Reumatizam最新文献

{"title":"[CLINICAL ENTITIES AND CHARACTERISTICS OF PAIN IN PATIENTS WITH RHEUMATIC DISEASES].","authors":"Višnja Prus,&nbsp;Željka Kardum","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Musculoskeletal pain is the most common symptom present in almost all rheumatic diseases. Rheumatic\u0000diseases include more than 150 clinical entities. There is no uniform classification of rheumatic diseases. In general, we\u0000distinguish inflammatory rheumatic diseases, non-inflammatory degenerative articular diseases, systemic connective tissue\u0000diseases, metabolic disorders with articular manifestations, and regional and extended pain syndromes. According to\u0000the International Association for the Study of Pain (IASP), pain is defined as an unpleasant sensation associated with tissue\u0000damage or reported simultaneously with such damage. Pain has a physical, mental, and social component. In rheumatic\u0000diseases the pain is mostly chronic and may severely impair the patient’s general condition. The defining criteria involve a\u0000period of more than 3 or 6 months, and according to some definitions more than 6 weeks. In most cases the pain is nociceptive\u0000rather than neuropathic. Musculoskeletal pain, especially chronic pain, is a global public health problem because of its\u0000prevalence, as well as the frequently associated muslculoskeletal function impairment and development of chronic pain\u0000syndrome, which can be considered as a separate clinical entity and requires a biopsychosocial treatment approach.</p>","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":"63 Suppl 1 ","pages":"23-6"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35984501","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":"[FIBROMYALGIA: IS IT A RHEUMATIC DISEASE?]","authors":"Dušanka Martinović Kaliterna,&nbsp;Ivona Božić","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fibromylagia (FM) is a complex chronic condition usually presenting with symptoms of widespread\u0000pain and fatigue, as well as sleep and cognitive disorders. The diagnosis is made by exclusion of other diseases and according\u0000to the EULAR criteria. The treatment of the disease is multidisciplinary and associated with a better understanding of\u0000the disease pathophysiology. The most commonly used drugs are tricylic antidepressants (TCA), serotonin and noradrenalin\u0000uptake inhibitors (SNRI), anticonvulsants, and opioids. For the purpose of reducing the patient’s overall symptom\u0000burden, adjunctive therapy with medicines targeted at specific symptoms, including sleep disorders, symptoms of\u0000irritable bowel syndrome, or autoimmune diseases, should be considered. Current therapeutic models neither completely\u0000treat FM symptoms nor benefit all patients; therefore, further research on new therapeutic approaches is needed.</p>","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":"63 Suppl 1 ","pages":"27-30"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35984502","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":"[Polymyositis and systemic sclerosis overlap - A case report and a review of the literature].","authors":"Marin Petrić,&nbsp;Dušanka Martinović Kaliterna,&nbsp;Ivona Božić,&nbsp;Marija Nuić,&nbsp;Dijana Perković","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Polymyositis (PM) is an autoimmune disease which affects skeletal muscles. In young age, it usually\u0000occurs as an idiopathic disorder associated with specific autoantibodies (anti-Jo), while in older age it is often associated\u0000with neoplasms. It can present with symptoms of other autoimmune diseases, such as systemic sclerosis (SSc), a\u0000rare progressive disease characterized by collagen deposits in various tissues and organs.\u0000A 65-year-old patient, long-time smoker, came to the ER because of painful edema in the distal parts of his limbs\u0000and proximal muscle weakness of his arms and legs. Although his muscle enzymes were not increased, PM was confirmed\u0000by the characteristic pathohistological finding. The patient had sclerodermal skin lesions on his back, but he did\u0000not have other typical SSc symptoms, and the specific autoantibodies were negative. He received glucocorticoid therapy\u0000(GC) after we had finished screening for malignant tumors. He felt better, his muscle strength returned, and the\u0000limb edema disappeared. Four weeks later, he developed symptoms which are more typical of SSc, such as dysphagia,\u0000Raynaud’s phenomenon, and skin thickening of the limbs that had been swollen.\u0000PM is often associated with SSc. It is not clear if the exacerbation of latent SSc was stimulated by GC, or if it was\u0000just a simple overlap of the two diseases with different onsets. There are no therapy guidelines for the treatment of this\u0000combination of diseases. Careful use of GC is necessary even if SSc symptoms are discreet, because of the well-known\u0000effects of GC in SSc.</p>","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":"63 1","pages":"10-3"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35976054","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":"[Long-term glucocorticoid therapy and the rapid development of squamous cell carcinoma in systemic sclerosis: Is there a connection?].","authors":"Ivona Božić,&nbsp;Dorotea Božić,&nbsp;Marin Petrić,&nbsp;Katarina Borić,&nbsp;Dušanka Martinović Kaliterna","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Systemic sclerosis (SSC) is an autoimmune disease associated with the risk of malignancies, especially\u0000lung cancer, among which adenocarcinoma and squamous cell carcinoma are the most frequent.\u0000A 63-year-old female patient with SSC was hospitalized due to blackouts, poor general condition, and changes in\u0000her fingers. Because of subsequent epileptic seizures resulting in weakness of the left side of her body, computerized\u0000tomography (CT) of the neurocranium was performed which showed metastatic lesions. A CT scan of the thoracic\u0000organs displayed pulmonary neoplasia in the right hilum, which were histologically evaluated as grade 2 squamous cell\u0000carcinoma. After one month of hospitalization with supportive therapy, the patient’s clinical condition improved, and\u0000she was discharged into home care with recommendations for further oncological treatment. However, the patient died\u0000several days later.\u0000In comparison to adenocarcinomas, squamous cell carcinomas of the lungs usually develop through a significantly\u0000longer period. We consider that the unusually rapid development of the carcinoma in this patient was stimulated by the\u0000immunosuppressive effect of high doses of glucocorticoids that she had been taking for several years on her own initiative.</p>","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":"63 1","pages":"14-9"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35976055","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":"[ETIOLOGY AND PATHOGENESIS OF PAIN IN RHEUMATIC DISEASES].","authors":"Melanie-Ivana Čulo,&nbsp;Jadranka Morović-Vergles","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Rheumatic diseases are chronic inflammatory disorders with ongoing inflammation that causes tissue\u0000damage. Inflammatory and damaged cells synthetize and release many diff erent intracellular substances which can\u0000activate highly specialized subsets of primary sensory neurons called nociceptors. Some of these proinflammatory\u0000mediators directly activate the nociceptor terminal and produce pain (such as hydrogen ion, adenosine triphosphate,\u0000and bradykinin), and others sensitize the terminal so that it becomes hypersensitive to subsequent and non-noxious\u0000stimuli (such as prostaglandin E2 and bradykinin). Acute pain has a protective role since it induces behavior that promotes\u0000healing and recovery, such as immobilization which limits tissue damage. Chronic pain is unhelpful pain that\u0000tends to be out of proportion to the actual tissue damage and persists long after the tissues have healed, so that the pain\u0000becomes the problem rather than the tissues of origin. Chronic pain affects the physical and mental status and causes\u0000impairment of quality of life as well as work disability. For rheumatologists the assessment and treatment of pain is a\u0000very important integral part of patient care, and understanding the etiology and pathogenesis of pain is necessary to\u0000fi nd adequate modalities of treatment to prevent suffering.</p>","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":"63 Suppl 1 ","pages":"18-22"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35981768","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":"[MYOCARDIAL INFARCTION AS A CONSEQUENCE OF CHILDHOOD POLYARTERITIS NODOSA – CASE REPORT].","authors":"Biktorija Ana Buljević,&nbsp;Matias Trbušić,&nbsp;Diana Delić-Brkljačić,&nbsp;Ivan Malčić","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Polyarteritis nodosa (PAN) is a systemic vasculitis histologically characterized by necrotic lesions of small and medium-\u0000sized arteries occurring mostly in their bifurcations. PAN is a multi-organ disorder that affects numerous visceral\u0000arteries and leads to inflammation and necrosis, which may result in ischemia of vital organs. The etiology of the disease\u0000is unknown. It occurs in four forms - cutaneous (most common), classic, systemic, and microscopic. PAN preferably\u0000affects the renal and coronary arteries. The most common findings in the affected blood vessels are aneurysm, thrombosis,\u0000and stenosis. Cardiac complications are rare in children, but 35% of patients develop a complication in adulthood. The\u0000most common complication in adulthood is cardiac decompensation, which can be explained as a consequence of longstanding\u0000hypertension and changes in coronary blood vessels. The incidence of myocardial infarction is low, particularly\u0000in young patients. This paper describes a 25-year-old patient with acute myocardial infarction accompanied by changes\u0000in the coronary blood vessels and persistent arterial hypertension as a result of PAN diagnosed in childhood.</p>","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":"63 2","pages":"15-20"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35982379","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":"[SYSTEMIC PHARMACOLOGICAL TREATMENT OF PAIN IN RHEUMATIC DISEASE].","authors":"Simeon Grazio,&nbsp;Ines Doko","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pain is a cardinal symptom of rheumatic diseases and the most common reason for seeking medical\u0000help. Pain relief has many benefi cial eff ects and is necessary for the functional recovery. A variety of drugs are used for\u0000the treatment of pain in rheumatic diseases. Th ey usually include acetaminophen, nonsteroidal anti-rheumatic drugs,\u0000and opioids (mostly weak opioids). Antidepressants and anticonvulsants can be used in cases with a predominant\u0000neuropathic component. In this descriptive review we present up-to-date results of trials with systemic analgesic drugs\u0000in rheumatic diseases, including nerve growth factor inhibitors and symptomatic slow-acting drugs for osteoarthritis.</p>","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":"63 Suppl 1 ","pages":"39-46"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35984500","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":"[RADIOLOGICAL FEATURES IN PEDIATRIC IMAGING].","authors":"Kristina Potočki,&nbsp;Dubravko Bajramović","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Juvenile idiopathic arthritis (JIA) is an autoimmune disease usually occurring in children before the\u0000age of 16. As one of the most prevalent rheumatic diseases in the pediatric population, with an estimated prevalence of\u00002 to 20 and an incidence of 16 to 150 per 100,000 children, it is defined as an inflammation of one or more joints, with\u0000a duration of 6 weeks minimum. JIA is primarily diagnosed clinically, confirmed by laboratory and radiological findings,\u0000with the goal of early detection and assessment of the spread and progress of the disease as well as the response to\u0000medication. The current International League of Associations for Rheumatology (ILAR) classification defines eight\u0000types of arthritis.</p>","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":"63 Suppl 1 ","pages":"73-9"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35982889","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":"[Controlled-release oxycodone in the treatment of chronic musculoskeletal pain: A preliminary experience of rheumatology center].","authors":"Simeon Grazio,&nbsp;Frane Grubišić,&nbsp;Vladimir Knež,&nbsp;Hana Skala Kavanagh,&nbsp;Tomislav Nemčić","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the etiology of non-malignant pain, a significant proportion is constituted by patients with pain\u0000originating in the musculoskeletal system. The use of strong opioids in the treatment of non-malignant pain is still\u0000controversial. Therefore, the aim of this study was to establish the efficacy and safety of oxycodone with a controlled\u0000release of the active substance (CR) in the treatment of patients with chronic, not well-controlled musculoskeletal pain.\u0000Here we present our preliminary results.\u0000In this prospective, open, single-center study conducted at a rheumatology center we enrolled consecutive patients\u0000with musculoskeletal pain due to a variety of musculoskeletal diseases (osteoarthritis, pain in the lower back, spondyloarthritis),\u0000who suffered from moderate to severe pain despite previous analgesic therapy (with NSAIDs, weak opioids,\u0000or a fixed combination of paracetamol and weak opioids). Patients were switched to therapy with oxycodone CR and\u0000followed for 14 days. The starting dose of oxycodone CR was 10 mg, and later the dose was adapted as necessary. The\u0000primary endpoint was to assess the effectiveness of oxycodone CR on pain intensity, and the secondary goal was\u0000to assess the efficiency on the general health of the patient (both on a horizontal visual analogue scale, VAS 0 = best,\u000010 = worst). Fifteen patients (12 women, 3 men), with a mean age of 61 ± 12 years and a diagnosis of osteoarthritis,\u0000pain in the lower back, or inflammatory arthritis, were included in the study. The duration of pain was 41 ± 12 months.\u0000The average intensity of pain before oxycodone CR treatment was 7.87 ± 2.28 (range 7-10), and at the end of the study\u0000it was 5.92 ± 2.43 (range 4-9) (p=0.069). General health was rated 7.27 ± 2.14 (range 3-10) before the start and 6.00 ±\u00001.53 (range 3-9) at the end of the study (p=0.028). In one patient the treatment was discontinued due to dizziness and\u0000nausea, and one patient voluntarily left the study because of fear and the subjective impression of no adequate pain\u0000control after 2 days of treatment. The oxycodone side-effect profile was as expected.\u0000Results of our preliminary study show that in patients with chronic non-malignant pain which is not well controlled\u0000by simple analgesics, NSAIDs, and weak opioids, treatment with oxycodone CR contributed to a significant\u0000reduction in the level of pain and improved the general health of the subjects.</p>","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":"63 1","pages":"20-3"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35976056","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 PAIN MANAGEMENT OF RHEUMATIC DISEASES].","authors":"Ana Poljičanin,&nbsp;Tonko Vlak","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Rheumatic diseases are a leading cause of chronic painful conditions, which, if not recognized and\u0000treated in a timely manner, cause inability and consequently reduce the quality of life of individuals. Chronic pain in\u0000rheumatic patients has a multifactorial background. Therefore, it is oft en accompanied by sleep and mood disturbances,\u0000fatigue, and reduced functional capacity of joints and the spine. Recent studies suggest that rheumatic pain is\u0000not exclusively nociceptive, and that in a large number of patients it may have the characteristics of neuropathic and\u0000central pain. Thus, the current approach to the treatment of rheumatic pain oft en had very modest results. For these\u0000reasons, rheumatic pain can no longer be treated only as a symptom, but should rather be viewed as a separate disease.\u0000Effective treatment of rheumatic pain requires a multidisciplinary, biopsychosocial approach taking into account the\u0000cause and nature of the pain, the disease characteristics, lifestyle, and psychological ability of an individual to deal with\u0000painful conditions. Careful selection of different modes of non-pharmacological treatment should be the fi rst step in\u0000the treatment of rheumatic pain with the use of available pharmacological interventions. A small number of systematic\u0000reviews, which included only a small number of causes and treatments for rheumatic pain with questionable quality\u0000of evidence, indicates the need to develop new high-quality randomized controlled trials, in order to enable real\u0000insight into the effectiveness of non-pharmacological methods for the treatment of rheumatic pain.</p>","PeriodicalId":76426,"journal":{"name":"Reumatizam","volume":"63 Suppl 1 ","pages":"47-52"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35982885","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}