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https://www.readbyqxmd.com/read/27904594/relationship-between-articular-and-nonarticular-manifestations-in-inflammatory-bowel-diseases
#1
Alimohammad Fatemi, Hourossadat Hashemi Jazi, Mohammad Hasan Emami, Amir Kazemizadeh, Hamid Tavakkoli, Abbas Smiley
BACKGROUND: Musculoskeletal manifestations (MSM) of inflammatory bowel diseases (IBDs) are usually the most frequent extraintestinal manifestations. However, they are not paid enough attention during regular office visits. This cross-sectional study aimed to draw a clinical picture of MSM and their relationships with other findings in patients with IBD. MATERIALS AND METHODS: Patients of our IBD cohort between March 2012 and September 2013 were consecutively evaluated...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27900299/assessment-of-enthesitis-in-patients-with-psoriatic-arthritis-using-clinical-examination-and-ultrasound
#2
Salome Kristensen, Jeppe Hagstrup Christensen, Erik Berg Schmidt, Jens Lykkegaard Olesen, Martin Berg Johansen, Kristian Bakke Arvesen, Annette Schlemmer
BACKGROUND: Enthesitis is a major feature of psoriatic arthritis. However, clinical assessment of enthesitis is known to lack accuracy and have poor interobserver reliability. OBJECTIVE: To determine effect of training on clinical assessment of enthesitis and to compare ultrasonography with clinical examination for the detection of entheseal abnormalities. METHODS: 20 rheumatologists performed repeated assessment of enthesitis in patients with established psoriatic arthritis before and after a 2-hour training session in standardised enthesitis count according to Leeds Enthesitis Index (LEI) and Spondyloarthritis Research Consortium of Canada Enthesitis Index (SPARCC)...
April 2016: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/27896522/tapering-biologics-in-rheumatoid-arthritis-a-pragmatic-approach-for-clinical-practice
#3
Aleksander Lenert, Petar Lenert
Optimal rheumatoid arthritis (RA) therapy in daily clinical practice is based on the treat-to-target strategy. Quicker escalation of therapy and earlier introduction of biological disease-modifying anti-rheumatic drugs have led to improved outcomes in RA. However, chronic immunosuppressive therapy is associated with adverse events and higher costs. In addition, our patients frequently express a desire for lower dosing and drug holidays. Current clinical practice guidelines from the American College of Rheumatology and European League Against Rheumatism suggest that rheumatologists consider tapering treatment after achieving remission...
November 28, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27896420/level-of-agreement-between-three-dimensional-volumetric-ultrasound-and-real-time-conventional-ultrasound-in-the-assessment-of-synovitis-tenosynovitis-and-erosions-in-rheumatoid-arthritis-patients
#4
Carlos Acebes, Neil McKay, Anna Ciechomska, Nicola Alcorn, John P Harvie, Barbara Robson, Nico Groenendijk, Moira McDonald, Alison Wilson, Jesus Garrido
The aim of the study was to assess agreement between three-dimensional volumetric ultrasound (3D US) performed by inexperienced staff and real-time conventional ultrasound (2D US) performed by experienced rheumatologists in detecting and scoring rheumatoid arthritis (RA) lesions. Thirty-one RA patients underwent examination of seven joints by 2D and 3D US for synovitis and tenosynovitis in B and PD modes and erosions in B mode. A global score for synovitis and global counts for synovitis, tenosynovitis and erosions were also calculated for every patient...
November 28, 2016: Rheumatology International
https://www.readbyqxmd.com/read/27894239/do-the-biologic-agents-increase-the-risk-of-infection-in-patients-undergoing-lower-limb-arthroplasty-surgery
#5
N A Sandiford
BACKGROUND: Biologic agents have contributed significantly to the management of patients with in rheumatoid arthritis (RA). A significant proportion of patients with RA still require arthroplasty procedures however. It is unclear whether these agents increase the risk of post operative infection after lower limb arthroplasty . The aim of this review is to review the contemporary literature about this topic along with the recommendations from specialist societies. METHOD: A literature search was performed for articles published over the last 10 years in the English language examining the association between anti-tumour necrosis factor inhibitors and the incidence of post operative infection in patients with RA undergoing hip and knee arthroplasty procedures...
November 27, 2016: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/27893771/a-nationwide-survey-on-patient-s-versus-physician%C3%A2-s-evaluation-of-biological-therapy-in-rheumatoid-arthritis-in-relation-to-disease-activity-and-route-of-administration-the-be-raise-study
#6
Sophie De Mits, Jan Lenaerts, Bert Vander Cruyssen, Herman Mielants, René Westhovens, Patrick Durez, Dirk Elewaut
OBJECTIVES: Biological treatment of rheumatoid arthritis (RA) is one of the cornerstones of current treatment strategies for the disease. Surprisingly little information exists on whether the route of administration affects patients' treatment satisfaction. It is equally unclear whether rheumatologists are able to accurately perceive their patients' appreciation. Thus, the Belgian Be-raise survey aimed to examine whether RA patient's experience of their current biological treatment coincided with the treating physician's perception...
2016: PloS One
https://www.readbyqxmd.com/read/27890176/the-risk-of-progressive-multifocal-leukoencephalopathy-in-the-biologic-era-prevention-and-management
#7
REVIEW
Eamonn S Molloy, Cassandra M Calabrese, Leonard H Calabrese
Progressive multifocal leukoencephalopathy (PML) is a rare, typically fatal, demyelinating central nervous system infection caused by reactivation of the John Cunningham virus that generally occurs in immunosuppressed patients. With an evolving understanding of a greater clinical heterogeneity of PML and significant implications for therapy, PML should be considered in the differential diagnosis of neurologic presentations of rheumatic diseases. Increased awareness of PML among rheumatologists is required, as earlier diagnosis and restoration of immune function may improve the otherwise grim prognosis associated with PML...
February 2017: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/27890174/immune-related-adverse-effects-of-cancer-immunotherapy-implications-for-rheumatology
#8
REVIEW
Laura C Cappelli, Ami A Shah, Clifton O Bingham
Immune checkpoint inhibitors (ICIs) are increasingly studied and used as therapy for a growing number of malignancies. ICIs work by blocking inhibitory pathways of T-cell activation, leading to an immune response directed against tumors. Such nonspecific immunologic activation can lead to immune-related adverse events (IRAEs). Some IRAEs, including inflammatory arthritis, sicca syndrome, myositis, and vasculitis, are of special interest to rheumatologists. As use of ICIs increases, recognition of these IRAEs and developing treatment strategies will become important...
February 2017: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/27890171/barriers-to-immunizations-and-strategies-to-enhance-immunization-rates-in-adults-with-autoimmune-inflammatory-diseases
#9
REVIEW
Elizabeth Kirchner, Victoria Ruffing
For as long as there have been immunizations, there have been barriers to them. Immunization rates in the United States are below target. Rheumatologists and rheumatology practitioners need to understand the issues of immunizations in patients with autoimmune inflammatory disease to identify and overcome barriers to immunization. Several strategies for overcoming these barriers are discussed.
February 2017: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/27890167/vaccines-and-disease-modifying-antirheumatic-drugs-practical-implications-for-the-rheumatologist
#10
REVIEW
Marcia A Friedman, Kevin L Winthrop
Patients with rheumatoid arthritis are highly vulnerable to infections because of abnormalities in their immune system, and because of immunosuppressive effects of their medications. Vaccinations in this population are complicated by disease-modifying antirheumatic drugs, which also modulate or suppress the immune system and potentially decrease the immunogenicity and efficacy of the vaccines. We review the available data regarding the impact of rheumatoid arthritis therapy on the immunogenicity of various common vaccines...
February 2017: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/27889825/a-critical-review-of-complementary-and-alternative-medicine-use-among-people-with-arthritis-a-focus-upon-prevalence-cost-user-profiles-motivation-decision-making-perceived-benefits-and-communication
#11
REVIEW
Lu Yang, David Sibbritt, Jon Adams
A critical review of complementary and alternative medicine (CAM) use among people with arthritis was conducted focusing upon prevalence and profile of CAM users as well as their motivation, decision-making, perceived benefits and communication with healthcare providers. A comprehensive search of peer-reviewed literature published from 2008 to 2015 was undertaken via CINAHL, Medline and AMED databases. The initial search identified 4331 articles, of which 49 articles met selection criteria. The review shows a high prevalence of CAM use (often multiple types and concurrent to conventional medical care) among those with arthritis which is not restricted to any particular geographic or social-economic status...
November 26, 2016: Rheumatology International
https://www.readbyqxmd.com/read/27888342/putting-recommendations-into-practice-australian-rheumatologists-opinions-on-leflunomide-use-in-rheumatoid-arthritis
#12
Ashley M Hopkins, Michael D Wiese, Catherine E O'Doherty, Susanna M Proudman
Leflunomide is the most recently introduced conventional disease-modifying anti-rheumatic drugs in Australia. It has several unique methods for initiation, unique monitoring recommendations and a distinctive cessation protocol in the event of serious toxicity. The aim of this study was to evaluate initiation and monitoring practices of Australian rheumatologists using leflunomide. A survey was emailed twice, approximately 3 months apart to 332 rheumatologist members of the Australian Rheumatology Association...
November 25, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27886804/sarcoidosis-rheumatology-perspective
#13
REVIEW
Arthur M F Yee
Sarcoidosis is a systemic inflammatory granulomatous disease for which rheumatologists are uniquely trained and qualified to treat. Historically, sarcoidosis has been managed within silos of medical subspecialties, but with increased appreciation of the systemic nature of this disorder and the availability of more therapeutic options, it is clear that a multidisciplinary approach, with the rheumatologist as a key component, can offer more optimal care. This manuscript reviews clinically relevant immunology and pathophysiology, diagnostic issues, management decision-making, and therapeutics in the care of patients with sarcoidosis...
April 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27886798/multicentric-reticulohistiocytosis-rheumatology-perspective
#14
REVIEW
Bahtiyar Toz, Nesimi Büyükbabani, Murat İnanç
Multicentric reticulohistiocytosis (MRH) is a rare, multisystemic non-Langerhans cell histiocytosis characterized by skin and articular involvement, and rarely involves various other organs. There are no specific laboratory findings for MRH. Diagnosis is based on clinical findings and skin or synovial biopsy results. There is currently no consensus for the treatment of MRH. Here, we review the differential diagnosis and treatment options of MRH from the rheumatologist's perspective. We also report an index case of MRH associated with Sjögren's syndrome and pulmonary embolism...
April 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27886691/pharmacotherapy-pearls-for-the-geriatrician-focus-on-oral-disease-modifying-antirheumatic-drugs-including-newer-agents
#15
REVIEW
Ann J Biehl, James D Katz
Providing safe and effective pharmacotherapy to the geriatric patients with rheumatological disorders is an ongoing struggle for the rheumatologist and geriatrician alike. Cohesive communication and partnership can improve the care of these patients and subvert adverse outcomes. Disease-modifying antirheumatic drugs, including methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide, and the newest oral agent for treatment of rheumatoid arthritis, tofacitinib, have distinctive monitoring and adverse effect profiles...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27882832/geographic-variation-in-the-quality-and-cost-of-care-for-patients-with-rheumatoid-arthritis
#16
Jason Shafrin, Arijit Ganguli, Yuri Sanchez Gonzalez, Jin Joo Shim, Seth A Seabury
BACKGROUND: There is considerable push to improve value in health care by simultaneously increasing quality while lowering or containing costs. However, for diseases that are best treated with comparatively expensive treatments, such as rheumatoid arthritis (RA), there could be tension between these aims. In this study, we measured geographic variation in quality, access, and cost for patients with RA, a disease with effective but costly specialty treatments. OBJECTIVE: To assess the geographic differences in the quality, access, and cost of care for patients with RA...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27882568/the-evolution-of-weak-standards-the-case-of-the-swedish-rheumatology-quality-registry
#17
Anna Essén, Michael Sauder
Research in sociology suggests that the effects of standards are not nearly as straightforward or as homogenising as they first appear. The present study extends these insights by demonstrating how even standards designed simply to collect data can produce extensive and unanticipated effects in medical fields as their uses evolve across actors and contexts. We draw on an embedded case study exploring the multifaceted consequences of the use of a practice-driven voluntary documentation standard: the Swedish rheumatology quality registry from 1995-2014...
November 23, 2016: Sociology of Health & Illness
https://www.readbyqxmd.com/read/27878408/rheumatologists-perception-of-systemic-lupus-erythematosus-quality-indicators-significant-interest-and-perceived-barriers
#18
Carolyn Casey, Cecilia P Chung, Leslie J Crofford, April Barnado
Differences in quality of care may contribute to health disparities in systemic lupus erythematosus (SLE). Studies show low physician adherence rates to the SLE quality indicators but do not assess physician perception of SLE quality indicators or quality improvement. Using a cross-sectional survey of rheumatologists in the southeastern USA, we assessed the perception and involvement of rheumatologists in quality improvement and the SLE quality indicators. Using electronic mail, an online survey of 32 questions was delivered to 568 rheumatologists...
November 22, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27875351/pathogenesis-and-immunotherapy-in-cutaneous-psoriasis-what-can-rheumatologists-learn
#19
Helen Alexander, Frank O Nestle
PURPOSE OF REVIEW: This review presents our current understanding of the pathogenesis and treatment of psoriasis with a particular focus on recent areas of research and emerging concepts. RECENT FINDINGS: Psoriasis arises in genetically predisposed individuals who have an abnormal innate and adaptive immune response to environmental factors. Recent studies have identified novel genetic, epigenetic and immunological factors that play a role in the disease pathogenesis...
January 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/27870762/review-of-current-workforce-for-rheumatology-in-the-countries-of-the-americas-2012-2015
#20
John D Reveille, Roberto Muñoz, Enrique Soriano, Miguel Albanese, Graciela Espada, Carlos Jose Lozada, Ruben Antonio Montúfar, Fernando Neubarth, Gloria M Vasquez, Michel Zummer, Rosa Sheen, Carlo V Caballero-Uribe, Carlos Pineda
BACKGROUND: With the increases in and aging of the populations of the Americas, monitoring the number of rheumatologists is critical to address and focus on areas of greatest need. OBJECTIVES: The aim of this study was to gather data on the rheumatology workforce from 21 national societies in the Pan American League of Associations for Rheumatology (PANLAR). METHODS: In September and October 2012 and again in October and November 2015, the heads of the 21 rheumatology national societies were contacted in the 2012 survey; all national societies responded except Cuba...
December 2016: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
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