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https://www.readbyqxmd.com/read/29035933/psoriatic-arthritis-new-evidence-for-old-concepts
#1
Enrique R Soriano, Josefina Marin, Maria L Acosta-Felquer
PURPOSE OF REVIEW: The review gives an updated overview of some of the new concepts in the management of psoriatic arthritis (PsA): early diagnosis, remission as an objective, treat-to-target, and treatment guidelines. RECENT FINDINGS: Early diagnosis, targeting remission as part of a treatment strategy, and new guidelines providing evidence-based support to these concepts are main topics in recent publications. SUMMARY: Dermatologists and rheumatologists should work together to reduce the number of patients remaining undiagnosed, and the time to do so...
October 13, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/29032478/total-knee-arthroplasty-in-patients-with-a-history-of-illicit-intravenous-drug-abuse
#2
David E Bauer, Andreas Hingsammer, Lukas Ernstbrunner, Alexander Aichmair, Andrea B Rosskopf, Franziska Eckers, Karl Wieser, Sandro F Fucentese
PURPOSE: Injection drug users are at high risk for both infection with blood-borne pathogens, namely, human immune deficiency virus (HIV), hepatitis-B, -C virus, various bacterial infections, as well as early primary and secondary joint degeneration. When total knee arthroplasty (TKA) is anticipated the risk of septic complications is a major concern. The purpose of this study was to assess the clinical and radiographic outcome of patients with a history of intravenous drug use after total knee arthroplasty...
October 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29031528/a-rare-unusual-presentation-of-primary-tuberculosis-in-the-temporomandibular-joint
#3
N T Geetha, Amarnath P Upasi, K V Umashakara, Kirthikumar Rai
Tuberculosis (TB) is a very common health problem in developing nations such as India. It can present as its primary form or as secondary forms (extrapulmonary TB). Maxillofacial manifestations of TB compose nearly 10% of all extrapulmonary manifestations of the disease. Extrapulmonary TB involving the maxillofacial region is very rare and can present in any tissues in this region. These infections generally involve the head and neck through hematogenous or lymphatic routes. Very few cases of primary TB of the temporomandibular joint (TMJ) have been reported in the literature...
September 19, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29030294/type-i-interferon-pathway-activation-in-copa-syndrome
#4
Stefano Volpi, Jessica Tsui, Marcello Mariani, Claudia Pastorino, Roberta Caorsi, Oliviero Sacco, Angelo Ravelli, Anthony K Shum, Marco Gattorno, Paolo Picco
Mutations of the COPA gene cause an immune dysregulatory disease characterised by polyarticular arthritis and progressive interstitial lung disease with pulmonary haemorrhages. We report the case of a young girl that presented at age 3 with polyarticular arthritis, chronic cough and high titer rheumatoid factor. Radiologic imaging showed interstitial lung disease with tree-in-a-bud nodules and air-filled cysts. Targeted genetic analysis of COPA gene showed the reported c.698G>A mutation. The patient was lost to follow up for 3years during which therapy was discontinued with the development of joint damage and deformities...
October 10, 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/29029863/changes-in-local-bone-density-in-early-thumb-carpometacarpal-joint-osteoarthritis
#5
Joseph J Schreiber, Thomas J McQuillan, Eni Halilaj, Joseph J Crisco, Arnold-Peter Weiss, Tarpit Patel, Deborah Kenney, Amy L Ladd
PURPOSE: Thumb carpometacarpal (CMC) osteoarthritis (OA) represents a major source of functional morbidity. The effects of early CMC OA on loading and use patterns potentially lead to changes in local bone density and microarchitecture. Hounsfield units (HU), a quantitative attenuation coefficient obtained from computed tomography (CT) scans, have been shown to be a reliable marker of bone density. We hypothesized that early CMC OA is associated with lower local bone density about the CMC joint as assessed by HU...
October 10, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29029308/difficult-to-treat-rheumatoid-arthritis-an-area-of-unmet-clinical-need
#6
Maria J H de Hair, Johannes W G Jacobs, Jan L M Schoneveld, Jacob M van Laar
Increased effectiveness of pharmacological treatments in early RA has led many to believe that difficult-to-treat, established RA is a condition of the past. However, there are still plenty of RA patients who continue to have signs and symptoms suggestive of inflammatory disease activity, despite consecutive treatment with multiple conventional synthetic and biological DMARDs. We argue that difficult-to-treat RA constitutes an area of unmet clinical need and propose a definition of this concept. An overview of what is known about the multiple contributory factors varying for each individual patient, and an approach towards improved patient-tailored management are presented...
October 4, 2017: Rheumatology
https://www.readbyqxmd.com/read/29029185/patient-reported-outcomes-in-newly-diagnosed-early-rheumatoid-arthritis-patients-treated-to-target-with-a-tocilizumab-or-methotrexate-based-strategy
#7
Xavier M Teitsma, Johannes W G Jacobs, Paco M J Welsing, Attila Pethö-Schramm, Michelle E A Borm, Lidy Hendriks, Natasja H A M Denissen, Jacob M van Laar, Floris P J G Lafeber, Johannes W J Bijlsma
Objective: To evaluate the effect of initiation of tocilizumab, with or without MTX, compared with MTX alone on patient-reported outcomes (PROs), in DMARD-naïve patients with early RA. Methods: In U-Act-Early, patients initiated treat-to-target step-up MTX, tocilizumab or tocilizumab plus MTX therapy. PROs assessed included the Functional Assessment of Chronic Illness Therapy-Fatigue, 36-item Short Form (SF-36), five dimensional EuroQol (EQ-5D) and the Revised Illness Perception Questionnaire...
September 23, 2017: Rheumatology
https://www.readbyqxmd.com/read/29029101/growth-outcomes-after-gh-therapy-of-patients-given-long-term-corticosteroids-for-juvenile-idiopathic-arthritis
#8
Hélène David, Camille Aupiais, Baptiste Louveau, Pierre Quartier, Evelyne Jacqz-Aigrain, Jean-Claude Carel, Dominique Simon
Context: GH therapy may improve statural growth outcomes in patients with severe juvenile idiopathic arthritis (JIA). Objectives: To evaluate the effect of GH treatment on adult height and to identify determinants of growth outcomes in JIA. Design and patients: Data from 58 JIA patients, including 53 given GH, enrolled in three prospective clinical trials between 1997 and 2002 were analyzed. Intervention: GH [0.056 mg/kg/d (IQR, 0...
October 5, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29028829/sodium-excretion-is-higher-in-patients-with-rheumatoid-arthritis-than-in-matched-controls
#9
Sarah Marouen, Guilhem du Cailar, Rachel Audo, Cedric Lukas, Gaelle Vial, Anne Tournadre, Emmanuel Barrat, Jean Ribstein, Bernard Combe, Jacques Morel, Claire I Daien
OBJECTIVE: It was shown that sodium can promote auto-immunity through the activation of the Th17 pathway. We aimed to compare sodium intake in patients with rheumatoid arthritis (RA) vs. matched controls. METHODS: This case-control study included 24 patients with RA at diagnosis and 24 controls matched by age, gender and body mass index. Sodium intake was evaluated by 24-hr urinary sodium excretion. RESULTS: Sodium excretion was greater for patients with early RA (2,849±1,350 vs...
2017: PloS One
https://www.readbyqxmd.com/read/29026341/benefits-of-different-postoperative-treatments-in-patients-undergoing-knee-arthroscopic-debridement
#10
Cesáreo Trueba Vasavilbaso, Carlos David Rosas Bello, Erla Medina López, Maria Pilar Coronel Granado, José Mario Navarrete Álvarez, Cesáreo Angel Trueba Davalillo, Félix Isaac Gil Orbezo
PURPOSE: To assess the effectiveness of viscosupplementation or platelet-rich plasma (PRP), compared to standard care, for pain relief after knee arthroscopic debridement in patients with meniscal pathology and osteoarthritis (OA), under normal clinical practice conditions. PATIENTS AND METHODS: We conducted a prospective, randomized, evaluator-blind, pilot study. After arthroscopy, patients were randomized to receive 1) five injections of HA1 (Suprahyal(®)/Adant(®)); 2) four injections of HA2 (Orthovisc(®)); 3) three injections of HA3 (Synvisc(®)); 4) a single injection of PRP (GPS™ II); or 5) standard care (control)...
2017: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/29024575/genetics-and-the-classification-of-arthritis-in-adults-and-children
#11
REVIEW
Peter A Nigrovic, Soumya Raychaudhuri, Susan D Thompson
Current classification of primary inflammatory arthritis begins from the assumption that adults and children are different. No form of juvenile idiopathic arthritis bears the same name as an adult arthritis, a nomenclature gap with implications for both clinical care and research. Recent genetic data question this adult/pediatric divide, revealing instead broad patterns that span the age spectrum. Combining these genetic patterns with demographic and clinical data, we propose that inflammatory arthritis segregates into four main clusters, largely irrespective of pediatric or adult onset: seropositive, seronegative (likely including a distinct group that usually begins in early childhood), spondyloarthritis and systemic...
October 12, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29022136/aortic-carotid-intima-media-thickness-and-flow-mediated-dilation-as-markers-of-early-atherosclerosis-in-a-cohort-of-pediatric-patients-with-rheumatic-diseases
#12
Emanuela Del Giudice, Anna Dilillo, Luciana Tromba, Giuseppe La Torre, Sara Blasi, Fabrizio Conti, Franca Viola, Salvatore Cucchiara, Marzia Duse
The aims of this study were to identify the presence of endothelial dysfunction as a marker of early atherosclerosis by measuring aortic and carotid intimal-medial thickness (aIMT and cIMT) and flow-mediated dilation (FMD) and their correlation with traditional and no traditional risk factors for atherosclerosis in children with rheumatic diseases. Thirty-nine patients (mean age 15.3 ± 5.7 years), 23 juvenile idiopathic arthritis, 9 juvenile spondyloarthropathies, 7 connective tissue diseases (mean disease duration and onset respectively 5 ± 3...
October 12, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/29022134/the-impact-of-smoking-on-disease-activity-disability-and-radiographic-damage-in-rheumatoid-arthritis-is-cigarette-protective
#13
Mario Andrés Quintana-Duque, Federico Rondon-Herrera, Enrique Calvo-Paramo, Juan Jose Yunis, Adriana Varela-Nariño, Antonio Iglesias-Gamarra
The ojective of this study is to assess the effect of tobacco smoking on disease activity, functional ability, and joint damage in a cohort of patients with early onset rheumatoid arthritis (EORA). 129 EORA patients attending the Rheumatology Unit of the School of Medicine of the "Universidad Nacional de Colombia" and the "Clínica de Artritis y Rehabilitación" in Bogota, Colombia, were enrolled in a prospective observational cohort study with 3-year follow-up. Clinical, biological, immunogenetics, and radiographic data were analyzed...
October 11, 2017: Rheumatology International
https://www.readbyqxmd.com/read/29020148/childhood-residential-and-agricultural-pesticide-exposures-in-relation-to-adult-onset-rheumatoid-arthritis-in-women
#14
Christine G Parks, Aimee A D'Aloisio, Dale P Sandler
Farming and pesticide exposure may influence risk of rheumatoid arthritis (RA), but the role of early life pesticide exposures is not known. In the Sister Study, a national cohort of women ages 35-74 (enrolled 2004-2009), we examined childhood pesticide exposures in adult-onset RA. Cases (n = 424), reported at enrollment and confirmed by disease modifying anti-rheumatic drugs or steroid use for RA and ≥6 weeks bilateral joint swelling, were compared to 48,919 non-cases. Data included pesticide use at the longest childhood residence through age 14, farm residence of ≥12 months with agricultural pesticide exposures through age 18, and maternal farm experience...
August 23, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29019640/spine-conditions-mechanical-and-inflammatory-low-back-pain
#15
Christopher Ledford
Mechanical low back pain (LBP) is an injury or derangement of an anatomic structure in the low back. When evaluating patients with LBP, clinicians should maintain clinical suspicion for vertebral fracture, cancer, and cauda equina syndrome. Management includes patient education focused on exercise, massage, and behavioral approaches such as cognitive behavioral therapy. Acupuncture can be an effective alternative and specific herbal supplements may provide short-term pain relief. The prognosis for patients with mechanical LBP is good...
October 2017: FP Essentials
https://www.readbyqxmd.com/read/29019639/spine-conditions-cervical-spine-conditions
#16
Marc A Childress
There are a variety of causes of neck pain, including trauma and degenerative changes. The history of onset helps to direct evaluation, including the need for imaging or ancillary testing. Patterns of pain, weakness, and other specific physical examination findings also aid in diagnosis. Management of most soft tissue injuries involves early mobilization, whereas fractures are managed based on patterns of instability. Acute spinal cord injury requires emergent care, to include possible decompressive surgery...
October 2017: FP Essentials
https://www.readbyqxmd.com/read/29018564/achieving-comprehensive-disease-control-in-patients-with-early-and-established-rheumatoid-arthritis-treated-with-adalimumab-plus-methotrexate-versus-methotrexate-alone
#17
Edward C Keystone, Ferdinand C Breedveld, Désirée van der Heijde, Ronald F van Vollenhoven, Paul Emery, Josef S Smolen, Iain Sainsbury, Stefan Florentinus, Hartmut Kupper, Kun Chen, Arthur Kavanaugh
OBJECTIVE: To evaluate the achievement of comprehensive disease control (CDC) following 1 year of treatment with adalimumab+methotrexate versus methotrexate alone and whether early achievement of remission (at week 24 or 26) is associated with CDC at week 52 in patients with either early or established rheumatoid arthritis (RA). METHODS: Post hoc analyses were conducted in three clinical studies assessing treatment with adalimumab+methotrexate: DE019 (NCT00195702) enrolled patients with established RA who were methotrexate inadequate responders; OPTIMA (NCT00420927) and PREMIER (NCT00195663) enrolled methotrexate-naive patients with early RA...
2017: RMD Open
https://www.readbyqxmd.com/read/29017507/polyunsaturated-fatty-acids-any-role-in-rheumatoid-arthritis
#18
REVIEW
Luca Navarini, Antonella Afeltra, Gabriele Gallo Afflitto, Domenico Paolo Emanuele Margiotta
BACKGROUND: Polyunsaturated fatty acids (PUFAs) are members of the family of fatty acids and are included in the diet. Particularly, western diet is usually low in n-3 PUFAs and high in n-6 PUFAs. PUFAs play a central role in the homeostasis of immune system: n-6 PUFAs have predominantly pro-inflammatory features, while n-3 PUFAs seem to exert anti-inflammatory and pro-resolving properties. Rheumatoid arthritis (RA) is a chronic inflammatory arthritis in which many inflammatory pathways contribute to joint and systemic inflammation, disease activity, and structural damage...
October 10, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28992800/antimalarial-induced-cardiomyopathy-a-systematic-review-of-the-literature
#19
K Tselios, M Deeb, D D Gladman, P Harvey, M B Urowitz
Background Antimalarials (AMs) are widely used in the treatment of connective tissue diseases. Their main side effect is retinal damage, while heart disease has been described in isolated cases. The aim of this study is to systematically review the existing literature on AM-induced cardiomyopathy (AMIC). Methods The PubMed database was searched for heart biopsy-confirmed AMIC cases. Information on demographics, clinical presentation, concomitant AM-related toxicity, cardiological investigations, treatment and outcome were collected...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28990250/galectin-3-is-persistently-increased-in-early-rheumatoid-arthritis-ra-and-associates-with-anti-ccp-seropositivity-and-mri-bony-lesions-while-early-fibrosis-markers-correlate-with-disease-activity
#20
Saida Farah Issa, Anne Friesgaard Christensen, Hanne M Lindegaard, Merete L Hetland, Kim Hørslev-Petersen, Kristian Stengaard-Pedersen, Bo Jannik Ejbjerg, Tine Lottenburger, Torkell Ellingsen, Jens Kristian Pedersen, Kirsten Junker, Anders Svendsen, Ulrik Tarp, Mikkel Østergaard, Peter Junker
Galectin-3 has been suggested as a pro-inflammatory mediator in animal arthritis and rheumatoid arthritis (RA). We aimed to study the serum level of galectin-3 in patients with newly diagnosed RA and associations with disease profile, Magnetic Resonance Imaging (MRI) findings and seromarkers of synovial matrix inflammation. One hundred and sixty DMARD naïve patients newly diagnosed with RA were included (CIMESTRA study). Clinical, serological and imaging data were recorded before treatment and at 6 weeks, 3 and 12 months...
October 9, 2017: Scandinavian Journal of Immunology
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