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Current Rheumatology Reviews

Derar Seyoum, Wasim Khan
The pre-operative assessment is used to clarify issues prior to surgery that can change management provided by a multidisciplinary team. A high proportion of rheumatoid arthritis patients are elderly requiring orthopaedic surgery which requires further investigations, assessment of risk through functional capacity and several anaesthetic considerations. Rheumatoid arthritis patients often provide a variety of medical issues that can be found on careful and thorough pre-assessment that can be accommodated for by the surgical and anaesthetic team, however aspects of holistic management is an important considerations for efficient and effective management...
September 27, 2016: Current Rheumatology Reviews
Samy Metyas, Tamer Rezk, Daniel Arkfeld, Thomas Leptich
Generalized pain with tender points in specific areas accompanied by systemic symptoms such as fatigue and stiffness is characteristic of fibromyalgia (FM) syndrome. The genesis of FM is still being investigated with conflicting data on factors including autonomic dysfunction, neurotransmitters, and hormones often in combination with external stressful events. However, recent research is starting to suggest that there is a previously underappreciated subtype of fibromyalgia called inflammatory Fibromyalgia (iFM)...
September 19, 2016: Current Rheumatology Reviews
Luana Mancarella, Olga Addimanda, Carlotta Cavallari, Riccardo Meliconi
BACKGROUND: Ultrasound is one of the most promising candidates for detection of inflammation and structural damage in hand osteoarthritis. OBJECTIVE: To evaluate new advances of US as a diagnostic and prognostic tool in hand osteoarthritis assessment. METHODS: We conducted a Medline on PubMed search for articles about "ultrasonography" and "hand OA" published between January 2012 and 15th April 2016, limiting our search to articles on human adults in English, excluding those involving inflammatory diseases, visualization of joints other than hands, ultrasound guided injections and surgical procedures...
September 9, 2016: Current Rheumatology Reviews
Allen P Anandarajah, Muhammad El-Taha, Cheng Peng
OBJECTIVE: To determine if there is an association between focal and systemic bone loss in patients with RA. METHODS: Bone loss is a hallmark finding in rheumatoid arthritis (RA) and manifests as localized, periarticular and systemic bone loss. RA patients were selected from the Consortium of Rheumatology Researchers of North America (CORRONA) database. Multiple logistic regression models were constructed to assess the association between the presence or absence of erosions and T-scores at the lumbar spine (LS) and total hips and adjusted for age, gender, body mass index (BMI), medications and disease activity indices...
September 8, 2016: Current Rheumatology Reviews
Kirk Sperber, Julia Ash, Farrah Gutwein, Amy Wasserrman, Varuni Rao, Mark Tratenberg
Localized scleroderma (LS) is characterized by excessive collagen deposition leading to thickening of the dermis, subcutaneous tissue or both. The outcome for most patients with localized scleroderma depends upon the type and extent of the lesion. The major challenge for untreated patients is not survival but morbidity due to skin, muscle and bone atrophy resulting in growth defects. Treatment is individualized to type and stage of the lesion and may include pharmacologic and non-pharmacologic therapies. Among the pharmacologic modalities, methotrexate with systemic glucocorticoids is currently the mainstay of treatment...
September 7, 2016: Current Rheumatology Reviews
Sara Tenti, Nicola Antonio Pascarelli, Sara Cheleschi, Giacomo Maria Guidelli, Antonella Fioravanti
Osteoarthritis (OA) is a multifaceted disorder defined by the alteration of homeostasis and degradation in articular cartilage. Recently mounting evidence suggests that OA should be conceived as an inflammatory disease rather than a simple wear-and-tear problem. Bradykinin (BK) and B2 receptors play a role in the pathogenesis of OA. The aim of this paper is to analyze preclinical and clinical studies examining the potential role of BK and of B2 receptor blockade in OA pathogenesis. We analyzed the data about the effects of BK in synoviocytes, endothelial cells and chondrocytes cultures and described the action of B2 receptor antagonists (Icatibant and Fasitibant)...
August 24, 2016: Current Rheumatology Reviews
Andrew Wang, Amer Zeidan, Cristina Brunet
Rheumatologic manifestations in hematologic malignancies are common. Tumor-associated systemic inflammation can often manifest as prototypic rheumatologic syndromes. Thus, paraneoplastic syndromes are important to recognize because they can herald an underlying malignancy. We review the common rheumatologic manifestations associated with hematologic malignancies and discuss their possible underlying pathophysiology.
August 15, 2016: Current Rheumatology Reviews
Ji Wei Yang, Eric Rich, Claire Saint-Cyr, Josiane Bourré-Tessier
The causal link between inherited complement deficiencies and systemic lupus erythematosus (SLE) has been well established, although it remains a rare cause of the disease. We present the case of three biological sisters with hereditary heterozygous C2 deficiency, but who differ widely in their clinical and serological manifestations. Patient 1 is 25 years old and was diagnosed with SLE at the age of 12. Further testing revealed positive ANA and anti-dsDNA, antiphospholipid syndrome (APS) and decreased C2, C3 and C4 levels...
August 7, 2016: Current Rheumatology Reviews
Mithun Neral, Dan Winger, Joseph Imbriglia, Ronit Wollstein
The literature evaluating external anatomical measurements and carpal tunnel syndrome (CTS) remains inconclusive. The purpose of this study was to compare hand- shape measurements of patients with and without (CTS). A retrospective case - control study of participants with suspected CTS (male/female ratio of 0.69) was performed. Nerve conduction tests (NCT) defined 73 involved hands (CTS) and 65 control hands. The relationship between 3 different hand index ratios (measuring palm length and width) and CTS (defined by NCT) was evaluated using Generalized Estimating Equations model (GEE) with the binary outcome of CTS...
August 5, 2016: Current Rheumatology Reviews
Yasser El Miedany, Maha El Gaafary, Sally Youssef, Samah Almedany, Deborah Palmer
BACKGROUND: The use of simulation-based learning in the medical field has many benefits, including patient safety, health care professional confidence, accelerating diagnostic and therapeutic procedures, meeting the unfulfilled demand for medical personnel, and lowering of medical errors. Developing of interactive learning tools for teaching a simulated clinical case studies program, is highly needed to improve specialist nurses and middle grade health care professionals skills and competency...
July 28, 2016: Current Rheumatology Reviews
Delesha M Carpenter, Carolyn T Thorpe, Dayna S Alexander, Adam J Sage, Megan Lewis, Susan L Hogan, Lorie L Geryk, Robert F DeVellis
Our goals were to describe the balance of social support to negative social interactions (i.e. social constraint) for autoimmune disease patients and determine whether support and constraint from spouses and non-spousal family and friends interact to influence patients' psychological adjustment. Using cross-sectional survey data from 109 married vasculitis and lupus patients, we found that patients reported that spouses and family/friends provided more social support than social constraint. In regression models, constraint from spouses (β= -0...
July 19, 2016: Current Rheumatology Reviews
Ana Paula Monteiro Gomides, Caliandra Lima, Franciso Rocha, Licia Mota, Sandra Oliveira
Gut parasites are among the oldest and most common infections in humans. Alterations in the host defense alterations caused by autoimmune diseases or immunosuppressive drugs can cause modifications of the symptoms: indolent parasites can be reactivated, asymptomatic patients may experience new symptoms, or mild or moderate symptoms can become serious and, rarely, may lead to death. In recent years, new drugs have been used in the treatment of rheumatoid arthritis (RA), causing a greater level of immunosuppression and therefore more concerns regarding the risk of serious parasitic diseases...
July 14, 2016: Current Rheumatology Reviews
Pulukool Sandhya, Biji Theyilamannil Kurien, Debashish Danda, Robert Hal Scofield
Sjögren's syndrome is a common autoimmune disease that presents with sicca symptoms and extraglandular features. Sjögren's syndrome is presumably as common as RA; yet it is poorly understood, underdiagnosed and undertreated. From the usual identity as an autoimmune exocrinopathy to its most recent designate as an autoimmune epithelitis - the journey of SS is complex. We herein review some of the most important milestones that have shed light on different aspects of pathogenesis of this enigmatic disease. This includes role of salivary gland epithelial cells, and their interaction with cells of innate and adaptive immune system...
July 14, 2016: Current Rheumatology Reviews
Klemens Trieb
: The treatment of metacarpophalangeal destruction by rheumatoid arthritis is often an indication for joint replacement, here the swanson spacer still has his place. The flexible spacer may be implanted with or without titanium guide sleeves ("grommets"). However, the imaginary abrasion protection for the silicone grommets may in turn lead through micro-movements to wear as it is observed in the case shown here. PATIENTS AND METHODS: One over a period of 30 years suffering from rheumatoid arthritis 69 years old female patient is presented...
July 8, 2016: Current Rheumatology Reviews
Valentina Grossi, Maria Infantino, Mariangela Manfredi, Francesca Meacci, Emanuele Bellio, Valerio Bellio, Francesca Li Gobbi, Simone Ugolini, Stefano Catani, Piercarlo Sarzi-Puttini, Fabiola Atzeni, Maurizio Benucci
BACKGROUND: Inflammatory arthritis (IA) is highly prevalent and so the discovery of new early diagnostic biomarkers is of particular interest. Calprotectin is a very sensitive and potentially a predictive biomarker of drug responsiveness. METHODS: Serum calprotectin levels were determined in 88 patients diagnosed as having rheumatoid arthritis (RA), psoriatic arthritis (PsA) or spondyloarthritis (SA), and 73 healthy subjects. RESULTS: Logistic regression and receiver operating characteristic (ROC) analyses showed that serum calprotectin levels were diagnostically accurate in the IA population...
June 28, 2016: Current Rheumatology Reviews
S Walters, S Chan, L Goh, T Ong, O Sahota
Introduction Vertebral fragility fractures are the most common fragility fracture. A significant proportion of patients still present to hospital for treatment due to their underlying older age and frailty syndrome. We aim to describe the prevalence of frailty within a cohort of hospitalised patients with vertebral fragility fracture using clinical frailty scales and comparing this group of patients with those that have a fragility fracture of the hip, a well-recognised frail group of patients. Method As part of a service improvement project, a prospective case series of all patients ≥50years admitted to hospital with a vertebral fragility fracture over a 6 week period (n=24) were screened for frailty...
June 19, 2016: Current Rheumatology Reviews
Renu Regunathan-Shenk, Jai Radhakrishnan
Systemic Lupus Erythematosis (SLE) is a heterogeneous and complex disease produced by diverse pathogenic events in the innate and adaptive immune system. Lupus nephritis affects over half of all patients with lupus and leads to substantial morbidity and mortality. This review presents our current understanding of the development of lupus nephritis and examines the role of genetics and epigenetics in further elucidating the pathogenesis of the disease. Advancements in genomics are leading the way to better understanding and novel biologic therapies for SLE...
June 13, 2016: Current Rheumatology Reviews
Neha Thakur, Narendra Rai, Prerna Batra
Systemic lupus erythematous (SLE) is a multisystem autoimmune disorder characterized by immune dysregulation and formation of autoantibodies. A high index of suspicion is necessary to diagnose SLE. Children have more systemic involvement than adults. Kidney involvement is seen in a significant proportion of children. With advancement of therapy the survival rate of patients with SLE has significantly improved. Even then lupus nephritis is still the most important predictor of morbidity and mortality. Treatment of lupus nephritis is mostly derived from studies in adults as data on children is still lacking...
April 4, 2016: Current Rheumatology Reviews
Hassan Bassiouni, Hany Aly, Khaled Zaky, Nouran Abaza, Thomas Bardin
OBJECTIVE: To compare serum 25 OH vitamin D (25 (OH) D) levels between medial femoro-tibial knee osteoarthritis (OA) patients and controls, and to detect structural progression in patients with mild to moderate knee osteoarthritis in relation to baseline 25(OH) D levels in a one-year longitudinal prospective cohort study. METHODS: Thirty eight patients with medial femoro-tibial knee OA according to the ACR criteria and no knee malalignement, and 20 age, sex and BMI-matched pain free controls were included in the vitamin D study...
April 4, 2016: Current Rheumatology Reviews
Michael Sattin, Tanveer Towheed
OBJECTIVES: Rheumatoid arthritis (RA) is strongly associated with cardiovascular morbidity and mortality. Previous studies have demonstrated that TNFα-inhibitors may reduce cardiovascular events (CVE) in patients with RA. Thus, the purpose of this systematic review was to evaluate the ability of TNFα-inhibitors to reduce the risk of CVE in patients with RA. This study will update the findings of two earlier systematic reviews that synthesized the data up until 2010. METHODS: A search of Medline, Embase, Medline In-Process and Other Non-Indexed Citations, American College of Physicians Journal Club, Database of Abstracts of Reviews of Effects, and the Cochrane Central Register of Controlled Trials was conducted for observational studies reporting on CVE in RA patients since 2009...
April 4, 2016: Current Rheumatology Reviews
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