Reumatologia clinica最新文献

{"title":"Usefulness of ultrasound in clinical decision-making in rheumatology clinical practice: A single-center longitudinal study","authors":"Marta Serrano-Warleta ,&nbsp;Aliuska Palomeque-Vargas ,&nbsp;Rosa Manzo ,&nbsp;Boris Blanco-Cáceres ,&nbsp;Mónica Vazquez-Díaz ,&nbsp;Carlos Guillen-Astete","doi":"10.1016/j.reumae.2024.02.004","DOIUrl":"10.1016/j.reumae.2024.02.004","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of the present study is to identify the extent to which it affects clinical decisions in a single-centre observational retrospective study.</p></div><div><h3>Method</h3><p>The results of 801 requests and 1174 consecutive individual ultrasound examinations performed over 10 months were analysed.</p></div><div><h3>Results</h3><p>The most frequent indication was diagnostic assistance (39%) followed by assessment of inflammatory activity (34%). By topography, the hand was the most frequently studied region (51%), followed by the foot (18.1%). Of all requests, 67% had an impact on decision-making. The impact on clinical decision-making was associated with a shorter waiting time for the evaluation of the results, being the greatest in those ultrasound scans performed on demand on the same day of the request. In 73% of bilateral ultrasound studies, findings in one of the joints exemplified the overall result reported.</p></div><div><h3>Conclusions</h3><p>Rheumatological musculoskeletal ultrasound has proven to be a useful decision-making technique, the greater the impact of which is seen the shorter the waiting time before it is performed.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 3","pages":"Pages 147-149"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023847","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":"Neurological manifestations of rheumatoid arthritis – Nearly 50 years of experience","authors":"Beatriz Samões ,&nbsp;Ana Paula Sousa ,&nbsp;Raquel Samões ,&nbsp;Ernestina Santos","doi":"10.1016/j.reumae.2024.02.008","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.02.008","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 3","pages":"Pages 169-171"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140138529","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":"Pseudoseptic arthritis as a complication of intra-articular infiltration of hyaluronic acid in a patient with rheumatoid arthritis","authors":"Chafik Chacur,&nbsp;Anastasia Mocritcaia,&nbsp;Raimon Sanmartí","doi":"10.1016/j.reumae.2024.02.007","DOIUrl":"10.1016/j.reumae.2024.02.007","url":null,"abstract":"<div><p>Pseudoseptic arthritis is a rare complication of hyaluronic acid (HA) 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 HA 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":94193,"journal":{"name":"Reumatologia clinica","volume":"20 3","pages":"Pages 166-168"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041246","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":"External validation of the 2017 ACR/EULAR classification criteria for inflammatory myopathies in a Mexican cohort: Role of autoantibodies in the diagnosis and classification of patients with inflammatory myopathies","authors":"Grisel Guadalupe Sánchez-Mendieta,&nbsp;David Vega-Morales,&nbsp;Miguel Ángel Villarreal-Alarcón,&nbsp;Jesús Eduardo Compean-Villegas,&nbsp;Ilse Andrea Moreno-Arquieta,&nbsp;Dionicio Ángel Galarza-Delgado","doi":"10.1016/j.reumae.2023.11.001","DOIUrl":"https://doi.org/10.1016/j.reumae.2023.11.001","url":null,"abstract":"<div><h3>Objective</h3><p>This retrospective study aimed to perform the first external validation of the ACR/EULAR classification criteria for inflammatory myopathy (IIM) in a Mexican dynamic cohort where the patients were evaluated with clinical and laboratory values. As secondary objectives, we presented the clinical characteristics of the patients and included antibodies other than anti Jo1 to evaluate their impact on our population.</p></div><div><h3>Methodology</h3><p>This study included 70 patients with IIM and 70 patients with differential diagnoses of IIM, according to the absolute score of the classification criteria. We obtained sensitivity and specificity in the modality without biopsy, and as an exploratory analysis, we added other antibodies from the myositis extended panel. We analyzed the area under the curve (AUC) of three models: score without antibodies, with anti Jo1 and with any antibody.</p></div><div><h3>Results</h3><p>The ACR/EULAR criteria showed increased specificity and at least similar sensitivity to that of the original cohort (85% sensitivity and 92% specificity), with a cohort point of &gt;55%. When we classified patients into definite, probable, possible, and no IIM categories, by adding the extended myopathy panel, 6 of the 10 patients initially classified as “no IIM” changed their classification to “Probable IIM” and 4 to “Definite IIM”; of the 16 patients classified as “probable IIM,” 15 changed their classification to “Definite IIM.”</p></div><div><h3>Conclusion</h3><p>Considering the limitations of this study, we concluded that the 2017 EULAR/ACR criteria for IIM classification are sensitive and specific for classifying patients with IIM in the Mexican population. Additionally, the addition of antibodies other than anti-Jo1 may improve performance in certain populations.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 3","pages":"Pages 142-146"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140138066","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":"Epidemiology of thromboembolic events in children and adolescents with antiphospholipid syndrome: A systematic review with meta-analysis","authors":"Mickael Essouma ,&nbsp;Jan Rene Nkeck ,&nbsp;Jean Jacques Noubiap","doi":"10.1016/j.reumae.2023.10.005","DOIUrl":"https://doi.org/10.1016/j.reumae.2023.10.005","url":null,"abstract":"<div><h3>Background and aim</h3><p>This was a systematic review and meta-analysis of the prevalence of thromboembolic events in children and adolescents with antiphospholipid syndrome (APS).</p></div><div><h3>Methods</h3><p>We searched PubMed, EMBASE and Web of Science to select relevant articles published between 1 January 2000 and 27 February 2022. We used the random-effects meta-analysis to estimate pooled point prevalence rates of thromboembolic events in studies with a minimum sample size of 30.</p></div><div><h3>Results</h3><p>We included five studies reporting data of 336 children and adolescents with primary APS and secondary APS (SAPS). Pooled point prevalence rates of initial general thrombosis, arterial thrombosis, venous thrombosis and stroke in individuals with seropositive APS were 98.2% (95% confidence interval [CI] 87.5–100), 27.6% (95% CI 21.4–34.2), 51.1% (95% CI 38.2–63.9) and 13.4% 95% CI (6.3–22.7), respectively. Pooled point prevalence rates of initial arterial and venous thromboses in children and adolescents with SAPS were 45.7% (95% CI 21.1–71.6) and 29.2% (95% CI 14.8–46), respectively.</p></div><div><h3>Conclusion</h3><p>Arterio-venous thromboembolism is highly frequent in children and adolescents with SAPS. More studies using thrombotic and non-thrombotic APS classification criteria are warranted to better assess the frequency and predictors of thromboembolism in age- and ancestry-diverse pediatric populations affected by different types of APS.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 3","pages":"Pages 155-161"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140138067","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":"Speciality training in rheumatology: Promotion, repetition and dropout rates in the city of Buenos Aires","authors":"Vanesa Laura Cosentino ,&nbsp;Gustavo Casado ,&nbsp;Carla Gobbi ,&nbsp;Anastasia Secco ,&nbsp;Félix Romanini ,&nbsp;Gustavo Citera ,&nbsp;Marcos Rosemffet ,&nbsp;Silvia Papasidero ,&nbsp;María Alejandra Medina ,&nbsp;Juan Manuel Bande ,&nbsp;Karen Roberts ,&nbsp;Alejandro Brigante ,&nbsp;Guillermo Pons Estel ,&nbsp;María Celina de la Vega ,&nbsp;Gabriel Sequeira ,&nbsp;Eduardo Mario Kerzberg","doi":"10.1016/j.reumae.2024.01.001","DOIUrl":"10.1016/j.reumae.2024.01.001","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate the trajectory of students enrolled in the specialty training in rheumatology.</p></div><div><h3>Methods</h3><p>Retrospective analysis (2009–2016). Promotion, repetition, and dropout rates were determined. Analysis was performed to define variables associated with academic success.</p></div><div><h3>Results</h3><p>Out of 119 students, the actual promotion rate was 66.4%, 11.8% failed an exam (at least) and completed the course after the stipulated time, and the dropout rate was 7.6%.</p><p>Among residents, the promotion rate was 82.5% vs. 48.2% among the rest (p &lt; 0.001), the lagging students’ repetition rate was 3.2% vs. 21.4% among the rest (p 0.005), and the dropout rate was 3.2% vs. 12.5% among the rest (p = 0.06). A higher average score in medical school increased the chances of success in the postgraduate programme (OR 3.41 CI 95% 2.0–6.4; p &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>The residency was associated with higher rates of academic success in postgraduate studies. The average score in medical school can help identify students at risk of failure.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 2","pages":"Pages 92-95"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643731","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 combined treatment with prednisone and methotrexate versus prednisone alone over laboratory parameters in giant cell arteritis","authors":"Ines Perez-Sancristobal ,&nbsp;Paula Alvarez-Hernandez ,&nbsp;Cristina Lajas-Petisco ,&nbsp;Benjamin Fernandez-Gutierrez","doi":"10.1016/j.reumae.2024.01.003","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.01.003","url":null,"abstract":"<div><h3>Objective</h3><p>To compare the effect of combined treatment with prednisone and methotrexate (MTX) versus prednisone alone over laboratory parameters in giant cell arteritis (GCA).</p></div><div><h3>Patients and methods</h3><p>We performed a double-blind, placebo-controlled, randomized clinical trial about usefulness of treatment with prednisone and MTX versus prednisone and placebo in GCA (Ann Intern Med 2001;134:106–114). As a part of follow-up of patients (<em>n</em> <!-->=<!--> <!-->42), we performed laboratory analysis in 20 time points during the two-year period of follow-up. To analyze differences, we calculated the area under the curve (AUC) for erythrocyte sedimentation rate (ESR), hemoglobin, and platelets, and compared the results in both groups adjusting by time of follow-up, existence of relapses and dose of prednisone.</p></div><div><h3>Results</h3><p>A total of 724 laboratory measurements were done. Median value of ESR was 33 [18–56] in patients with placebo and 26 [15–44] in patients with MTX (<em>P</em> <!-->=<!--> <!-->0.0002). No significant differences were observed in ESR during relapses. The mean ESR value followed a parallel course in both groups, but was lower in the group with MTX than in the group with placebo in 18 of 20 time points of follow-up. The AUC of ESR by time of follow-up was 28,461.7<!--> <!-->±<!--> <!-->12,326 in the group with placebo and 19,598.4<!--> <!-->±<!--> <!-->8,117 in the group with MTX (mean difference 8,863, 95% CI 1.542–16.184; <em>P</em> <!-->=<!--> <!-->0.019). The course of other laboratory parameters paralleled, without statistical significance, those observed for ESR.</p></div><div><h3>Conclusions</h3><p>These data, along with clinical data, suggest that MTX might play a role as a disease-modifying agent in the treatment of GCA.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 2","pages":"Pages 108-112"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139915015","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":"Health personnel perception about central sensitivity syndrome-fibromyalgia patients","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.reumae.2024.01.004","DOIUrl":"10.1016/j.reumae.2024.01.004","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> &lt; 0.05).</p></div><div><h3>Results</h3><p>200 surveys were collected, most of them physicians 63.5% (<em>n</em> = 127) or nurses 25.5% (<em>n</em> = 51). 71% of physicians reported using the WHO analgesic scale. 53% (<em>n</em> = 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. 52% 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":94193,"journal":{"name":"Reumatologia clinica","volume":"20 2","pages":"Pages 73-79"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139718187","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":"Pleural tuberculosis and endocarditis as complications of multifactorial origin in granulomatosis with polyangiitis: Clinical case report","authors":"Jesús Anguamea-Maldonado,&nbsp;Eduardo Sanchez-Zazueta,&nbsp;Rene Vidal-Morales","doi":"10.1016/j.reumae.2024.01.002","DOIUrl":"10.1016/j.reumae.2024.01.002","url":null,"abstract":"<div><p><span>We present the case of a 36-year-old woman with a history of granulomatosis with polyangiitis<span><span>; chronic kidney disease<span><span>; systemic arterial hypertension. Debut with dyspnea, weakness, and </span>hemoptysis, she was suspected in </span></span>atypical pneumonia<span>, discarded, persisting with tachypnea<span>, tachycardia<span><span><span>, chest pain. The protocol for </span>pulmonary tuberculosis was started with negative </span>sputum samples, positive blood culture for </span></span></span></span></span><em>S. haemolyticus</em><span><span>, chest tomography with left </span>pneumothorax<span> and ipsilateral pleural effusion, exudate-type pleural fluid was obtained, acid-fast staining, negative PCR for </span></span><em>M. tuberculosis</em><span><span>; A follow-up echocardiogram was performed due to a new murmur, reporting valvular vegetation, concluding a diagnosis of </span>pleural tuberculosis<span> and endocarditis<span> as complications of multifactorial origin associated with immunosuppression in granulomatosis with polyangiitis.</span></span></span></p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 2","pages":"Pages 104-107"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643681","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":"Comparison of plasma inflammatory biomarkers between MIS-C and potentially serious infections in pediatric patients","authors":"Núria Visa-Reñé,&nbsp;Adriana Rubio-Páez,&nbsp;Núria Mitjans-Rubies,&nbsp;Fernando Paredes-Carmona","doi":"10.1016/j.reumae.2024.01.005","DOIUrl":"10.1016/j.reumae.2024.01.005","url":null,"abstract":"<div><h3>Background</h3><p>Inflammatory biomarkers have been used for the diagnosis and management of multisystemic inflammatory syndrome in children (MIS-C). We aimed to compare the clinical and laboratory findings of MIS-C cases versus other febrile cases cataloged as potentially suspected bacterial infection (non-MIS-C).</p></div><div><h3>Methods</h3><p>Unicentric ambispective observational cohort study (June 2020–February 2022). We analyzed demographics, clinical symptoms and laboratory findings in MIS-C cases and in non-MIS-C cases with febrile processes of patients under 15 years of age admitted to hospital.</p></div><div><h3>Results</h3><p>We enrolled 54 patients with potential suspected bacterial infection and 20 patients with MIS-C for analysis. Fever (100%), gastrointestinal (80%) and mucocutaneous findings (35%) were common in MIS-C patients, also hypotension (36.8%) and tachycardia (55%). Laboratory findings showed significantly elevated proBNP (70%), ferritin (35%), D-dimer (80%) and lymphopenia (55%) and thrombocytopenia (27.8%) in MIS-C cases. IL-6 values were high in non-MIS-C patients (92.6%).</p></div><div><h3>Conclusions</h3><p>In the management of MIS‐C patients, the dynamic monitoring of proBNP, ferritin, D-dimer, lymphocytes and platelets could be helpful to pediatricians to effectively evaluate the progress of MIS‐C in the early phases, not IL-6 values. The applicability of the IL-6 level as a prognostic biomarker in MIS-C patients may require closer discussion. In addition, the optimal laboratory markers, as stated in our study, can help establish a biomarkers model to early distinguish the MIS-C versus non-MIS-C in patients who are admitted to febrile syndrome.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 2","pages":"Pages 84-91"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139718210","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}