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Shu-Yi Lin, Zheng-Hao Huang, Hsiang-Cheng Chen, Deh-Ming Chang, Chun-Chi Lu
INTRODUCTION: Multidrug-resistant Acinetobacter baumannii (MDRAB) pneumonia with severe sepsis in a patient with rheumatoid arthritis (RA), who is predisposed after treatment with tumor necrosis factor inhibitor (TNFI), is a rare severe infection and can be successfully treated with prompt antibiotics. CASE PRESENTATION: A 75-year-old woman was diagnosed with RA >30 years previously. After inadequate treatment responses to conventional disease-modifying antirheumatic drugs (DMARDs), she developed progressive RA, including swollen joints in both hands, and had a high disease activity score of 4...
August 2018: Medicine (Baltimore)
Ryan A Shields, Robert A Kleinman, Stephen J Smith, Steven R Sanislo, Quan Dong Nguyen
Purpose: To report a fatal case of Susac syndrome in a 24-year-old female. Observations: A 24-year-old female presented with progressive encephalopathy of unknown etiology. Her previous evaluation consisted of laboratory testing, imaging, and a brain biopsy to investigate for infectious and rheumatologic diseases. Several months after onset of symptoms, she underwent ophthalmic examination, which demonstrated bilateral branch retinal artery occlusions. Further review of her medical record revealed a recent history of hearing loss...
December 2018: American Journal of Ophthalmology Case Reports
Nikhil Gupta, Anuj K Bhatnagar
Background: Data of musculoskeletal manifestations of tuberculosis (TB) are limited to case reports, series, or retrospective studies. Therefore, we conducted this study to create awareness among doctors about musculoskeletal manifestations of TB. Materials and Methods: This was a prospective observational study conducted at a referral TB Hospital in North India in September and October 2016. The aim of our study was to study musculoskeletal manifestations of TB...
May 2018: Journal of Family Medicine and Primary Care
P S Joshi
Multiple rice body formation is a rare presentation of chronic sub-acromial bursitis secondary to extensive underlying rheumatoid arthritis, sero-negative inflammatory arthritis or tuberculous joints. Although there is usually an accompanying inflammatory arthropathy, it can occur in the absence of any underlying systemic disorder. We report a case of five years old neglected rice body deposition in shoulder in a 54-years old lady diagnosed to be having rheumatoid arthritis. After initial investigations, arthroscopic removal of rice bodies with bursa excision relieved the symptoms...
July 2018: Malaysian Orthopaedic Journal
Yair Levi, Lilach Israeli-Shani, Michael Kuchuk, Gali Epstein Shochet, Matthew Koslow, David Shitrit
OBJECTIVE: Interstitial lung diseases (ILD) form a diverse group of parenchymal lung disorders. Currently, a multidisciplinary team (MDT) including pulmonologists, radiologists, and pathologists is the gold standard for ILD diagnosis. Recently, additional subtypes of connective tissue disease (CTD)-ILD with autoimmune features were defined, making the rheumatological assessment increasingly important. We aimed to assess the effect of adding a rheumatologist to the MDT for routine rheumatology assessment...
August 15, 2018: Journal of Rheumatology
Roy M Fleischmann, Rieke Alten, Margarita Pileckyte, Kasia Lobello, Steven Y Hua, Carol Cronenberger, Daniel Alvarez, Amy E Bock, K Lea Sewell
BACKGROUND: This double-blind, randomized, 78-week study evaluated the efficacy, safety, immunogenicity, pharmacokinetics, and pharmacodynamics of PF-06410293, a candidate adalimumab biosimilar, versus adalimumab reference product (Humira® ) sourced from the EU (adalimumab-EU) in biologic-naïve patients with active rheumatoid arthritis (RA) despite methotrexate (MTX) (10-25 mg/week). We report results for the first 26 weeks of treatment. METHODS: Patients with active RA (N = 597) were randomly assigned (1:1) to PF-06410293 or adalimumab-EU, while continuing with MTX treatment...
August 15, 2018: Arthritis Research & Therapy
Nida Saleem, Tahir Aziz Ahmed, Mukarram Bashir, Muhammad Omair Riaz, Ali Hamid
OBJECTIVE: To compare the frequency and the functional state of the collagen II reactive T cells with disease activity in rheumatoid arthritis patients and healthy controls. METHODS: This case-control cross-sectional study was carried out at the Department of Immunology; Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from June to October 2014. Rheumatologist from Rehmat Noor Rheumatology Clinic, a private health facility of the city, was requested to send in patients with clinical diagnosis of rheumatoid arthritis...
August 2018: JPMA. the Journal of the Pakistan Medical Association
Sam Norton, Benjamin Ellis, Beatriz Santana Suárez, Samana Schwank, Ray Fitzpatrick, Andrew Price, James Galloway
Objectives: The Musculoskeletal Health Questionnaire (MSK-HQ) is a recently developed Patient Reported Outcome Measure for use across patients with musculoskeletal conditions. This study provides a validation of the MSK-HQ examining construct validity and reliability in inflammatory arthritis. Methods: 287 adults with inflammatory arthritis completed the MSK-HQ and other Patient Reported Outcome Measures at baseline and after 3 months. Construct validity was assessed using item response theory methods...
August 10, 2018: Rheumatology
Mehret Birru Talabi, Megan E B Clowse, Susan J Blalock, Larry Moreland, Nalyn Siripong, Sonya Borrero
OBJECTIVE: To determine contraception use among a cohort of reproductive-age women (18-50 years) with rheumatic diseases. METHODS: We conducted a study of administrative data from a single, large medical center between years 2013 and 2014. Women who had 1 of 21 rheumatic disease diagnoses and had at least 2 outpatient rheumatology visits were included in this analysis. We used logistic regression analyses to evaluate adjusted associations between the use of prescription contraception, use of potentially fetotoxic medications, and visits with rheumatologists, primary care providers (PCP), and gynecologists...
August 14, 2018: Arthritis Care & Research
GuangMing Tan, Ari J Mintz, Bruce Mintz, Jorge C Borges, Mary Deborah Hines, Robert M Schainfeld, Michael R Jaff, Ido Weinberg
Amphetamine and its related derivatives and analogues (ADRA) are highly addictive central nervous system stimulants that are used commonly in the treatment of attention-deficit/hyperactivity disorder and narcolepsy. These medications are associated with many side effects but reports of peripheral arterial manifestations associated with ADRA usage are scarce. We retrospectively reviewed the records of 16 patients (median age 37 years (IQR 31-47), 13 females) referred to a single tertiary referral service while receiving ADRA...
August 14, 2018: Vascular Medicine
Ayushi Dixit, Yesika Garcia, Lauren Tesoriero, Charles Berman, Vincent Rizzo
Early disseminated Lyme disease typically presents with cardiac, rheumatologic, or neurologic symptoms. Though uncommon, Borrelia burgdorferi can invade the central nervous system and cause neuroborreliosis. In these patients, facial palsy, headache, and stiffness of the neck are the most common presenting symptoms. Our case describes a patient with oculomotor nerve palsy manifesting as double vision as the initial presentation of neuroborreliosis.
2018: Case Reports in Neurological Medicine
Moaaz Soliman, Fatima Neemuchwala, Amanda Sankar, Rama Jasty, Raja Rabah, Antonia P Popova, Erika A Newman
A 14-year-old male patient presented with a nonproductive cough, weight loss, fatigue, and malaise. A chest radiograph showed large bilateral cavitary lung lesions in both upper and lower lobes that failed to improve with antibiotics and anti-inflammatory medications. Infectious and rheumatologic work-ups were negative. Thoracoscopic lung biopsies were diagnostic for nodular lymphocyte predominant Hodgkin lymphoma (NLPHL). The patient received combination chemotherapy and immunotherapy based on current treatment standards with an excellent clinical response...
August 10, 2018: Journal of Pediatric Hematology/oncology
Ertan Yılmaz, Lut Tamam
Objective: Data which indicate a greater role of the central nervous system in the etiology of fibromyalgia are increasing. The goal of the present study is to determine the link between fibromyalgia and attention-deficit hyperactivity disorder (ADHD) and, in addition, to reveal the relevance of impulsivity dimension. Methods: The study included 78 females with fibromyalgia who applied to a physical medicine and rehabilitation polyclinic in Ceyhan State Hospital and 54 healthy females...
2018: Neuropsychiatric Disease and Treatment
Clara Kwan, Linett Martirossian, Joshua Scheers-Masters, Gerald Hollander
Ankylosing spondylitis (AS) is a rheumatological disorder of the spine, and like many other rheumatological diseases, it can manifest as a systemic inflammation. We present a rare case of cardiac manifestations of AS in a 25-year-old man with recurrent chest pain and pericardial effusions. He initially presented with pleuritic chest pain, was diagnosed with cardiac tamponade and required emergent pericardiocentesis. The patient returned again with chest pain and was found to have reaccumulation of pericardial effusion...
August 11, 2018: BMJ Case Reports
Eldad Ben-Chetrit, Marco Gattorno, Ahmet Gul, Daniel L Kastner, Helen J Lachmann, Isabelle Touitou, Nicolino Ruperto
Autoinflammatory diseases (AIDs) are a relatively new family of disorders, defined about 19 years ago. Some of them are hereditary and some are not. The names given to these diseases do not follow any systematic guidelines, and sometimes the same disorder carries several names. The aim of this study is to refine the definition of AIDs and to provide some conventions for their naming. We focused mainly on monogenetic AIDs. Delphi technique, which enables consensus among a group of experts through internet and mail communication and questionnaires, was employed...
August 12, 2018: Annals of the Rheumatic Diseases
Byoungjin Park, Yong-Jae Lee
BACKGROUND: Metabolic syndrome (MetS) is clinically important because of its association with increased risk of sudden cardiac death, as well as cardiovascular disease-related mortality. Data between MetS and prolonged corrected QT (QTc) intervals, a useful predictor of sudden cardiac death, are limited in apparently healthy adults. OBJECTIVE: This study determined the association between MetS and QTc interval in apparently healthy Korean men and women. METHODS: We examined the association between MetS and QTc interval in 2157 Korean adults (1317 men and 840 women) in a health examination program but excluded participants with a history of ischemic heart disease, stroke, cardiac arrhythmia, cancer, thyroid, respiratory, renal, hepatobiliary, or rheumatologic disease...
July 20, 2018: Journal of Clinical Lipidology
Zara Izadi, Patricia P Katz, Gabriela Schmajuk, Julie Gandrup, Jing Li, Milena Gianfrancesco, Jinoos Yazdany
OBJECTIVE: Most studies evaluating patient-reported outcomes such as the PROMIS Physical Function Short Form 10a (PF10a) in rheumatoid arthritis (RA) have been performed in Caucasian and English-speaking populations. We assessed the measurement properties of the PF10a in a racially/ethnically diverse population with RA. We determined the effect of non-English language proficiency, insurance status and race/ethnicity, on the validity and responsiveness of the PF10a. METHODS: Data were abstracted from electronic health records for all RA patients seen in a university-based rheumatology clinic between 2013 and 2017...
August 12, 2018: Arthritis Care & Research
Qian Wang, Ya-Ming Li, Yuan Li, Feng-Chun Hua, Quan-Shi Wang, Xiao-Li Zhang, Chao Cheng, Hua Wu, Zhi-Ming Yao, Wei-Fang Zhang, Qing-Yi Hou, Wei-Bing Miao, Xue-Mei Wang
PURPOSE: To evaluate the clinical value of 18 F-FDG-PET/CT for the diagnosis of fever of unknown origin (FUO) and inflammation of unknown origin (IUO) in Chinese population, as well as the characteristics of PET/CT in different category of etiological disease. METHODS: A total of 376 consecutive patients with FUO/IUO who underwent FDG-PET/CT at 12 hospitals were retrospectively studied. FDG uptake was quantitatively and visually evaluated, by using SUVmax and a 4-grade scale respectively...
August 11, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Jesús Tornero Molina, Alejandro Balsa Criado, Francisco Blanco García, Ricardo Blanco Alonso, Sagrario Bustabad, Jaime Calvo Alen, Héctor Corominas, Antonio Fernández Nebro, Jose Andrés Román Ivorra, Raimon Sanmartí
OBJECTIVE: To draft recommendations on interleukin 6 (IL-6) blockade in rheumatoid arthritis (RA), based on best evidence and experience. METHODS: A group of 10 experts on IL-6 blockade in RA was selected. The 2 coordinators formulated 23 questions about IL-6 blockade (indications, efficacy, safety, etc.). A systematic review was conducted to answer the questions. Using this information, inclusion and exclusion criteria were established, as were the search strategies (Medline, EMBASE and the Cochrane Library were searched)...
August 8, 2018: Reumatología Clinica
Thurayya Arayssi, Manale Harfouche, Andrea Darzi, Samar Al Emadi, Khaled A Alnaqbi, Humeira Badsha, Farida Al Balushi, Carole Dib, Bassel Elzorkany, Hussein Halabi, Mohammed Hammoudeh, Wissam Hazer, Basel Masri, Mira Merashli, Mohammed Omair, Nelly Salloum, Imad Uthman, Sumeja Zahirovic, Nelly Ziade, Raveendhara R Bannuru, Timothy McAlindon, Mohamed A Nomier, Jasvinder A Singh, Robin Christensen, Peter Tugwell, Holger Schünemann, Elie A Akl
Clinical practice guidelines can assist rheumatologists in the proper prescription of newer treatment for rheumatoid arthritis (RA). The objective of this paper is to report on the recommendations for the management of patients with RA in the Eastern Mediterranean region. We adapted the 2015 American College of Rheumatology guidelines in two separate waves. We used the adolopment methodology, and followed the 18 steps of the "Guidelines 2.0" comprehensive checklist for guideline development. For each question, we updated the original guidelines' evidence synthesis, and we developed an Evidence Profile (EP) and an Evidence to Decision (EtD) table...
August 10, 2018: Clinical Rheumatology
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