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Alyssa Wohlfahrt, Anarosa Campos, Maura D Iversen, Joshua J Gagne, Elena Massarotti, Daniel H Solomon, Candace H Feldman
OBJECTIVE: Adherence to medications among patients with rheumatic diseases is often suboptimal. Patient navigators, individuals trained in care coordination, motivational interviewing and basic rheumatology and pharmacology, have not been employed to explore and address this issue. We piloted a single-site, single arm intervention to determine the feasibility and acceptability of using rheumatology-specific navigators to understand and reduce barriers to adherence to oral disease modifying anti-rheumatic drugs (DMARDs)...
2018: PloS One
Ewa Wielosz, Maria Majdan, Magdalena Dryglewska, Robert Zwolak
BACKGROUND: It is known that anti-citrullinated protein (a-CCP) antibodies and rheumatoid factor (RF) can be present in systemic sclerosis (SSc) patients, particularly with joint involvement. OBJECTIVES: The aim of the study was to assess the prevalence of a-CCP antibodies and immunoglobulin M class (IgM) RF, and the relationships between their presence and joint manifestations in patients with SSc. MATERIAL AND METHODS: The study included 100 European Caucasian SSc patients hospitalized consecutively in the Department of Rheumatology and Connective Tissue Diseases (Lublin, Poland)...
July 19, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Richard D Sontheimer
James Neil Gilliam, MD, was an American academic physician who was trained in internal medicine, dermatology, dermatopathology and rheumatology. This "quadruple-threat" profile of postgraduate medical training provided him with a rather unique perspective on genetically-complex, environmentally-impacted human autoimmune disorders such as lupus erythematosus (LE). Both the skin and vital internal organs can be damaged by LE autoimmunity. And, LE is clinically-expressed quite variably from one individual to another making prognosis difficult...
June 2018: Annals of Translational Medicine
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
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
Carolina Vidal, Carina Ruano, Vera Bernardino, Pedro Lavado Carreira, Ana Lladó, Maria Céu Santos, Heidi Gruner, António Panarra, Nuno Riso, Maria Francisca Moraes-Fontes
INTRODUCTION: Systemic sclerosis is a complex disorder that requires systematic screening. Our objective is to report the European Scleroderma Trials and Research group centre affiliation and its impact in our clinical practice. MATERIAL AND METHODS: The European Scleroderma Trials and Research group affiliation process, database update and current patient evaluation, with respect to demographic and clinical features. Cumulative mortality was analysed. RESULTS: We identified 19 female patients (which met all the American College of Rheumatology/ European League Against Rheumatism 2013 criteria for systemic sclerosis) under current follow-up, divided according to the LeRoy classification into diffuse cutaneous (n = 5), limited cutaneous (n = 11) and limited (n = 3) types, followed for a median period of 5, 12 and 6 years, respectively...
June 29, 2018: Acta Médica Portuguesa
Donald L Kimpel, Janet E Lewis, Elizabeth Gaughan, William W Grosh, Christiana Brenin
No abstract text is available yet for this article.
July 18, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
G V Novak, B C Molinari, J C Ferreira, A P Sakamoto, M T Terreri, R M R Pereira, C Saad-Magalhães, N E Aikawa, L M Campos, C A Len, S Appenzeller, V P Ferriani, M F Silva, S K Oliveira, A G Islabão, F R Sztajnbok, L B Paim, C M Barbosa, M C Santos, B E Bica, E G Sena, A J Moraes, A M Rolim, P F Spelling, I M Scheibel, A S Cavalcanti, E N Matos, T C Robazzi, L J Guimarães, F P Santos, C T Silva, E Bonfá, C A Silva
Objective The objective of this study was to compare demographic data, clinical/laboratorial features and disease activity at diagnosis in three different groups with distinct time intervals between onset of signs/symptoms and disease diagnosis. Methods A multicenter study was performed in 1555 childhood-onset systemic lupus erythematosus (American College of Rheumatology criteria) patients from 27 pediatric rheumatology services. Patients were divided into three childhood-onset systemic lupus erythematosus groups: A: short time interval to diagnosis (<1 month); B: intermediate time interval (≥1 and <3 months); and C: long time interval (≥3 months)...
January 1, 2018: Lupus
Abdalla Ibrahim, Eoghan Meagher, Alexander Fraser, Thomas J Kiernan
A 34-year-old male presented with retrosternal chest pain, fatigue, shortness of breath, and a history of a previous episode of myocarditis four years prior. He had elevated troponin T, normal skeletal muscle enzymes, and negative inflammatory markers. Cardiac magnetic resonance imaging (MRI) confirmed active myocarditis with extensive myocardial fibrosis and normal left ventricular ejection fraction (LVEF). His myocarditis symptoms resolved with steroids and anti-inflammatory treatment, but on closer questioning, he reported a vague history of long-standing calf discomfort associated with episodes of stiffness, fatigue, and flu-like symptoms...
2018: Case Reports in Cardiology
Giacomo Caio, Roberto De Giorgio, Francesco Ursini, Silvia Fanaro, Umberto Volta
Aim: To assess the prevalence of celiac disease (CD) serological markers in a cohort of patients referred to an Italian rheumatological outpatient clinic. Background: Current guidelines do not suggest CD screening in patients with rheumatological diseases and these subjects are not considered to be at high risk for CD. Methods: A total of 230 sera of rheumatological patients referred to the Division of Internal Medicine at the Department of Medical and Surgical Sciences between January 2005 and December 2013 were screened for CD by testing IgA antitransglutaminase (TTG IgA), IgG deamidated gliadin peptides (DGP IgG) and IgA antiendomysium (EMA) antibodies...
2018: Gastroenterology and Hepatology From Bed to Bench
Elham Elhami, Zahra Zakeri, Amir Sadeghi, Mohammad Rostami-Nejad, Umberto Volta, Mohammad Reza Zali
Aim: Patients with Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA), and Fibromyalgia (FM) may have underlying non-diagnosed celiac disease (CD). Background: The aim of this study was to determine the prevalence of CD in patients with these underlying diseases in Iran. Methods: This cross-sectional study was performed among 300 consecutive patients with SLE, RA, and FM (each group 100 patients) since 2015 to 2017. The blood samples were collected and serum IgA anti-tissue trans-glutaminase (Anti-tTG) level was assessed for all patients...
2018: Gastroenterology and Hepatology From Bed to Bench
Sara Sabbagh, Tova Ronis, Patience H White
The transition from pediatric to adult health care is often a challenging process due to multiple interwoven complexities, especially for children with chronic medical conditions. Health care transition (HCT) is a process of moving from a pediatric to an adult model of health care with or without a transfer to a new clinician. This paper focuses on what is known about HCT for youth and young adults (Y/YA) with rheumatic diseases within a larger context of HCT recommendations. HCT barriers for youth, families, and providers and current evidence for a structured HCT processes are reviewed...
2018: Open Access Rheumatology: Research and Reviews
Pei-Wen Wu, Po-Hsuan Shih, Yen-Ying Kung, Fang-Pey Chen, Ching-Mao Chang
OBJECTIVES: To report on the potential effectiveness of Chinese herbal medicine (CHM) as part of an integrated treatment for lupus nephritis. CLINICAL FEATURES AND OUTCOME: A 55-year-old female with systemic lupus erythematosus had experienced bilateral lower-limbs edema for half a year. Her urinary total protein (M-TP) was 1367.9 mg/24 h. Lupus nephritis (LN) was suspected by the Division of Rheumatology without a renal biopsy. Oral corticosteroid medication did not improve the edema; therefore, the patient requested CHM for integrated therapy, and was subsequently treated for seven months with a modified CHM prescription mainly composed of Zhi-Bo-Di-Huang-Wan, Gui-Shao-Zhi-Mu-Tang, and Zhu-Ling-Tang...
August 2018: Complementary Therapies in Medicine
Amanda L Piquet, Stacey L Clardy
When patients present with neurological syndromes, such as encephalopathy/encephalitis, meningitis, and/or myelopathy/myelitis, the differential diagnosis is often broad, including infectious, inflammatory, autoimmune, vascular, and neoplastic etiologies. Just with inflammatory and autoimmune etiologies alone, there are numerous causative diseases. A comprehensive history and physical examination investigating for extraneurologic manifestations of immune-mediated disease is often necessary. Moreover, evaluating for an underlying infection and/or immunodeficiency becomes a critical aspect to the workup...
June 2018: Seminars in Neurology
Elif Çelikel, Z Birsin Özçakar, Semanur Özdel, Nilgün Çakar, Fatma Aydın, Seda Şahin, Fatoş Yalçınkaya
OBJECTIVES: Familial Mediterranean fever (FMF) is an autosomal recessive disease characterised by recurrent, self limited attacks of fever with serositis. Recently, it was shown that FMF patients with early disease onset have more severe disease. The aim of this study was to describe the demographic, clinical and genetic features of FMF patients who had disease onset during the neonatal period. METHODS: Medical records of all patients diagnosed as FMF and had been seen in the outpatient clinic of Pediatric Rheumatology department between January 2013-January 2014 were retrospectively evaluated...
July 14, 2018: Modern Rheumatology
Ewa Wielosz, Maria Majdan, Magdalena Dryglewska, Bożena Targońska-Stępniak
Introduction: It is known, that course of the disease differs between overlap syndromes (OS) and systemic sclerosis (SSc) group. Aim: To compare the prevalence of OS in limited cutaneous systemic sclerosis (lcSSc) and diffuse cutaneous SSc (dcSSc) and to analyze the presence of different manifestations in the SSc and OS group. Material and methods: The study included 126 European Caucasian SSc patients (99 females and 27 males) hospitalized consecutively in the Department of Rheumatology and Connective Tissue Diseases...
June 2018: Postȩpy Dermatologii i Alergologii
Ofir Elalouf, Sibel Bakirci Ureyen, Zahi Touma, Melanie Anderson, Gurjit S Kaeley, Sibel Z Aydin, Lihi Eder
OBJECTIVE: As part of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) ultrasound working group, we performed a systematic review of the literature to assess the evidence and knowledge gaps in scoring instruments of enthesitis in psoriatic arthritis (PsA). METHODS: A systematic search of PubMed, EMBase, and Cochrane databases was performed. The search strategy was constructed to find original publications containing terms related to ultrasound, enthesitis, spondyloarthritis (SpA) or PsA...
July 15, 2018: Journal of Rheumatology
Ki Won Moon, Shin-Seok Lee, Yun Jong Lee, Jae-Bum Jun, Su-Jin Yoo, Ji Hyeon Ju, Sung Hae Chang, In Ah Choi, Tae Young Kang, Eun Bong Lee, Seung-Geun Lee
OBJECTIVE: We aimed to investigate demographic and clinical features and predictors of mortality in Korean patients with systemic sclerosis (SSc). METHODS: We performed a retrospective multicenter medical chart review in Korean patients diagnosed with SSc from 1986 to 2016 at 11 university hospitals representing each geographic area of Korea. SSc patients were defined according to the American College of Rheumatology preliminary classification criteria and subtyped as limited cutaneous (lcSSc) or diffuse cutaneous (dcSSc) SSc...
July 15, 2018: Journal of Rheumatology
Samar Alharbi, Zareen Ahmad, Arthur A Bookman, Zahi Touma, Jorge Sanchez-Guerrero, Nicholas Mitsakakis, Sindhu R Johnson
OBJECTIVE: Systemic sclerosis (SSc) may overlap with systemic lupus erythematous (SLE). Little is known about the epidemiology, clinical characteristics, and survival of SSc-SLE overlap. We evaluated the prevalence of SSc-SLE overlap and differences in SSc characteristics, and compared survival with SSc without SLE. METHODS: A cohort study was conducted including subjects who fulfilled the American College of Rheumatology (ACR)/European League Against Rheumatism classification criteria for SSc and/or the ACR criteria for SLE...
July 15, 2018: Journal of Rheumatology
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