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Clinical Rheumatology

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https://www.readbyqxmd.com/read/28547208/pulse-wave-velocity-and-augmentation-index-are-not-independently-associated-with-carotid-atherosclerosis-in-patients-with-rheumatoid-arthritis
#1
M Robustillo-Villarino, J J Alegre-Sancho, E Rodilla-Sala, A Corrales, J Llorca, M A Gonzalez-Gay, P H Dessein
Arterial stiffness can enhance cardiovascular risk by increasing atherogenesis or adverse hemodynamic effects. We examined whether the arterial stiffness markers of aortic pulse wave velocity (PWV) and the augmentation index (AIx) are independently associated with carotid artery intima-media thickness (IMT) and plaque in patients with rheumatoid arthritis (RA). PWV and AIx were determined by brachial oscillometry using the Mobil-O-Graph® system and carotid IMT and plaque by ultrasound in 194 consecutive RA patients without established cardiovascular disease, chronic kidney disease, and diabetes at disease onset...
May 25, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28540607/treatment-response-to-etanercept-in-methotrexate-refractory-juvenile-idiopathic-arthritis-an-analysis-of-predictors-and-long-term-outcomes
#2
Yueh Su, Yao-Hsu Yang, Bor-Luen Chiang
The aim of the study is to evaluate the long-term outcomes, predictors, and the role of inflammatory cytokines in methotrexate (MTx) refractory juvenile idiopathic arthritis (JIA) patients. This is a retrospective cohort study. MTx refractory JIA patients who received etanercept as their first biological agent in National Taiwan University Hospital (NTUH) were enrolled. Patients were classified into remission group, non-remission group, relapsing group, and non-relapsing group according to the criteria of disease remission and disease flares defined by Wallace et al...
May 24, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28540606/diagnostic-performances-of-serum-igg4-concentration-and-igg4-igg-ratio-in-igg4-related-disease
#3
Chang-Sheng Xia, Chun-Hong Fan, Yan-Ying Liu
Patients with IgG4-related disease (IgG4-RD) often have elevated serum IgG4 levels. Here, we aimed to evaluate the diagnostic performances of elevated serum IgG4 concentration and IgG4/IgG ratio for IgG4-RD. We retrospectively analyzed 1381 patients subjected to serum IgG subclass testing to differentiate IgG4-RD from other diseases at Peking University People's Hospital from 2012 to 2016. This sample included 133 IgG4-RD patients and 1248 non-IgG4-RD patients. Serum IgG subclass concentrations were measured using Siemens reagents...
May 24, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28540605/characteristics-of-rheumatoid-arthritis-patients-undergoing-reverse-shoulder-arthroplasty
#4
Julio J Jauregui, J Paul Hovis, S Ashfaq Hasan
The risks and complication profile of reverse total shoulder arthroplasty (RSA) in rheumatoid arthritis (RA) patients has yet to be clearly defined as most studies have small cohorts. Using a large inpatient database, the purpose on our study was to determine the overall demographics, hospitalization characteristics, and early complication rates in rheumatoid patients and compared these to rotator-cuff arthropathy patients without RA undergoing RSA. Utilizing United States Nationwide Inpatient Sample from 2010 to 2013, we evaluated a total of 919 RA RSA and compared them to 8097 patients without RA undergoing RSA...
May 24, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28536825/intramuscular-clodronate-in-erosive-osteoarthritis-of-the-hand-is-effective-on-pain-and-reduces-serum-comp-a-randomized-pilot-trial-the-er-o-d-e-study-erosive-osteoarthritis-and-disodium-clodronate-evaluation
#5
Gianantonio Saviola, Lul Abdi-Ali, Maria Rosaria Povino, Lorella Campostrini, Silvano Sacco, Luca Dalle Carbonare
We evaluated the efficacy and safety of intramuscular clodronate (CLO) for the treatment of active erosive osteoarthritis of the hand (EOA). Forty outpatients treated with anti-inflammatory (NSAIDs) or analgesic drugs since at least 6 months, for at least 3 days a week, were randomly divided into two groups. Group A: 24 patients treated for 6 months with intramuscular (i.m.) CLO added to usual NSAIDs or analgesic drugs. The attack dose was 200 mg/day i.m. for 10 days followed by a maintenance dose of CLO i...
May 23, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28536824/association-between-low-bone-mineral-density-and-fibromyalgia-a-meta-analysis
#6
Young Ho Lee, Gwan Gyu Song
We aimed to evaluate the relationship between bone mineral density (BMD) and fibromyalgia (FM). Meta-analyses were performed comparing BMD in FM patients and healthy controls, and in FM patients in subgroups based on ethnicity, BMD site, age, sex, and measurement method. Twelve studies including 695 FM patients and 784 controls were selected. Meta-analysis by ethnicity revealed a significantly lower BMD in the FM group in Caucasian populations [standardized mean difference (SMD) = -0.144, 95% CI = -0.271-(-0...
May 23, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28536823/efficacy-and-safety-of-anakinra-in-tumor-necrosis-factor-receptor-associated-periodic-syndrome-traps-complicated-by-severe-renal-failure-a-report-after-long-term-follow-up-and-review-of-the-literature
#7
REVIEW
Stefano Gentileschi, Donato Rigante, Antonio Vitale, Jurgen Sota, Bruno Frediani, Mauro Galeazzi, Luca Cantarini
Tumor necrosis factor receptor-associated periodic syndrome (TRAPS), caused by mutations in the TNFRSF1A gene, is the most frequent autosomal dominant autonflammatory disease displaying a relevant risk of reactive AA amyloidosis, if left untreated. Our report deals with one adult with TRAPS complicated by amyloidosis-related renal failure, treated with the recombinant human interleukin-1 receptor antagonist anakinra at a higher than conventional dosage. This treatment did not present any adverse event and led remarkably to the disappearance of all TRAPS-related manifestations and prompt decrease of laboratory abnormalities, including proteinuria...
May 23, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28536822/assessment-of-typical-spa-lesions-on-mri-of-the-spine-do-local-readers-and-central-readers-agree-in-the-desir-cohort-at-baseline
#8
Manouk de Hooge, Jean-Baptiste Pialat, Monique Reijnierse, Désirée van der Heijde, Pascal Claudepierre, Alain Saraux, Maxime Dougados, Antoine Feydy
Comparing local reading (LocR) with central reading (CentR) of typical spondyloarhritis lesions including bone marrow edema (BME) and structural lesions on magnetic resonance imaging of the spine (MRI-spine), in patients with inflammatory back pain (IBP; ≥3 months, <3 years). Baseline data of 667 patients, age 18-50 years, from the Devenir des Spondylarthopathies Indifferenciees Recentes (DESIR)-cohort were used. Two trained central readers scored anterior and posterior corner BME, fatty lesions, erosions and syndesmophytes on MRI-spine...
May 23, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28534076/serum-prolidase-activity-in-systemic-sclerosis
#9
Ahmet Celik, Muhammed Nur Birer, Metin Kilinc
Systemic sclerosis, also known as scleroderma, is a complex systemic inflammatory autoimmune disease that targets the vasculature and connective tissue-producing cells and components of the innate and adaptive immune systems. The disease is characterized by a hardening of the skin and an increased synthesis of collagen . Prolidase is a specific imidodipeptidase involved in collagen degradation. The aim of this study was to search the serum prolidase activity (SPA) in the two subtypes of systemic sclerosis: diffuse and limited cutaneous systemic sclerosis...
May 22, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28534075/comparison-between-different-disease-activity-scores-in-rheumatoid-arthritis-an-egyptian-multicenter-study
#10
M Eissa, A El Shafey, M Hammad
The aim of our work was to assess the performance of different Disease Activity Score (DAS) other than DAS-ESR in daily clinical practice in our Egyptian outpatient clinics and also to evaluate the accuracy of European League Against Rheumatism Classification (EULAR) proposed cutoffs for these scores to stratify Egyptian patients into different categories of disease activity. This study is a cross-sectional Egyptian multicenter study. It included 130 rheumatoid arthritis (RA) patients who visited our Rheumatology and Rehabilitation outpatient and inpatient clinics; 80 patients from Cairo University Hospitals and 50 patients from Zagazig University Hospitals...
May 22, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28528519/il-6-blockade-in-the-management-of-non-infectious-uveitis
#11
Giuseppe Lopalco, Claudia Fabiani, Jurgen Sota, Orso Maria Lucherini, Gian Marco Tosi, Bruno Frediani, Florenzo Iannone, Mauro Galeazzi, Rossella Franceschini, Donato Rigante, Luca Cantarini
Several pathogenetic studies have paved the way for a newer more rational therapeutic approach to non-infectious uveitis, and treatment of different forms of immune-driven uveitis has drastically evolved in recent years after the advent of biotechnological drugs. Tumor necrosis factor-α targeted therapies, the first-line recommended biologics in uveitis, have certainly led to remarkable results in patients with non-infectious uveitis. Nevertheless, the decision-making process turns out to be extremely difficult in anti-tumor necrosis factor or multidrug-resistant cases...
May 20, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28526972/patient-experiences-attitudes-and-expectations-towards-receiving-information-about-anti-tnf-medication-a-quantitative-study
#12
Jon Packham, Paul Arkell, Tom Sheeran, Ann Brownfield, Anthony Cadwgan, Sarah Ryan
The objective of the study was to measure patient attitudes and experience of information received during drug counselling for rheumatoid arthritis (RA) medications. This is a cross-sectional UK postal questionnaire study. Three RA patient groups-disease-modifying antirheumatic drugs (DMARDs) only, first anti-tumour necrosis factor (anti-TNF) and failed anti-TNF-were sent postal questionnaires. Data on patient history/demographics, drug counselling experience, knowledge of drug side effects, attitudes to vaccinations, cancer screening and blood borne virus testing was collected; 264/679 (39%) patients responded (median age 65 years, 66% female, median disease duration 15 years)...
May 19, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28508950/malignancy-as-a-comorbidity-in-rheumatic-diseases-a-retrospective-hospital-based-study
#13
Hai-Long Wang, Yong-Ming Zhou, Guang-Zhao Zhu, Zhu Yang, Bao-Jin Hua
Patients with Rheumatic diseases (RDs) are at an increased risk of malignancies compared with the general population. The aim of this study was to examine the relative frequency of several cancers in a single homogeneous cohort of patients with different RDs. Patients diagnosed with rheumatoid arthritis (RA), Ankylosing spondylitis (AS), Sjögren's syndrome (SS), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), dermatomyositis (DM), or polymyositis were included. Out of 3982 adult residents admitted to the division of rheumatology, 61 malignancies were observed...
May 16, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28508103/to-be-or-not-to-be-rheumatologist-survey-among-belgian-medical-students-and-internal-medicine-trainees-what-do-certified-rheumatologists-think-about-the-current-rheumatology-training-program
#14
Ruth Wittoek, Herman Mielants
In several countries, there have been increasing concerns over the years that fewer medical students or trainees choose rheumatology as a specialty. The aim of this three-step survey is to study the motivational factors for students and trainees in internal medicine to choose for rheumatology as a future career option and the idea among experienced rheumatologists about the needs for changes in the training program. An online survey was distributed among students in medical training (in the final 3 years) and trainees in internal medicine from the Ghent University and University Hospital...
May 15, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28503707/the-value-of-ultrasound-in-diagnosing-extracranial-large-vessel-vasculitis-compared-to-fdg-pet-ct-a-retrospective-study
#15
Christian Löffler, Johannes Hoffend, Urs Benck, Bernhard K Krämer, Raoul Bergner
Large-vessel vasculitis (LVV) is a group of diseases mainly comprised of giant-cell arteritis (GCA), Takayasu arteritis, and a series of rare diseases like Behçet's disease, IgG4-related disease, infectious aortitis, and other unfrequent entities. Besides clinical and laboratory features, Doppler sonography (DS) can assist in establishing the diagnosis. Its diagnostic sensitivity has been evaluated in various studies, most of them, however, in temporal arteritis (TA) respectively in LVV with involvement of the temporal artery...
May 15, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28497237/efficacy-of-long-term-nonsteroidal-antiinflammatory-drug-treatment-on-magnetic-resonance-imaging-determined-bone-marrow-oedema-in-early-active-axial-spondyloarthritis-patients
#16
Mei Tang, Leixi Xue, Yueping Shen, Lin Bo, Ru Yang, Jian Wen, Yi Zhang, Zhichun Liu, Jinxiang Fu
To assess the efficacy of long-term treatment with nonsteroidal antiinflammatory drugs (NSAIDs) on bone marrow oedema (BMO) of the sacroiliac joint in newly diagnosed axial spondyloarthritis (SpA) with a symptom duration of less than 4 years, a single-center, open-label study in a cohort of consecutive patients with newly diagnosed axial SpA was conducted. Eligible patients had magnetic resonance imaging (MRI)-determined BMO of the sacroiliac joint at baseline, had a symptom duration of less than 4 years, and were naïve to NSAIDs...
May 11, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28492994/metabolic-characteristics-and-renal-dysfunction-in-65-patients-with-tophi-prior-to-gout
#17
Chuan-Chin Lu, Shyi-Kuen Wu, Wei-Sheng Chung, Liang-Hung Lin, Ta-Wei Hung, Chih-Jung Yeh
Tophi typically occur many years after uncontrolled gout. Therefore, their development before gout remains unusual. Such patients might exhibit some characteristic differences compared with typical tophaceous gout patients. In this study, 65 tophaceous gout patients with tophi as the first sign of gout (tophi-first group) were enrolled. Their clinical characteristics were compared with those of 1421 patients whose tophi occurred after gout (tophi-after group). Compared with the tophi-after group, the tophi-first group had a significantly higher percentage of female patients and patients with elderly onset of disease and a lower percentage of patients with a positive family history; these patients had lower body mass indices, serum urate levels, and estimated glomerular filtration rates (eGFRs)...
May 10, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28488125/recurrent-infections-in-a-patient-with-psoriatic-arthritis-and-hypogammaglobulinemia-treated-with-conventional-and-biologic-disease-modifying-anti-rheumatic-drugs-a-primary-or-secondary-entity
#18
REVIEW
Ewa Więsik-Szewczyk, Aleksandra Kucharczyk, Katarzyna Świerkocka, Elżbieta Rutkowska, Karina Jahnz-Różyk
A 54-year-old man with confirmed psoriatic arthritis, treated with conventional and biologic disease-modifying anti-rheumatic drugs, suffered from severe, recurrent respiratory tract infections. He was found to have hypogammaglobulinemia. Further investigations confirmed the diagnosis of common variable immunodeficiency. Introduction of immunoglobulin G replacement therapy allowed for safe and effective treatment of psoriatic arthritis with etanercept and methotrexate. Patients with a history of recurrent infections on disease-modifying anti-rheumatic drugs and hypogammaglobulinemia should be assessed for primary antibody immunodeficiencies, even in adulthood...
May 9, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28488124/hypomyopathic-dermatomyositis-associated-with-interstitial-lung-disease-and-good-response-to-mycophenolate-mofetil-case-based-review
#19
REVIEW
Roberta Vilela Lopes Koyama, Tiago Kiyoshi Kitabayashi Braga, George Alberto da Silva Dias, Satomi Fujihara, Hellen Thais Fuzii, Gilberto Toshimitsu Yoshikawa
Hypomyopathic dermatomyositis (HDM) is a rare form of dermatomyositis (DM). Interstitial lung disease (ILD) associated with clinically amyopathic DM (CADM-ILD) or hypomyopathic DM (HDM-ILD) is a rare condition with a more unfavorable prognosis than ILD associated with classic DM (CDM-ILD). There is no effective treatment for HDM-ILD. A 62-year-old woman with a 6-month history of chronic polyarthritis and myalgia presented skin lesions characteristic of DM (erythematous lesion on extensor surface of elbows, Gottron's papules, V-neck sign) with no clinical muscle impairment (global muscle strength: grade 5)...
May 9, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28484887/the-effect-of-tnf-a-antagonists-on-aortic-stiffness-and-wave-reflections-a-meta-analysis
#20
C Vlachopoulos, A Gravos, G Georgiopoulos, D Terentes-Printzios, N Ioakeimidis, D Vassilopoulos, K Stamatelopoulos, D Tousoulis
Patients with rheumatoid arthritis (RA) have higher aortic stiffness and cardiovascular risk. Tumor necrosis factor alpha (TNF-a) antagonists reduce inflammation in RA and are indicated for the treatment of patients with severe active rheumatoid disease. However, it is debatable if they have favorable effects on cardiovascular health. The present meta-analysis evaluates the effect of TNF-a antagonists on aortic stiffness and wave reflections, predictors of cardiovascular events and mortality, in RA patients...
May 8, 2017: Clinical Rheumatology
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