Reumatizam最新文献

{"title":"Sacral insufficiency fractures – a commonl y overlooked cause of low back and pelvic pain; a case report and literature review","authors":"D. Vujaklija, Tea Schnurrer Luke-Vrbanić","doi":"10.33004/reumatizam-67-2-10","DOIUrl":"https://doi.org/10.33004/reumatizam-67-2-10","url":null,"abstract":"sacral stress fractures are divided into fatigue fractures and insufficiency fractures. Fatigue fractures occur in a normal bone exposed to abnormal or repetitive stresses, whereas insufficiency fractures occur in weakened bones under normal stress and with no underlying trauma. sacral insufficiency fractures are often overlooked causes of nonspecific lumbosacral back pain, especially in elderly women with underlying osteoporosis. in addition to old age and postmenopausal osteoporosis, other condi-tions which reduce bone mineral density and present risk factors for the occurrence of insufficiency fractures include: long-term glucocorticoid and bisphosphonates therapy, long-term vitamin d insufficiency and osteomalacia, renal osteodystrophy, primary hyperparathyroidism, Paget’s disease, long-term immobilisation and radiotherapy for the treatment of malignant diseases. There are no typical clinical signs to suggest sacral stress fracture. These fractures are often associated with degenerative diseases of the spine and intervertebral disc, and they are often accompanied by pre-existing osteoporotic vertebral compression fractures. Plain radiographs of the spine and pelvis, which are the first step in diagnostic imaging, are usually non-diagnostic when it comes to sacral fractures. due to radicular pain symptoms, magnetic resonance imaging of the lumbosacral spine is the next step in diagnosis, in which sacral fractures are often revealed as accidental findings. in this paper, we shall present a case of an elderly patient with multiple comor-bidities and multiple risk factors, in whose case physical therapy did not prove to be effective. during diagnostic testing, a subsequent mri showed an accidental finding confirming the sacral fracture. Furthermore, we shall highlight the importance of early detection of sacral stress fracture in high-risk patients, in order to avoid unnecessary, and sometimes invasive, diagnostic procedures and to reduce the possibility of possible complications. The imaging method of choice for the diagnosis of sacral stress fractures is mri.","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48311085","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":"New parameters of hand grip in rheumatoid arthritis patients based on electrodynamic measurements – a pilot evaluation study","authors":"A. Dubravić, I. Michieli, B. M. Rogina, S. Grazio","doi":"10.33004/reumatizam-67-2-7","DOIUrl":"https://doi.org/10.33004/reumatizam-67-2-7","url":null,"abstract":"Introduction: in rheumatoid arthritis, inflammation and damage lead to functional impairment. as the hand is a typical site of involvement, lower grip strength is often found in patients with rheumatoid arthritis. in these patients it is necessary to evaluate the hand grip impairment in a more detailed way. The aim of this study was to analyze a new method for measuring hand grip. Methods: an expert electronic measuring system for obtaining dynamic time series of hand grip force was developed. We tested it in a sample of 24 participants, 12 patients with rheumatoid arthritis and 12 ageand sex-matched healthy controls. The main dynamometric parameters obtained were: maximum grip force, fatigue, grip velocity, and functional potential. These were measured at the baseline and at 60, 120, and 180 days. Results: compared to the control group, at baseline the patients with rheumatoid arthritis had a significantly lower maximum grip force (68.2 vs. 97.3), earlier occurrence of fatigue (22.4 vs. 24.9), as well as lower grip velocity (14.8 vs. 22.2) and functional potential (808.2 vs. 1876.3). a significant improvement in all measured variables was observed during the follow-up period. Conclusion: in our pilot study we tested a newly developed electrodynamometer measuring system and found that it can provide an objective and detailed description of the hand condition. This system has the potential to be used as a relevant indicator of hand function in patients with rheumatoid arthritis as well as to help tailor their rehabilitation.","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43129399","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":"Kidney involvement in adults with IgA vasculitis: experiences from Clinical Hospital Dubrava, Zagreb","authors":"A. Gračanin, Tea Mikula, Ivica Horvatić, Luka Torić, M. Golob, J. Dobša, Matea Liskij, Gabrijela Buljan, K. Draženović, Matej Nedić, D. Ljubanović, KRESIMIR Galešić","doi":"10.33004/reumatizam-67-2-8","DOIUrl":"https://doi.org/10.33004/reumatizam-67-2-8","url":null,"abstract":"Introduction: IgA vasculitis, formerly named henoch-schönlein purpura, is a systemic small-vessel vasculitis that occurs commonly in children, while in adults, the disease remains rare. It is characterised by non-thrombocytopenic palpable purpura, arthritis, arthralgia, kidney disease and gastrointestinal pain. This study aimed to determine clinical signs and symptoms, laboratory and pathohistological parameters and therapy of IgA vasculitis in adults with renal involvement, by conducting our research on a sample of patients of a tertiary referral hospital. Research subjects and methods: In this retrospective cohort study, patients treated at clinical hospital dubrava from 2011 to 2019 were included, who were diagnosed with IgA vasculitis, based on clinical, laboratory and pathohistological criteria. clinical and laboratory parameters, were determined through the use of methods commonly used in clinical practice. In patients with symptoms and signs of kidney involvement and after patients’ consent, kidney biopsy was performed, and analysed by light, immunofluorescence and electron microscopy. Results: twenty-two adults (12 m, 10 F), whose median age was 57, were included in our study. Palpable purpura and nephritis were present in all patients. Thirteen (59.1%) patients had arthralgia and five of them (22.5%) experienced abdominal pain. respiratory infection preceded vasculitis in six (27.3%) patients, six patients ((27.3%) were taking medications and got vaccinated prior to the occurrence of vasculitis, and in ten (45.4%) patients the predisposing factor was unknown. Asymptomatic hematuria was present in ten (47.6%), subnephrotic proteinuria in three (14.3%), nephrotic syndrome in nine (42.9%) and nephritic syndrome in three (14.3%) patients. According to the findings of kidney biopsy, which was performed on 18 patients, eleven (61.6%) had mesangial proliferation, fourteen Reumatizam 2020;67(2):83–92 https://doi.org/10.33004/reumatizam-67-2-8 professional paper struČni rad","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49330986","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":"Tendinopathy: From Basic Science to Clinical Management","authors":"","doi":"10.1007/978-3-030-65335-4","DOIUrl":"https://doi.org/10.1007/978-3-030-65335-4","url":null,"abstract":"","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":"16 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50971794","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":"WHEN TO SUSPECT AN AUTOINFLAMMATORY DISEASE?","authors":"M. Šestan, M. Jelušić","doi":"10.33004/reumatizam-67-1-4","DOIUrl":"https://doi.org/10.33004/reumatizam-67-1-4","url":null,"abstract":"Autoinflammatory diseases are clinical disorders caused by a deficiency or dysregulation of innate immunity, characterized by recurrent or persistent inflammation (increased levels of acute phase reactants) and the absence of a primary pathogenic role of adaptive immunity (autoreactive T lymphocytes or antibody production). They are clinically manifested by recurrent episodes of systemic inflammation due to the activation of an intense nonspecific inflammatory reaction with no apparent or sufficient cause. In terms of pathogenesis, autoinflammatory diseases can be divided into monogenic, or those that are caused by a mutation in a well-defined gene, and non-monogenic, also referred to as unclassified. According to the three main pathogenic patterns of emergence in monogenic autoinflammatory diseases described to date, they are divided into inflammasomopathies, interferonopathies, and ubiquitinopathies. Clinically, inflammasomopathies are most commonly manifested by fever (often periodic type), rash, serositis, hepatosplenomegaly, and lymphadenopathy. The therapeutic approach in many of these diseases is based on the use of an interleukin-1 inhibitor. Interferonopathies are most commonly manifested as acral and lung vasculopathy and fibrosis, with an onset of skin changes like chilblains, intracranial calcifications, and myositis. Janus kinase inhibitors are used in the treatment. Ubiquitinopathies are most commonly manifested by granuloma, ulceration, uveitis, and immunodeficiency. The therapeutic approach in these diseases is based on the use of tumor necrosis factor-alpha inhibitors. Unclassified autoinflammatory diseases include diseases that meet the clinical and biological criteria for autoinflammatory diseases but to date have no detected genetic background (for example, syndrome of periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis, Schnitzler syndrome, or systemic-onset juvenile idiopathic arthritis), and some multifactorial diseases that are polygenic or caused by complex interactions of multiple genes and environmental factors and not associated with Mendelian inheritance patterns (eg., gout, Behcet disease). In the diagnosis of patients with suspected autoinflammatory disease, it is necessary to exclude infections, malignancies, immunodeficiencies, and rheumatic diseases. The main indication for genetic testing is the presence of clinical symptoms that meet the criteria for one or more autoinflammatory diseases. There are a number of unanswered questions in genetic diagnostics, the main problem being the interpretation of the results.","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46958364","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":"NON-PHARMACOLOGICAL TREATMENT OF PAINFUL SHOULDER SYNDROME – COMPARATIVE RESEARCH","authors":"Ivana Vlak, A. Poljičanin, T. Vlak","doi":"10.33004/reumatizam-67-1-2","DOIUrl":"https://doi.org/10.33004/reumatizam-67-1-2","url":null,"abstract":"Non-pharmacological treatment is undeniably a significant part of painful shoulder syndrome treatment. Medical exercises are its most important segment, according to the results of evidence-based medicine. Due to the fact that exercises are rarely used as monotherapy, we were particularly interested in the data regarding other non-pharmacological methods of treatment found in the Cochrane library and PEDro database (Physiotherapy Evidence Database). Simultaneously, we conducted a research study of painful shoulder syndrome treatment with conventional methods of physical therapy. The study included 157 patients, which allowed us to compare our preliminary results with data found in the previously mentioned databases. The majority of quality studies that can be found in the literature database involve the use of modern technology, such as extracorporeal shock wave therapy and high-intensity laser therapy, because they have proven to be very effective in the reduction of pain intensity and the increase of functional capacity of the painful shoulder. These methods of treatment have shown to be effective even in patients with calcific tendinitis, a more severe form of the disease, as well as in patients who had no calcifications. Conventional methods of treatment, often referred to as standard physical therapy (low-level laser therapy, electrotherapy, therapeutic ultrasound) have proven to be effective, but less effective compared to the aforementioned methods. The results of our research also corroborate the previously mentioned fact, thus confirming that the use of conventional methods of physical medicine (therapeutic ultrasound, diclofenac sonophoresis, interferential current therapy, low-level laser therapy, cryotherapy) has been successful in reducing pain intensity and increasing the functional capacity of the painful shoulder. Among the conventional methods of treatment, electrotherapy (interferential current therapy) turned out to be the most efficient one. Non-pharmacological treatment have to be an integral part of all painful shoulder syndrome treatment protocols, and in the future, the use of modern technology in addition to conventional methods of treatment should be encouraged.","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42761943","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":"Effect of disease activity and functional impairment in patients with rheumatoid arthritis on satisfaction with provided rheumatology health care","authors":"U. aktivnosti, bolesti i fUnkcionalne, razinU zadovoljstva prUženom, reUmatološkom UslUgom, Darija Čubelić, Mirna Reihl Crnogaj, M. Mayer","doi":"10.33004/reumatizam-67-1-3","DOIUrl":"https://doi.org/10.33004/reumatizam-67-1-3","url":null,"abstract":"rheumatoid arthritis (ra) is a disease that requires regular monitoring of therapeutic efficacy and patients’ quality of life (Qol). The aim of this study is to determine the influence of disease activity and duration, as well as functional disability, on the patients’ perception of satisfaction with the provided care, and to evaluate the satisfaction with respect to the patient-physician relationship and the factors that affect the patients’ satisfaction level. The observational non-interventional study included 53 consecutive ra patients who regularly attend the outpatient clinic. prior to the scheduled examination the patients completed a standardized patient satisfaction Questionnaire and a Health care assessment Questionnaire (HaQ). The patients were divided according to their HaQ score, disease activity measured by das28 score (disease activity score 28), disease duration, and presence of bdmards (biologic disease-modifying antirheumatic drugs) in therapy. The results showed that the patients were largely satisfied with the service provided. The highest scores were achieved in the categories of the technical quality and competence of the physician and the doctor’s attitude towards the patient. The lowest scores were related to the inability of an easy telephone access or emergency consultation and to the time spent in the waiting room. The level of disease activity did not significantly affect the degree of satisfaction with the provided health care. additionally, patients who were classified as having severe to very severe disability by HaQ score had slightly lower satisfaction rates in all examined categories. furthermore, patients treated with bdmards and those with disease lasting more than five years reported higher satisfaction rates in all categories. in conclusion, patients with a higher degree of disability experience a slightly lower level of satisfaction with medical care, whereas patients with long-standing disease and those treated with bdmards report higher levels of Reumatizam 2020;67(1):27–35 https://doi.org/10.33004/reumatizam-67-1-3 profEssional papEr STRUČNI RAD","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43726118","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":"Gender differences in clinical manifestations and comorbidities in patients with SLE : a single-center experience","authors":"Leona Žuvan, D. Kaliterna","doi":"10.33004/reumatizam-67-1-1","DOIUrl":"https://doi.org/10.33004/reumatizam-67-1-1","url":null,"abstract":"Aim: The aim of this study was to determine gender differences in the clinical manifestations and comorbidities in sle patients treated at the university hospital of split during a ten-year period. Methods: The medical records of patients diagnosed with sle were collected from the outpatient clinics, ward, and day hospital of the department of Rheumatology and clinical immunology of the university hospital of split. all sle manifestations and comorbidities were recorded. The spss 25 (ibm, new York, usa) package was used for statistical analysis. assessment of the differences between the genders was performed by χ2 test, univariate logistic regression, and multivariate logistic regression. Results: The study included 268 sle patients, 242 (90%) females and 26 (10%) males, aged 22-88 years (median 52; Q1-Q3: 41-62.75 y). in univariate regression analysis significant association was obtained between sjögren syndrome (ss) and associated neoplasms and the female gender, while antiphospholipid syndrome (aps) and vasculitis were associated with the male gender. in multivariate logistic regression with age and gender as independent variables, a significantly higher frequency of ss (p = 0.04) and associated neoplasms (p = 0.004) were found in females, while vasculitis (p = 0.014) and aps (p = 0.003) were more frequent in males. significant association was found between younger age and skin changes and lupus nephritis in both genders. in older patients, a significant correlation was found for dyslipidemia, hypertension, osteoporosis, gastritis, and heart involvement. Conclusion: in our study of sle patients, ss and associated neoplasms were more common in women, whereas in men vasculitis and aps were more frequent. lupus nephritis and skin changes occured more frequently in patients of younger age in both genders. in elderly patients, dyslipidemia, hypertension, heart involvement, osteoporosis, and gastritis were more likely to occur. for a better understanding of this problem it is necessary to examine a larger population of patients and monitor it over time.","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69479957","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":"Pubic symphysis diastasis in twin pregnancy","authors":"Egon Kruezi, V. Kosec","doi":"10.33004/reumatizam-67-1-5","DOIUrl":"https://doi.org/10.33004/reumatizam-67-1-5","url":null,"abstract":"Pubic symphysis diastasis is a rare pregnancy complication whose exact incidence is still not known, but it is estimated to be in the range of 1:300 to 1:30,000 pregnancies. it is defined as a distance between the two pubic bones or an interpubic gap greater than 10 mm with typical presentation. typical symptoms of diastasis symphysis are pain in the symphyseal region that radiates to the lower back and thighs, waddling gait, painful movement, reduced mobility, and, rarely, urinary retention. in this case report we present a case of antepartum pubic symphysis diastasis diagnosed by palpation during a pelvic exam in a multiparous woman with a twin pregnancy. The patient had an uneventful previous antenatal period; at a routine follow-up she reported symphyseal pain over a longer period with exacerbation in the previous three weeks, in addition to difficulty walking and staying in an upright position. on manual palpation a 10-mm interpubic gap was found and the patient was hospitalized. in view of the twin pregnancy and pubic symphysis diastasis it was decided that a cesarean section was the appropriate mode of delivery. a postoperative pelvic X-ray showed an interpubic gap of 14 mm. With regard to the simplicity and reliability of manual palpation in cases of suspected pubic symphysis diastasis, implementing palpation of the pubis in regular obstetrical practice would enable early recognition, immediate treatment, and a better outcome in the long term. also, as there are no evidence-based guidelines considering antepartum pubic symphysis diastasis and each case is approached individually, a comprehensive investigation of this condition is needed in order to achieve standardization of practice.","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45987701","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":"ULTRASOUND EVALUATION OF THE ANKLE JOINTS AND TENDONS IN SYSTEMIC LUPUS ERYTHEMATOS","authors":"Smiljanić Tomičević, Darija Čubelić, M. Mayer, B. Anić","doi":"10.33004/reumatizam-66-2-8","DOIUrl":"https://doi.org/10.33004/reumatizam-66-2-8","url":null,"abstract":"Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with musculoskeletal involvement as one of the most common clinical manifestations. High-resolution ultrasound (US) has been proven to be a useful diagnostic tool for the evaluation of joints and tendons in the majority of inflammatory rheumatic diseases. The aim of this study is to assess the frequency of ankle joint and tendon involvement in SLE patients with the use of US, and correlate the findings with the physical examination, laboratory tests, and disease activity scores. Here we will show preliminary results of the survey in the first 10 out of 60 included patients. Ten consecutive SLE patients were enrolled in the study and underwent clinical evaluation, laboratory tests, and bilateral high-resolution US on the same day. Gray-scale and power Doppler (PD) US were performed for imaging of the talocrural (TC) and subtalar joints (ST), ankle tendons, second and third metacarpophalangeal (MCP) joints, second and third proximal interphalangeal (PIP) joints, second and third metatarsophalangeal (MTP) joints, and wrists. A total of 180 joints and 200 tendons were examined. Preliminary results showed US-detected inflammatory joint abnormalities in 7/10 (70%) patients and tendon involvement in 1/10 (10%). Both the MTP and TC joints were affected in 60% of the patients, MCP joints in 50%, ST in 40%, wrists in 30%, and PIP joints in 10% of the patients. The most prevalent pathological US finding was joint effusion, less frequently synovial hypertrophy, while a positive PD signal was rarely detected. Effusion in the TC joints was present in 60% of the patients, synovial hypertrophy in 40%, and a positive PD in 10%. As many as 62.5% of the patients without inflammatory joint symptoms had pathological US findings in the ankle joints. The results showed a high prevalence of US-verified inflammatory joint changes in SLE patients. Surprisingly, the MTP and ankle joints were most commonly affected. Additionally, a great number of asymptomatic patients also had pathological US findings in the ankle joints.","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41561026","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}