologists, who defined implementation strategies to increase the uptake of the recommendations.</p></div><div><h3>Results</h3><p>The review included 4 articles, 2 of them included direct recommendations on the identification and management of psychological problems in patients with SpA and IBD. None assessed the level of implementation of the recommendations in routine clinical practice. Our survey showed a great lack of awareness and implementation of the recommendations, even though psychological issues are very relevant for health professionals. Lack of time, resources, and knowledge are considered the main barriers to adherence to the recommendations. We propose several implementation strategies related to educational activities, clinical practice, and others to increase the uptake of reported recommendations.</p></div><div><h3>Conclusions</h3><p>Further research and efforts are required to achieve behaviour changes in clinical practice to improve the identification and management of psychological problems and needs in patients with SpA and IBD.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49889893","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":"Las manifestaciones primordiales de la fibromialgia, dolor generalizado e insomnio, en la pintura de Remedios Varo","authors":"Brenda J. Caro-Cocotle ,&nbsp;Lucía Peñalosa ,&nbsp;María-Fernanda Mejía-Ávila ,&nbsp;Angélica Vargas-Guerrero ,&nbsp;Manuel Martínez-Lavín","doi":"10.1016/j.reuma.2023.04.005","DOIUrl":"10.1016/j.reuma.2023.04.005","url":null,"abstract":"<div><p>The sensitivity of plastic artists to human suffering has been expressed in different ways. This article recounts the circumstances that led the Spanish-Mexican surrealist painter, Remedios Varo, to depict in an original way the 2 cardinal manifestations of fibromyalgia; widespread pain and insomnia.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45739131","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":"Altered sleep in axial spondyloarthritis and psoriatic arthritis: Post hoc comparative study based on a sleep-specific question from the ASAS health index","authors":"Sara Alonso ,&nbsp;Isla Morante ,&nbsp;Ignacio Braña ,&nbsp;Rubén Queiro","doi":"10.1016/j.reuma.2023.01.003","DOIUrl":"https://doi.org/10.1016/j.reuma.2023.01.003","url":null,"abstract":"<div><h3>Background and aims</h3><p>Sleep problems are common in spondyloarthritis (SpA), but the factors associated with them are only partially known. In this study, responses to item #16 from the Assessment of SpondyloArthritis international Society-Health Index (ASAS HI) that explores the sleep category according to the International Classification of Functioning, Disability and Health (ICF) were compared between psoriatic arthritis (PsA) and axial SpA (axSpA).</p></div><div><h3>Methods</h3><p><em>Post hoc</em> analysis of a multicentre cross-sectional study included a total of 201 consecutive patients. The prevalence, correlations, and disease factors associated with a positive response to item #16 were analyzed in both SpA populations.</p></div><div><h3>Results</h3><p>Forty-eight/111 (43.2%) patients with axSpA and 42/90 (46.7%) with PsA reported sleep problems. There was a moderate–high correlation between item #16 and the ASAS HI sum score in both populations (<em>r</em> <!-->≥<!--> <!-->.59). In axSpA, poor sleep was associated with disease activity (OR 8.45, <em>p</em> <!-->&lt;<!--> <!-->.001), biological therapy use (OR .24, <em>p</em> <!-->&lt;<!--> <!-->.05) and CRP levels (OR .16, <em>p</em> <!-->&lt;<!--> <!-->.05). In PsA, disturbed sleep was independently associated with disease activity showing a dose-response effect (OR 1.16, <em>p</em> <!-->&lt;<!--> <!-->.001). Taking both populations together, disease severity (OR 6.33, <em>p</em> <!-->&lt;<!--> <!-->.001) and axSpA (OR .50, <em>p</em> <!-->&lt;<!--> <!-->.05) were independently associated with a positive response to item #16. Correlations between the different components of the ASAS HI and item #16 were markedly different in both populations.</p></div><div><h3>Conclusions</h3><p>A positive response to item #16 was common in both SpA phenotypes. However, the link between inflammatory burden and disturbed sleep was higher in axSpA than in PsA.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49906446","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":"Efectividad del entrenamiento propioceptivo en la recuperación funcional de la artrosis en la base del pulgar. Ensayo clínico multicéntrico con aleatorización simple no cegado","authors":"Leire Cruz-Gambero ,&nbsp;Alejandra Lucía Tuljak ,&nbsp;Santiago Garcia Orza ,&nbsp;Jorge H. Villafañe ,&nbsp;Raquel Cantero-Téllez","doi":"10.1016/j.reuma.2023.01.001","DOIUrl":"10.1016/j.reuma.2023.01.001","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Osteoarthritis at the base of the thumb (CMC-1 OA) is a pathology that mainly affects postmenopausal women. The main symptoms including pain, decreased hand-thumb strength and fine motor capacity. Although a proprioceptive deficit has already been demonstrated in people with CMC-1 OA, there is insufficient evidence regarding the effects of proprioceptive training. The main objective of this study is to determine the effectiveness of proprioceptive training in functional recovery.</p></div><div><h3>Materials and methods</h3><p>A total of 57 patients were included in the study, 29 in the control group and 28 in the experimental group. Both groups underwent the same basic intervention programme, but the experimental group included a proprioceptive training protocol. Variables of the study were pain (VAS), perception of occupational performance (COMP), sense position (SP) and force sensation (FS).</p></div><div><h3>Results</h3><p>Statistically significant improvement was observed in the experimental group in pain (p<!--> <!-->&lt;<!--> <!-->.05) and occupational performance (p<!--> <!-->&lt;<!--> <!-->.001) after 3 months of treatment. No statistical differences were found in sense position (SP) or sensation of force (FS).</p></div><div><h3>Discussion and conclusions</h3><p>The results concord with previous studies focussing on proprioception training. The incorporation of a proprioceptive exercise protocol reduces pain and significantly improves occupational performance.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48929701","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}