Reumatologia Clinica最新文献

{"title":"Utilidad de la realidad virtual en la formación médica: manejo clínico de un paciente con monoartritis de rodilla","authors":"Javier de Toro Santos ,&nbsp;Ana Isabel Turrión ,&nbsp;Mariano Andrés Collado ,&nbsp;M. Carmen San José Méndez ,&nbsp;Roberto Rilo Antelo ,&nbsp;Juan Antonio Juanes Méndez","doi":"10.1016/j.reuma.2024.08.002","DOIUrl":"10.1016/j.reuma.2024.08.002","url":null,"abstract":"<div><div>The use of technological environments with virtual reality (VR) techniques for the practice of arthrocentesis offers an effective and safe way to learn and improve the necessary skills to carry out a medical procedure and patient care. This article presents an interactive simulator using immersive VR, in which the participant experiences practicing clinical management and decision-making in the face of a person presenting with monoarthritis in a medical consultation. The objective with this development is for the user to acquire the competence to perform, correctly and safely, a knee arthrocentesis and to differentiate the types of synovial fluids that can be found in a joint. In turn, it provides clinical guidance and assists with the user's medical decision-making. There fore, the aim is to improve the quality of care and patient safety when practicing this technique previously through clinical simulation.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 10","pages":"Pages 555-559"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748799","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":"Epidemiología del lupus eritematoso sistémico en Latinoamérica","authors":"Ivet Etchegaray-Morales ,&nbsp;Claudia Mendoza-Pinto ,&nbsp;Francisco Javier Arellano-Avendaño ,&nbsp;Sandra Ibañez-Ovando ,&nbsp;Pamela Munguía-Realpozo ,&nbsp;Jacsiry Guadalupe Orbe-Sosa ,&nbsp;Edith Ramírez-Lara ,&nbsp;Mario García-Carrasco","doi":"10.1016/j.reuma.2024.09.005","DOIUrl":"10.1016/j.reuma.2024.09.005","url":null,"abstract":"<div><div>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects several organs, causing significant morbidity and increased mortality. It's more frequent in young, fertile women and can appear in all ethnic groups.</div><div>The worldwide prevalence report indicates that there are at least 5 million patients with SLE. Although this disease can be found in every geographic region, certain races are more affected, such as Afro-American, Hispanic, and Asian populations. Furthermore, most of the epidemiologic information comes from Europe or the USA. In Latin America, only a few countries have reported data, like Argentina, Colombia, or Mexico, and even in these countries, the numbers vary.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 10","pages":"Pages 560-566"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748800","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":"Psicosis como manifestación en el lupus eritematoso sistémico: tratamiento y resultados a largo plazo. serie de casos","authors":"Maria Joselin Rodarte-Gallegos,&nbsp;Ma. Azucena Ramos-Sánchez,&nbsp;Yadhira Mejia-Holguin,&nbsp;Ariana Maia Becerra-Márquez,&nbsp;Luciano Ortiz-Treviño","doi":"10.1016/j.reuma.2024.09.004","DOIUrl":"10.1016/j.reuma.2024.09.004","url":null,"abstract":"<div><div>We present a case series of 5 patients with psychosis associated with SLE according to the ACR 1999 criteria. It presented as an initial clinical manifestation, clinically they had visual and auditory hallucinations, all the patients were women, average age 25 years, the accompanying manifestations were mostly mucocutaneous, articular and renal. Two patients presented antiphospholipid syndromes. The remission induction treatment was based on pulses of steroids and cyclophosphamide with a complete response in 4/5 patients, maintenance was left with mycophenolic acid and azathioprine.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 10","pages":"Pages 567-569"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748801","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":"Clinical course and flare predictors in patients with rheumatoid arthritis in low disease activity and ultrasound remission monitored by ultrasound yearly and on-demand: A prospective 2-year observation study","authors":"Takeo Abe ,&nbsp;Masao Tamura ,&nbsp;Kazuyuki Tsuboi ,&nbsp;Yuko Minagawa ,&nbsp;Kazuteru Noguchi ,&nbsp;Chie Ogita ,&nbsp;Teppei Hashimoto ,&nbsp;Naoto Azuma ,&nbsp;Kiyoshi Matsui","doi":"10.1016/j.reuma.2024.08.003","DOIUrl":"10.1016/j.reuma.2024.08.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Ultrasound (US) remission in rheumatoid arthritis (RA) targets synovitis absence. Tenosynovitis triggers flares. Despite increased ultrasound use, flare patterns among patients with low disease activity (LDA) and ultrasound remission, especially in real-world settings, are poorly understood. This study examined flare rates and predictors of US remission in patients without synovitis or tenosynovitis.</div></div><div><h3>Materials and methods</h3><div>In a study of 88 patients achieving US remission and LDA, the focus was on the time to the first flare over a 2-year follow-up. US remission, indicated by the absence of active synovitis and tenosynovitis based on a power Doppler (US-PD) score of 0, was assessed on various joints. Flares are defined by the need for additional medication or encountering a US-PD flare. They were monitored at the baseline, 1-year, and 2-year visits with further US evaluation at clinical flare-ups. Baseline factors linked to a shorter time to flare were analyzed.</div></div><div><h3>Results</h3><div>At 1 year, LDA and US remission rates were 75% and 92%, respectively, and at 2 years, 73% and 87% respectively. Over the 2 years, 40% experienced flare, occurring on average at 11.7<!--> <!-->±<!--> <!-->7.0 months. Notably, 5.7% have US-PD flares without clinical signs. Analysis revealed Stage III disease and CRP as factors linked to a shorter time to flare.</div></div><div><h3>Discussion and conclusions</h3><div>In patients with RA achieving LDA and US remission, frequent flares were observed with US remission over 2 years, but most maintained sustained remission. Baseline factors are essential for predicting flares, emphasizing continuous monitoring and personalized treatment to sustain remission and minimize flare risks in RA management.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 10","pages":"Pages 517-525"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748337","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":"TNFα-inhibitors cycling with golimumab as second drug in inflammatory arthritis patients: Data from the multicenter GO-REAL registry","authors":"Carolina Ayelen Isnardi ,&nbsp;Emma Estela Civit De Garignani ,&nbsp;Agustín García Ciccarelli ,&nbsp;Jimena Sanchez Alcover ,&nbsp;Ingrid Strusberg ,&nbsp;Marcos Baravalle ,&nbsp;Sol Castaños ,&nbsp;Liliana Morales ,&nbsp;Matias Palombo ,&nbsp;Eduardo Albiero ,&nbsp;Carla Gobbi ,&nbsp;Rodrigo Garcia Salinas ,&nbsp;Sebastian Magri ,&nbsp;Edson Velozo ,&nbsp;Enrique R. Soriano ,&nbsp;Alfredo Vargas Caselles ,&nbsp;Luis Carlos Palomino Romero ,&nbsp;Sergio Paira ,&nbsp;Romina Calvo ,&nbsp;Alberto Ortiz ,&nbsp;Gustavo Citera","doi":"10.1016/j.reuma.2024.09.007","DOIUrl":"10.1016/j.reuma.2024.09.007","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>There are still controversies about the efficacy of cycling to a second tumor necrosis factor inhibitor (TNFi) in patients with inflammatory arthritis. The aim of this study was to evaluate survival, persistence and effectiveness of golimumab (GLM) in patients with rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) with previous experience with other TNFi and to compare these results with TNFi naive patients.</div></div><div><h3>Methods</h3><div>Observational cohort of consecutive patients with RA, PsA and axSpA who had started treatment with GLM according to medical indication. bDMARD naive and TNFi experienced patients were selected.</div></div><div><h3>Results</h3><div>A total of 147 (62.3%) bDMARD naive and 45 (19.1%) TNFi experienced patients were included. Patients were followed up for a total of 441.5 patients/year, 55 (28.6%) discontinued GLM, 42 (28.6%) and 13 (28.9%) in each group, respectively (<em>p</em> <!-->=<!--> <!-->0.967). The majority (63.6%) suspended due to inefficacy, followed by lack of access (23.6%) and adverse events (9.1%). Median GLM survival was 74.0 months (95% CI 57.0, 91.0) and 71.0 months (95% CI 37.0, 105.0), in the bDMARD naive and TNFi experienced patients, respectively (<em>p</em> <!-->=<!--> <!-->0.695). Drug persistence at 6, 12, 24 and 36 months was 92.8%, 88.1%, 76.1%, 65.4% and 93.1%, 77.4%, 74.2%, 68.5%, respectively. In the multivariable analysis, having public health insurance was associated with higher risk of drug discontinuation (HR 2.56, 95% CI 1.28–5.00, <em>p</em> <!-->=<!--> <!-->0.008). TNFi experienced patients did not show significantly higher risk of GLM suspension (HR 1.35, 95% CI 0.70–2.57, <em>p</em> <!-->=<!--> <!-->0.370).</div></div><div><h3>Conclusion</h3><div>In this cohort, TNFi experienced patients had comparable survival and persistence of treatment with GLM. Having public health insurance was associated with lower drug retention rates.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 10","pages":"Pages 539-546"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748797","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":"Tratamiento exitoso de la granulomatosis eosinofílica con poliangeítis con metotrexato y dosis bajas de mepolizumab","authors":"Luis Francisco Valdés-Corona ,&nbsp;Patricia Aguilar-Dominguez ,&nbsp;Ariel Jasqui-Bucay ,&nbsp;Mariana Arroyo-Machiavelo","doi":"10.1016/j.reuma.2024.09.003","DOIUrl":"10.1016/j.reuma.2024.09.003","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 10","pages":"Pages 571-572"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748802","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":"Changes in immature granulocyte levels and their association with disease activation following biologic therapy in patients with ankylosing spondylitis","authors":"Burak Okyar ,&nbsp;Servet Yüce ,&nbsp;İbrahim Halil Bilen ,&nbsp;Bekir Torun ,&nbsp;İlyas Öztürk ,&nbsp;Gözde Yıldırım Çetin","doi":"10.1016/j.reuma.2024.09.006","DOIUrl":"10.1016/j.reuma.2024.09.006","url":null,"abstract":"<div><h3>Introduction</h3><div>AS is a chronic disease with an inflammatory serum microenvironment characterized by increased oxidative stress (OS). Along with OS, reactive oxygen species (ROS) are elevated in patients with AS. Overexpression of ROS causes active inflammatory processes leading to the secretion of pro-inflammatory factors, including tumor necrosis factor-alpha (TNF-α). Immature granulocytes (IG) are essential to the chronic inflammatory process. This may mean that IG can be a parameter used in the follow-up of chronic inflammatory diseases such as AS.</div></div><div><h3>Objective</h3><div>We aimed to evaluate the change in IG in patients with AS who were on biologic medication for six months after diagnosis and to assess its relationship with disease activity, remission, and BASDAI score.</div></div><div><h3>Methods</h3><div>This single-center, retrospective study was conducted between January 2020 and January 2022. For the study, 68 patients were included in the patient group and 74 patients in the control group. Demographic and laboratory data were recorded and compared in the groups. Then, the patient group was divided into two groups: pre-biologic drug and post-biologic drug. Hemogram data, IG, ESR, CRP, and BASDAI data were recorded for both groups. Correlation analysis was performed between the results of IG data and hemogram and laboratory data.</div></div><div><h3>Conclusion</h3><div>In our study, WBC, neutrophil, IG, and IG% ratios were significantly higher in AS patients compared to the control group. Neutrophil, IG, and IG% levels were significantly decreased in the AS group compared to pretreatment and post-treatment comparisons. In addition, IG levels were correlated with WBC, neutrophil, CRP, and ESR levels. This study hypothesized that IG values may be a valuable parameter for monitoring AS disease severity, response to treatment, and disease activation after biological drug use.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 10","pages":"Pages 533-538"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748796","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":"Vacunación contra virus de papiloma humano en pacientes con enfermedades inmunomediadas","authors":"Marco Tobar-Marcillo ,&nbsp;Carlos Guerrero-Solís ,&nbsp;Daniel Goyes-Burbano ,&nbsp;Jorge Esteban Toro-Tobar","doi":"10.1016/j.reuma.2024.08.001","DOIUrl":"10.1016/j.reuma.2024.08.001","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 10","pages":"Page 570"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748803","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":"The “target sign”: A hallmark of lupus enteritis","authors":"Adriana C. Esteves ,&nbsp;Beatriz Mendes ,&nbsp;Helena Assunção ,&nbsp;Luís Inês","doi":"10.1016/j.reuma.2024.08.004","DOIUrl":"10.1016/j.reuma.2024.08.004","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 9","pages":"Pages 515-516"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578923","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 detailed quantitative analysis of circulating T peripheral and follicular helper lymphocytes in patients with rheumatoid arthritis and systemic lupus erythematosus","authors":"Raquel Sánchez-Gutiérrez ,&nbsp;Marlen Vitales-Noyola ,&nbsp;Larisa González-Baranda ,&nbsp;Diana P. Portales-Pérez ,&nbsp;Esther Layseca-Espinosa ,&nbsp;Mariana H. García-Hernández ,&nbsp;Roberto González-Amaro","doi":"10.1016/j.reuma.2024.07.002","DOIUrl":"10.1016/j.reuma.2024.07.002","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Peripheral and follicular helper T lymphocytes (Tph and Tfh, respectively) have an important role in B cell immune responses and the pathogenesis of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Although several studies on the number of Tph and Tfh cells in these conditions have been published, different phenotypes have been employed for their analysis. In this study, we assessed the levels and function of Tph and Tfh cells in blood samples from patients with RA and SLE by using an extended immunophenotype.</div></div><div><h3>Materials and methods</h3><div>In a cross-sectional pilot study, blood samples from twenty-seven patients with RA and fifteen with SLE, and twenty-six healthy controls were studied. The levels of Tph (CD4⁺PD-1⁺CXCR5⁻CD38⁺CD69⁺ICOS⁺) and Tfh (CD4⁺PD-1⁺CXCR5⁺CD38⁺CD69⁺ICOS⁺) cells were analyzed by flow cytometry. In addition, the function of Tph/Tfh cells was estimated by measuring the synthesis of IL-21 by these lymphocytes as well as the number of circulating plasmablasts (CD19⁺CD27⁺CD20⁻CD38^hi).</div></div><div><h3>Results</h3><div>Increased percentages of Tph and Tfh lymphocytes were detected in patients with RA and SLE. Furthermore, the synthesis of IL-21 tended to be higher in both conditions, and higher levels of plasmablasts were detected in these patients, compared to controls. In patients with SLE, the number of Tph cells was associated with disease activity and with the levels of circulating plasmablasts, whereas in patients with RA a significant correlation between Tph cells and evolution time was observed.</div></div><div><h3>Discussion and conclusions</h3><div>Our data of Tph and Tfh lymphocytes, based in the analysis of an extended phenotype of these cells, provides further evidence on their involvement in the pathogenesis of RA and SLE.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 9","pages":"Pages 476-483"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578918","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}