Reumatologia clinica最新文献

{"title":"Utility of virtual reality in medical training: Clinical management of a patient with knee monoarthritis","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.reumae.2024.11.004","DOIUrl":"10.1016/j.reumae.2024.11.004","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. Therefore, the aim is to improve the quality of care and patient safety when practicing this technique previously through clinical simulation.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Pages 555-559"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635272","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":"Eosinophilic granulomatosis with poliangiitis: Successful treatment with methotrexate and low-dose of mepolizumab","authors":"Luis Francisco Valdés-Corona ,&nbsp;Patricia Aguilar-Dominguez ,&nbsp;Ariel Jasqui-Bucay ,&nbsp;Mariana Arroyo-Machiavelo","doi":"10.1016/j.reumae.2024.11.001","DOIUrl":"10.1016/j.reumae.2024.11.001","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Pages 571-572"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635264","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":"Psychosis as a manifestation in systemic lupus erythematosus: treatment and long-term results. Number of cases","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.reumae.2024.11.002","DOIUrl":"10.1016/j.reumae.2024.11.002","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":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Pages 567-569"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635271","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.reumae.2024.08.001","DOIUrl":"10.1016/j.reumae.2024.08.001","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":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Pages 517-525"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746358","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":"Factors associated with patient-reported outcome measures in knee osteoarthritis: A cross-sectional community-based study","authors":"Rudy Hidayat ,&nbsp;Faisal Parlindungan ,&nbsp;Sumariyono Sumariyono ,&nbsp;Suryo Anggoro Kusumo Wibowo ,&nbsp;Anna Ariane ,&nbsp;Johanda Damanik ,&nbsp;Abirianty Priandani Araminta ,&nbsp;Jessica Audrey ,&nbsp;Mitra Alparisa","doi":"10.1016/j.reumae.2024.11.006","DOIUrl":"10.1016/j.reumae.2024.11.006","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Knee pain resulting from osteoarthritis (OA) often leads to functional limitations and disabilities, significantly affecting an individual's quality of life. This study aimed to explore the factors associated with patient-reported outcome measures in knee OA.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted using data from the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) study in Jakarta. A home-to-home survey using multistage stratified random sampling was conducted involving subjects who met the clinical criteria for knee OA. Data collected included demographic information, body height and weight, history of injury, degree of work activities, presence of body aches and joint pain, and comorbidities. Patient-reported knee outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Bivariate and multivariate analyses were performed to identify factors associated with KOOS and its subscales.</div></div><div><h3>Results</h3><div>A total of 71 subjects meeting the clinical criteria for knee OA were included in the analysis, with a mean age of 54.54<!--> <!-->±<!--> <!-->9.97 years. Cardiovascular disease was significantly associated with overall KOOS scores and all five subscales. Additionally, OA subjects with a history of knee injury scored worse specifically on the KOOS quality of life subscale.</div></div><div><h3>Conclusion</h3><div>Cardiovascular disease and a history of knee injury were significantly associated with worse patient-reported knee outcomes among knee OA subjects. Future studies involving more cities are recommended to confirm these findings and provide more robust results for the Indonesian population.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Pages 526-532"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746359","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.reumae.2024.11.008","DOIUrl":"10.1016/j.reumae.2024.11.008","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":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Pages 539-546"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746361","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":"HLA-B*51:01 in Iranian patients with Behcet uveitis syndrome","authors":"Zahra Hoseini ,&nbsp;Fatemeh Rezaei Rad ,&nbsp;Mohammad Zarei ,&nbsp;Nazanin Ebrahimiadib ,&nbsp;Zahra Salimian ,&nbsp;Mahdi Zamani","doi":"10.1016/j.reumae.2024.07.011","DOIUrl":"10.1016/j.reumae.2024.07.011","url":null,"abstract":"<div><h3>Background</h3><div>Behcet's disease (BD) is a multisystem disorder prevalent along the historic Silk Road, with Behcet's uveitis (BU) representing a significant complication contributing to disability. Various studies have linked different HLA alleles with BD across diverse populations.</div></div><div><h3>Methods</h3><div>In this study, we investigated the association between HLA-B51:01/x and HLA-B27/x genotypes with Behcet's uveitis in 50 unrelated Iranian patients diagnosed with Behcet's uveitis, comparing them to a control group of 70 healthy individuals. Our analysis aimed to determine the susceptibility conferred by these alleles and assess their clinical relevance.</div></div><div><h3>Results</h3><div>Our findings indicate a notable susceptibility conferred by the HLA-B51:01/x genotype for Behcet's uveitis (<em>P</em> <!-->=<!--> <!-->0.0001). Conversely, the B27/x genotype did not demonstrate significant associations with Behcet's uveitis. Furthermore, we employed prevalence-corrected positive predictive value (PcPPV) calculations to gauge the clinical utility of testing for these alleles within the Iranian Behcet's uveitis patient population. The PcPPV for B27/x genotype testing was determined to be 0.05%, while the PcPPV for B51:01/x genotype testing in the same population was 0.065%. These results suggest that carriers of the B*51:01 allele, when presenting with clinical symptoms, exhibit a heightened risk for Behcet's uveitis compared to the general population.</div></div><div><h3>Conclusion</h3><div>Individuals carrying the B51:01 allele, when symptomatic, face an elevated Behcet's uveitis risk. This insight aids in targeted clinical assessments for at-risk populations.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 9","pages":"Pages 470-475"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635286","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 with elevated rheumatoid factor is associated with poor therapeutic response but not with progression to rheumatoid arthritis. Prospective cohort study","authors":"Freddy Liñán Ponce,&nbsp;Juan Leiva Goicochea,&nbsp;David Sevilla Rodríguez,&nbsp;Elmer Hidalgo Bravo,&nbsp;Ginna Obregón Atanacio,&nbsp;Inés Loyola Macalapú,&nbsp;Paola Jáuregui Rojas,&nbsp;Jackeline Yampufe Canani","doi":"10.1016/j.reumae.2024.10.001","DOIUrl":"10.1016/j.reumae.2024.10.001","url":null,"abstract":"<div><h3>Objetive</h3><div>Evaluate response to treatment and progression to rheumatoid arthritis (RA) in patients with fibromyalgia (FM) associated with elevated rheumatoid factor (RF).</div></div><div><h3>Material and methods</h3><div>Prospective cohort study. The sample consisted of 124 patients with FM: 62 with high RF (&gt;20 U/mL) and 62 with negative RF (0−20 U/mL). All patients were evaluated using FM treatment improvement score (FIQR) and progression to RA according to EULAR/ACR 2010 criteria at 6 and 12 months. Pearson's χ² test for homogeneity was used to relate variables of improvement to FM treatment and progression to RA.</div></div><div><h3>Results</h3><div>The response to treatment was lower in the high RF group (24 and 20 patients improved at 6 and 12 months, respectively, compared to 45 and 38 patients in the negative RF group), with a significant difference. Progression to rheumatoid arthritis was similar in both groups (5 in the high RF group and 4 in the negative RF group), with a non-significant relationship.</div></div><div><h3>Conclusions</h3><div>FM with elevated RF is associated with a poor therapeutic response but not with progression to RA.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 9","pages":"Pages 459-462"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515627","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":"Inclusion Body Myositis: A Late Diagnosis Case Report","authors":"Deysi Andrea Hernández-Rivero ,&nbsp;Lisette Bazán-Rodríguez ,&nbsp;María del Pilar Cruz-Domínguez ,&nbsp;Gabriela Medina ,&nbsp;Ana Lilia Peralta Amaro ,&nbsp;Olga Vera-Lastra","doi":"10.1016/j.reumae.2024.10.002","DOIUrl":"10.1016/j.reumae.2024.10.002","url":null,"abstract":"<div><div>Inclusion body myositis is a idiopathic inflammatory myopathy characterized by muscle weakness and dysphagia, with muscle biopsy showing inflammation and rimmed vacuoles. We present the case of a patient who was diagnosed with polymyositis but due to lack of response to treatment, a new biopsy revealed inclusion body myositis.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 9","pages":"Pages 511-512"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549884","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.reumae.2024.10.007","DOIUrl":"10.1016/j.reumae.2024.10.007","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 9","pages":"Pages 515-516"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635287","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}