Reumatologia Clinica最新文献

{"title":"Consenso Delphi sobre el uso de la telemedicina en reumatología: estudio RESULTAR","authors":"Jenaro Graña Gil ,&nbsp;María José Moreno Martínez ,&nbsp;María del Carmen Carrasco Cubero","doi":"10.1016/j.reuma.2024.01.005","DOIUrl":"10.1016/j.reuma.2024.01.005","url":null,"abstract":"<div><h3>Background and objectives</h3><p>There is growing interest in the potential of telemedicine (TM) as an alternative to physical consultation. Although numerous studies prove the benefits of TM in rheumatology, there are no recommendations on its implementation in Spain. The aim of this study was to analyze the application of TM in rheumatology consultations in Spain.</p></div><div><h3>Materials and methods</h3><p>Qualitative, cross-sectional, multicenter study with Delphi methodology in 2 rounds of queries. A structured ad hoc questionnaire was designed that included statements on teleconsultation, nursing teleconsultation, telecare, telerehabilitation, teleradiology, telehealth tele-education, main barriers, advantages and disadvantages of telehealth tele-education and TM in rheumatoid arthritis. The participants were rheumatology specialists practicing in Spain.</p></div><div><h3>Results</h3><p>The participating rheumatologists (N<!--> <!-->=<!--> <!-->80) had a mean age of 42.4 (±<!--> <!-->9.0) years, with 12.6 (±<!--> <!-->8.4) years of experience. Some of the aspects of TM that obtained the greatest consensus were: TM is useful for follow-up of some patients, to help determine if a face-to-face consultation is necessary, or to assist patients with rheumatoid arthritis if they present low activity or in remission; certain patients, such as those in their first consultation or those who present digital barriers or cognitive deterioration, should be seen face-to-face; TM presents some technical and patient access barriers; TM can be useful in nursing and in continued medical education.</p></div><div><h3>Conclusions</h3><p>TM can be beneficial for the treatment and follow-up of patients with rheumatic diseases, as well as for alleviating the face-to-face care burden in rheumatology.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 5","pages":"Pages 254-262"},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140462375","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":"Infecciones graves en vasculitis necrosantes sistémicas","authors":"Claudia Pena,&nbsp;Ana Carolina Costi,&nbsp;Lucila García,&nbsp;Mercedes García","doi":"10.1016/j.reuma.2024.01.003","DOIUrl":"10.1016/j.reuma.2024.01.003","url":null,"abstract":"<div><p>Infections in patients with systemic vasculitis represent one of the main causes of mortality. Corticosteroid use, immunosuppressive therapy, age, associated organic involvement and dialysis dependence are risk factors of infection.</p></div><div><h3>Objectives</h3><p>To determine the prevalence of severe infection and associated factors in patients diagnosed with ANCA-associated vasculitis and polyarteritis nodosa (PAN).</p></div><div><h3>Methods</h3><p>Retrospective study was conduced in a single rheumatology center (2000-2018). We included patients diagnosed with ANCA-associated vasculitis (granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis and microscopic polyangiitis and PAN. Serious infectious events requiring hospitalization or prolonged antibiotic/antiviral treatment, recurrent infection of herpes zoster virus or opportunistic infections were evaluated. Sites of infection, isolated microorganisms and mortality related were analyzed.</p></div><div><h3>Results</h3><p>A total of 105 patients were analyzed, follow-up time median 18 months, 58.7% were women and median age was 52 years. Types of vasculitis: 41.9% microscopic polyangiitis, 16.2% eosinophilic granulomatosis with polyangiitis, 40% granulomatosis with polyangiitis, 1.9% PAN. Constitutional, pulmonary, renal and otorhinolaryngology manifestations were the most frequent.</p></div><div><h3>The prevalence of infection</h3><p>was 34,2%, with a median of 3 months from diagnosis of vasculitis to the infectious event. Low respiratory tract (42.8%), sepsis (31.4%), and urinary tract (14.3%) were the most common sites of infections. Bacterial etiology was the most prevalent (67.7%). Mortality at the first event was 14.3% and a 72.2% of patients were in the induction phase of treatment.</p><p>Infectious events were significantly associated with age<!--> <!-->&gt; 65 years (<em>P</em> <!-->=<!--> <!-->0.030), presence of lung (<em>P</em> <!-->=<!--> <!-->0.016) and renal involvement (<em>P</em> <!-->=<!--> <!-->0.001), BVASv3<!--> <!-->&gt; 15 and mortality (<em>P</em> <!-->=<!--> <!-->0.0002).</p></div><div><h3>Conclusions</h3><p>The prevalence of infection was 34.2%. Lower airway infections, septicemia and urinary tract infections were the most prevalent. Infections were associated with renal and pulmonary involvement, age older than 65 years and score BVAS<!--> <!-->&gt;15. Severe infections were associated with mortality, especially in elderly patients.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 5","pages":"Pages 237-242"},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140469368","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":"Prevalence of polypharmacy and drug interaction in older adults with rheumatic disease","authors":"Rodrigo Lozano-Lozano ,&nbsp;David Vega-Morales ,&nbsp;Macarena del Rosario Sifuentes-Martinez ,&nbsp;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> <!-->&lt;<!--> <!-->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}

{"title":"Cardiovascular disease in patients with systemic autoimmune diseases: The relationship between self-perceived risk and actual risk","authors":"Cristiana Sieiro Santos ,&nbsp;Maria Miguel Oliveira ,&nbsp;Paulo Ney Solari ,&nbsp;Pedro Mateus ,&nbsp;Maria José Santos ,&nbsp;Hector Corominas ,&nbsp;Carolina Álvarez Castro ,&nbsp;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":"From clots to cuts in antiphospholipid syndrome","authors":"Abihai Lucas Hernández ,&nbsp;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}

{"title":"Comunicaciones orales","authors":"","doi":"10.1016/S1699-258X(24)00059-7","DOIUrl":"https://doi.org/10.1016/S1699-258X(24)00059-7","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 ","pages":"Pages S1-S54"},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094891","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":"Pósteres: P1-P99","authors":"","doi":"10.1016/S1699-258X(24)00061-5","DOIUrl":"https://doi.org/10.1016/S1699-258X(24)00061-5","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 ","pages":"Pages S131-S220"},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094893","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":"Pósteres: P100-P199","authors":"","doi":"10.1016/S1699-258X(24)00062-7","DOIUrl":"https://doi.org/10.1016/S1699-258X(24)00062-7","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 ","pages":"Pages S220-S312"},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094894","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":"Pósteres: P400-P465","authors":"","doi":"10.1016/S1699-258X(24)00065-2","DOIUrl":"https://doi.org/10.1016/S1699-258X(24)00065-2","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 ","pages":"Pages S489-S551"},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141095360","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 ,&nbsp;Tamara Martínez ,&nbsp;Fernando Galeano ,&nbsp;Judith Coronel ,&nbsp;Lorena Quintero ,&nbsp;Rolando Jimenez ,&nbsp;Jorge Ayala ,&nbsp;Sara Amarilla ,&nbsp;Dolores Lovera ,&nbsp;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}