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guidelines rheumatology

Jessica Fernandes Vivaldo, Jaqueline Cristina de Amorim, Paulo Rogério Julio, Rodrigo Joel de Oliveira, Simone Appenzeller
Systemic lupus erythematosus (SLE) patients have frequently neuropsychiatric manifestations. From the first description of coma in 1875, a variety of manifestations has been described to occur in SLE. However, the lack of standardization reduced the comparability of published studies. In 1999, the American College of Rheumatology published guidelines to define neuropsychiatric nomenclature in SLE. This was the first step toward uniform diagnostic criteria. Several studies have been published since then applying the ACR criteria and frequencies of different manifestations can now be compared between cohorts...
2018: Frontiers in Medicine
Ruben Daniel Arellano, Lizette Sarai Aguilar, Rafael Argüello, Fernando Hernadez, Faviel Francisco Gonzalez, Javier Moran
Objectives: This study aims (i) to compare synovial fluid and serum cartilage oligomeric matrix protein levels in patients with primary knee osteoarthritis and healthy controls, (ii) compare variations of synovial fluid and serum cartilage oligomeric matrix protein levels according to sex, Kellgren-Lawrence grades, and daytime sampling, and (iii) correlate the synovial fluid and serum cartilage oligomeric matrix protein levels with age, severity of disease, and daytime sampling. Patients and methods: One hundred and twenty-four individuals (44 males, 80 females; median age 66 years; range 42 to 87 years) were diagnosed with primary knee osteoarthritis according to the American College of Rheumatology guidelines...
September 2017: Archives of Rheumatology
Guillermo Ruiz-Irastorza, Amaia Ugarte, Ioana Ruiz-Arruza, Jose-Gabriel Erdozain, Cristina Gonzalez-Echavarri, Adriana Soto
No abstract text is available yet for this article.
June 9, 2018: Rheumatology
Caroline Gordon, Maame-Boatemaa Amissah-Arthur, Mary Gayed, Sue Brown, Ian N Bruce, David D'Cruz, Benjamin Empson, Bridget Griffiths, David Jayne, Munther Khamashta, Liz Lightstone, Peter Norton, Yvonne Norton, Karen Schreiber, David Isenberg
No abstract text is available yet for this article.
June 9, 2018: Rheumatology
Kellie S Gallagher, Jon Godwin, Gordon J Hendry, Martijn Steultjens, Jim Woodburn
Background: Foot pain is common in rheumatoid arthritis and appears to persist despite modern day medical management. Several clinical practice guidelines currently recommend the use of foot orthoses for the treatment of foot pain in people with rheumatoid arthritis. However, an evidence gap currently exists concerning the comparative clinical- and cost-effectiveness of prefabricated and customised foot orthoses in people with early rheumatoid arthritis. Early intervention with orthotics may offer the best opportunity for positive therapeutic outcomes...
2018: Journal of Foot and Ankle Research
Faranak Esmaeilbeigi, Janet E Pope
OBJECTIVES: To determine practices regarding cardiovascular (CV) risk assessment in systemic lupus erythematosus (SLE) amongst rheumatologists. METHODS: A questionnaire assessing preventative strategies, risk assessment, and beliefs regarding SLE and CV disease was sent electronically to 425 members of the Canadian Rheumatology Association. Questions were based on published recommendations for CV risk management. Responses were stratified based practitioner's characteristics...
May 28, 2018: Clinical and Experimental Rheumatology
F Buttgereit, T Brabant, H Dinges, I Hiemer, M Kaplani, U Kiltz, D Kyburz, A Reißhauer, M Schneider, C Weseloh, C Dejaco
Polymyalgia rheumatica (PMR) occurs almost exclusively in persons aged 50 years or older and it is the second most common inflammatory rheumatic disease in older people after rheumatoid arthritis. Since there are no specific tests for PMR, the exclusion of clinically similar differential diagnoses is essential to ascertain the diagnosis. These recommendations for the management of PMR assume an already established diagnosis of PMR. It is recommended to initiate treatment with glucocorticoids immediately after diagnosis and to provide appropriate patient information and education about the impact of the disease and its treatment...
May 30, 2018: Zeitschrift Für Rheumatologie
Sheila T Angeles-Han, Mindy S Lo, Lauren A Henderson, Melissa A Lerman, Leslie Abramson, Ashley M Cooper, Miriam F Parsa, Lawrence S Zemel, Tova Ronis, Timothy Beukelman, Erika Cox, H Nida Sen, Gary N Holland, Hermine I Brunner, Andrew Lasky, C Egla Rabinovich
OBJECTIVE: Systemic immunosuppressive treatment of pediatric chronic anterior uveitis (CAU), both juvenile idiopathic arthritis (JIA)-associated and idiopathic varies, making it difficult to identify best treatments. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) developed consensus treatment plans (CTPs) for CAU for the purpose of reducing practice variability and allowing future comparison of treatments by comparative effectiveness analysis techniques. METHODS: A core group of pediatric rheumatologists, ophthalmologists with uveitis expertise, and a lay advisor comprised the CARRA uveitis workgroup who performed literature review on pharmacologic treatments, held teleconferences, and developed a case-based survey administered to the CARRA membership to delineate treatment practices...
May 28, 2018: Arthritis Care & Research
Amanda Mary Scott, Janeth Yinh, Timothy McAlindon, Robert Kalish
Neurosarcoidosis is uncommon with an incidence of approximately 5 to 15%. Central nervous system involvement can be divided into brain and spinal cord neurosarcoidosis. Spinal cord sarcoidosis is extremely rare, occurring in less than 1% of all sarcoidosis cases. Its manifestations may include cauda equina syndrome, radiculopathy, syringomyelia, cord atrophy, arachnoiditis, and myelopathy or transverse myelitis. We highlight two cases of spinal cord sarcoidosis, each presenting with longitudinally extensive transverse myelitis, that demonstrate the dilemmas that physicians face with regard to diagnosis and treatment...
May 17, 2018: Clinical Rheumatology
Kieran E Murray, Louise Moore, Celine O'Brien, Anne Clohessy, Caroline Brophy, Patricia Minnock, Oliver FitzGerald, Eamonn S Molloy, Anne-Barbara Mongey, Shane Higgins, Mary F Higgins, Fionnuala M Mc Auliffe, Douglas J Veale
BACKGROUND: Rheumatoid arthritis (RA) is a chronic immune-mediated inflammatory disease which can cause significant disability, morbidity, mortality, and impaired fertility. It commonly affects women of childbearing age. Managing rheumatoid arthritis (RA) in the perinatal period poses challenges. There is concern about the teratogenic effects of many traditional disease-modifying anti-rheumatic drugs (DMARDs) and an ever-growing list of new therapeutic options with limited data in pregnancy and breastfeeding...
May 10, 2018: Irish Journal of Medical Science
Daniel Xibillé-Friedmann, Marcela Pérez-Rodríguez, Sandra Carrillo-Vázquez, Everardo Álvarez-Hernández, Francisco Javier Aceves, Mario C Ocampo-Torres, Conrado García-García, José Luis García-Figueroa, Javier Merayo-Chalico, Ana Barrera-Vargas, Margarita Portela-Hernández, Sandra Sicsik, Lilia Andrade-Ortega, Víctor Manuel Rosales-Don Pablo, Aline Martínez, Pilar Prieto-Seyffert, Mario Pérez-Cristóbal, Miguel Ángel Saavedra, Zully Castro-Colín, Azucena Ramos, Gabriela Huerta-Sil, María Fernanda Hernández-Cabrera, Luis Javier Jara, Leonardo Limón-Camacho, Lizbet Tinajero-Nieto, Leonor A Barile-Fabris
There are national and international clinical practice guidelines for systemic lupus erythematosus treatment. Nonetheless, most of them are not designed for the Mexican population or are devoted only to the treatment of certain disease manifestations, like lupus nephritis, or are designed for some physiological state like pregnancy. The Mexican College of Rheumatology aimed to create clinical practice guidelines that included the majority of the manifestations of systemic lupus erythematosus, and also incorporated guidelines in controversial situations like vaccination and the perioperative period...
May 4, 2018: Reumatología Clinica
Carmen E Gota
Patients with fibromyalgia typically have pain "all over," tender points, generalized weakness and fatigue, nonrestorative sleep, and a plethora of other symptoms. In contrast to inflammatory and autoimmune conditions, laboratory tests and physical examination findings are usually normal. American College of Rheumatology guidelines facilitate diagnosis. Management requires a multifaceted, long-term strategy that emphasizes improving function rather than reducing pain.
May 2018: Cleveland Clinic Journal of Medicine
Hideto Kameda
As of February 2018, 5 originator TNF inhibitors(infliximab, etanercept, adalimumab, golimumab and certolizumab pegol)and biosimilar agents of infliximab and etanercept are available for rheumatoid arthritis(RA)in Japan. The effectiveness of TNF inhibitors considerably improves with concomitant methotrexate regardless of their immunogenicity. The Japan College of Rheumatology guideline for TNF inhibitor use in RA has been updated in March 2017 according to recent evidences. During the remission induction phase, maintenance of drug trough level above effective blood concentration is paramount, while the tapering and withdrawal of TNF inhibitors may be considered after achieving sustained remission...
2018: Clinical Calcium
Tamás Constantin, Ivan Foeldvari, Clare E Pain, Annamária Pálinkás, Peter Höger, Monika Moll, Dana Nemkova, Lisa Weibel, Melinda Laczkovszki, Philip Clements, Kathryn S Torok
Juvenile localized scleroderma (jLS), also known as morphea, is an orphan disease. Pediatric guidelines regarding diagnosis, assessment, and management are lacking.Our objective was to develop minimum standards of care for diagnosis, assessment, and management of jLS. A systematic review was undertaken to establish the pediatric evidence for assessment and monitoring of jLS. An expert panel, including members of the Pediatric Rheumatology European Society (PRES) Scleroderma Working Group, were invited to a consensus meeting where recommendations were developed based on evidence graded by the systematic review and, where evidence was lacking, consensus opinion...
May 4, 2018: European Journal of Pediatrics
Hideto Kameda, Takao Fujii, Ayako Nakajima, Ryuji Koike, Akira Sagawa, Katsuaki Kanbe, Tetsuya Tomita, Masayoshi Harigai, Yasuo Suzuki
Methotrexate (MTX), the anchor drug in the current treatment strategy for rheumatoid arthritis (RA), was first approved for treatment of RA in Japan in 1999 at the recommended dose of 6-8 mg/week; it was approved as first-line drug with the maximum dose of 16 mg/week in February 2011. However, more than half of Japanese patients with RA are unable to tolerate a dose of 16 mg/week of MTX. Moreover, some serious adverse events during the treatment with MTX, such as pneumocystis pneumonia and lymphoproliferative disorders, have been observed much more frequently in Japan than in other countries...
May 2, 2018: Modern Rheumatology
K T Amber, S A Grando
Managing corticosteroid related comorbidities, including bone mineral density loss (BMDL), is an essential part of caring for the autoimmune blistering disease (AIBD) patient. The American College of Rheumatology (ACR) issued an evidence-based BMDL prophylaxis guideline for patients receiving systemic corticosteroids. 2010 guidelines divided patients as low, medium, and high-risk. Accordingly, for patients greater than 50 and on corticosteroids for ≥3 months, low-risk patients should receive bisphosphonate prophylaxis if receiving ≥7...
April 28, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Akpabio Akanimo Akpabio, Pam Stephen Dung-Gwom, Babatunde Hakeem Olaosebikan, Olufemi Oladipo Adelowo
Objectives: To highlight common precipitants and co-morbidities of gout in Nigerians; determine the frequency of chronic kidney disease (CKD) in Nigerian gout patients, as well as identify significant associations of CKD in gout patients. Material and methods: Retrospective cross-sectional study of gout cases seen at the Rheumatology Clinic of the Lagos State University Teaching Hospital over five years from January 2011 to December 2015. Gout was diagnosed using the 1977 American Rheumatism Association (ARA) criteria...
2018: Reumatologia
John D FitzGerald, Ted R Mikuls, Tuhina Neogi, Jasvinder A Singh, Mark Robbins, Puja P Khanna, Amy S Turner, Rachel Myslinski, Lisa G Suter
OBJECTIVE: Electronic clinical quality measures (eCQMs) are increasingly used by health registries and third parties to evaluate and improve the quality of health care. To complete these eCQMs, data are extracted from electronic health records (EHRs). The treatment of gout has been an area identified with gaps in quality of care. On behalf of the American College of Rheumatology (ACR), we sought to develop and test eCQMs to evaluate gout care. METHODS: Drawing from the 2012 ACR gout guidelines, a working group developed candidate gout process measures that were evaluated by an interdisciplinary panel of health care stakeholders, the ACR Quality Measures Subcommittee (QMS), and ultimately the ACR Board of Directors for formal validity testing...
May 2018: Arthritis Care & Research
Mansoor M Aman, R Jason Yong, Alan David Kaye, Richard D Urman
PURPOSE OF REVIEW: Fibromyalgia (FM) is the second most common rheumatologic pain disorder after osteoarthritis with a multisystem presentation. While the treatment of FM in a clinical setting incorporates both pharmacologic and non-pharmacologic modalities, the present investigation reviews evolving literature on cognitive behavioral and complementary medical therapies. The recent medical literature on FM was reviewed between 2012 and 2017 via MEDLINE and the Cochrane Central Registry of Controlled Trials, with an emphasis on randomized controlled trials, meta-analyses, and evidence-based treatment guidelines...
April 4, 2018: Current Pain and Headache Reports
Gudrun Arna Johannsdottir, Olafur Palsson, Helgi Jonsson, Bjorn Gudbjornsson
Gout is a disabling and common arthritis with increasing prevalence. Without treatment the disease can cause permanent joint damage. It is commonly associated with the metabolic syndrome but can also be related to a number of life-threatening diseases and their treatments. Gout is often misdiagnosed and its long-term management is suboptimal despite the availability of effective treatments. Recently The American College of Rheumatology (ACR) and European League against Rheumatism (EULAR) released common guidelines for the diagnosis of gout and EULAR updated their guidelines for management...
April 2018: Læknablađiđ
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