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https://www.readbyqxmd.com/read/28535545/portuguese-recommendations-for-the-use-of-methotrexate-in-rheumatic-diseases-2016-update
#1
Ana Catarina Duarte, Daniela Santos-Faria, Maria João Gonçalves, Alexandre Sepriano, Ana Filipa Mourão, Cátia Duarte, Joana Sousa Neves, Ana Filipa Águeda, Pedro Ávila Ribeiro, Alexandra Daniel, Adriano Neto, Ana Cordeiro, Ana Rodrigues, Anabela Barcelos, Cândida Silva, Cristina Ponte, Elsa Vieira-Sousa, Filipa Teixeira, Filipa Oliveira-Ramos, Filipe Araújo, Filipe Barcelos, Helena Canhão, Helena Santos, João Ramos, Joaquim Pereira, José Costa, José António Melo Gomes, Luís Cunha-Miranda, Lúcia Costa, Marcos Cerqueira, Margarida Cruz, Maria José Santos, Miguel Bernardes, Paula Oliveira, Pedro Abreu, Ricardo Figueira, Rita Barros, Sandra Falcão, Patrícia Pinto, Sofia Pimenta, Susana Capela, Vitor Teixeira, João Eurico Fonseca
BACKGROUND: Methotrexate (MTX) is the first-line drug in the treatment of rheumatoid arthritis (RA) and the most commonly prescribed disease modifying anti-rheumatic drug. Moreover, it is also used as an adjuvant drug in patients under biologic therapies, enhancing the efficacy of biologic agents. OBJECTIVES: To review the literature and update the Portuguese recommendations for the use of MTX in rheumatic diseases first published in 2009. METHODS: The first Portuguese guidelines for the use of MTX in rheumatic diseases were published in 2009 and were integrated in the multinational 3E Initiative (Evidence Expertise Exchange) project...
May 9, 2017: Acta Reumatológica Portuguesa
https://www.readbyqxmd.com/read/28529116/italian-consensus-guidelines-for-the-management-of-hepatitis-b-virus-infections-in-patients-with-rheumatoid-arthritis
#2
Marco Sebastiani, Fabiola Atzeni, Laura Milazzo, Luca Quartuccio, Carlo Scirè, Giovanni Battista Gaeta, Giovanni Lapadula, Orlando Armignacco, Marcello Tavio, Ignazio Olivieri, Pierluigi Meroni, Laura Bazzichi, Walter Grassi, Alessandro Mathieu, Claudio Mastroianni, Evangelista Sagnelli, Teresa Santantonio, Caterina Uberti Foppa, Massimo Puoti, Loredana Sarmati, Paolo Airò, Oscar Massimiliano Epis, Rossana Scrivo, Miriam Gargiulo, Agostino Riva, Andreina Manfredi, Giovanni Ciancio, Gianguglielmo Zehender, Gloria Taliani, Luca Meroni, Salvatore Sollima, Piercarlo Sarzi-Puttini, Massimo Galli
OBJECTIVES: Hepatitis B (HBV) infection, which is prevalent worldwide, is also frequently seen in patients with rheumatoid arthritis (RA). The Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) endorsed a national consensus process to review the available evidence on HBV management in RA patients and to produce practical, hospital-wide recommendations. METHODS: The consensus panel consisted of infectious disease consultants, rheumatologists and epidemiologists and used the criteria of the Oxford Centre for Evidence-based Medicine to assess the quality of the evidence and the strength of their recommendations...
May 18, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28473089/acr-appropriateness-criteria-%C3%A2-suspected-osteomyelitis-septic-arthritis-or-soft-tissue-infection-excluding-spine-and-diabetic-foot
#3
Francesca D Beaman, Paul F von Herrmann, Mark J Kransdorf, Ronald S Adler, Behrang Amini, Marc Appel, Erin Arnold, Stephanie A Bernard, Bennett S Greenspan, Kenneth S Lee, Michael J Tuite, Eric A Walker, Robert J Ward, Daniel E Wessell, Barbara N Weissman
Infection of the musculoskeletal system is a common clinical problem. Differentiating soft tissue from osseous infection often determines the appropriate clinical therapeutic course. Radiographs are the recommend initial imaging examination, and although often not diagnostic in acute osteomyelitis, can provide anatomic evaluation and alternative diagnoses influencing subsequent imaging selection and interpretation. MRI with contrast is the examination of choice for the evaluation of suspected osteomyelitis, and MRI, CT, and ultrasound can all be useful in the diagnosis of soft tissue infection...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28419275/clinical-care-guideline-for-improving-pediatric-acute-musculoskeletal-infection-outcomes
#4
Murray D Spruiell, Justin Benjamin Searns, Travis C Heare, Jesse L Roberts, Erin Wylie, Laura Pyle, Nathan Donaldson, Jaime R Stewart, Heather Heizer, Jennifer Reese, Halden F Scott, Kelly Pearce, Colin J Anderson, Mark Erickson, Sarah K Parker
Background.: Acute pediatric musculoskeletal infections are common, leading to significant use of resources and antimicrobial exposure. In order to decrease variability and improve the quality of care, Children's Hospital Colorado implemented a clinical care guideline (CCG) for these infections. The purpose of this study is to evaluate clinical and resource outcomes PRE and POST this CCG. Methods.: Retrospective chart review evaluated patients admitted to a large pediatric quaternary referral center (CHCO) diagnosed with acute osteomyelitis, septic arthritis, pyomyositis, and/or musculoskeletal abscess prior to and after guideline implementation...
April 17, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28410044/tackling-comorbidity-associated-with-rheumatic-diseases-in-standard-practice
#5
Deborah Palmer, Yasser El Miedany
In spite of the dramatic improvement of the long-term prognosis of inflammatory arthritic conditions, patients living with arthritis remain more likely to have a shorter lifespan in contrast to the age-matched population without arthritis. This high incidence of morbidity-mortality has been attributed to an increased prevalence of comorbidities, particularly cardiovascular disease, infections, and the development of malignant space-occupying lesions. In spite of the published guidelines highlighting the importance of comorbidity assessment and management, implementing these recommendations in standard clinical practice remains a challenge for the treating rheumatologists and rheumatology nurse specialists...
April 13, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28318613/latent-tuberculosis-infection-screening-prior-to-biological-treatment-in-tunisian-patients
#6
Marwa Slouma, Ines Mahmoud, Olfa Saidane, Selma Bouden, Leila Abdelmoula
OBJECTIVES: The screening of latent tuberculosis infection (LTBI) is necessary to prevent infection in patients with chronic inflammatory disease (CID) undergoing biological treatment. We aimed to assess the efficacy of LTBI screening prior to biological treatment in Tunisia, considered as a high-incidence area of active TB disease. METHODS: We conducted a retrospective study over a period of 8 years [2007-2014] including patients with chronic inflammatory rheumatism receiving biologic agents since at least 6 months...
February 24, 2017: Thérapie
https://www.readbyqxmd.com/read/28262590/the-implications-of-biologic-therapy-for-elective-foot-and-ankle-surgery-in-patients-with-rheumatoid-arthritis
#7
REVIEW
Ross Diaper, Ernest Wong, Stuart A Metcalfe
INTRODUCTION: Rheumatoid arthritis (RA) is one of a number of inflammatory arthropathies resulting in foot pain and deformity. Patients with this disease may require surgical intervention as part of their management. Many of these patients are now taking biologic agents which pose several risks to patients in the perioperative phase. The surgical team therefore need to be aware of these associated complications and how to manage these cases. AIM: This paper aims to review the current literature about perioperative needs (foot and ankle surgery) associated with patients with rheumatoid arthritis receiving biologic therapy...
March 2017: Foot
https://www.readbyqxmd.com/read/28255643/use-of-etanercept-to-treat-rheumatoid-arthritis-in-an-hiv-positive-patient-a-case-based-review
#8
REVIEW
Shen-Ju Liang, Quan-You Zheng, Yan-Long Yang, Yi Yang, Chong-Yang Liu
Rheumatoid arthritis (RA) is a relatively common autoimmune disease that is associated with progressive disability and systemic complications, with a relatively high socioeconomic burden. The treatment of RA has been revolutionized by the use of biological drugs, such as anti-tumor necrosis factor (TNF) agents. A wide spectrum of RA disease severity has been reported among patients with human immunodeficiency virus (HIV) infection. Yet, only a few cases using anti-TNF therapy have been described in this clinical population...
March 2, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28187026/an-algorithmic-approach-to-the-suspected-septic-wrist
#9
Jeffrey R Claiborne, Leslie G Branch, Michael Reynolds, Anthony J Defranzo
An acutely painful, erythematous wrist can be due to a variety of pathologic processes, including crystalline arthropathy, infection, trauma, osteoarthritis, and systemic disease. The broad differential diagnosis of the inflamed wrist and nonspecific clinical findings make accurate diagnosis challenging. There is no published clinical or laboratory criterion that reliably differentiates septic wrist arthritis from a sterile inflammatory arthropathy. For septic joint patients, long-term results are notably poorer in patients with a delay in treatment, therefore establishing evidenced-based guidelines deserves attention...
June 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28137898/mycobacterium-chelonae-hand-infection-after-steroid-injection-in-a-patient-with-rheumatoid-arthritis-receiving-long-term-linezolid-therapy
#10
Jens Steen Olesen, Mikala Wang, Christian Wejse
A 66-year-old multimorbid man with rheumatoid arthritis developed an infection after a steroid injection in the hand. Mycobacterium chelonae was cultured 1-month after presentation. In the mean time, his third finger had been amputated. Further treatment was based on preliminary susceptibility testing and the American Thoracic Society guidelines. No regression of the infection was observed before the addition of linezolid (600 mg×1/day) to a combination antimicrobial therapy also consisting of clarithromycin (500 mg×2/day) and moxifloxacin (400 mg×1/day), even though two methods of susceptibility testing, the E-test and broth microdilution, had shown susceptibility to other antimicrobial drugs...
January 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28123778/factors-influencing-the-use-of-tocilizumab-as-monotherapy-in-patients-with-rheumatoid-arthritis-in-a-real-life-setting-results-at-1%C3%A2-year-of-the-act-solo-study
#11
René-Marc Flipo, Jean-Francis Maillefert, Pascal Chazerain, Isabelle Idier, Mathieu Coudert, Jacques Tebib
INTRODUCTION: Using a biologic disease-modifying antirheumatic drug (bDMARD) as monotherapy in clinical practice for patients with rheumatoid arthritis (RA) is common and recognised by health authorities although current guidelines recommend to combine them with conventional synthetic (cs)DMARDs. This study mainly aimed to search for real-life factors influencing the use of tocilizumab as MONO or in combination (COMBO). METHODS: In this non-interventional, prospective, national, multicentre study, data were collected every 3 months over a 12-month period in RA patients starting tocilizumab...
2017: RMD Open
https://www.readbyqxmd.com/read/28101910/a-practical-approach-to-vaccination-of-patients-with-autoimmune-inflammatory-rheumatic-diseases-in-australia
#12
REVIEW
Peter Kk Wong, Hanish Bagga, Claire Barrett, Paddy Hanrahan, Doug Johnson, Amel Katrib, Karin Leder, Mona Marabani, Peta Pentony, John Riordan, Ray White, Laurel Young
Autoimmune inflammatory rheumatic diseases (AIIRD) such as rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) are often complicated by infection, which results in significant morbidity and mortality. The increased risk of infection is probably due to a combination of immunosuppressive effects of the AIIRD, comorbidities, and the use of immunosuppressive conventional synthetic disease modifying anti-rheumatic drugs (DMARDS) and more recently, targeted synthetic DMARDS and biologic DMARDS which block specific pro-inflammatory enzymes, cytokines or cell types...
January 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28042124/improvement-in-herpes-zoster-vaccination-in-patients-with-rheumatoid-arthritis-a-quality-improvement-project
#13
Heena Sheth, Larry Moreland, Hilary Peterson, Rohit Aggarwal
OBJECTIVE: To improve herpes zoster (HZ) vaccination rates in high-risk patients with rheumatoid arthritis (RA) being treated with immunosuppressive therapy. METHODS: This quality improvement project was based on the pre- and post-intervention design. The project targeted all patients with RA over the age of 60 years while being treated with immunosuppressive therapy (not with biologics) seen in 13 rheumatology outpatient clinics. The study period was from July 2012 to June 2013 for the pre-intervention and February 2014 to January 2015 for the post-intervention phase...
January 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28040397/should-preoperative-antibiotics-be-tailored-according-to-patient-s-comorbidities-and-susceptibility-to-organisms
#14
Timothy L Tan, Miguel M Gomez, Michael M Kheir, Mitchell G Maltenfort, Antonia F Chen
BACKGROUND: Preoperative antibiotic prophylaxis remains one of the most important strategies for preventing periprosthetic joint infection (PJI). Current guidelines recommend giving universal antibiotic prophylaxis to all total joint arthroplasty patients regardless of their medical conditions or immune status; however, no studies have evaluated the individualizing of antibiotics. The aims of this study were (1) to determine if comorbidities influence the organism profile of PJIs, and (2) to investigate if the efficacy of two different perioperative antibiotics (cefazolin or vancomycin) for preventing PJI is affected by patient's comorbidities...
November 23, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28013198/effect-of-tocilizumab-on-neutrophils-in-adult-patients-with-rheumatoid-arthritis-pooled-analysis-of-data-from-phase-3-and-4-clinical-trials
#15
Robert J Moots, Anthony Sebba, William Rigby, Andrew Ostor, Benjamin Porter-Brown, Francis Donaldson, Sophie Dimonaco, Andrea Rubbert-Roth, Ronald van Vollenhoven, Mark C Genovese
Objectives.: To investigate changes in neutrophil count and occurrences of infection in RA patients treated with the IL-6 receptor-α inhibitor tocilizumab (TCZ). Methods.: Data were pooled from patients who received i.v. TCZ (4 mg/kg + MTX, 8 mg/kg ± DMARDs, 10 mg/kg) or placebo + DMARDs in phase 3/4 clinical trials, long-term extensions or a pharmacology study. Neutrophil counts were measured routinely according to the Common Toxicity Criteria for Adverse Events grades; TCZ dosing was adjusted if necessary...
April 1, 2017: Rheumatology
https://www.readbyqxmd.com/read/27986496/medical-diagnostics-for-indoor-mold-exposure
#16
REVIEW
Julia Hurraß, Birger Heinzow, Ute Aurbach, Karl-Christian Bergmann, Albrecht Bufe, Walter Buzina, Oliver A Cornely, Steffen Engelhart, Guido Fischer, Thomas Gabrio, Werner Heinz, Caroline E W Herr, Jörg Kleine-Tebbe, Ludger Klimek, Martin Köberle, Herbert Lichtnecker, Thomas Lob-Corzilius, Rolf Merget, Norbert Mülleneisen, Dennis Nowak, Uta Rabe, Monika Raulf, Hans Peter Seidl, Jens-Oliver Steiß, Regine Szewszyk, Peter Thomas, Kerttu Valtanen, Gerhard A Wiesmüller
In April 2016, the German Society of Hygiene, Environmental Medicine and Preventative Medicine (Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin (GHUP)) together with other scientific medical societies, German and Austrian medical societies, physician unions and experts has provided an AWMF (Association of the Scientific Medical Societies) guideline 'Medical diagnostics for indoor mold exposure'. This guideline shall help physicians to advise and treat patients exposed indoors to mold. Indoor mold growth is a potential health risk, even without a quantitative and/or causal association between the occurrence of individual mold species and health effects...
December 5, 2016: International Journal of Hygiene and Environmental Health
https://www.readbyqxmd.com/read/27803223/international-consensus-on-the-definition-and-classification-of-fibrosis-of-the-knee-joint
#17
N S Kalson, L A Borthwick, D A Mann, D J Deehan, P Lewis, C Mann, M A Mont, R Morgan-Jones, S Oussedik, F M K Williams, A Toms, J N Argenson, J Bellemans, A Bhave, O Furnes, H Gollwitzer, F S Haddad, S Hofmann, V Krenn
AIMS: The aim of this consensus was to develop a definition of post-operative fibrosis of the knee. PATIENTS AND METHODS: An international panel of experts took part in a formal consensus process composed of a discussion phase and three Delphi rounds. RESULTS: Post-operative fibrosis of the knee was defined as a limited range of movement (ROM) in flexion and/or extension, that is not attributable to an osseous or prosthetic block to movement from malaligned, malpositioned or incorrectly sized components, metal hardware, ligament reconstruction, infection (septic arthritis), pain, chronic regional pain syndrome (CRPS) or other specific causes, but due to soft-tissue fibrosis that was not present pre-operatively...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27745829/-treatment-and-progression-of-acute-communautary-osteoarticular-infections-in-healthy-children-a-retrospective-monocentric-study-of-64%C3%A2-patients
#18
A Lemoine, F Baudin, R Vialle, E Grimprel
INTRODUCTION: The prognosis of osteoarticular infections has improved over the past 20 years but it still remains potentially severe. The treatment of these infections has been simplified and shortened. In 2008, the Pediatric Infectious Disease Group (GPIP) established new therapeutic guidelines in order to standardize treatment in France. The aim of this study is to analyze practices in a Parisian hospital and assess the efficacy of this treatment in short and medium terms. MATERIALS AND METHODS: This retrospective study focused on patients older than 3 months, without comorbidities, who were hospitalized for an acute osteoarticular infection in 2012 at Trousseau Hospital (Paris), with a follow-up of at least 4 weeks...
November 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27520996/post-streptococcal-reactive-arthritis-where-are-we-now
#19
Himanshu Pathak, Tarnya Marshall
A 35-year-old man presented with polyarthritis and constitutional symptoms, and a recent history of multiple tick bites and skin rash on trekking holiday. He did not respond to oral doxycycline and cephalexine for presumed Lyme's disease. Further investigation confirmed strongly positive streptococcal serology. There was absence of clinical or echocardiography evidence of heart involvement and immunological screening for inflammatory arthritis was negative. In the absence of other major Jones criteria for acute rheumatic fever, besides polyarthritis and the serological evidence of a recent streptococcal infection, a diagnosis of post-streptococcal reactive arthritis (PSRA) was also made...
August 12, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27348896/-lyme-disease-clinical-manifestations-and-treatment
#20
Ingo Stock
Lyme disease (Lyme borreliosis) is a systemic infectious disease that can present in a variety of clinical manifestations. The disease is caused by a group of spirochaetes--Borrelia burgdorferi sensu lato or Lyme borrelia--that are transmitted to humans by the bite of Ixodes ticks. Lyme disease is the most common arthropode-borne infectious disease in many European countries including Germany. Early localized infection is typically manifested by an erythema migrans skin lesion, in rarer cases as a borrelial lymphocytoma...
May 2016: Medizinische Monatsschrift Für Pharmazeuten
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