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Best Practice & Research. Clinical Rheumatology

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https://www.readbyqxmd.com/read/27964798/immunization-in-patients-with-inflammatory-rheumatic-diseases
#1
REVIEW
Konstantinos Thomas, Dimitrios Vassilopoulos
Immunization represents the most efficient and simplest intervention to prevent certain viral and bacterial infections in the general population as well as in the vulnerable population of patients with inflammatory rheumatic diseases treated with immunosuppressives. Here, we present an updated review of literature data regarding the safety and efficacy of immunizations against different pathogens in rheumatic patients treated with conventional immunosuppressives or the newer biologic agents while at the same time we provide practical guidance for the appropriate vaccine administration in this patient population...
October 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27964797/the-role-of-psychological-factors-in-inflammatory-rheumatic-diseases-from-burden-to-tailored-treatment
#2
REVIEW
Henriët van Middendorp, Andrea W M Evers
Inflammatory rheumatic diseases have a long-lasting effect on patients' physical and psychological functioning, for instance, due to disabling symptoms and unpredictable disease course. Consequently, many patients show adjustment problems such as depressed mood, which in turn can negatively influence their disease outcome. Specific biopsychosocial factors have shown to affect this outcome. For example, daily stress, cognitive-behavioral risk factors such as pain catastrophizing and avoidance, and resilience factors such as optimism and social support influence the quality of life, physical symptoms of pain and fatigue, and inflammatory markers...
October 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27964796/vasculitis-and-inflammatory-arthritis
#3
REVIEW
Richard A Watts, David G I Scott
Vasculitis has been described in most types of inflammatory arthritis. The best described and most widely recognised form is rheumatoid vasculitis. The incidence of systemic rheumatoid vasculitis has declined significantly following the general early use of methotrexate in the 1990s, and it is now a rare form of vasculitis. Treatment of rheumatoid vasculitis is conventionally with glucocorticoids and cyclophosphamide, but there is an increasing role for rituximab similar to that in other types of vasculitis...
October 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27964795/metabolic-abnormalities-in-patients-with-inflammatory-rheumatic-diseases
#4
REVIEW
Patrick H Dessein, Ahmed Solomon, Ivana Hollan
Patients with rheumatoid arthritis (RA) experience an increased cardiometabolic risk factor burden that is substantially driven by systemic inflammation. This occurs less consistently in patients with ankylosing spondylitis (AS). Psoriatic arthritis most strongly associates with excess adiposity and metabolic risk. RA patients also often have systemic inflammation-induced proinflammatory high-density lipoprotein (HDL) cholesterol particles and lean/muscle mass loss in association with increased adiposity, a condition termed rheumatoid cachexia, which further enhances cardiovascular risk...
October 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27964794/the-role-of-the-gastrointestinal-tract-in-the-pathogenesis-of-rheumatic-diseases
#5
REVIEW
Francesco Ciccia, Angelo Ferrante, Giuliana Guggino, Giovanni Triolo
Dysregulation of the intestinal epithelial barrier in genetically susceptible individuals may lead to both intestinal and extraintestinal autoimmune disorders. There is emerging literature on the role of microbiota changes in the pathogenesis of systemic rheumatic diseases such as rheumatoid arthritis, spondyloarthropathies, and connective tissue diseases. Although the role of the gastrointestinal tract in the pathogenesis of spondyloartropathies is well defined and many studies underline the importance of gastrointestinal inflammation in modulating local and systemic inflammation, the data are inconclusive regarding the effect of dysbiosis on rheumatoid arthritis and connective tissue diseases...
October 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27964793/lung-involvement-in-inflammatory-rheumatic-diseases
#6
REVIEW
Clive Kelly, Kundan Iqbal, La'ali Iman-Gutierrez, Phil Evans, Kanchan Manchegowda
This chapter describes the involvement of the lung in systemic inflammatory joint disease (IJD) with a particular focus on rheumatoid arthritis, although the topics of pulmonary involvement in ankylosing spondylitis and psoriatic arthritis are also addressed. Interstitial lung disease is the most lethal pulmonary complication of IJD and the chapter describes recent advances in both our understanding of this complication and the therapeutic options that offer real hope for improved outcomes. Although less well recognised, airways disease is just as common and its association with IJD is described in some detail, with a section devoted to the recent surge in interest in bronchiectasis...
October 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27964792/cardiovascular-disease-in-inflammatory-rheumatic-diseases
#7
REVIEW
Santos Castañeda, Michael T Nurmohamed, Miguel A González-Gay
Chronic inflammatory rheumatic diseases (IRD), including rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis, are prevalent conditions worldwide, with a considerable burden on healthcare systems. They are associated with increased cardiovascular (CV) morbidity and mortality. In this review, we focused on the epidemiology, traditional CV risk factors, genetics, and the link between chronic inflammation, atherosclerosis, and CV disease. Remarkably, patients with IRD have higher vulnerability to atheromatous plaques...
October 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27964791/orofacial-manifestations-in-patients-with-inflammatory-rheumatic-diseases
#8
REVIEW
John Hamburger
The main orofacial manifestation of the inflammatory rheumatic diseases is that of Sjögren's syndrome. In addition, there is a constellation of orofacial manifestations of the inflammatory rheumatic diseases, many of which are extra-articular with some constituting presenting signs of the underlying rheumatic disease. This review will discuss the orofacial manifestations in a variety of connective tissue diseases and will also allude to the oral adverse drug reactions that may occur as a consequence of therapy...
October 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27964790/the-eye-and-inflammatory-rheumatic-diseases-the-eye-and-rheumatoid-arthritis-ankylosing-spondylitis-psoriatic-arthritis
#9
REVIEW
Philip Ian Murray, Saaeha Rauz
Rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis are associated with potentially sight-threatening inflammatory eye disease. Although the ocular manifestations associated with ankylosing spondylitis and psoriatic arthritis are similar, such as anterior uveitis, this differs from rheumatoid arthritis where dry eye, peripheral ulcerative keratitis and scleritis are the major ocular complications. Apart from causing sight loss, these conditions are painful, debilitating, often recurrent or chronic and may require long-term therapy...
October 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27964789/rheumatologic-diseases-as-the-cause-of-fever-of-unknown-origin
#10
REVIEW
C M Mulders-Manders, A Simon, C P Bleeker-Rovers
In 30% of patients with fever or inflammation of unknown origin (FUO/IUO), the cause is eventually found to be a rheumatologic disease such as autoimmune or granulomatous disease or vasculitis. Most of these patients suffer from an uncommon presentation of a common disease, instead of an uncommon disease. We demonstrate the diagnostic challenge with several cases. The workup of FUO is based on the identification of potential diagnostic clues (PDCs). In the absence of PDCs, a standardized diagnostic protocol should be followed, including early FDG-PET/CT...
October 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27964788/a-different-perspective-inflammatory-rheumatic-diseases-and-other-organs
#11
EDITORIAL
George D Kitas, Piet L C M van Riel
No abstract text is available yet for this article.
October 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27931967/imaging-in-mechanical-back-pain-anything-new
#12
REVIEW
Bjarke Brandt Hansen, Philip Hansen, John A Carrino, Gilles Fournier, Zoreh Rasti, Mikael Boesen
Low back pain is common and relates to a variety of overlapping pathologies. Within the last few decades, almost every medical imaging modality has been applied in the evaluation of low back pain. Imaging of the spine has a high priority in the assessment of patients with low back pain, who seem to expect such procedures to be undertaken. However, the majority of conventional imaging techniques do not have adequate precision to identify the primary source of pain. Not only can this be frustrating to both clinicians and patients, but importantly, inadequate correlation between imaging findings and symptoms hampers the ability of clinicians to devise a specific treatment plan for the patient...
August 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27931966/imaging-in-osteoporosis-in-rheumatic-diseases
#13
REVIEW
Peter Mandl, Franz Kainberger, Mette Friberg Hitz
Osteoporosis is a common comorbidity of all major rheumatic diseases, and manifests itself both systemically and locally. Systemic bone loss manifests because of several factors, primarily inflammation, immobility, and commonly used medical treatment for rheumatic diseases. Local bone loss manifests as periarticular demineralization and bone erosion due to local release of inflammatory agents and cytokines, which promote bone resorption. All these factors contribute to the phenomenon of arthritis-associated osteoporosis...
August 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27931965/musculoskeletal-interventional-procedures-with-or-without-imaging-guidance
#14
REVIEW
David Kane, Juhani Koski
Aspiration and injection of joints and soft tissues is an indispensable skill used in everyday practice by the clinical rheumatologist. Most rheumatologists recognise that performing these procedures using anatomical landmarks is not always successful, particularly in the case of small or infrequently injected joints, bursae or tendon sheaths. Musculoskeletal ultrasound confirms the local pathological-anatomical diagnosis and is the most applicable and feasible imaging method that can be applied in clinical practice in guiding musculoskeletal interventional procedures...
August 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27931964/imaging-in-paediatric-rheumatology-is-it-time-for-imaging
#15
REVIEW
Paz Collado, Clara Malattia
Juvenile idiopathic arthritis (JIA) is a heterogeneous group of arthritides characterized by chronic synovial inflammation that can lead to structural damage. The main objective of JIA therapies is to induce disease control to avoid disability in childhood. The advances in therapeutic effectiveness have created a need to search for imaging tools that describe more precisely disease activity in children with JIA. Musculoskeletal ultrasound and magnetic resonance imaging have demonstrated to be more sensitive than clinical examination in early detection of synovitis...
August 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27931963/imaging-of-regional-pain-syndromes-from-syndromes-to-conditions-using-imaging
#16
REVIEW
Ingrid Möller, Marcin Szkudlarek
Musculoskeletal regional pain syndromes often lead to patient referrals in general and rheumatological practice. Detailed history taking and clinical examination can in most cases reveal the cause for pain and direct the subsequent management of the conditions. Yet, when in doubt, imaging methods have to support the clinical assessment. This paper presents the underlying pathologies of the most frequently encountered regional pain syndromes and the role of musculoskeletal ultrasonography and magnetic resonance imaging in their visualization...
August 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27931962/imaging-of-vasculitis-state-of-the-art
#17
REVIEW
Francesco Muratore, Nicolò Pipitone, Carlo Salvarani, Wolfgang A Schmidt
The increasing availability and improvement of imaging techniques are making a profound impact in the evaluation and management of patients with vasculitis, particularly for those with large vessel vasculitis, and will most likely play an ever more important role in the future. Deep, large vessels can be examined by CT or MRI, while ultrasound is the method of choice for the evaluation of superficial vessels (such as temporal, carotid, and axillary arteries). PET is very sensitive in detecting large vessel inflammation, but it does not delineate the vessel wall...
August 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27931961/imaging-of-connective-tissue-diseases-beyond-visceral-organ-imaging
#18
REVIEW
Maurizio Cutolo, Nemanja Damjanov, Barbara Ruaro, Ana Zekovic, Vanessa Smith
Connective tissues diseases (CTDs) can also be diagnosed early by "external" and safe imaging methods beyond the visceral organ analysis. This study aims to explore various imaging techniques used in diagnosing CTDs. Skin impairment in systemic sclerosis (SSc) may be recognized and studied by the modified Rodnan skin score (mRSS), which has some drawbacks, whereas high-frequency ultrasound (US) seems advantageous for the early identification of skin involvement. Salivary gland involvement in Sjögren syndrome (SS) can be assessed using standard tests such as unstimulated salivary flow test, salivary gland scintigraphy or contrast sialography...
August 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27931960/imaging-of-osteoarthritis-oa-what-is-new
#19
REVIEW
Alexander Mathiessen, Marco Amedeo Cimmino, Hilde Berner Hammer, Ida Kristin Haugen, Annamaria Iagnocco, Philip G Conaghan
In daily clinical practice, conventional radiography is still the most applied imaging technique to supplement clinical examination of patients with suspected osteoarthritis (OA); it may not always be needed for diagnosis. Modern imaging modalities can visualize multiple aspects of the joint, and depending on the diagnostic need, radiography may no longer be the modality of choice. Magnetic resonance imaging (MRI) provides a complete assessment of the joint and has a pivotal role in OA research. Computed tomography (CT) and nuclear medicine offer alternatives in research scenarios, while ultrasound can visualize bony and soft-tissue pathologies and is highly feasible in the clinic...
August 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27931959/imaging-of-gout-new-tools-and-biomarkers
#20
REVIEW
Elizabeth G Araujo, Bernhard Manger, Fernando Perez-Ruiz, Ralf G Thiele
While joint aspiration and crystal identification by polarizing microscopy remain the gold standard for diagnosing tophaceous gout, agreement among medical and ancillary health personnel examining synovial fluid using polarizing microscopy for the detection of monosodium urate (MSU) crystals appears to be poor. Imaging modalities, including conventional radiography (CR), ultrasonography (US), magnetic resonance imaging (MRI), and dual-energy computed tomography (DECT), have been found to provide information on the deposition of MSU crystals in tissues, and the consequences of such deposition...
August 2016: Best Practice & Research. Clinical Rheumatology
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