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Arthritis and rheumatism

Le-Nyu Gao, Bing Zhong, Yong Wang
RATIONALE: Hansen disease is an infectious chronic disease with various clinical manifestations. Its joint performance may easily mimic rheumatoid arthritis. PATIENT CONCERNS: We report a case of a 57-year-old woman diagnosed with Hansen disease 10 years ago, who suffered from joints swelling, pain and joints deformities of both hands for 19 years. The skin on the hands showed rashes, thickening, desquamation and chapping, with both thenar muscles atrophy. She also had severe hypoalgesia of the whole body, and morning stiffness for one hour...
July 2018: Medicine (Baltimore)
Durga Prasanna Misra, Aman Sharma, Vikas Agarwal
The practice of rheumatology in a country like India presents its own unique challenges, including the need to manage patients in a cost-constrained setting, where the lack of uniform government funding for healthcare merits the need to optimize the use of cheaper medicines, as well as devise innovative strategies to minimize the use of costlier drugs such as biologic disease-modifying agents. Use of immunosuppressive agents is also associated with increased risks of infectious complications, such as the reactivation of tuberculosis...
July 19, 2018: Rheumatology International
Gil Bornstein, Nadav Furie, Nimrod Perel, Ilan Ben-Zvi, Chagai Grossman
It is well established that some rheumatic syndromes (RS) are associated with several hematological malignancies. We aimed to describe the clinical course of patients with hematological malignancies mimicking RS. We studied a series of four patients presenting with apparent RS who were eventually diagnosed with hematological malignancies, and reviewed the relevant literature. Our series consisted of 4 patients, with a mean age of 62.8 ± 20.3 years, who presented to our rheumatology unit between December 2012 and March 2018...
July 18, 2018: Rheumatology International
LaVonn Williams
Gout, a common and complex form of inflammatory arthritis, is characterized by abnormally elevated levels of uric acid in the blood. It is estimated that 52.5 million people in the U.S. have arthritis or one of the rheumatic diseases, according to the Centers for Disease Control and Prevention. There are over 100 rheumatic diseases and conditions. In the U.S., the most common types of arthritis or rheumatic diseases are osteoarthritis, gout, fibromyalgia, and rheumatoid arthritis, in that order according to prevalence...
July 2018: International Journal of Pharmaceutical Compounding
Marion Herbette, Jean Baptiste Cren, Laurie Joffres, Charlotte Lucas, Emilie Ricard, Carine Salliot, Jérôme Guinard, Aleth Perdriger, Elisabeth Solau-Gervais, Béatrice Bouvard, Alain Saraux
OBJECTIVES: To determine when Tropheryma whipplei polymerase chain reaction (PCR) is appropriate in patients evaluated for rheumatological symptoms. METHODS: In a retrospective observational study done in rheumatology units of five hospitals, we assessed the clinical and radiological signs that prompted T. whipplei PCR testing between 2010 and 2014, the proportion of patients diagnosed with Whipple's disease, the number of tests performed and the number of diagnoses according to the number of tests, the patterns of Whipple's disease, and the treatments used...
2018: PloS One
Katalin Bognar, Jason Shafrin, Michelle Brauer, Lauren Zhao, Rick Hockett, Michael O'Neil, Anupam Jena
AIMS: Improvements in information technology have granted the recent development of rapid, cloud-enabled, onsite laboratory testing for rheumatoid arthritis (RA). This study aims to quantify the value to payers of such technologies. MATERIALS AND METHODS: To calculate the value of rapid, cloud-enabled, onsite laboratory testing to diagnose RA relative to traditional, centralized laboratory testing, we created an Excel-based decision tree model that simulated potential cost-savings to payers who cover routine evaluations of RA patients in the United States...
July 18, 2018: Journal of Medical Economics
Stefano Alivernini, Barbara Tolusso, Luca Petricca, Laura Bui, Clara Di Mario, Maria R Gigante, Gabriele Di Sante, Roberta Benvenuto, Anna L Fedele, Francesco Federico, Gianfranco Ferraccioli, Elisa Gremese
Objectives: To examine synovial tissue (ST) predictors of clinical differentiation in patients with seronegative undifferentiated peripheral inflammatory arthritis (UPIA). Methods: Fourty-two patients with IgA/IgM-Rheumatoid Factor and anti-citrullinated peptide antibodies negative UPIA, naive to Disease-Modifying Anti-Rheumatic Drugs, underwent Gray Scale (GSUS) and power Doppler (PDUS) evaluation and Ultrasound (US) guided ST biopsy. CD68, CD3, CD21, CD20, and CD31 synovial expression was evaluated by immunohistochemistry...
2018: Frontiers in Medicine
Bente Glintborg, Jan Sørensen, Merete Lund Hetland
Objectives: National Danish guidelines in May 2015 dictated a mandatory switch from originator infliximab (INX) to biosimilar CT-P13 in patients with inflammatory rheumatic disease. We investigated if this non-medical switch changed use of outpatient hospital resources. Methods: Observational cohort study. Switchers were identified in DANBIO. Rheumatic outpatient contacts, visits and services were identified in the National Patient Registry. The 6-month rate for (1) number of visits (or services) and (2) days with ≥1 visit (or service) were compared before/after switching (paired t-tests)...
2018: RMD Open
Joël Ferri, Julien Potier, Jean-Michel Maes, Hervey Rakotomalala, Ludovic Lauwers, Mickael Cotelle, Romain Nicot
Rheumatic diseases (RD) of the temporomandibular joints (TMJs) are increasingly frequent affections and unfortunately often confused with "classic" manducatory dysfunctions (disk dislocation, myofascial pain syndroms). Their diagnosis is mandatory, given the major subsequent craniofacial disorders, which may occur (mandibular condylar hypoplasia, facial hyperdivergence, remodelling of the condylar unit, ankylosis), although the clinical implementation remains unspecific. The delayed diagnosis may be explained by the embryologic, anatomical and physiological characteristics of this joint...
July 12, 2018: International Orthodontics
Ntobeko A B Ntusi, Jane M Francis, Emily Sever, Alexander Liu, Stefan K Piechnik, Vanessa M Ferreira, Paul M Matthews, Matthew D Robson, Paul B Wordsworth, Stefan Neubauer, Theodoros D Karamitsos
BACKGROUND: Rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are common disorders associated with increased rates of cardiovascular disease (CVD), but the contribution of cytokine-induced inflammation to impaired cardiovascular function in these conditions remains poorly understood. OBJECTIVES: We assessed the effect of anti-TNF therapy on myocardial and vascular function, myocardial tissue characteristics and perfusion in inflammatory arthropathy and systemic rheumatic disease (IASRD) patients, using cardiovascular magnetic resonance (CMR)...
June 25, 2018: International Journal of Cardiology
Laura-Alexandra Anghel, Andreea Maria Farcaş, Radu Nicolae Oprean
Background: Several drugs are available for the treatment of autoimmune rheumatic diseases; however, their effectiveness may be negatively influenced by inappropriate adherence. Low adherence and persistence rates have a significant impact on patient quality of life and are associated with health-related expenses. Purpose: To provide an up-to-date narrative review on treatment adherence and persistence rates, and discuss the factors that influence them, in patients with autoimmune rheumatic diseases...
2018: Patient Preference and Adherence
Céline Mortier, Srinath Govindarajan, Koen Venken, Dirk Elewaut
Innate-like T cells such as invariant natural killer T (iNKT) cells and mucosal-associated T (MAIT) cells, characterized by a semi-invariant T cell receptor and restriction toward MHC-like molecules (CD1 and MR1 respectively), are a unique unconventional immune subset acting at the interface of innate and adaptive immunity. Highly represented at barrier sites and capable of rapidly producing substantial amounts of cytokines, they serve a pivotal role as first-line responders against microbial infections. In contrast, it was demonstrated that innate-like T cells can be skewed toward a predominant pro-inflammatory state and are consequently involved in a number of autoimmune and inflammatory diseases like inflammatory bowel diseases and rheumatic disorders, such as spondyloarthritis (SpA) and rheumatoid arthritis...
2018: Frontiers in Immunology
Ingris Peláez-Ballestas, Ysabel Granados, Rosana Quintana, Adalberto Loyola-Sánchez, Flor Julián-Santiago, Celenia Rosillo, Alfonso Gastelum-Strozzi, Jose Alvarez-Nemegyei, Natalia Santana, Adriana Silvestre, Cesar Pacheco-Tena, Mario Goñi, Conrado García-García, Ligia Cedeño, Bernardo A Pons-Éstel
Epidemiological studies in Latin America suggest indigenous people lack proper healthcare for musculoskeletal (MSK) and rheumatic diseases. OBJECTIVES: This study aimed to estimate the prevalence of MSK disorders and rheumatic diseases in eight Latin American indigenous communities, and to identify which factors influence such prevalence using network analysis and syndemic approach. METHODS: This is a cross-sectional, community-based census study according to Community-Oriented Program for the Control of Rheumatic Diseases methodology...
July 14, 2018: Annals of the Rheumatic Diseases
Eirik Ikdahl, Grunde Wibetoe, Silvia Rollefstad, Anne Salberg, Kjetil Bergsmark, Tore K Kvien, Inge C Olsen, Dag Magnar Soldal, Gunnstein Bakland, Åse Lexberg, Bjørg Tilde Svanes Fevang, Hans Christian Gulseth, Glenn Haugeberg, Anne Grete Semb
OBJECTIVES: Patients with inflammatory joint diseases (IJD) have an increased risk of cardiovascular disease (CVD). Our goal was to examine indications for, and use of, lipid-lowering therapy (LLT) and antihypertensive treatment (AntiHT) in patients with IJD. Furthermore, to investigate the frequency of low-density lipoprotein cholesterol (LDL-c) and blood pressure (BP) goal attainment among IJD patients. METHODS: The cohort was derived from the NOrwegian Collaboration on Atherosclerosis in patients with Rheumatic joint diseases (NOCAR)...
July 2, 2018: International Journal of Cardiology
G Leuschner, C Neurohr
BACKGROUND: Pulmonary involvement in patients with underlying autoimmune diseases poses a major diagnostic and therapeutic challenge to the treating physician. Due to the associated increased mortality risk, early diagnosis is crucial. OBJECTIVE: The incidence and mortality rate of connective tissue disease-related interstitial lung diseases (CTD-ILD) and pulmonary hypertension (PH) were evaluated in patients with rheumatic disease including clinical aspects, diagnostic procedure, prognosis and treatment recommendations...
July 13, 2018: Zeitschrift Für Rheumatologie
Elena Generali, Tanima Bose, Carlo Selmi, J Willem Voncken, Jan G M C Damoiseaux
Spondyloarthritides (SpA) include inflammatory joint diseases with various clinical phenotypes that may also include the axial skeleton and/or entheses. SpA include psoriatic arthritis, reactive arthritis, enteropathic arthritis and ankylosing spondylitis; the latter is frequently associated with extra-articular manifestations, such as uveitis, psoriasis, and inflammatory bowel disease. SpA are associated with the HLA-B27 allele and recognize T cells as key pathogenetic players. In contrast to other rheumatic diseases, SpA affect women and men equally and are not associated with detectable serum autoantibodies...
July 10, 2018: Autoimmunity Reviews
Alice Mason, Clive Holmes, Christopher J Edwards
Dementia is a major international public health problem which looks set to grow as the ageing population increases. Despite large amounts of investment there has been relatively little progress in developing new therapies to combat this. There is a growing body of evidence that both local and systemic inflammation are important in dementia; with cerebral inflammation occurring secondarily to beta-amyloid plaques, raised levels of serum inflammatory molecules and cytokines being present in Alzheimer's disease patients and systemic inflammation being associated with cerebral microvasculature disease in vascular dementia...
July 10, 2018: Autoimmunity Reviews
Jamie C Sergeant, Kimme L Hyrich, James Anderson, Kamilla Kopec-Harding, Holly F Hope, Deborah P M Symmons, Anne Barton, Suzanne M M Verstappen
BACKGROUND: Methotrexate (MTX) remains the disease-modifying anti-rheumatic drug of first choice in rheumatoid arthritis (RA) but response varies. Predicting non-response to MTX could enable earlier access to alternative or additional medications and control of disease progression. We aimed to identify baseline predictors of non-response to MTX and combine these into a prediction algorithm. METHODS: This study included patients recruited to the Rheumatoid Arthritis Medication Study (RAMS), a UK multi-centre prospective observational study of patients with RA or undifferentiated polyarthritis, commencing MTX for the first time...
July 13, 2018: Arthritis Research & Therapy
Rachel H Mackey, Lewis H Kuller, Larry W Moreland
Cardiovascular disease (CVD) risk is 1.5-fold higher in rheumatoid arthritis (RA), partly due to subclinical atherosclerosis that develops before the diagnosis of RA. Dyslipidemia in RA is better quantified by lipoproteins and apolipoproteins than by cholesterol levels. Current risk factors likely underestimate CVD risk by underestimating prior risk factor levels. Some of the 2-fold higher risk of heart failure and total mortality in RA may be due to myocardial disease caused by inflammation. Per recent recommendations, to reduce CVD risk in RA, control disease activity, reduce inflammation, and aggressively treat CVD risk factors...
August 2018: Rheumatic Diseases Clinics of North America
Maria Karolina Jonsson, Aase Haj Hensvold, Monika Hansson, Anna-Birgitte Aga, Joseph Sexton, Linda Mathsson-Alm, Martin Cornillet, Guy Serre, Siri Lillegraven, Bjørg-Tilde Svanes Fevang, Anca Irinel Catrina, Espen Andre Haavardsholm
BACKGROUND: Anti-citrullinated protein antibody (ACPA) reactivities precede clinical onset of rheumatoid arthritis (RA), and it has been suggested that ACPA reactivities towards distinct target proteins may be associated with differences in RA phenotypes. We aimed to assess the prevalence of baseline ACPA reactivities in an inception cohort of patients with early RA, and to investigate their associations with disease activity, treatment response, ultrasound findings and radiographic damage...
July 13, 2018: Arthritis Research & Therapy
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