Reumatologia Clinica最新文献

{"title":"Emerging trends in nurse-led programs of care for management of patients with established rheumatoid arthritis: Systematic literature review","authors":"Pía Lois ,&nbsp;Leticia López Pedraza ,&nbsp;María Rodero ,&nbsp;Teresa Mulero ,&nbsp;Cristina Lajas ,&nbsp;Esther Toledano ,&nbsp;Leticia Leon ,&nbsp;Luis Rodríguez ,&nbsp;Benjamin Fernandez Gutierrez ,&nbsp;Lydia Abasolo ,&nbsp;Gloria Candelas","doi":"10.1016/j.reuma.2023.06.008","DOIUrl":"https://doi.org/10.1016/j.reuma.2023.06.008","url":null,"abstract":"<div><h3>Introduction</h3><p>In patients with rheumatoid arthritis (RA), nurses are considered as essential, not only to ensure pharmacological safety, but also in the promotion in self-care and decision-making, favouring the empowerment of patients. This systematic review aimed to summarize the available literature on the health education by the nurse in patients with RA.</p></div><div><h3>Material and methods</h3><p>Following Cochrane Collaboration procedures, the PRISMA statement and PRISMA checklist, relevant quantitative studies published were retrieved from the CINAHL, Scopus, PubMed and Medic databases and then systematically reviewed. The search ended in August 2021. Nineteen studies were retained for inclusion and evaluated with the Scottish Intercollegiate Guidelines Network for Systematic Reviews.</p></div><div><h3>Results</h3><p>We found statistically significant improvement in self-care (five studies), disease activity (three studies), quality of life (two studies), satisfaction (five studies) and adherence (one study) with the nursing-led management of patients with established rheumatoid arthritis.</p></div><div><h3>Discussion</h3><p>Although there is solid evidence of improvement in satisfaction and self-care, there seems to be a trend also to improve other outcomes, such as DAS28, from the EULAR recommendations, the expansion of the therapeutic arsenal for rheumatoid arthritis and shared decision-making. In addition, recently and due to the implementation of new technologies, the role of the nurse has been evaluated through virtual consultations. The results of recent studies have shown that this an effective and well-accepted novel approach for the management of patients with stable rheumatoid arthritis.</p></div><div><h3>Conclusion</h3><p>Our study suggests that nurse-led health education, in addition of improvement in satisfaction and self-care, improve activity disease scores in RA patients.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92063206","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":"Whole-hand and regional bone mineral density involvement in rheumatoid arthritis","authors":"María Lorena Brance ,&nbsp;Agustín Razzini ,&nbsp;Bernardo A. Pons-Estel ,&nbsp;Norberto J. Quagliato ,&nbsp;Marisa Jorfen ,&nbsp;Guillermo Berbotto ,&nbsp;Lucas R. Brun","doi":"10.1016/j.reuma.2023.04.003","DOIUrl":"https://doi.org/10.1016/j.reuma.2023.04.003","url":null,"abstract":"<div><p><span>Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by symmetric polyarthritis that can lead to joint deformity, disability, and osteoporosis. We aimed to evaluate whole hand and regional BMD in RA patients compared to controls. In addition, we evaluated the BMD of dominant versus non-dominant hands in healthy subjects. We included adult female and male RA patients and control subjects matched by age, sex, and BMI. BMD (g/cm</span>²<span>) was measured by DXA in lumbar spine (LS), whole hand, and three regions of interest: carpus, metacarpal bones, and phalanges. Results: 44 control subjects (49.5</span> <!-->±<!--> <!-->11.8 y) and 60 with RA (52.7<!--> <!-->±<!--> <!-->12.7 y) were included. Significant lower BMD in RA patients was found in LS (−8.7%), dominant whole hand (−9.5%), carpus, metacarpal bones, and phalanges, and non-dominant whole hand (−8.7%), metacarpal bones, and phalanges compared to controls. A significant positive correlation was found between LS and whole-hand BMD (dominant <em>r</em> <!-->=<!--> <!-->.63, non-dominant <em>r</em> <!-->=<!--> <!-->.67). Finally, the whole hand, metacarpal bones, and carpus BMD measurements were significantly higher in the dominant hand compared to the non-dominant hand without differences in the phalangeal ROI. In conclusion, hand BMD was significantly lower in RA patients compared to control subjects and there was a significant correlation with LS BMD. We demonstrated that BMD measurements of the whole-hand, and different ROI (carpus, metacarpal bones, and phalanges) by DXA would be an easily reproducible technique to evaluate bone loss. In addition, the whole hand, metacarpal bones and carpus BMD measurements were significantly higher in the dominant hand compared to the non-dominant hand without differences in the phalanges.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72284196","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":"Response to Letter to the Editor: Thresholds based on bone mineral density for therapeutic decision-making in postmenopausal women and men older than 50 years old under glucocorticoid therapy","authors":"María Lorena Brance ,&nbsp;María Silvia Larroudé ,&nbsp;Luis Fernando Somma ,&nbsp;Luis Agustín Ramirez Stieben ,&nbsp;Lucas R. Brun","doi":"10.1016/j.reuma.2023.09.008","DOIUrl":"10.1016/j.reuma.2023.09.008","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135221301","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 impact of COVID-19 and other factors on the usage status of the biologic drug therapies for rheumatoid arthritis: A study from Vietnam","authors":"Hai-Binh Bui ,&nbsp;Hong-Thinh Lai ,&nbsp;Thanh-Lam Nguyen ,&nbsp;Thuy-Duong Vu ,&nbsp;Nhat-Le Bui ,&nbsp;Van-Hung Nguyen ,&nbsp;Thi-To-Chau Tran ,&nbsp;Thi-Phuong-Thuy Nguyen ,&nbsp;Thi-Ngoc-Lan Nguyen ,&nbsp;Jaffar A. Al-Tawfiq ,&nbsp;Dinh-Toi Chu","doi":"10.1016/j.reuma.2023.09.012","DOIUrl":"10.1016/j.reuma.2023.09.012","url":null,"abstract":"<div><h3>Objectives</h3><p>To describe the status of using biological Disease Modifying Anti Rheumatic Drugs (bDMARDs) to treat rheumatoid arthritis (RA) and related factors. In addition, the study determined the impact of COVID-19 on the usage of bDMARDs.</p></div><div><h3>Methods</h3><p>This is a cross-sectional study and included 219 RA patients over 18 years old. The Kaplan–Meier method and the log-rank test (<em>p</em> <!-->&lt;<!--> <!-->0.05) were used to estimate the retention time and compare between different times. Cox regression analysis was used to determine the factors affecting the retention time of biological drugs (<em>p</em> <!-->&lt;<!--> <!-->0.05).</p></div><div><h3>Results</h3><p>Out of 1967 courses of treatment, there were 149 (7.6%) drug discontinuations, 760 (38.6%) doses extensions and 64 (3.3%) drug switch. Moderate disease level and choosing tumor necrosis factor (TNF) inhibitors initially were associated with retention time of COVID-19. Drug discontinuations and dose extensions increased after COVID-19 emergence. The retention time during COVID-19 was significantly different from that of pre-COVID-19. Gender, type of first-used bDMARD, conventional synthetic DMARDs (csDMARDs) and corticoid usage status, disease activity levels were associated with retention time.</p></div><div><h3>Conclusion</h3><p>The presence of COVID-19 has a significant effect on usage status of the biologic drug. Further longitudinal studies are needed to clarify the relationship between COVID-19 and drug usage as well as related factors.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136093209","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":"Síndrome de pinzamiento isquiofemoral: a propósito de una serie de 5 casos","authors":"Adrián Mayo-Juanatey ,&nbsp;Luís García-Ferrer ,&nbsp;Aránzazu Ballester-Suárez ,&nbsp;Elia Valls-Pascual ,&nbsp;Ignacio Vázquez-Gómez ,&nbsp;Juan José Alegre-Sancho","doi":"10.1016/j.reuma.2023.09.009","DOIUrl":"10.1016/j.reuma.2023.09.009","url":null,"abstract":"<div><p>Gluteal pain is a frequent cause of medical attention in the daily clinical practice. It can be caused by multiple pathologies, being ischiofemoral impingement syndrome among those included in its differential diagnosis. Encompassed within the deep gluteal syndromes, this entity occurs as a consequence of the entrapment of the neuromuscular structures between the lesser femoral trochanter and the ischial tuberosity, causing pain in the root of the lower limb, with irradiation towards the thigh or the gluteal region and poor tolerance to deambulation and sedestation. The magnetic resonance imaging of the hip is fundamental for its diagnosis, and its management consists on medical treatment at onset. Despite not being a frequent diagnosis in the clinical practice in rheumatology, keeping it in mind helps improving its prognosis by establishing an early and adequate treatment.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135811837","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":"Artritis pseudoséptica como complicación de infiltración intraarticular de ácido hialurónico en una paciente con artritis reumatoide","authors":"Chafik Chacur,&nbsp;Anastasia Mocritcaia,&nbsp;Raimon Sanmartí","doi":"10.1016/j.reuma.2023.09.001","DOIUrl":"10.1016/j.reuma.2023.09.001","url":null,"abstract":"<div><p>Pseudoseptic arthritis is a rare complication of hyaluronic acid injections that often is difficult to differentiate from septic arthritis. Patients present acute pain, swelling and joint effusion normally around 24<!--> <!-->h after the second or third infiltration. We describe a female patient with seropositive rheumatoid arthritis and flare-ups of knee arthritis with pseudoseptic features in the past, who develops pseudoseptic arthritis of the knee following her first injection of hyaluronic acid.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135606986","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 impact of the website campaign “A ti también te puede tocar” (“It could also be you”) to spread awareness of systemic autoimmune rheumatic diseases","authors":"Ana De las Heras-Alonso ,&nbsp;Daniel Seoane-Mato ,&nbsp;Mercedes Guerra ,&nbsp;Cristina Macía-Villa","doi":"10.1016/j.reuma.2023.09.002","DOIUrl":"10.1016/j.reuma.2023.09.002","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135607147","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":"El viaje del paciente con fibromialgia en Latinoamérica","authors":"Teresa Otón ,&nbsp;Osvaldo Daniel Messina ,&nbsp;Daniel G. Fernández Ávila ,&nbsp;Manuel Robles San Román ,&nbsp;Darío Mata ,&nbsp;Constanza Arguissain ,&nbsp;Jorge Miguel Galindo Guzmán ,&nbsp;Marina Pérez ,&nbsp;Loreto Carmona ,&nbsp;Grupo Fibrojourney Latam","doi":"10.1016/j.reuma.2023.07.003","DOIUrl":"10.1016/j.reuma.2023.07.003","url":null,"abstract":"<div><h3>Objectives</h3><p>To explore the patient journey of people with fibromyalgia (FM) in Latin American countries in order to identify problems in health care and other areas that may be resolvable.</p></div><div><h3>Methods</h3><p>Qualitative study with phenomenological and content analysis approach through focus groups and patient journey (Ux; User Experience) methodology. Nine virtual focus groups were conducted with FM patients and healthcare professionals in Argentina, Mexico and Colombia recruited from key informants and social networks.</p></div><div><h3>Results</h3><p>Forty-three people participated (33 were clinicians and 10 were patients). The agents interacting with the patient in their disease journey are found in three spheres: healthcare (multiple medical specialists and other professionals), support and work life (including patient associations) and socioeconomic context. The line of the journey presents two large sections, two loops and a thin dashed line. The two major sections represent the time from first symptoms to medical visit (characterized by self-medication and denial) and the time from diagnosis to follow-up (characterized by high expectations and multiple contacts to make life changes that are not realized). The two loop phases include (1) succession of misdiagnoses and mistreatments and referrals to specialists and (2) new symptoms every so often, visits to specialists, diagnostic doubts, and impatience. Very few patients manage to reach the final phase of autonomy.</p></div><div><h3>Conclusion</h3><p>The journey of a person with FM in Latin America is full of obstacles and loops. The desired goal is for all the agents involved to understand that self-management by the patient with FM is an essential part of success, and this can only be achieved with early access to resources and guidance from professionals.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135654475","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":"Recomendaciones SER sobre la gestión de riesgo del tratamiento con FAME biológicos o sintéticos dirigidos en pacientes con artritis reumatoide","authors":"Alejandro Balsa ,&nbsp;Petra Díaz del Campo Fontecha ,&nbsp;Lucía Silva Fernández ,&nbsp;José Valencia Martín ,&nbsp;Virginia Nistal Martínez ,&nbsp;Fernando León Vázquez ,&nbsp;M. Vanesa Hernández Hernández ,&nbsp;Héctor Corominas ,&nbsp;Rafael Cáliz Cáliz ,&nbsp;José María Aguado García ,&nbsp;Gloria Candelas Rodríguez ,&nbsp;Nora Ibargoyen Roteta ,&nbsp;Arturo Martí Carvajal ,&nbsp;M. Nieves Plana Farras ,&nbsp;Janet Puñal Riobóo ,&nbsp;Hye Sang Park ,&nbsp;Yolanda Triñanes Pego ,&nbsp;Virginia Villaverde García","doi":"10.1016/j.reuma.2023.07.001","DOIUrl":"https://doi.org/10.1016/j.reuma.2023.07.001","url":null,"abstract":"<div><h3>Objective</h3><p>To present recommendations based on the available evidence and the consensus of experts, for risk management of biological treatment and JAK inhibitors in patients with rheumatoid arthritis.</p></div><div><h3>Methods</h3><p>Clinical research questions relevant to the purpose of the document were identified. These questions were reformulated in PICO format (patient, intervention, comparison, outcome) by a panel of experts, selected based on their experience in the area. A systematic review of the evidence was carried out, grading according to the GRADE criteria (Grading of Recommendations Assessment, Development, and Evaluation). Specific recommendations were then formulated.</p></div><div><h3>Results</h3><p>Six PICO questions were proposed by the panel of experts based on their clinical relevance and the existence of recent information regarding the risk of occurrence of serious infections, the risk of reactivation of the hepatitis<!--> <!-->B virus, the risk of reactivation of the virus varicella-zoster, the risk of appearance of skin (melanoma and non-melanoma) or hematological cancer, the risk of appearance of thromboembolic disease and the risk of progression of the human papilloma virus.</p><p>A total of 29 recommendations were formulated, structured by question, based on the evidence found and the consensus of the experts.</p></div><div><h3>Conclusions</h3><p>The SER recommendations on risk management of treatment with biologic therapies and JAK inhibitors in rheumatoid arthritis are presented.</p></div>","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":"72284213","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":"Percepción del profesional sanitario sobre el paciente con síndrome de sensibilidad central-fibromialgia","authors":"Gastón A. Ghio ,&nbsp;Angels Jaen Manzanera ,&nbsp;Julia Torguet Carbonell ,&nbsp;Camila Inés Donoso Isla ,&nbsp;Alirio José Falcón Marchena ,&nbsp;Silvia Martínez Pardo","doi":"10.1016/j.reuma.2023.07.004","DOIUrl":"10.1016/j.reuma.2023.07.004","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Fibromyalgia is characterized by musculoskeletal pain and asthenia of chronic course. Fibromyalgia patients are often a challenge for the health care community as a whole. Existing studies are often limited to the opinion of rheumatologists or family physicians. With this study we seek to know what are the actions, perceptions and knowledge of health professionals as a whole when caring for patients with this disease.</p></div><div><h3>Materials and methods</h3><p>Descriptive cross-sectional study, by means of a self-administered and anonymous survey. Distributed mainly in hospital wards and primary care centers. Statistical analysis of the variables collected was performed (<em>P</em> <!-->˂<!--> <!-->.05).</p></div><div><h3>Results</h3><p>Two hundred surveys were collected, most of them physicians (63.5%; n<!--> <!-->=<!--> <!-->127) or nurses (25.5%; n<!--> <!-->=<!--> <!-->51). 71% of physicians reported using the WHO analgesic scale. 53% (n<!--> <!-->=<!--> <!-->59) use NSAIDs or paracetamol. Antidepressants are the third drug of choice. Most believe that the referral specialists should be rheumatologists or primary care physicians, a similar percentage, that management should be multidisciplinary. Fifty two percent feel discouraged or annoyed when dealing with these patients. Physicians have more negative connotations and believe that the care that the patient receives is mostly influenced by the diagnosis of fibromyalgia, compared to nurses and other professionals.</p></div><div><h3>Conclusions</h3><p>Our study shows that the lack of knowledge and therapeutic tools generates, to a large extent, frustration and discomfort in health personnel. It is important to develop new approaches to this entity.</p></div>","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":"135568222","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}