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Vassy JL, Knevel R, Liao KP. Finding the Right Fit for Genes in Rheumatology Clinical Care. Arthritis Rheumatol 2024; 76:675-676. [PMID: 38057135 DOI: 10.1002/art.42769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 12/08/2023]
Affiliation(s)
- Jason L Vassy
- Veterans Affairs Boston Healthcare System, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Rachel Knevel
- Leiden University Medical Centre, Leiden, the Netherlands, and Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Katherine P Liao
- Veterans Affairs Boston Healthcare System, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
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2
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Walker D. 45 years in rheumatology. Rheumatology (Oxford) 2024; 63:904-905. [PMID: 37935418 DOI: 10.1093/rheumatology/kead589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/09/2023] Open
Affiliation(s)
- David Walker
- Department of Rheumatology, North Tyneside General Hospital, North Shields, UK
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3
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Fedorchenko Y, Mahmudov K, Abenov Z, Zimba O, Yessirkepov M. Rehabilitation of patients with inflammatory rheumatic diseases and comorbidities: unmet needs. Rheumatol Int 2024; 44:583-591. [PMID: 38296848 DOI: 10.1007/s00296-023-05529-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/25/2023] [Indexed: 02/02/2024]
Abstract
Comorbidities may contribute to inadequate response to therapy and accelerate disability in various rheumatic diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and psoriatic arthritis (PsA). Cardiovascular, oncological, and infectious comorbidities are common in rheumatic patients. The rehabilitation of patients with inflammatory rheumatic diseases (IRDs) with comorbidities requires a multidisciplinary approach to improving patients' functional mobility, slowing down the disease progression and minimizing the risks of complications. The evidence suggests that cardiac rehabilitation can be implemented in daily practice in patients with IRDs to reduce mortality for those with established risk factors. Physical exercises reduce the severity, improve the clinical course, and reduce hospitalization rates in patients with rheumatic diseases. A rehabilitation program with focused physical therapy can lead to functional improvements and reduction of disease activity in patients with lowered quality of life (QoL). Health professionals should provide evidence-based recommendations for patients with rheumatic diseases and comorbidities to initiate the self-management of their diseases and prevent complications.
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Affiliation(s)
- Yuliya Fedorchenko
- Department of Pathophysiology, Ivano-Frankivsk National Medical University, Halytska Str. 2, Ivano-Frankivsk, 76018, Ukraine.
| | - Khaiyom Mahmudov
- Department of Propaedeutics of Internal Diseases, Avicenna Tajik State Medical University, Dushanbe, Tajikistan
| | - Zhumabek Abenov
- Student Polyclinic, Shymkent, Kazakhstan
- South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Olena Zimba
- Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
- Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Marlen Yessirkepov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
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Shin JH, Pyo JY, Han M, Lee M, Lim SM, Baek JY, Lee JY, Kang JM, Jung I, Ahn JG. Incidence and disease burden of autoimmune inflammatory rheumatic diseases after non-pharmaceutical interventions in the COVID-19 era: A nationwide observational study in Korea. Int J Rheum Dis 2024; 27:e15144. [PMID: 38590055 DOI: 10.1111/1756-185x.15144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/04/2023] [Accepted: 03/26/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Infections are considered risk factors for autoimmune inflammatory rheumatic diseases (AIRDs), the incidence of which is considered to have been impacted by the COVID-19 pandemic. The impact of non-pharmaceutical interventions (NPIs) on the incidence of AIRDs and their associated health care services and medical expenses in Korea was investigated. METHODS We included all AIRD cases reported between January 2016 and February 2021 based on the National Health Insurance Service data. We evaluated changes in incidence trends for each AIRD before and after NPI implementation (Feb 2020 to Feb 2021) using segmented regression analysis. Changes in health care utilization and medical costs for each AIRD before and after NPI implementation were also investigated. RESULTS After NPI implementation, monthly incidence rates declined significantly by 0.205 per 1 000 000 (95% confidence interval [CI], -0.308 to -0.101, p < .001) in patients with systemic lupus erythematosus (SLE). No significant changes in the incidence of all AIRDs other than SLE were observed before and after implementation. Further, annual outpatient department visits per patient were lower during implementation for all diseases, except juvenile idiopathic arthritis (JIA). The prescription days per outpatient visit increased significantly during implementation for all diseases, except JIA and ankylosing spondylitis. During implementation, the total annual medical costs per patient tended to decrease for all diseases, except JIA and mixed connective tissue disease. CONCLUSION Implementation of NPIs to contain the pandemic led to a reduction in the incidence of SLE and changed patterns of medical care utilization and treatment cost for most AIRDs.
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Affiliation(s)
- Je Hee Shin
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung Yoon Pyo
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Minkyung Han
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Myeongjee Lee
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Min Lim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jee Yeon Baek
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji Young Lee
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji-Man Kang
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, South Korea
| | - InKyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Gyun Ahn
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, South Korea
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5
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Naye F, Toupin-April K, de Wit M, LeBlanc A, Dubois O, Boonen A, Barton JL, Fraenkel L, Li LC, Stacey D, March L, Barber CEH, Hazlewood GS, Guillemin F, Bartlett SJ, Berthelsen DB, Mather K, Arnaud L, Akpabio A, Adebajo A, Schultz G, Sloan VS, Gill TK, Sharma S, Scholte-Voshaar M, Caso F, Nikiphorou E, Nasef SI, Campbell W, Meara A, Christensen R, Suarez-Almazor ME, Jull JE, Alten R, Morgan EM, El-Miedany Y, Singh JA, Burt J, Jayatilleke A, Hmamouchi I, Blanco FJ, Fernandez AP, Mackie S, Jones A, Strand V, Monti S, Stones SR, Lee RR, Nielsen SM, Evans V, Srinivasalu H, Gérard T, Demers JL, Bouchard R, Stefan T, Dugas M, Bergeron F, Beaton D, Maxwell LJ, Tugwell P, Décary S. OMERACT Core outcome measurement set for shared decision making in rheumatic and musculoskeletal conditions: a scoping review to identify candidate instruments. Semin Arthritis Rheum 2024; 65:152344. [PMID: 38232625 DOI: 10.1016/j.semarthrit.2023.152344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVES Shared decision making (SDM) is a central tenet in rheumatic and musculoskeletal care. The lack of standardization regarding SDM instruments and outcomes in clinical trials threatens the comparative effectiveness of interventions. The Outcome Measures in Rheumatology (OMERACT) SDM Working Group is developing a Core Outcome Set for trials of SDM interventions in rheumatology and musculoskeletal health. The working group reached consensus on a Core Outcome Domain Set in 2020. The next step is to develop a Core Outcome Measurement Set through the OMERACT Filter 2.2. METHODS We conducted a scoping review (PRISMA-ScR) to identify candidate instruments for the OMERACT Filter 2.2 We systematically reviewed five databases (Ovid MEDLINE®, Embase, Cochrane Library, CINAHL and Web of Science). An information specialist designed search strategies to identify all measurement instruments used in SDM studies in adults or children living with rheumatic or musculoskeletal diseases or their important others. Paired reviewers independently screened titles, abstracts, and full text articles. We extracted characteristics of all candidate instruments (e.g., measured construct, measurement properties). We classified candidate instruments and summarized evidence gaps with an adapted version of the Summary of Measurement Properties (SOMP) table. RESULTS We found 14,464 citations, read 239 full text articles, and included 99 eligible studies. We identified 220 potential candidate instruments. The five most used measurement instruments were the Decisional Conflict Scale (traditional and low literacy versions) (n=38), the Hip/Knee-Decision Quality Instrument (n=20), the Decision Regret Scale (n=9), the Preparation for Decision Making Scale (n=8), and the CollaboRATE (n=8). Only 44 candidate instruments (20%) had any measurement properties reported by the included studies. Of these instruments, only 57% matched with at least one of the 7-criteria adapted SOMP table. CONCLUSION We identified 220 candidate instruments used in the SDM literature amongst people with rheumatic and musculoskeletal diseases. Our classification of instruments showed evidence gaps and inconsistent reporting of measurement properties. The next steps for the OMERACT SDM Working Group are to match candidate instruments with Core Domains, assess feasibility and review validation studies of measurement instruments in rheumatic diseases or other conditions. Development and validation of new instruments may be required for some Core Domains.
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Affiliation(s)
- Florian Naye
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec J1H 5N4, Canada
| | - Karine Toupin-April
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada; Institut du savoir Montfort, Ottawa, Canada
| | | | - Annie LeBlanc
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, Canada; VITAM Centre de recherche en santé durable, Quebec City, Canada
| | - Olivia Dubois
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec J1H 5N4, Canada
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Jennifer L Barton
- VA Portland Health Care System, Oregon Health & Science University, Portland, USA
| | - Liana Fraenkel
- Department of Internal Medicine, Yale University, New Haven, USA
| | - Linda C Li
- Department of Physical Therapy, Arthritis Research Canada, University of British Columbia, Vancouver, Canada
| | - Dawn Stacey
- School of Nursing, University of Ottawa, Ottawa, Canada; The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Lyn March
- Department of Medicine, The University of Sydney, Sydney, Australia; Institute of Bone and Joint Research, Department of Rheumatology, Royal North Shore Hospital, Sydney, Australia
| | - Claire E H Barber
- Department of Medicine, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | | | - Susan J Bartlett
- Divisions of Clinical Epidemiology, Rheumatology and Respiratory Epidemiology and Clinical Trials Unit, McGill University, Canada; Research Institute - McGill University Health Centre, Canada; Johns Hopkins Medicine Division of Rheumatology, Montreal, Canada
| | - Dorthe B Berthelsen
- Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen & Research Unit of Rheumatology, Department of Clinical Research, Odense & Department of Rehabilitation, Municipality of Guldborgsund, Odense University Hospital, University of Southern Denmark, Nykoebing, Denmark
| | | | - Laurent Arnaud
- Department of Rheumatology, CRMR RESO, University Hospitals of Strasbourg, France
| | | | - Adewale Adebajo
- Faculty of Medicine, Dentistry and Health, University of Sheffield, UK
| | | | - Victor S Sloan
- Sheng Consulting LLC, Flemington, NJ, USA; The Peace Corps, Washington, DC, USA
| | - Tiffany K Gill
- Faculty of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Australia
| | - Saurab Sharma
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia; Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Marieke Scholte-Voshaar
- Patient Research Partner, Department of Pharmacy and Department of Research & Innovation, Sint Maartenskliniek, Nijmegen, The Netherlands; Department of Pharmacy, Radboud university medical center, Nijmegen
| | - Francesco Caso
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
| | - Elena Nikiphorou
- Centre for Rheumatic Diseases, King's College Hospital, School of Immunology and Microbial Sciences, King's College London, UK; Rheumatology Department, King's College Hospital, London, UK
| | - Samah Ismail Nasef
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Willemina Campbell
- Patient research partner, Toronto Western Hospital, University Health Network, Canada
| | - Alexa Meara
- Division of Rheumatology, The Ohio State University, Columbus, USA
| | - Robin Christensen
- Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, & Department of Rheumatology, Odense University Hospital, Denmark
| | - Maria E Suarez-Almazor
- Department of General Internal Medicine, Section of Rheumatology and Clinical Immunology, University of Texas MD Anderson Cancer Center, Houston, USA
| | | | - Rieke Alten
- Department of Internal Medicine II, Rheumatology Research Center, Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Charité, University Medicine Berlin, Berlin, Germany
| | - Esi M Morgan
- Department of Pediatrics, University of Washington, Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington, USA
| | | | | | - Jennifer Burt
- Newfoundland and Labrador Health Services, St. Clare's Mercy Hospital, St John's, Newfoundland and Labrador, Canada
| | | | - Ihsane Hmamouchi
- Health Sciences Research Centre (CReSS), Faculty of Medicine, International University of Rabat (UIR), Rabat, Morocco
| | - Francisco J Blanco
- Departamento de Fisioterapia, Medicina y Ciencias Médicas, Universidad de A Coruña, A Coruña, Spain
| | - Anthony P Fernandez
- Departments of Dermatology and Pathology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sarah Mackie
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Chapel Allerton Hospital, University of Leeds, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Allyson Jones
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Vibeke Strand
- Division of Immunology/Rheumatology, Stanford University, Stanford, California, USA
| | - Sara Monti
- Department of Rheumatology, Policlinico S. Matteo, IRCCS Fondazione, University of Pavia, Pavia, Italy
| | - Simon R Stones
- Patient research partner, Envision Pharma Group, Wilmslow, UK
| | - Rebecca R Lee
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; National Institute for Health Research Biomedical Research Centre, Manchester University Hospital NHS Trust, Manchester, UK
| | - Sabrina Mai Nielsen
- Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Odense University Hospital, and University of Southern Denmark, Copenhagen, Demark, Copenhagen, Denmark
| | - Vicki Evans
- Patient Research Partner and Discipline of Optometry, Faculty of Health, University of Canberra, Canberra, Australia
| | - Hemalatha Srinivasalu
- Pediatric Rheumatology, Children's National Hospital, Washington DC, USA; GW School of Medicine, Washington DC, USA
| | - Thomas Gérard
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec J1H 5N4, Canada
| | | | - Roxanne Bouchard
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, Canada
| | - Théo Stefan
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, Canada
| | - Michèle Dugas
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, Canada
| | | | | | - Lara J Maxwell
- Centre for Practice Changing Research, Ottawa Hospital Research Institute and Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Peter Tugwell
- Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Simon Décary
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec J1H 5N4, Canada.
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Dey D, Katso B, Baah A, Isaaka S, Amoako E. Exploring paediatric rheumatology care: a ten-year retrospective analysis of the patient population in Ghana. Pediatr Rheumatol Online J 2024; 22:40. [PMID: 38515165 PMCID: PMC10956341 DOI: 10.1186/s12969-024-00975-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/12/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Rheumatic diseases can seriously impact children's general health, development, and growth. However, due to a lack of resources, paediatric rheumatology is a largely underdeveloped speciality in many African nations. Children with rheumatic disorders face obstacles in accessing specialized medical care, including lack of specialists, care centres, medication access, and limited research and education to increase understanding of paediatric rheumatic disease among healthcare practitioners. This study described the disease characteristics, prevalence, and challenges faced by paediatric rheumatic disease patients receiving care at a teaching hospital in Accra, Ghana. METHODS A retrospective record-based study was conducted among all paediatric cases presenting to the rheumatology clinic of the Korle Bu Teaching Hospital (KBTH) from January 2011 to December 2021. Data collected include clinical features, laboratory findings at disease presentation, andtherapeutic regimens prescribed per standard guidelines and experiences. RESULTS A total of 121 cases were identified as of 2021, indicating a point prevalence of 0.0011%. The majority (73%) were females with a mean age of 13.4 ± 3.2 years. The mean duration of symptoms in months experienced by patients before being successfully referred to a rheumatologist was 18 months. There were significant differences between referred and confirmed diagnoses, especially in cases involving mixed connective tissue diseases (MCTD), systemic lupus erythematosus (SLE), and juvenile dermatomyositis (JDM), suggesting that these conditions may be under-recognised. Arthralgia and arthritis were the most common presenting symptoms. More than three-quarters (86.8%) of the cases studied were treated with steroids (oral or intravenous). In cases requiring immunosuppressive therapy, methotrexate was the most commonly prescribed in 33.9% of instances. Mortality was recorded at 8.3%, with the majority involving SLE cases. Most (95.7%) of the primary caregivers expressed positive experiences regarding care received at the adult rheumatology clinic. CONCLUSION There were significant delays in diagnosis and diagnostic accuracy for patients with paediatric rheumatic disease (PRD). This highlights the pressing need for strengthening paediatric rheumatology services in Africa, including increasing awareness about these conditions among the public and healthcare providers to improve early diagnosis and quality of life for children with these conditions.
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Affiliation(s)
- Dzifa Dey
- Rheumatology Unit, Department of Medicine and Therapeutics, University of Ghana Medical School Legon-Accra, Accra, Ghana.
- Rheumatology Unit, Department of Medicine and Therapeutics, Korle Bu Teaching Hospital, Accra, Ghana.
| | - Bright Katso
- Rheumatology Unit, Department of Medicine and Therapeutics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Afia Baah
- Department of Medicine and Therapeutics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Saudatu Isaaka
- Rheumatology Unit, Department of Medicine and Therapeutics, Korle Bu Teaching Hospital, Accra, Ghana
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Mitteilungen der DGRh - Veranstaltungen der Rheumaakademie. Z Rheumatol 2024; 83:172. [PMID: 38416149 DOI: 10.1007/s00393-024-01486-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
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Bao Y, Liang Q, Ji J, Cheng C, Dong C, Zhao R. Effects of exercise on depression in patients with rheumatic diseases: a systematic review and meta-analysis. Z Rheumatol 2024; 83:40-47. [PMID: 37079036 DOI: 10.1007/s00393-023-01321-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE To assess the effects of exercise intervention on depression in rheumatic diseases by means of a meta-analysis. METHODS The Cochrane Library, Embase, Medline, PubMed, and relevant records were searched. The qualities of randomized controlled trials were evaluated. Meta-analysis of the obtained related data was completed using RevMan 5.3. Heterogeneity was also evaluated with χ2 test and I2. RESULTS Twelve RCTs were reviewed. Compared with baseline, the meta-analysis results showed that there was significant difference in the improvement of depression assessed by HADs, BDI, CES‑D, and AIMS in patients with rheumatic diseases (post exercise vs. baseline, -0.73 [-1.05, -0.4], P < 0.0001, I2 = 0%). In subgroup analysis, although none of these trends in BDI and CES‑D subgroups were significant at P < 0.05, there were clear trends towards improvement in depression. CONCLUSION As an alternative or supplementary treatment, the effect of exercise on rheumatism is obvious. Rheumatologists can consider exercise as an integral part of the treatment of patients with rheumatism.
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Affiliation(s)
- Yanfeng Bao
- Nanjing University of Traditional Chinese Medicine, 210023, Nanjing, China
- Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China
| | - Qian Liang
- Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China
- Medical College, Nantong University, 226001, Nantong, China
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, China
| | - Juan Ji
- Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China
| | - Chun Cheng
- Nanjing University of Traditional Chinese Medicine, 210023, Nanjing, China
| | - Chen Dong
- Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China.
- Medical College, Nantong University, 226001, Nantong, China.
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, China.
| | - Rui Zhao
- Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China.
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, China.
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9
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Pickles T, Cowern M, Christensen R, Nielsen SM, Simon LS, Jones CMP, Maxwell LJ, Shea B, Strand V, Touma Z, Toupin-April K, Mease P, Choy E. Exploring the complexities of pain phenotypes: OMERACT 2023 chronic pain working group workshop. Semin Arthritis Rheum 2024; 64:152342. [PMID: 38128175 DOI: 10.1016/j.semarthrit.2023.152342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To educate and discuss pain mechanisms (nociceptive, neuropathic, nociplastic) illuminating its possible impact when measuring different outcomes, which may modify, confound and potentially bias the outcome measures applied across various aspects of Rheumatic Musculoskeletal Diseases (RMDs) clinical trials. METHODS In the plenary presentations, PM lectured on different pain mechanisms and impact on disease activity assessment. Data from two data sets of RMDs patients, which assessed the prevalence and impact of nociplastic pain were presented and reviewed. Audience breakout group sessions and polling were conducted. RESULTS Mixed pain etiologies may differentially influence disease activity assessment and therapeutic decision-making. Polling demonstrated a consensus on the need to assess different types of pain as a phenotype, as it constitutes an important contextual factor (a variable that is not an outcome of the trial, but needs to be recognized [and measured] to understand the study results), and to standardize across RMDs. CONCLUSION There is need for a standardized pain measure that can differentiate underlying pain mechanisms.
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Affiliation(s)
- Tim Pickles
- Centre for Trials Research, Cardiff University, Cardiff, UK.
| | | | - Robin Christensen
- Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Research Unit of Rheumatology, Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Copenhagen, Denmark
| | - Sabrina M Nielsen
- Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Research Unit of Rheumatology, Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Copenhagen, Denmark
| | | | - Caitlin M P Jones
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; The Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, NSW, Australia
| | - Lara J Maxwell
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Beverley Shea
- The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Vibeke Strand
- Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Zahi Touma
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Division of Rheumatology, Toronto Lupus Program, University of Toronto, Toronto, Ontario, Canada
| | - Karine Toupin-April
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Institut du Savoir Montfort, Ottawa, Ontario, Canada
| | - Philip Mease
- Seattle Rheumatology Associates and Division of Rheumatology Research, Swedish Medical Center, Seattle, WA, USA
| | - Ernest Choy
- CREATE Centre, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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Mitteilungen der DGRh - Veranstaltungen der Rheumaakademie. Z Rheumatol 2024; 83:83. [PMID: 38319364 DOI: 10.1007/s00393-024-01475-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
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11
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Proft F, Vossen D, Baraliakos X, Berliner MN, Fleck M, Keyßer G, Krause A, Lorenz HM, Manger B, Schuch F, Specker C, Wollenhaupt J, Voormann A, Raspe M, Krusche M, Pfeil A. Survey on the working, training, and research conditions of resident physicians in internistic and rheumatological continuing education-BEWUSST. Z Rheumatol 2024; 83:31-39. [PMID: 37847298 PMCID: PMC10879383 DOI: 10.1007/s00393-023-01433-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Data on the training and continuing education situation of residents in the field of internal medicine and rheumatology are not available for Germany. For this reason, the Commission for Education and Training of the German Society of Rheumatology (DGRh) initiated the BEWUSST survey on the working, training and research conditions of residents in rheumatology. METHODS A total of 102 questions on the topics of working conditions in everyday professional life, continuing medical education and training, compatibility of career and family, compatibility of work and research, perspectives as a rheumatologist and practical activities were included in an online questionnaire. RESULTS A total of 102 participants took part in the survey. Of the respondents 48.1% were satisfied with their professional situation, 40.2% of the participants were supervised by a specialist mentor and 54.9% were working as scientists during their work as a physician. A compatibility of family and career was possible for 34.7%. After completion of the residency 52.9% of the respondents aspired to a combined clinical and outpatient activity. CONCLUSION Half of the trainee rheumatologists are satisfied with their professional activities, although mentoring of the assistants in training should be further improved. With respect to the desired combined clinical and outpatient activity, the existing options should be expanded or new professional fields of activity should be established, so that the specialty remains attractive for the upcoming generations.
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Affiliation(s)
- Fabian Proft
- Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Diana Vossen
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Germany
| | | | - Michael N Berliner
- Rheumatology and Geriatrics, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Martin Fleck
- Clinic and Polyclinic for Internal Medicine I, University Hospital Regensburg, Regenburg, Germany
- Clinic and Polyclinic for Rheumatology/Clinical Immunology, Asklepios Klinikum Bad Abbach, Bad Abbach, Germany
| | - Gernot Keyßer
- Department of Internal Medicine, Clinic for Internal Medicine II, University Hospital Halle, Halle (Saale), Germany
| | - Andreas Krause
- Clinic for Internal Medicine, Department of Rheumatology, Clinical Immunology and Osteology, Immanuel Hospital Berlin, Berlin, Germany
| | - Hanns-Martin Lorenz
- Division of Rheumatology, Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Bernhard Manger
- Medical Clinic 3, Rheumatology and Immunology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Florian Schuch
- Internal Practice Group Rheumatology-Nephrology, Erlangen, Germany
| | - Christof Specker
- Clinic for Rheumatology and Clinical Immunology, Evangelisches Krankenhaus Kliniken Essen-Mitte, Essen, Germany
| | | | | | - Matthias Raspe
- Department of Infectious Diseases and Pulmonary Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Martin Krusche
- Section for Rheumatology and Inflammatory Systemic Diseases, University Hospital Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Alexander Pfeil
- Department of Internal Medicine III, University Hospital Jena, Friedrich-Schiller-University Jena, Am Klinikum 1, 07747, Jena, Germany.
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Avčin T, Ravelli A. Shaping the future of pediatric rheumatology. Pediatr Rheumatol Online J 2024; 22:15. [PMID: 38229098 DOI: 10.1186/s12969-024-00957-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024] Open
Affiliation(s)
- Tadej Avčin
- Department of Allergology, Rheumatology and Clinical Immunology, University Children's Hospital, University Medical Center Ljubljana, Bohoričeva 20, SI-1525, Ljubljana, Slovenia.
- Department of Pediatrics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| | - Angelo Ravelli
- IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal-Infantile Sciences, University of Genoa, Genoa, Italy
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13
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Dreher M, Witte T, Hoeper K, Assmann G, Proft F, Poddubnyy D, Murawski N, Triantafyllias K, Grodd M, Graf E, Fichtner UA, Binder H, Zeidler J, Hoeper JR, Callhoff J, Karberg K, Trautwein A, Tibyampansha D, Wojnowski L, Schmidt RE, Schwarting A. Rheuma-VOR study: optimising healthcare of rheumatic diseases by multiprofessional coordinating centres. Ann Rheum Dis 2024; 83:184-193. [PMID: 37890976 PMCID: PMC10850684 DOI: 10.1136/ard-2023-224205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 09/04/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVES Early diagnosis of inflammatory arthritis is critical to prevent joint damage and functional incapacities. However, the discrepancy between recommendations of early diagnosis and reality is remarkable. The Rheuma-VOR study aimed to improve the time to diagnosis of patients with early arthritis by coordinating cooperation between primary care physicians, specialists and patients in Germany. METHODS This prospective non-randomised multicentre study involved 2340 primary care physicians, 72 rheumatologists, 4 university hospitals and 4 rheumatology centres in 4 German Federal States. The two coprimary endpoints (time to diagnosis and screening performance of primary care physicians) were evaluated for early versus late implementation phase. Additionally, time to diagnosis and secondary endpoints (decrease of disease activity, increase in quality of life and overall well-being, improvement of fatigue, depression, functional ability, and work ability, reduction in drug and medical costs and hospitalisation) were compared with a reference cohort of the German Rheumatism Research Centre (DRFZ) reflecting standard care. RESULTS A total of 7049 patients were enrolled in the coordination centres and 1537 patients were diagnosed with a rheumatic disease and consented to further participation. A follow-up consultation after 1 year was realised in 592 patients. The time to diagnosis endpoint and the secondary endpoints were met. In addition, the calculation of cost-effectiveness shows that Rheuma-VOR has a dominant cost-benefit ratio compared with standard care. DISCUSSION Rheuma-VOR has shown an improvement in rheumatological care, patient-reported outcome parameters and cost savings by coordinating the cooperation of primary care physicians, rheumatologists and patients, in a nationwide approach.
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Affiliation(s)
- Matthias Dreher
- Division of Rheumatology and Clinical Immunology, Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Torsten Witte
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Kirsten Hoeper
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- Center for Rheumatology Lower Saxony, Hannover, Germany
| | - Gunter Assmann
- Center of Rheumatology and Clinical Immunology, RUB-University Hospital Minden JWK, Minden, Germany
| | - Fabian Proft
- Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Denis Poddubnyy
- Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Niels Murawski
- Internal Medicine I Oncology, Haematology, Clinical Immunology and Clinical Rheumatology, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany
| | - Konstantinos Triantafyllias
- Division of Rheumatology and Clinical Immunology, Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
- Center for Rheumatology Rhineland-Palatinate, Bad Kreuznach, Germany
| | - Marlon Grodd
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Erika Graf
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Urs A Fichtner
- Institute of Medical Biometry and Statistics, Section of Healthcare Research and Rehabilitation Research, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Jan Zeidler
- Center for Health Economics Research Hannover (CHERH), Leibniz Universitat Hannover, Hannover, Germany
| | - Juliana Rachel Hoeper
- Center for Health Economics Research Hannover (CHERH), Leibniz Universitat Hannover, Hannover, Germany
| | - Johanna Callhoff
- Epidemiology and Health Services Research, German Rheumatism Research Centre, Berlin, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charite Universitatsmedizin Berlin, Berlin, Germany
| | | | - Anna Trautwein
- Division of Rheumatology and Clinical Immunology, Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Dativa Tibyampansha
- Department of Pharmacolgy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Leszek Wojnowski
- Department of Pharmacolgy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Reinhold E Schmidt
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Andreas Schwarting
- Division of Rheumatology and Clinical Immunology, Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
- Center for Rheumatology Rhineland-Palatinate, Bad Kreuznach, Germany
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14
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Maheswaranathan M, Miller B, Ung N, Sinha R, Harrison C, Egeli BH, Degirmenci HB, Sirotich E, Liew JW, Grainger R, Chock EY. Patient perspectives on telemedicine use in rheumatology during the COVID-19 pandemic: survey results from the COVID-19 Global Rheumatology Alliance. Clin Rheumatol 2024; 43:543-552. [PMID: 37552351 DOI: 10.1007/s10067-023-06717-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/15/2023] [Accepted: 07/22/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE The COVID-19 pandemic resulted in rapid adoption of telemedicine in rheumatology. We described perspectives of patients with rheumatic diseases related to telemedicine use. METHODS An anonymous online survey for people with rheumatic diseases was launched in January 2021. We collected data on reasons for telemedicine use, perceived benefits, disadvantages and obstacles of telemedicine, perceived telemedicine effectiveness for different clinical tasks, level of satisfaction with telemedicine use, and future preferences for telemedicine. We summarized results with descriptive statistics and identified themes in free text responses to describe perspectives of telemedicine qualitatively. RESULTS We received 596 complete responses (85% female and 47% 41-60 years old). During the COVID-19 pandemic, 78% (467/596) of respondents used telemedicine, and 61% (283/467) of telemedicine users reported that telemedicine was as effective or more effective than an in-person visit. Younger participants and those in North America reported effectiveness and satisfaction with telemedicine at higher frequencies. Participants reported similar effectiveness to in-person visits for making medication changes and discussing disease symptoms or complications. CONCLUSION Most respondents found telemedicine at least as effective as in-person visits. Participants found telemedicine to be effective for specific scenarios, such as making medication changes and discussion of disease activity. Telemedicine may continue to be of importance in the care of patients with rheumatic diseases post pandemic, but likely for specific subsets of patients for specific visit indications. Key Points • Most patients with rheumatic disease found telemedicine as effective as in-person visits, particularly for some indications.
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Affiliation(s)
- Mithu Maheswaranathan
- Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
| | - Bruce Miller
- Department of Medicine, University of California San Diego School of Medicine, La Jolla, San Diego, CA, USA
| | - Natasha Ung
- NSW Health, St Leonards, NSW, Australia
- University of Sydney, Camperdown, NSW, Australia
| | | | - Carly Harrison
- LupusChat, New York, NY, USA
- COVID-19 Global Rheumatology Alliance, New York, NY, USA
| | - Bugra Han Egeli
- Department of Pediatrics, Children's Hospital of Los Angeles, University of Southern California, Los Angeles, CA, USA
| | - Huseyin Berk Degirmenci
- Section of Rheumatology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Emily Sirotich
- COVID-19 Global Rheumatology Alliance, New York, NY, USA
- Yale University School of Medicine, New Haven, CT, USA
| | - Jean W Liew
- Section of Rheumatology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Rebecca Grainger
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Eugenia Y Chock
- Section of Rheumatology, Department of Medicine, Yale School of Medicine, New Haven, CT, USA
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15
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Kocyigit BF, Assylbek MI, Akyol A, Abdurakhmanov R, Yessirkepov M. Vagus nerve stimulation as a therapeutic option in inflammatory rheumatic diseases. Rheumatol Int 2024; 44:1-8. [PMID: 37814148 DOI: 10.1007/s00296-023-05477-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/19/2023] [Indexed: 10/11/2023]
Abstract
The vagus nerve forms intricate neural connections with an extensive number of organs, particularly the digestive system. The vagus nerve has a pivotal role as a fundamental component of the autonomic nervous system, exhibiting an essential effect. It establishes a direct link with the parasympathetic system, consequently eliciting the synaptic release of acetylcholine. Recent studies have revealed the potential anti-inflammatory function of the vagus nerve. The activation of the hypothalamic system through the stimulation of vagal afferents is fundamentally involved in regulating inflammation. This activation process leads to the production of cortisol. The other mechanism, defined as the cholinergic anti-inflammatory pathway, is characterized by the involvement of vagal efferents. These fibers release the neurotransmitter acetylcholine at particular synaptic connections, involving interactions with macrophages and enteric neurons. The mechanism under consideration is ascribed to the α-7-nicotinic acetylcholine receptors. The fusion of acetylcholine receptors is responsible for the restricted secretion of inflammatory mediators by macrophages. A potential mechanism for anti-inflammatory effects involves the stimulation of the sympathetic system through the vagus nerve, leading to the control of immunological responses within the spleen. This article offers an extensive summary of the present knowledge regarding the therapeutic effectiveness of stimulating the vagus nerve in managing inflammatory rheumatic conditions based on the relationship of inflammation with the vagus nerve. Furthermore, the objective is to present alternatives that may be preferred while applying vagus nerve stimulation approaches.
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Affiliation(s)
- Burhan Fatih Kocyigit
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Adana Health Practice and Research Center, Adana, Turkey.
| | - Meirgul I Assylbek
- Department of Neurology, Psychiatry, Neurosurgery and Rehabilitation, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
- Department of Social Health Insurance and Public Health, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
- Medical Center ''Mediker'', Shymkent, Kazakhstan
| | - Ahmet Akyol
- Physiotherapy and Rehabilitation Application and Research Center, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Ruslan Abdurakhmanov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Marlen Yessirkepov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
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Miyamae T, Bando Y. Transition of Patients with Childhood-onset Rheumatic Diseases to Adult Medical Care in Japan. Intern Med 2024; 63:25-29. [PMID: 36261384 PMCID: PMC10824644 DOI: 10.2169/internalmedicine.0859-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/11/2022] [Indexed: 11/05/2022] Open
Abstract
Medical advances in childhood-onset chronic diseases (CCDs) have significantly improved the prognosis of these diseases; however, they have also resulted in an increase in the number of cases requiring continued medical care in adulthood. The transition from the pediatric to adult healthcare system has recently received worldwide attention. In Japan, in the last decade, there has been a growing awareness of the transition to adult health care in each specialized chronic disease area with a childhood onset. This review focuses on transitional care in pediatric rheumatology, a CCD. Non-pediatric rheumatology departments, such as rheumatology and orthopedics, are potential counterparts for accepting pediatric rheumatology patients; however, several challenges must be met for a seamless transition to adult care. The characteristics of pediatric rheumatic diseases, which are rarer than non-pediatric rheumatic diseases, and the status and problems in transition will be outlined. The mission of pediatricians is not only to follow up diseases but also to support patients' independence. All medical staff and multidisciplinary professionals must cooperate toward this new goal.
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Affiliation(s)
- Takako Miyamae
- Department of Pediatric Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Japan
- Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Japan
| | - Yuki Bando
- Department of Pediatrics, Kitasato University School of Medicine, Japan
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17
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Salvato M, Doria A. Controversies in in rheumatology and autoimmunity: Is CORA meeting a good educational tool to increase the scientific knowledge? Autoimmun Rev 2024; 23:103419. [PMID: 37633352 DOI: 10.1016/j.autrev.2023.103419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 08/22/2023] [Indexed: 08/28/2023]
Abstract
Rheumatology and Autoimmunity are closely related fields and are among the most exciting areas in Medicine. Many conditions once regarded as mysterious and incurable are better understood and managed nowadays. Part of the great interest in these subjects derives from the fact that many controversial issues have arisen due to the rapid progression of knowledge, which means they are debatable. Over the years, the Controversies in Rheumatology and Autoimmunity (CORA) meetings promoted critical discussions not as an end but as a tool to increase the scientific knowledge of Rheumatologists and Clinical Immunologists. Beyond pursuing knowledge, being critical means questioning our inveterate beliefs and evaluating new conjectures and hypotheses. Thus, the approach to the debates in Medicine should be done with an open mind and free from all prejudices. Freedom of thought and speech are the fundamental values of our University, as exemplified by the motto "Universa Universis Patavine Libertas" which means "Padua freedom is universal for everyone". Patavine libertas initially referred to freedom from political and religious power but also freedom in research and teaching. For these reasons, Galileo Galilei moved to Padua in 1592, where he spent the most prosperous years of his life before being accused of heresy by the catholic church. We aim for the CORA congress to be an open-minded forum where active participation and exchange of ideas are promoted without prejudice. This special Issue of Autoimmunity Reviews is devoted to some controversies debated during the 7th CORA conference held in Turin, Italy, on March 16-18, 2023. Here we will discuss controversial entities, the use of old and new drugs, and insights into the classification, assessment of disease activity, and management of rheumatic diseases.
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Affiliation(s)
- Mariangela Salvato
- Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Andrea Doria
- Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy.
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Dewing K. Reflections on the COVID-19 Pandemic: Advance Practice Providers-The Multitools of Rheumatology. Arthritis Care Res (Hoboken) 2024; 76:4-6. [PMID: 37544733 DOI: 10.1002/acr.25213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 07/20/2023] [Indexed: 08/08/2023]
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19
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Marinkov A, Dimova R, Karalilova R, Keskinova D, Bahariev D, Batalov K, Popova V, Batalov Z, Batalov A. The COVID-19 pandemic's impact on rheumatic disease patients' satisfaction with access to medical services. Rheumatol Int 2024; 44:157-164. [PMID: 37776498 DOI: 10.1007/s00296-023-05413-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/28/2023] [Indexed: 10/02/2023]
Abstract
The COVID-19 hurt various lifestyle aspects, especially the treatment and follow-up of patients with chronic diseases such as autoimmune inflammatory rheumatic diseases (RD). The new circumstances changed the frequency of medical examinations and the way patients with rheumatic diseases are followed up. The objective is to study the impact of COVID-19 on RD patients' satisfaction with access to medical services. A national multicenter observational cross-sectional anonymous online survey was conducted on patients with RD using a specially developed web-based platform and structured questionnaire https://rheumatologycovid19.bg/ . The study was carried out with the support of intra-university project №6/2022 MU-Plovdiv. 1288 patients participated, with an average age of 47.03 (SD ± 12.80 years), of whom 992 (81.6%) were women. The questionnaire contained 41 questions grouped into 5 panels. Descriptive statistics were used-mean, alternative analysis, logistic regression and Decision Tree using the CRT (classification and regression trees) method. The study found that RD patients' satisfaction with access to medical services was influenced by communication type and the frequency of visits to the rheumatologist, difficulties in prescribing and finding medicines and the presence of comorbidities. The likelihood of patients' satisfaction with their rheumatologist was 5.5 and 3 times higher for in-person and other means of communication, respectively, compared to those without any communication. The relative share of patients who communicated by phone was larger (59%) compared to pre-pandemic (41%), where direct contact with the physician prevailed (80%). The results of the study confirmed the need to optimize remote access to medical care for patients with RD during the pandemic.
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Affiliation(s)
- Aleksandar Marinkov
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
| | - Rositsa Dimova
- Department of Health Management and Health Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, 4002, Bulgaria.
| | - Rositsa Karalilova
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
| | - Donka Keskinova
- Department of Applied and Institutional Sociology, Faculty of Philosophy and History, University of Plovdiv Paisiy Hilendarski, Plovdiv, Bulgaria
| | - Dimitar Bahariev
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
- Medical University of Plovdiv, Plovdiv, 4002, Bulgaria
| | - Konstantin Batalov
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
| | - Velichka Popova
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
| | - Zguro Batalov
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
| | - Anastas Batalov
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
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20
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Huffman KF, Grimm KF, Allen KD. Reflections on the COVID-19 Pandemic: Impacts on Clinical Rheumatology Research. Arthritis Care Res (Hoboken) 2024; 76:15-18. [PMID: 37533231 DOI: 10.1002/acr.25214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/04/2023]
Affiliation(s)
- Katie F Huffman
- Department of Medicine, Division of Rheumatology, Allergy, and Immunology and Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill
| | - Kimberlea F Grimm
- Department of Medicine, Division of Rheumatology, Allergy, and Immunology and Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill
| | - Kelli D Allen
- Department of Medicine, Division of Rheumatology, Allergy, and Immunology and Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill, and Center of Innovation to Accelerate Discovery and Practice Transformation, Department of Veterans Affairs Health Care Center, Durham, North Carolina
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21
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Hsieh E, Dey D, Grainger R, Li M, Machado PM, Ugarte-Gil MF, Yazdany J. Global Perspective on the Impact of the COVID-19 Pandemic on Rheumatology and Health Equity. Arthritis Care Res (Hoboken) 2024; 76:22-31. [PMID: 37277949 DOI: 10.1002/acr.25169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/30/2023] [Indexed: 06/07/2023]
Abstract
Although the public health emergency associated with the COVID-19 pandemic has ended, challenges remain, especially for individuals with rheumatic diseases. We aimed to assess the historical and ongoing effects of COVID-19 on individuals with rheumatic diseases and rheumatology practices globally, with specific attention to vulnerable communities and lessons learned. We reviewed literature from several countries and regions, including Africa, Australia and New Zealand, China, Europe, Latin America, and the US. In this review, we summarize literature that not only examines the impact of the pandemic on individuals with rheumatic diseases, but also research that reports the lasting changes to rheumatology patient care and practice, and health service use. Across countries, challenges faced by individuals with rheumatic diseases during the pandemic included disruptions in health care and medication supply shortages. These challenges were associated with worse disease and mental health outcomes in some studies, particularly among those who had social vulnerabilities defined by socioeconomic, race, or rurality. Moreover, rheumatology practice was impacted in all regions, with the uptake of telemedicine and changes in health care utilization. While many regions developed rapid guidelines to disseminate scientific information, misinformation and disinformation remained widespread. Finally, vaccine uptake among individuals with rheumatic diseases has been uneven across the world. As the acute phase of the pandemic wanes, ongoing efforts are needed to improve health care access, stabilize rheumatology drug supplies, improve public health communication, and implement evidence-based vaccination practices to reduce COVID-19 morbidity and mortality among individuals with rheumatic diseases.
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Affiliation(s)
- Evelyn Hsieh
- Yale School of Medicine, New Haven, Connecticut, and VA Connecticut Healthcare System, West Haven, Connecticut
| | - Dzifa Dey
- Korle-bu Teaching Hospital and the University of Ghana Medical School, Accra, Ghana
| | | | - Mengtao Li
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Pedro M Machado
- University College London, NIHR University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, Northwick Park Hospital, and London North West University Healthcare NHS Trust, London, UK
| | - Manuel F Ugarte-Gil
- Universidad Científica del Sur and Hospital Nacional Guillermo Almenara Irigoyen - EsSalud, Lima, Perú
| | - Jinoos Yazdany
- San Francisco General Hospital and University of California, San Francisco
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22
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Martín Pérez AM, Máximo-Bocanegra N, Rivas Ruíz F, Alguacil-Diego IM, Martínez-Piédrola RM. [Occupational balance, disability and functionality in people with rheumatic disease]. An Sist Sanit Navar 2023; 46:e1053. [PMID: 38153135 PMCID: PMC10807200 DOI: 10.23938/assn.1053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/07/2023] [Accepted: 10/07/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND We aimed to assess the occupational balance of people with rheumatic disease, analyze its relationship with participation, performance, and satisfaction with daily life activities, and evaluate whether age or receiving non-pharmacological treatment affects the outcome. METHODS Cross-sectional study carried out between March and November 2021; patients with non-advanced stage of rheumatic disease from the ConArtritis Association - selected through simple random sampling -, were included. Sociodemographic data and scores from the OBQ, IMPACT-S, COPM questionnaires, and a questionnaire created ad hoc for daily life activities were collected online and/or by telephone. RESULTS The occupational balance of the 47 participants was low (OBQ: 34.2; SD: 13.7). Despite a high participation in daily life activities (IMPACT-S: 76.8; SD: 13.1), the degree of performance and satisfaction with these activities was far from optimal (COPM-R: 3.9; SD: 2.0 and COPM-S: 4.3; SD: 2.5); 46.8% of the participants found limitations in at least four daily life activities (basic and instrumental) and 61.7% used at least one support product in their daily lives. These limitations reduced their resting time and affected their jobs, hobbies, and personal relationships. The level of performance was negatively related to age (p=0.04); No changes in the scores were found in patients who received non-pharmacological treatment. CONCLUSIONS Our results suggest that individuals with non- advanced stage of a rheumatic disease perceive that their occupational balance may be improved should they have fewer limitations in daily life activities.
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Affiliation(s)
- Ana M Martín Pérez
- Universidad Rey Juan Carlos. Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física. Madrid. España.
| | - Nuria Máximo-Bocanegra
- Universidad Rey Juan Carlos. Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física. Madrid. España.
| | - Francisco Rivas Ruíz
- Hospital Costa del Sol. Unidad de Investigación e Innovación. Marbella, Málaga. España.
| | - Isabel M Alguacil-Diego
- Universidad Rey Juan Carlos. Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física. Madrid. España.
| | - Rosa M Martínez-Piédrola
- Universidad Rey Juan Carlos. Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física. Madrid. España.
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23
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Nasonov EL. [Autoimmunity in rheumatology: A review]. TERAPEVT ARKH 2023; 95:1056-1063. [PMID: 38158939 DOI: 10.26442/00403660.2023.12.202501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
Autoimmunity and autoinflammation, co-potentiating pathological processes, are considered within the "immune-inflammatory" continuum (continuity with a variety of elements), reflecting the close relationship between the innate and acquired immune responses. Autoimmunity is the leading pathogenetic mechanism for a specific type of human chronic inflammatory disorders - autoimmune diseases, affecting more than 10% of people in the general population. Advances in molecular biology, pharmacogenetics, and bioinformatics provided the background for individualizing therapy for systemic autoimmune rheumatic diseases within personalized medicine. Studying the immunopathogenesis mechanisms, improving diagnostics, interpreting the molecular taxonomy, and developing approaches to the prevention and personalized therapy of systemic autoimmune rheumatic diseases are the priority issues of modern medicine.
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Affiliation(s)
- E L Nasonov
- Nasonova Research Institute of Rheumatology
- Sechenov First Moscow State Medical University (Sechenov University)
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24
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Alqanatish J, Almojali A, Alfadhel A, Albelali A, Ahmed A, Alqahtani A, Alrasheed A, Alsewairi W, Alghnam S. COVID-19 and Pediatric Rheumatology: A Comprehensive Study from a Leading Tertiary Center in Saudi Arabia. J Epidemiol Glob Health 2023; 13:676-684. [PMID: 37594620 PMCID: PMC10686932 DOI: 10.1007/s44197-023-00142-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 07/24/2023] [Indexed: 08/19/2023] Open
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic has emerged as a significant global health concern, impacting millions of individuals worldwide. However, there remains a notable gap in the literature regarding pediatric studies, specifically focusing on children with rheumatic diseases and the potential risk factors associated with COVID-19 contraction in this specific patient population. Patients with rheumatic diseases are often undergoing immunemodulator/immunosuppressant therapies, which can further complicate their immune system response to infections. This is a retrospective cohort study conducted at King Abdullah Specialized Children's Hospital (KASCH), the largest tertiary care children's hospital in Saudi Arabia. The aim was to investigate the rate, clinical manifestations, risk factors, and outcomes of COVID-19 infection in pediatric patients with rheumatic diseases. All rheumatology patients (< 19 years) who presented to the hospital as outpatients, inpatients, and/or ER visits during the period of March 2020 to March 2022 were reviewed for confirmed diagnosis of COVID-19. Among 482 patients included in this study, 126 (26.1%, 95% CI 21.8-31.1) had COVID-19 infection, and no factors were identified to increase the risk of contracting the virus. Fever (55.6%, n = 70) followed by respiratory symptoms (55.6%, n = 70) were the most common clinical manifestations, and around 30% of the patients were asymptomatic. Though most of the patients recovered without complications (97.6%, n = 123), mortality was reported in 3 patients (2.38%). The risk of hospitalization was almost 6 times higher in males (OR = 5.97), and higher in patients receiving t-DMARDs (OR = 17.53) or glucocorticoids (OR = 6.69). The study also revealed that vaccinated children were at lower risk of hospitalization due to COVID-19 than non-vaccinated children. The findings of this study help to identify the risk factors for COVID-19 among children with rheumatic diseases and provide insight into the impact of the pandemic on this group. Overall, while most cases were mild and resolved on their own, unvaccinated patients and those receiving t-DMARDs or glucocorticoids needs vigilant monitoring during the COVID-19 infection. Furthermore, we strongly advocate for the widespread promotion of COVID-19 vaccination among pediatric rheumatology patients as it significantly reduces their risk of COVID-19-related hospitalization.
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Affiliation(s)
- Jubran Alqanatish
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 14611, Riyadh, Saudi Arabia.
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia.
- King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City (National Guard Health Affairs), 14611, Riyadh, Saudi Arabia.
| | - Abdullah Almojali
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 14611, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia
- King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City (National Guard Health Affairs), 14611, Riyadh, Saudi Arabia
| | - Abdulmajeed Alfadhel
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 14611, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia
- King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City (National Guard Health Affairs), 14611, Riyadh, Saudi Arabia
| | - Areej Albelali
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 14611, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia
- King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City (National Guard Health Affairs), 14611, Riyadh, Saudi Arabia
| | - Amal Ahmed
- King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City (National Guard Health Affairs), 14611, Riyadh, Saudi Arabia
| | - Abdullah Alqahtani
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia
| | - Abdulrhman Alrasheed
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 14611, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia
- King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City (National Guard Health Affairs), 14611, Riyadh, Saudi Arabia
| | - Wafaa Alsewairi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 14611, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia
- King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City (National Guard Health Affairs), 14611, Riyadh, Saudi Arabia
| | - Suliman Alghnam
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia
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25
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Ulysse SN, Chandler MT, Santacroce L, Cai T, Liao KP, Feldman CH. Social Determinants of Health Documentation Among Individuals With Rheumatic and Musculoskeletal Conditions in an Integrated Care Management Program. Arthritis Care Res (Hoboken) 2023; 75:2529-2536. [PMID: 37331999 PMCID: PMC10725994 DOI: 10.1002/acr.25174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/18/2023] [Accepted: 06/13/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE Social determinants of health (SDoH), such as poverty, are associated with increased burden and severity of rheumatic and musculoskeletal diseases. This study was undertaken to study the prevalence and documentation of SDoH-related needs in electronic health records (EHRs) of individuals with these conditions. METHODS We randomly selected individuals with ≥1 International Classification of Diseases, Ninth/Tenth Revision (ICD-9/10) code for a rheumatic/musculoskeletal condition enrolled in a multihospital integrated care management program that coordinates care for medically and/or psychosocially complex individuals. We assessed SDoH documentation using terms for financial needs, food insecurity, housing instability, transportation, and medication access according to EHR note review and ICD-10 SDoH billing codes (Z codes). We used multivariable logistic regression to examine associations between demographic factors (age, gender, race, ethnicity, insurance) and ≥1 (versus 0) SDoH need as the odds ratio (OR) with 95% confidence interval (95% CI). RESULTS Among 558 individuals with rheumatic/musculoskeletal conditions, 249 (45%) had ≥1 SDoH need documented in EHR notes by social workers, care coordinators, nurses, and physicians. A total of 171 individuals (31%) had financial insecurity, 105 (19%) had transportation needs, 94 (17%) had food insecurity; 5% had ≥1 related Z code. In the multivariable model, the odds of having ≥1 SDoH need was 2.45 times higher (95% CI 1.17-5.11) for Black versus White individuals and significantly higher for Medicaid or Medicare beneficiaries versus commercially insured individuals. CONCLUSION Nearly half of this sample of complex care management patients with rheumatic/musculoskeletal conditions had SDoH documented within EHR notes; financial insecurity was the most prevalent. Only 5% of patients had representative billing codes suggesting that systematic strategies to extract SDoH from notes are needed.
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Affiliation(s)
- Sciaska N. Ulysse
- Division of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Mia T. Chandler
- Division of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Rheumatology Program, Division of Immunology, Boston Children’s Hospital, Boston, MA
| | - Leah Santacroce
- Division of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Tianrun Cai
- Division of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Katherine P. Liao
- Division of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Candace H. Feldman
- Division of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
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26
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Mitteilungen der DGRh - Veranstaltungen der Rheumaakademie. Z Rheumatol 2023; 82:903. [PMID: 38047953 DOI: 10.1007/s00393-023-01456-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
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27
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Begum J, Clark R, Cornell T, Ryan S. Transforming rheumatology telephone advice line services. Musculoskeletal Care 2023; 21:1551-1553. [PMID: 37830782 DOI: 10.1002/msc.1833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023]
Affiliation(s)
- Julie Begum
- Bedfordshire Hospitals NHS Foundation Trust, Luton, UK
| | - Robert Clark
- Royal Free London NHS Foundation Trust, London, UK
| | - Trish Cornell
- University Hospitals Dorset NHS Foundation Trust, Poole, UK
| | - Sarah Ryan
- Midlands Partnership University NHS Foundation Trust, Newcastle-under-Lyme, UK
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28
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Schneeweiss-Gleixner M, Hillebrand C, Jaksits S, Fries J, Zauner M, Heinz G, Sengölge G, Staudinger T, Zauner C, Aletaha D, Machold KP, Schellongowski P, Bécède M. Characteristics and outcome of critically ill patients with systemic rheumatic diseases referred to the intensive care unit. RMD Open 2023; 9:e003287. [PMID: 38030230 PMCID: PMC10689389 DOI: 10.1136/rmdopen-2023-003287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVES Patients with systemic rheumatic diseases (SRDs) are at risk of admission to the intensive care unit (ICU). Data concerning these critically ill patients are limited to few retrospective studies. METHODS This is a single-centre retrospective study of patients with SRDs admitted to an ICU at the Vienna General Hospital between 2012 and 2020. Single-predictor and multiple logistic regression analysis was performed to identify potential outcome determinants. RESULTS A total of 144 patients accounting for 192 ICU admissions were included. Connective tissue diseases (CTDs), vasculitides and rheumatoid arthritis were the most common SRDs requiring ICU admission. Leading causes for ICU admission were respiratory failure and shock, as reflected by a high number of patients requiring mechanical ventilation (60.4%) and vasopressor therapy (72.9%). Overall, 29.2% of admissions were due to SRD-related critical illness. In 70.8% patients, co-existent SRD not responsible for the acute critical illness was documented. When comparing these subgroups, CTDs and vasculitides had a higher frequency in the patients with SRD-related critical illness. In a significantly higher proportion of patients in the SRD-related subgroup, diagnosis of SRD was made at the ICU. ICU and 6-month mortality in the overall population was 20.3% and 38.5%, respectively. Age, glucocorticoid therapy prior to hospital admission and disease severity were associated with poor outcome. CONCLUSIONS In this study, respiratory failure was the leading cause of ICU admission as reflected by high rates of required mechanical ventilation. Despite considerable severity of critical illness, survival rates were comparable to a general ICU population.
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Affiliation(s)
- Mathias Schneeweiss-Gleixner
- Clinical Division of Gastroenterology and Hepatology, Department of Medicine III, Intensive Care Unit 13.h1, Medical University of Vienna, Vienna, Austria
| | - Caroline Hillebrand
- Clinical Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Stephanie Jaksits
- Clinical Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Jonathan Fries
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Michael Zauner
- Clinical Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Gottfried Heinz
- Clinical Division of Cardiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
| | - Gürkan Sengölge
- Clinical Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Thomas Staudinger
- Intensive Care Unit 13.i2, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Christian Zauner
- Clinical Division of Gastroenterology and Hepatology, Department of Medicine III, Intensive Care Unit 13.h1, Medical University of Vienna, Vienna, Austria
| | - Daniel Aletaha
- Clinical Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Klaus P Machold
- Clinical Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Peter Schellongowski
- Intensive Care Unit 13.i2, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Manuel Bécède
- Clinical Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
- Lower Austrian Centre for Rheumatology, Department of Medicine II, State Hospital Stockerau, Stockerau, Austria
- Karl Landsteiner Institute for Clinical Rheumatology, Stockerau, Austria
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29
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Mitteilungen der DGRh - Veranstaltungen der Rheumaakademie. Z Rheumatol 2023; 82:821. [PMID: 37930388 DOI: 10.1007/s00393-023-01448-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
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30
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Yamazaki S, Izawa K, Matsushita M, Moriichi A, Kishida D, Yoshifuji H, Yamaji K, Nishikomori R, Mori M, Miyamae T. Promoting awareness of terminology related to unmet medical needs in context of rheumatic diseases in Japan: a systematic review for evaluating unmet medical needs. Rheumatol Int 2023; 43:2021-2030. [PMID: 37597057 DOI: 10.1007/s00296-023-05425-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 08/06/2023] [Indexed: 08/21/2023]
Abstract
To optimize patient prognosis, patient needs, including unmet needs, should be adequately assessed. However, such needs are more challenging to report and, consequently, more likely to go unmet compared with the needs reported by physicians. We aimed to determine the appropriate direction of future research on unmet medical needs in rheumatic diseases in Japan by conducting a literature review. We searched PubMed and Web of Science using 23 terms linked to unmet medical needs for major rheumatic diseases in Japan. Further, we collected articles on health-related quality of life and investigated the scales used for assessment, as well as whether the terms "unmet needs" or "unmet medical needs" were used. We identified 949 papers on 10 diseases, including systemic lupus erythematosus, systemic sclerosis, dermatomyositis, juvenile idiopathic arthritis, adult-onset Still's disease, antiphospholipid syndrome, mixed connective tissue disease, Takayasu arteritis, Sjögren's syndrome, and Behçet's disease; 25 of the 949 papers were selected for full-text review. Fifteen articles on five diseases were related to health-related quality of life. The term "unmet needs" was used in only one article. Six out of 15 studies used the 36-item short form survey, whereas the scales used in other studies differed. The optimal treatment plan determined by a physician may not necessarily align with the best interests of the patient. In clinical research, cross sectional and standardized indicators of health-related quality of life should be employed along with highly discretionary questionnaires to assess and optimize resource allocation in healthcare and simultaneously achieve patient-desired outcomes.
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Affiliation(s)
- Susumu Yamazaki
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Kazushi Izawa
- Department of Pediatrics, Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - Masakazu Matsushita
- Department of Internal Medicine and Rheumatology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Akinori Moriichi
- Division of Specific Pediatric Chronic Diseases, Research Institute, National Center for Child Health and Development, Tokyo, Japan
| | - Dai Kishida
- Department of Medicine (Neurology & Rheumatology), Shinshu University School of Medicine, Nagano, Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ken Yamaji
- Department of Internal Medicine and Rheumatology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Ryuta Nishikomori
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Masaaki Mori
- Department of Lifetime Clinical Immunology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takako Miyamae
- Pediatric Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University School of Medicine, Nagano, Japan
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31
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Chan A, Knitza J. Remote monitoring in rheumatology: seeing the right patient at the right time. Nat Rev Rheumatol 2023; 19:680-681. [PMID: 37550496 DOI: 10.1038/s41584-023-01008-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Affiliation(s)
- Antoni Chan
- Department of Rheumatology, Royal Berkshire NHS Foundation Trust, Reading, UK
| | - Johannes Knitza
- Department of Internal Medicine 3- Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.
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32
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Xiang L, Yoon S, Low AHL, Leung YY, Fong W, Lau TC, Koh DR, Thumboo J. Social cognitive theory to improve symptom appraisal and help-seeking among patients with autoimmune rheumatic diseases: A qualitative study. Int J Rheum Dis 2023; 26:2258-2266. [PMID: 37740602 DOI: 10.1111/1756-185x.14923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/11/2023] [Accepted: 09/07/2023] [Indexed: 09/24/2023]
Abstract
AIM Social cognitive theory (SCT) has been successfully employed to improve symptom appraisal and help-seeking among patients with various conditions but is yet to be applied in the context of autoimmune rheumatic diseases (ARDs). This study aimed to explore the applicability of SCT in and possible approaches to improving symptom appraisal and help-seeking of patients with ARDs, one of the key barriers to earlier diagnosis. METHODS Semi-structured interviews were conducted with 33 ARD patients with a prolonged pre-diagnosis interval (>3 months). We coded the transcripts deductively using SCT as the overarching framework and inductively for approaches identified from the interviews. RESULTS All six main concepts of SCT (behavioral capacity, expectations, self-efficacy, observational learning, reinforcements, and reciprocal determinism) were observed in the three stages of symptom appraisal and help-seeking (detection, interpretation, and response) of patients with ARDs. While many participants reported that they were able and confident to detect their symptoms, they lacked the behavioral capacity and self-efficacy to interpret symptoms correctly, which resulted in delayed help-seeking and diagnosis. Possible approaches to address this suggested by participants (such as education of the general population) could improve behavioral capacity and self-efficacy in symptom interpretation and enhance expectations, observational learning, reinforcements, and reciprocal determinism in symptom response. CONCLUSION Lack of behavioral capacity and self-efficacy was observed in symptom interpretation of patients with ARDs, which resulted in delayed help-seeking. Approaches could target the behavioral capacity and self-efficacy for symptom interpretation to facilitate early help-seeking and, in turn, earlier diagnosis among individuals with possible ARDs.
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Affiliation(s)
- Ling Xiang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sungwon Yoon
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Andrea H L Low
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Ying Ying Leung
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Tang Ching Lau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Medicine, National University Hospital, Singapore, Singapore
| | - Dow Rhoon Koh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Medicine, National University Hospital, Singapore, Singapore
| | - Julian Thumboo
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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33
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Proceedings of the 29th European Paediatric Rheumatology Congress. Pediatr Rheumatol Online J 2023; 21:122. [PMID: 37848930 DOI: 10.1186/s12969-023-00879-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
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34
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Gaertner K, Beer AM, Matthes H, Keusgen M, Frass M, Teut M, Steinmann D, Etter G, Geiger M, Weiermayer P. [Argument for an objective review of the available evidence on homeopathy in rheumatic diseases]. Z Rheumatol 2023; 82:711-713. [PMID: 37792029 DOI: 10.1007/s00393-023-01423-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 10/05/2023]
Affiliation(s)
- Katharina Gaertner
- Institut für Integrative Medizin, Universität Witten/Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Deutschland.
| | - André-Michael Beer
- Klinik für Naturheilkunde, Katholisches Klinikum Bochum, Klinik Blankenstein, Hattingen, Deutschland
| | | | | | - Michael Frass
- Institut für Homöopathieforschung, Wissenschaftliche Gesellschaft für Homöopathie (WissHom), Köthen, Wien, Österreich
| | - Michael Teut
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - Diana Steinmann
- Medizinische Hochschule Hannover, Klinik für Strahlentherapie und Spezielle Onkologie, Bereichsleitung Klaus-Bahlsen-Zentrum für Integrative Onkologie am CCC Hannover, Hannover, Deutschland
| | - Gisela Etter
- UNION Schweizerischer komplementärmedizinischer Ärzteorganisationen, Luzern, Schweiz
| | - Michaela Geiger
- Deutscher Zentralverein homöopathischer Ärzte (DZVhÄ), Berlin, Deutschland
| | - Petra Weiermayer
- Wissenschaftliche Gesellschaft für Homöopathie (WissHom), Köthen, Deutschland
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Jiang Y, Rudin RS, Solomon DH. Clinical Visit Frequencies in Rheumatology: A Systematic Literature Review. Arthritis Care Res (Hoboken) 2023; 75:2054-2062. [PMID: 36807719 PMCID: PMC10440366 DOI: 10.1002/acr.25106] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/02/2023] [Accepted: 02/16/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVE Clinical visits are a fundamental aspect of rheumatic disease care, but recommendations for appropriate visit frequencies are largely absent from guidelines, scarcely studied, and inconsistently reported. The aim of this systematic review was to summarize the evidence pertaining to visit frequencies for major rheumatic diseases. METHODS This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Title/abstract screening, full-text screening, and extraction were carried out by 2 independent authors. Annual visit frequencies were either extracted or calculated and stratified by disease type and country of study. Weighted mean annual visit frequencies were calculated. RESULTS A total of 273 relevant manuscript records were screened, and 28 were included after applying selection criteria. The included studies were equally divided between US and non-US and were published between 1985 and 2021. Most (n = 16) focused on rheumatoid arthritis (RA), systemic lupus erythematosus (SLE; n = 5), and fibromyalgia (FM; n = 4). For RA, the average annual visit frequencies were 5.25 for US rheumatologists, 4.80 for US non-rheumatologists, 3.29 for non-US rheumatologists, and 2.74 for non-US non-rheumatologists. For SLE, annual visit frequencies for non-rheumatologists were much higher than for US rheumatologists (12.3 versus 3.24). For FM, annual visit frequencies were 1.80 for US rheumatologists and 0.40 for non-US rheumatologists. There was a decreasing trend of visit frequency to rheumatologists from 1982 to 2019. CONCLUSION Evidence for rheumatology clinical visits was limited and heterogeneous on a global scale. However, general trends suggest more frequent visits in the US and less frequent visits in recent years.
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Affiliation(s)
| | | | - Daniel H Solomon
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Mitteilungen der DGRh - Veranstaltungen der Rheumaakademie. Z Rheumatol 2023; 82:725. [PMID: 37823954 DOI: 10.1007/s00393-023-01439-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
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Abstract
INTRODUCTION Sarcopenia is a condition characterized by decreased muscle strength and muscle mass, which can impact physical function. Sarcopenia develops as a consequence of age-related decline (primary sarcopenia) and has a major impact on physical, social, and emotional well-being. In addition, patients with rheumatic diseases may suffer from sarcopenia independently of aging (secondary sarcopenia). Exercise, pharmacological treatments, and nutritional supplementation are some of the strategies used for the management of sarcopenia in the general population. The aim of this review is to summarize the evidence around the prevalence and impact of sarcopenia in patients with rheumatic diseases. CONCLUSIONS From our review, we can state that sarcopenia is a common and prevalent condition among the rheumatic diseases. Furthermore, the impacts of sarcopenia are not well-appreciated, and the implementation of treatment strategies has not been widespread. Strategies such as exercise and some pharmacological treatments are effective in improving physical and functional impairment related to these conditions. FUTURE RESEARCH DIRECTIONS IN THE FIELD New pharmacological treatments are being actively studied and may contribute in the future to the management of sarcopenia.
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Affiliation(s)
- Rafaela Cavalheiro do Espírito Santo
- From the Laboratório de Doenças Auto Imunes, Serviço de Reumatologia, Hospital de Clínicas de Porto Alegre, Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Joshua F Baker
- Corporal Michael J. Crescenz VA Medical Center and the University of Pennsylvania, Philadelphia, PA
| | - Leonardo Peterson Dos Santos
- From the Laboratório de Doenças Auto Imunes, Serviço de Reumatologia, Hospital de Clínicas de Porto Alegre, Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Ricardo Machado Xavier
- From the Laboratório de Doenças Auto Imunes, Serviço de Reumatologia, Hospital de Clínicas de Porto Alegre, Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Kellahan S, Burnitt L, Eisen S, Curtis MP, Parks D. Development of a structured musculoskeletal and rheumatic disease continuing education program for nurse practitioners. J Am Assoc Nurse Pract 2023; 35:534-539. [PMID: 36626394 DOI: 10.1097/jxx.0000000000000832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/08/2022] [Indexed: 01/11/2023]
Abstract
ABSTRACT The workforce shortage of musculoskeletal and rheumatic disease (MSK-RMD) trained providers has led to the need for additional education for nurse practitioners (NPs) in MSK-RMD. An educational certificate was developed and implemented collaboratively between an academic medical center and a college of nursing. The NP-focused MSK-RMD education program enhanced the assessment and treatment of a variety of common RSK-RMD conditions. Interviews and online surveys were conducted with participants to evaluate the program experience. Participant interviews and survey findings demonstrate overall NP satisfaction with the program. Expanding the program to create an accessible virtual continuing education course may improve accessibility of MSK-RMD education for NPs in primary care and multidisciplinary environments.
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Affiliation(s)
- Sara Kellahan
- Division of Rheumatology, Washington University School of Medicine, Saint Louis, Missouri
| | - Lisa Burnitt
- BJC Medical Group, Rheumatology and Internal Medicine Associates, Saint Louis, Missouri
| | - Seth Eisen
- Director of Clinical Rheumatology Research Program, Washington University School of Medicine, Saint Louis, Missouri
| | - Mary P Curtis
- Barnes Jewish College, Goldfarb School of Nursing, Director of the Adult-Gerontology Primary Care Nurse Practitioner Program, Saint Louis, Missouri
| | - Deborah Parks
- Director of Clinical Operations, Rheumatology Washington University School of Medicine, Saint Louis, Missouri
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Mitteilungen der DGRh - Veranstaltungen der Rheumaakademie. Z Rheumatol 2023; 82:623. [PMID: 37695552 DOI: 10.1007/s00393-023-01426-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
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Iagnocco A, Ciccia F, Conti F, D'Angelo S, Epis OM, Govoni M, Guiducci S, Iannone F, Mosca M, Salaffi F, Sebastiani GD, Sonnati M, Caporali RF. Adherence to therapy in people with rheumatic and musculoskeletal diseases in Italy and the role of the digital health: results of an expert Delphi consensus survey. Clin Exp Rheumatol 2023; 41:1917-1925. [PMID: 37382465 DOI: 10.55563/clinexprheumatol/uip1u1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/29/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES To present the results of a Delphi consensus survey among Italian rheumatologists on adherence to therapy in people with rheumatic and musculoskeletal diseases (RMDs) in Italy and the role of digital health. METHODS A taskforce of 12 rheumatologists comprehensively discussed the applicability of the 2020 EULAR Points to Consider (PtCs) for Italian rheumatology practice and formulated 44 new country-specific statements. Through an on-line survey, the panellists voted on their level of agreement with the statements using a 10-point Likert scale (0: no agreement; 10: total agreement). A combination of two distinct criteria, a mean agreement level ≥8 and a percentage of at least 75% of responses with a value ≥8, was deemed acceptable. RESULTS The consensus threshold was reached for 43 of the 44 country-specific statements. The following were acknowledged among the barriers to applicability of the recommendations: visit time too short; lack of resources; lack of a clear operational flow-chart; lack of communication skills and poor knowledge of techniques to improve patient adherence by healthcare professionals (HCPs). CONCLUSIONS This consensus initiative helps contribute to more widespread implementation of EULAR PtCs in Italian rheumatology practice. Optimisation of visit time, greater availability of resources, specific training, use of standardised and validated protocols, and active involvement of patients represent the main goals. Digital health can provide valuable support for the application of PtCs and, more generally, in improving adherence. A collaborative effort between HCPs, patients and their associations, scientific societies, and policymakers is strongly advocated to overcome some of the barriers.
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Affiliation(s)
- Annamaria Iagnocco
- Academic Rheumatology Centre, AO Mauriziano Torino, and Dipartimento Scienze Cliniche e Biologiche, Università degli Studi di Torino, Italy.
| | - Francesco Ciccia
- Department of Precision Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - Fabrizio Conti
- Division of Rheumatology, Department of Internal Clinical Sciences, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy
| | | | - Oscar Massimiliano Epis
- Division of Rheumatology, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marcello Govoni
- Rheumatology Unit, Department of Medical Sciences, University of Ferrara, Italy
| | - Serena Guiducci
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Florence, Italy
| | | | - Marta Mosca
- Department of Rheumatology, University of Pisa, Italy
| | - Fausto Salaffi
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | | | | | - Roberto Felice Caporali
- Division of Clinical Rheumatology, ASST Gaetano Pini-CTO Institute, Milan, and Department of Clinical Sciences and Community Health, University of Milan, Italy
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Lakomek HJ, Fiori W. [Rheumatology centers according to the regulations of the Federal Joint Committee]. Z Rheumatol 2023; 82:552-562. [PMID: 36169704 DOI: 10.1007/s00393-022-01270-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 11/29/2022]
Abstract
With the Nursing Staff Strengthening Act (Pflegepersonal-Stärkungs-Gesetz), the legislator delegated the specification of the special tasks of centers and focal points to the Federal Joint Committee (G-BA). Due to extensive preliminary work it was already possible to agree on quality requirements and special tasks for rheumatology centers and centers for pediatric and adolescent rheumatology in the first version of the G‑BA regulations. Since publication in the Federal Gazette (Bundesanzeiger) on 12 March 2020, rheumatology centers have been able to negotiate surcharges for their special tasks if they have been designated accordingly by the state authorities responsible for hospital planning. So far, 14 rheumatological centers have been designated. Many patients continue to be treated in healthcare structures that are not specialized in acute inpatient rheumatological care. In addition to the additional remuneration, the designation as a rheumatology center can also contribute to patients becoming even more aware of the healthcare structures that are specialized for them. Acute inpatient rheumatology has several specializations. Some clinics have specialized in the multimodal treatment of chronic rheumatism patients and have gained a high level of expertise in this field. Many of these highly specialized clinics have so far been denied recognition as a center because the regulations of the G‑BA require the provision of further specialist departments at the same location. While for a large number of medical specializations the establishment at a maximum care hospital is likely to make sense, the specialist clinics focusing on the multimodal treatment of chronic rheumatism patients offer the possibility of strengthening rural areas.
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Affiliation(s)
| | - Wolfgang Fiori
- DRG-Research Group, Roeder & Partner - Ärzte PartG, Roeder & Partner - Ärzte PartG, 48308, Senden, Deutschland
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Skinner-Taylor CM, Perez-Barbosa L, Carrazco-Chapa A, Cardenas-de la Garza JA, Corral-Trujillo ME, Arévalo-Nieto FR, Guajardo-Aldaco AL, Aguilar-Leal A, Galarza-Delgado DA. The economic burden of prenatal care for women with rheumatic diseases: a cross-sectional study from a university hospital. Clin Rheumatol 2023; 42:2521-2523. [PMID: 37515655 DOI: 10.1007/s10067-023-06713-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/28/2023] [Accepted: 07/19/2023] [Indexed: 07/31/2023]
Affiliation(s)
- Cassandra Michele Skinner-Taylor
- Rheumatology Division, Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Lorena Perez-Barbosa
- Rheumatology Division, Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico.
| | - Anahí Carrazco-Chapa
- Rheumatology Division, Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Jesus Alberto Cardenas-de la Garza
- Rheumatology Division, Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Maria Eugenia Corral-Trujillo
- Rheumatology Division, Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Fany Rocío Arévalo-Nieto
- Rheumatology Division, Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Andrea Lizbeth Guajardo-Aldaco
- Rheumatology Division, Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Andrea Aguilar-Leal
- Rheumatology Division, Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Dionicio Angel Galarza-Delgado
- Rheumatology Division, Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
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Mitteilungen der DGRh - Veranstaltungen der Rheumaakademie. Z Rheumatol 2023; 82:537. [PMID: 37505254 DOI: 10.1007/s00393-023-01399-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
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Kocyigit BF, Sagtaganov Z, Yessirkepov M. The effectiveness of yoga as a form of exercise in the management of rheumatic diseases. Rheumatol Int 2023; 43:795-801. [PMID: 36856817 DOI: 10.1007/s00296-023-05291-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 02/18/2023] [Indexed: 03/02/2023]
Abstract
Yoga, a long-standing Indian tradition, has gained popularity globally, inspiring many different disciplines to employ it as a complementary treatment for various diseases. Yoga is primarily composed of numerous physical poses and positions that are coupled with breathing techniques, profound relaxation, and meditation. There are many types of yoga with varying levels of difficulty. Yoga, consisting of various poses and postures with distinct postural mechanics, is frequently highlighted as an exercise that improves both physical and mental health. Applying the proper techniques to yoga poses can boost balance, strength, and flexibility while also improving general health and quality of life. In addition to its physical benefits, it is recognized that yoga enhances an individual's mood, anxiety, and depression levels and their ability to deal with stress. Rheumatic diseases affect many different organs, particularly the musculoskeletal structures, and negatively impact patients' quality of life. Maintaining a sufficient level of exercise is essential to preserve and enhance physical function in addition to pharmaceutical therapy, the mainstay of rheumatic disease treatment. In treatment guidelines for many rheumatic diseases, exercise, and physiotherapy techniques are stressed as the most substantial component of non-pharmacological treatment. This review considered yoga a form of exercise outside of traditional practices. From this perspective, we aimed to summarize the efficacy of yoga practices on various rheumatic diseases. Additionally, we aimed to highlight possible mechanisms of action.
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Affiliation(s)
- Burhan Fatih Kocyigit
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey.
| | - Zhaxybek Sagtaganov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Marlen Yessirkepov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
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Kocyigit BF, Sagtaganov Z, Yessirkepov M, Akyol A. Assessment of complementary and alternative medicine methods in the management of ankylosing spondylitis, rheumatoid arthritis, and fibromyalgia syndrome. Rheumatol Int 2023; 43:617-625. [PMID: 36583800 PMCID: PMC9801164 DOI: 10.1007/s00296-022-05267-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/21/2022] [Indexed: 12/31/2022]
Abstract
A wide variety of musculoskeletal, arthritic, connective tissue, and vasculitic diseases fall under the umbrella of "rheumatic diseases". Ankylosing spondylitis, rheumatoid arthritis, and fibromyalgia syndrome are the three members of this disease group with relatively high prevalence. Pharmacological options are at the center of therapeutic algorithms in treating rheumatic diseases, particularly in reducing inflammation. Despite significant advances in pharmacological treatment in recent years, achieving complete treatment success in a group of patients is impossible. Therefore, patients with rheumatic diseases frequently utilize alternative treatment options, such as complementary and alternative medicine. Complementary and alternative medicine is a broad category of health practices not part of the leading health system. Patients with rheumatic diseases turn to complementary and alternative medicine for various reasons, including restricted access to some treatments due to high prices and rigorous regulations, worries about drug side effects, and symptoms that continue despite pharmacological treatment. In addition, because complementary and alternative medicine options are considered natural, they are frequently accepted as well tolerated and have few harmful effects. Ankylosing spondylitis, rheumatoid arthritis, and fibromyalgia syndrome are the primary foci of this comprehensive review. First, we attempted to summarize the non-traditional physical medicine and complementary and alternative medicine options that can be utilized to manage these diseases. Second, we addressed the link between exercise and inflammation in rheumatic diseases. We briefly discussed the possible benefits of exercise-based approaches. In addition, we highlighted the benefits of cooperation between rheumatology and physical medicine-rehabilitation clinics.
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Affiliation(s)
- Burhan Fatih Kocyigit
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey.
| | - Zhaxybek Sagtaganov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Marlen Yessirkepov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Ahmet Akyol
- Physiotherapy and Rehabilitation Application and Research Center, Hasan Kalyoncu University, Gaziantep, Turkey
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Vossen D, Knitza J, Klemm P, Haase I, Mucke J, Kernder A, Meyer M, Kleyer A, Sewerin P, Bendzuck G, Eis S, Krusche M, Morf H. [Acceptance of video consultation among patients with inflammatory rheumatic diseases depends on gender and location-Results of an online survey among patients and physicians]. Z Rheumatol 2023; 82:108-113. [PMID: 34448915 PMCID: PMC8391858 DOI: 10.1007/s00393-021-01052-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION In order to successfully integrate telemedicine into the daily routine of rheumatology, both the patient's and the physician's perspective are important. For this purpose, a detailed study by means of a web-based survey was conducted by the Working Group Young Rheumatology (AGJR) of the German Society for Rheumatology (DGRh) and the German Rheumatism League National Association. By means of subgroup analysis of the data regarding video consultation, the aim was now to find out which requirements and wishes patients and physicians have for video consultations. METHODS The prospective survey was distributed via social media, QR code and email. Descriptive statistics and regression analysis related to video consultation were performed and correlations were shown. RESULTS The data indicated positive attitudes toward video consultation on the part of both patients (n = 299) and rheumatologists (n = 129). A correlation between age and positive opinion of the video consultation was found among the patients (r = 0.161, p = 0.006), especially among female patients a positive approval of the video consultation was found with increasing age (r = 0.244, p < 0.001 to male patients: r = -0.190, p = 0.145). Regarding the travelling time to the treating rheumatologist, male patients found the video consultation more attractive with increasing travelling time (r = 0.229, p = 0.078). With respect to the wishes of patients and physicians, video consultation should be used primarily for follow-up or emergency appointments. Video consultation for initial appointments, on the other hand, was very rarely mentioned. CONCLUSION During the COVID 19 pandemic, video consultation was increasingly popular among rheumatology patients as well as among rheumatologists.
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Affiliation(s)
- Diana Vossen
- Rheinisches Rheumazentrum Meerbusch, St. Elisabeth Hospital, Hauptstr. 74-76, 40668, Meerbusch, Deutschland.
- Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft für Rheumatologie, Berlin, Deutschland.
| | - Johannes Knitza
- Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft für Rheumatologie, Berlin, Deutschland
- Medizinische Klinik 3 - Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - Philipp Klemm
- Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft für Rheumatologie, Berlin, Deutschland
- Abteilung für Rheumatologie & Klinische Immunologie, Campus Kerckhoff der Justus-Liebig-Universität Gießen, Bad Nauheim, Deutschland
| | - Isabell Haase
- Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft für Rheumatologie, Berlin, Deutschland
- Poliklinik für Rheumatologie & Hiller Forschungszentrum, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Johanna Mucke
- Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft für Rheumatologie, Berlin, Deutschland
- Poliklinik für Rheumatologie & Hiller Forschungszentrum, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Anna Kernder
- Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft für Rheumatologie, Berlin, Deutschland
- Poliklinik für Rheumatologie & Hiller Forschungszentrum, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Marco Meyer
- Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft für Rheumatologie, Berlin, Deutschland
- Abteilung für Rheumatologie, Klinikum Bad Bramsted, Bad Bramstedt, Deutschland
| | - Arnd Kleyer
- Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft für Rheumatologie, Berlin, Deutschland
- Medizinische Klinik 3 - Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - Philipp Sewerin
- Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft für Rheumatologie, Berlin, Deutschland
- Poliklinik für Rheumatologie & Hiller Forschungszentrum, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | | | - Sabine Eis
- Deutsche Rheuma-Liga Bundesverband e. V., Bonn, Deutschland
| | - Martin Krusche
- Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft für Rheumatologie, Berlin, Deutschland
- Abteilung für Rheumatologie und klinische Immunologie, Campus Charité Mitte, Berlin, Deutschland
| | - Harriet Morf
- Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft für Rheumatologie, Berlin, Deutschland
- Medizinische Klinik 3 - Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
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Mitteilungen der DGRh - Veranstaltungen der Rheumaakademie. Z Rheumatol 2023; 82:183. [PMID: 36862176 DOI: 10.1007/s00393-023-01339-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Siegel CH, Choi JM, D'Angelo D, Christos P, Lally L, Navarro-Millan I, Cooke J, Goyal P, Mandl LA, Barbhaiya M. Outcomes of COVID-19 and Factors Associated With Its Severity Among Hospitalized Patients With and Without Systemic Rheumatic Disease During the First Wave of the Pandemic in New York City. J Clin Rheumatol 2023; 29:7-15. [PMID: 35905465 PMCID: PMC9803346 DOI: 10.1097/rhu.0000000000001891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND/OBJECTIVE Conflicting data exist regarding whether patients with systemic rheumatic disease (SRD) experience more severe outcomes related to COVID-19. Using data from adult patients hospitalized with COVID-19 in New York City during the first wave of the pandemic, we evaluated whether patients with SRD were at an increased risk for severe outcomes. METHODS We conducted a medical records review study including patients aged ≥18 years with confirmed SARS-CoV-2 infection hospitalized at 3 NewYork-Presbyterian sites, March 3-May 15, 2020. Inverse probability of treatment weighting was applied to a multivariable logistic regression model to assess the association between SRD status and the composite of mechanical ventilation, intensive care unit admission, or death. RESULTS Of 3710 patients hospitalized with COVID-19 (mean [SD] age, 63.7 [17.0] years; 41% female, 29% White, and 34% Hispanic/Latinx), 92 (2.5%) had SRD. Patients with SRD had similar age and body mass index but were more likely to be female, ever smokers, and White or Black, compared with those without SRD. A higher proportion of patients with versus without SRD had hypertension and pulmonary disease, and used hydroxychloroquine, corticosteroids, and immunomodulatory/immunosuppressive medications before admission. In the weighted multivariable analysis, patients with SRD had an odds ratio of 1.24 (95% confidence interval, 1.10-1.41; p < 0.01) for the composite of mechanical ventilation, intensive care unit admission, or death, compared with patients without SRD. CONCLUSIONS During the initial peak of the pandemic in New York City, patients with versus without SRD hospitalized with COVID-19 had a 24% increased likelihood of having severe COVID-19 after multivariable adjustment.
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Affiliation(s)
- Caroline H. Siegel
- From the Division of Rheumatology, Hospital for Special Surgery
- Department of Medicine, Weill Cornell Medicine
| | - Jacky M. Choi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY
| | - Debra D'Angelo
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY
| | - Paul Christos
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY
| | - Lindsay Lally
- From the Division of Rheumatology, Hospital for Special Surgery
- Department of Medicine, Weill Cornell Medicine
| | - Iris Navarro-Millan
- From the Division of Rheumatology, Hospital for Special Surgery
- Department of Medicine, Weill Cornell Medicine
| | - Joseph Cooke
- Department of Medicine, Weill Cornell Medicine
- Department of Medicine, NewYork-Presbyterian/Queens, Queens, NY
| | - Parag Goyal
- Department of Medicine, Weill Cornell Medicine
| | - Lisa A. Mandl
- From the Division of Rheumatology, Hospital for Special Surgery
- Department of Medicine, Weill Cornell Medicine
| | - Medha Barbhaiya
- From the Division of Rheumatology, Hospital for Special Surgery
- Department of Medicine, Weill Cornell Medicine
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY
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Jacobs A, Elghawy O, Baruqui DL, Elghawy AA. Current State of Platelet-rich Plasma in the Treatment of Rheumatic Disease: A Retrospective Review of the Literature. Curr Rheumatol Rev 2023; 19:400-407. [PMID: 37078351 PMCID: PMC10523354 DOI: 10.2174/1573397119666230420112017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 04/21/2023]
Abstract
INTRODUCTION Rheumatic diseases are a spectrum of autoimmune or inflammatory diseases that cause damage to the musculoskeletal system as well as vital organs, such as the heart, lungs, kidneys, and central nervous system. METHODS The study of rheumatic disease has made great progress in the understanding and management of these conditions in the last few decades using disease-modifying antirheumatic drugs and synthesized biological immunomodulating therapies. However, one potential treatment that has not been well investigated in rheumatic disease is platelet-rich plasma (PRP). PRP is proposed to facilitate the healing of injured tendons and ligaments through a variety of mechanisms, including mitogenesis, angiogenesis and macrophage activation via cytokine release, although its exact mechanism is unclear. RESULT There has been a great deal of work in determining the exact preparation method and composition of PRP for regenerative purposes in orthopedic surgery, sports medicine, dentistry, cardiac surgery, pediatric surgery, gynecology, urology, plastic surgery, ophthalmology, and dermatology. Despite this, there is a paucity of research on the impact of PRP on rheumatic disease. CONCLUSION This study aims to summarize and evaluate the current research concerning the use of PRP in rheumatic disease.
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Affiliation(s)
- Adam Jacobs
- Mount Sinai Medical Center, Miami Beach, FL, United States
| | - Omar Elghawy
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | | | - Ahmed Aly Elghawy
- Department of Rheumatologic and Immunologic Disease, Cleveland Clinic, Cleveland, OH, United States
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50
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Zhou Y, Song HM. [Interpretation on the 2021 European League Against Rheumatism and American College of Rheumatology points to consider for diagnosis and management of autoinflammatory type Ⅰ interferonopathies]. Zhonghua Er Ke Za Zhi 2022; 60:1258-1261. [PMID: 36444426 DOI: 10.3760/cma.j.cn112140-20220825-00750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Y Zhou
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - H M Song
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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