Revista Colombiana de Reumatología (English Edition)最新文献

Growing up with juvenile idiopathic arthritis: Social issues 在幼年特发性关节炎中成长：社会问题

Revista Colombiana de Reumatología (English Edition)

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreue.2023.08.003

Sirine Miri , Hanene Lassoued Ferjani , Dorra Ben Nessib , Fatma Majdoub , Dhia Kaffel , Kaouther Maatallah , Wafa Hamdi

Introduction

Juvenile idiopathic arthritis is a chronic inflammatory condition interfering with daily activities, social integration, and school attendance in children because of pain and joint inflammation during disease flares. Online resources might help children with JIA improve their social interactions and enhance their knowledge about their disease and the available therapeutic strategies.

Objective

This study aims to reveal the social issues encountered by teenagers prone to JIA and determine their perception of the impact of social media on their daily life.

Material and methods

We conducted this study using inductive qualitative methods to describe the sociocultural perception and experience of adolescents with JIA aged between 8 and 16 years.

Results

Individual interviews were held with 22 adolescents diagnosed with JIA. Fifty-two percent felt like outcasts and rejected by their peers because of their illness. Most of the participants expressed a need for their friends to be informed about their JIA diagnosis. Twenty-two-point-seven percent stated that they played sports for more than 5 h a week. A total of 31.8% found their physical performance was not affected by their disease. Ninety-seven of the participants confirmed that they use social media on average 3 h a day. YouTube and Facebook were ranked respectively as the first and the second preferred platforms. Seventeen percent of the children viewed these platforms as positive and helpful in dealing with JIA, especially by taking their minds off the pain, dealing with the stress resulting from the lack of mobility, and facilitating interactions with others.

Conclusion

Social integration in children with JIA is still challenging. Social media is helpful in managing JIA and improving social interactions, and in gaining useful information.

导言青少年特发性关节炎是一种慢性炎症，由于疾病发作时的疼痛和关节炎症，会影响儿童的日常活动、社会融合和上学。本研究旨在揭示易患 JIA 的青少年所遇到的社会问题，并确定他们对社交媒体对其日常生活的影响的看法。材料和方法我们采用归纳定性方法进行了这项研究，以描述 8 至 16 岁 JIA 青少年的社会文化观念和经历。52%的受访者感觉自己是被遗弃者，因为他们的疾病而被同龄人排斥。大多数参与者表示需要让他们的朋友了解他们的JIA诊断。22.7%的人表示他们每周运动时间超过 5 小时。31.8%的人认为他们的运动表现没有受到疾病的影响。97%的参与者确认他们平均每天使用社交媒体 3 小时。YouTube 和 Facebook 分别被列为第一和第二首选平台。17%的儿童认为这些平台对他们应对 JIA 有积极的帮助，尤其是可以让他们忘却疼痛、应对因行动不便而产生的压力以及促进与他人的交流。社交媒体有助于管理 JIA、改善社交互动和获取有用信息。

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引用次数: 0

Design and implementation of clinical care centres for spondyloarthritis. A benchmark care and disease model in chronic pathologies 脊柱关节炎临床护理中心的设计与实施。慢性病的基准护理和疾病模式

Revista Colombiana de Reumatología (English Edition)

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreue.2024.08.003

Wilson Bautista-Molano , Paul Méndez-Patarroyo , Helbert Orlando Arévalo Roa , Gerardo Quintana-López

Introduction

Spondyloarthritis (SpA) is a musculoskeletal disease presenting with phenotypic clinical manifestations, integrating a set of interrelated inflammatory conditions, which share immunogenetic, epidemiological, and therapeutic characteristics.

Objective

to do a reflection exercise through the experience of designing and implementing a clinical care center for spondyloarthropathies, from the administrative and clinical perspective to the implications in decision making and impact on the different indicators related to efficiencies and safety of the services included in the model.

Results

In clinical practice, the reality of the care process in patients diagnosed with SpA represents an area of opportunity in multiple aspects. The fragmentation of clinical care and the heterogeneous flow of the patient in the care pathway, are associated with suboptimal and undesired clinical outcomes. Several aspects highlight the reality of patients with SpA in the national scenario, which -to a certain extent- could reflect what is observed in other Latin American countries. SpA represents a very significant burden for society and for individuals affected by this condition. Comprehensive assessment of the burden of disease from the perspective of the clinician and the patient is important, in order to support decisions related to treatment and comprehensive management of this condition. The improvement in health outcomes and the reduction in the cost of chronic inflammatory diseases, such as SpA, are the main advantages of implementing a care model in specialized centres integrating a multidisciplinary team.

Conclusion

This is an opportunity to include the perspective of individuals affected by this condition, seeking integration between an informed patient and a highly qualified multidisciplinary care team in the comprehensive management of patients with SpA.

导言软骨关节炎（Spondyloarthritis，SpA）是一种具有表型临床表现的肌肉骨骼疾病，它综合了一系列相互关联的炎症，具有共同的免疫遗传学、流行病学和治疗学特征。目标通过设计和实施脊柱关节病临床护理中心的经验进行反思，从行政和临床角度分析决策的影响，以及对该模式所含服务的效率和安全性相关不同指标的影响。临床护理的分散性和患者在护理路径中的异质性流动与不理想和不期望的临床结果有关。有几个方面凸显了国内 SpA 患者的实际情况，这在一定程度上反映了其他拉美国家的情况。SpA给社会和患者带来了沉重的负担。从临床医生和患者的角度对疾病负担进行全面评估非常重要，有助于做出治疗和综合管理该疾病的相关决定。结论：这是一个将受该疾病影响的个人视角纳入其中的机会，寻求将知情患者与高素质的多学科护理团队整合在一起，对 SpA 患者进行综合管理。

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引用次数: 0

Inadequate sleep as a limiting factor in achieving remission in patients with rheumatoid arthritis 睡眠不足是限制类风湿关节炎患者病情缓解的因素之一

Revista Colombiana de Reumatología (English Edition)

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreue.2023.05.005

Amarilis J. Pérez De Jesus , Nahir S. Pérez Soto , Miguel A. Vázquez Padua

Introduction

Good sleep has a restorative effect at the cellular level and helps maintain the body's homeostasis.

Objectives

Given our clinical experiences, we propose that sleep quality should be evaluated in patients with rheumatoid arthritis. Poor sleep quality should be considered as a factor that may impact clinical outcomes in patients with rheumatoid arthritis.

Materials and methods

We researched medical literature on clinical and physiological pathways associated with sleep quality.

Results

There is evidence that interleukin-6 and tumor necrosis factor have a role in inflammatory and immune imbalance as well as in sleep disturbance in patients with rheumatoid arthritis, which leads to the chronic inflammatory process seen in these patients. Most patients with rheumatoid arthritis report sleep problems, be it insomnia or other complaints of non-refreshing sleep. Lack of sleep or poor sleep patterns in these patients further compromise their quality of life. In patients with RA, aetiologies such as restless leg syndrome (RLS), sleep apnoea syndrome, and Temporomandibular Joint Dysfunction (TMJ) syndromes might contribute to sleep disturbances. This lack of restful sleep might limit our goal, as treating physicians, to achieve remission states in these patients.

Conclusions

It is our opinion that sleep quality evaluation must be addressed, monitored, and treated as part of the management of patients with RA. Bad sleep adds an additional burden to disease activity in patients with RA, besides, it limits patients’ possibility of achieving disease remission.

导言良好的睡眠在细胞水平上具有恢复作用，有助于维持机体的平衡。目的根据临床经验，我们建议对类风湿性关节炎患者的睡眠质量进行评估。结果有证据表明，白细胞介素-6 和肿瘤坏死因子在类风湿性关节炎患者的炎症和免疫失衡以及睡眠障碍中发挥作用，从而导致这些患者出现慢性炎症过程。大多数类风湿性关节炎患者都有睡眠问题，无论是失眠还是其他睡眠不清爽的主诉。这些患者缺乏睡眠或睡眠模式不佳会进一步影响他们的生活质量。在类风湿性关节炎患者中，不宁腿综合征（RLS）、睡眠呼吸暂停综合征和颞下颌关节功能障碍（TMJ）综合征等病因都可能导致睡眠障碍。我们认为，睡眠质量评估必须作为 RA 患者管理的一部分来处理、监测和治疗。我们认为，睡眠质量评估必须作为 RA 患者管理的一部分来处理、监测和治疗。睡眠质量差不仅会增加 RA 患者疾病活动的负担，还会限制患者获得疾病缓解的可能性。

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引用次数: 0

Evaluation of clinical outcomes in patients with rheumatoid arthritis from the patient's perspective: a narrative review of the literature 从患者角度评估类风湿关节炎患者的临床疗效：文献叙事回顾

Revista Colombiana de Reumatología (English Edition)

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreue.2024.09.002

Juliana Gil Samper , Felipe García Durán , Wilson Bautista Molano

Introduction

The evaluation of clinical outcomes in rheumatoid arthritis patients, including the patient's perspective, allows the inclusion of the patient's perspective in clinical decision-making using instruments designed for this purpose.

Objective

To identify and describe the instruments validated in Spanish to evaluate clinical outcomes in rheumatoid arthritis in daily clinical practice and from the patient's perspective, including disease activity, functionality, impact of the disease, adherence to treatment and quality of life.

Materials and methods

A review of the literature in various databases (PubMed, Scopus, Bireme, Scielo) was conducted looking for questionnaires that evaluate clinical outcomes in rheumatoid arthritis patients, including those with a validated Spanish translation that allow self-assessment of the disease by the patient and clinical monitoring.

Results

Fifteen questionnaires were identified and selected that met the inclusion criteria. Four instruments were found that evaluate quality of life, three that evaluate functionality, four that evaluate disease impact, one that evaluate disease activity, and three that evaluate adherence to treatment.

Conclusion

Questionnaires and scales that evaluate rheumatoid arthritis allow a clinical approach to the evolution of the disease as perceived and reported by the patients, optimizing clinical follow up. Implementation of these tools in clinical decision making allows for an improvement in quality of care of patient with this condition.

目的确定并描述经西班牙文验证的用于评估类风湿关节炎患者在日常临床实践中的临床结果的工具，并从患者的角度进行评估，包括疾病活动、功能、疾病影响、治疗依从性和生活质量。材料与方法对各种数据库（PubMed、Scopus、Bireme、Scielo）中的文献进行了回顾，以寻找评估类风湿关节炎患者临床疗效的问卷，包括那些经过验证的西班牙语翻译，允许患者对疾病进行自我评估和临床监测的问卷。结论评估类风湿性关节炎的问卷和量表有助于临床了解患者感知和报告的疾病演变情况，从而优化临床随访。在临床决策中使用这些工具可以提高对该病患者的护理质量。

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引用次数: 0

About autoimmunity and COVID-19 in pediatrics 关于儿科中的自身免疫和 COVID-19

Revista Colombiana de Reumatología (English Edition)

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreue.2024.09.003

Adriana Diaz-Maldonado

引用次数: 0

Autoimmunity in paediatric patients from a region of Colombia, after a SARS-CoV2 peak SARS-CoV2 高峰过后哥伦比亚某地区儿科患者的自身免疫问题

Revista Colombiana de Reumatología (English Edition)

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreue.2024.08.005

Valeria Camila Restrepo Arias

Introduction

With the onset of the 2019 coronavirus pandemic, there was an increase in the number of reported cases of autoimmune manifestations in the midst of the disease and new cases of autoimmunity after infection.

Objective

To correlate the rate of positive tests of SARS-CoV-2 with the rate of new diagnoses of autoimmune disease in paediatric patients of the department of Huila (Colombia), between March 2020 and September 2021.

Methods

The socio-demographic characterization of the subjects diagnosed with autoimmune disease and of the cases of SARS-CoV-2 was performed; an analysis of the monthly trend of events was performed and a correlation model was applied between the rate of SARS-CoV-2 diagnosis and the rate of autoimmune diseases during the study period.

Results

94 cases of autoimmune disease were diagnosed, with an average age of 8.3 years, most were girls and belonged to the urban area and the subsidized regimen, and immune thrombocytopenic purpura was the most common diagnosis. In addition, 4303 cases of SARS-CoV-2 were detected, mostly adolescents, from urban areas and the contributory system. Finally, it was evidenced that the highest rate of autoimmune disease was reported just after the highest peak of SARS-CoV-2.

Conclusions

This study did not show a statistical correlation between the rate of SARS-CoV-2 and the rate of diagnoses of autoimmune disease; however, it showed an enormous peak of autoimmunity after the highest peak of infection in paediatric patients of the department during the first eighteen months of the pandemic.

摘要: 随着2019年冠状病毒大流行的到来，在疾病期间报告的自身免疫表现病例和感染后新出现的自身免疫病例数量有所增加。方法对诊断为自身免疫性疾病的受试者和 SARS-CoV-2 病例进行社会人口学特征描述；对每月事件趋势进行分析，并在研究期间应用 SARS-CoV-2 诊断率与自身免疫性疾病发病率之间的相关模型。结果 94 例确诊为自身免疫性疾病，平均年龄为 8.3 岁，大多数为女孩，属于城市地区和补助疗程，免疫性血小板减少性紫癜是最常见的诊断。此外，还发现了 4303 例 SARS-CoV-2 病例，其中大部分是青少年，来自城市地区和补助系统。结论这项研究并未显示出 SARS-CoV-2 感染率与自身免疫性疾病诊断率之间存在统计学上的相关性；但研究显示，在大流行的前 18 个月中，该部门儿科患者的自身免疫性疾病发病率在感染最高峰之后达到了一个巨大的高峰。

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引用次数: 0

Validation of FACIT-fatigue in Spanish-speaking patients with rheumatoid arthritis 在讲西班牙语的类风湿关节炎患者中验证 FACIT 疲劳测试

Revista Colombiana de Reumatología (English Edition)

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreue.2023.05.006

Samantha Rodríguez-Muguruza , Sonia Castro , María José Poveda , Silvia Paredes , Delia Taverner , Oliver Valero , Ramon Fontova

Introduction

Fatigue is a frequent symptom in patients with rheumatoid arthritis (RA). The Functional Assessment of Chronic illnesses Therapy-Fatigue (FACIT-F) is an instrument that assesses self-reported fatigue and was validated for measuring fatigue in RA.

Objective

The aim of this study was to validate the FACIT-F for use in Spanish-speaking RA patients.

Materials and methods

Cross-sectional, multicentre study. We included patients (n = 192) with RA diagnosis from two hospitals. Exploratory and confirmatory analyses were conducted. Construct validity and internal consistency were evaluated.

Results

FACIT-F showed high internal consistency (Alpha = .87, Omega = .93). Analysis of the main components showed a single factor, which explained 62% of the variance. The confirmatory factor analysis showed a satisfactory fit of the model. We found a correlation between FACIT–F, VAS fatigue (−.72 p-value <,001), and BRAF-MDQ (−.81 p-value <.001).

Conclusion

FACIT-F is a valid instrument with a high internal consistency for measuring fatigue in clinical practice and research in Spanish-speaking patients with RA.

导言疲劳是类风湿关节炎（RA）患者经常出现的症状。慢性疾病治疗功能评估-疲劳（FACIT-F）是一种评估自我报告疲劳的工具，已被验证可用于测量 RA 患者的疲劳。我们纳入了两家医院的 RA 患者（n = 192）。进行了探索性和确认性分析。结果FACIT-F显示出较高的内部一致性（Alpha = .87，Omega = .93）。主成分分析表明，只有一个因子可以解释 62% 的方差。确认性因子分析显示模型的拟合度令人满意。我们发现 FACIT-F、VAS 疲劳度（-.72 p-value<,001）和 BRAF-MDQ （-.81 p-value<.001）之间存在相关性。

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引用次数: 0

Central tolerance in T cells, what’s new? T 细胞的中枢耐受性，有什么新发现？

Revista Colombiana de Reumatología (English Edition)

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreue.2024.09.001

Alex Imbachí-Salamanca , Gloria Vásquez

Introduction

Random somatic recombination of T cell receptors facilitates the variability of response to foreign antigens. Then, central tolerance occurs, a mechanism designed to avoid exit of autoreactive T cells from the thymus. However, failures in this process can induce the appearance of autoimmunity.

Materials and methods

This narrative review was conducted through a literature search focused on describing relevant and recent concepts of central tolerance of T cells.

Results

Multiple cell groups are part of the thymic microenvironment, among them, thymic epithelial cells are responsible for directing development of thymocytes, especially medullary thymic epithelial cells that direct the negative selection process.

Conclusions

Factors that affect thymocytes, the thymic microenvironment, or interaction between them, can lead to development of immunodeficiencies and/or autoimmunity.

导言T细胞受体的随机体细胞重组促进了对外来抗原反应的可变性。然后，中枢耐受发生，这是一种旨在避免自体反应性 T 细胞从胸腺退出的机制。材料与方法本综述通过文献检索进行，重点是描述 T 细胞中枢耐受的相关最新概念。结果胸腺微环境中有多个细胞群，其中胸腺上皮细胞负责指导胸腺细胞的发育，尤其是髓质胸腺上皮细胞指导负选择过程。

引用次数: 0

Balancing inflammation and adverse effects of glucocorticoids in clinical practice 在临床实践中平衡炎症和糖皮质激素的不良反应

Revista Colombiana de Reumatología (English Edition)

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreue.2023.08.004

Juan Sebastián Peinado-Acevedo , Tatiana Rivera-Bustamante , Jairo Rivera , Yeison Santamaría-Alza

Corticosteroids play a vital role in enabling the body to tolerate stressful situations and regulate the inflammatory process. Excessive or persistent inflammation can lead to tissue damage and the development of diseases. Glucocorticoids are crucial in modulating the impact of inflammatory disorders, such as allergies, autoimmune diseases, and sepsis. These disorders can be life-threatening and benefit from glucocorticoid administration. Natural and synthetic glucocorticoids are utilized for the diagnosis and treatment of adrenal function disorders and various inflammatory, immune, and neoplastic conditions. The discovery of glucocorticoids is a testament to the ingenuity and collaboration of researchers. For over 70 years, glucocorticoids have revolutionized medicine and are widely employed in various medical conditions. This article provides a comprehensive review of the critical considerations for the clinical application of glucocorticoids, aiming to strike a balance between their benefits and potential risks. Understanding its history, chemical structure, pharmacology, and mechanisms of action provides the foundation for achieving proper use of this type of medication.

皮质类固醇在帮助人体承受压力和调节炎症过程方面发挥着重要作用。过度或持续的炎症可导致组织损伤和疾病的发生。糖皮质激素对调节过敏、自身免疫性疾病和败血症等炎症性疾病的影响至关重要。这些疾病可能会危及生命，而糖皮质激素的应用会使它们受益。天然和合成的糖皮质激素可用于诊断和治疗肾上腺功能紊乱以及各种炎症、免疫和肿瘤疾病。糖皮质激素的发现证明了研究人员的智慧和合作。70 多年来，糖皮质激素给医学带来了革命性的变化，并被广泛应用于各种病症。本文全面回顾了糖皮质激素临床应用的关键注意事项，旨在平衡其益处和潜在风险。了解糖皮质激素的历史、化学结构、药理学和作用机制为正确使用此类药物奠定了基础。

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引用次数: 0

A comparison of core muscle endurance of females with fibromyalgia versus healthy females: An observational study 纤维肌痛女性患者与健康女性核心肌耐力的比较：观察研究

Revista Colombiana de Reumatología (English Edition)

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreue.2024.08.001

Dewanshu Sindwani, Manjyot Kaur

Introduction

Despite the numerous benefits of core muscle strengthening in improving symptoms of fibromyalgia (FM), limited studies have quantified core muscle function in FM patients.

Objective

To compare the core muscle endurance of FM females with age-matched healthy females and determine whether a correlation exists between core muscle endurance and FM severity.

Materials and methods

Pre-diagnosed female FM patients (n = 7) and age-matched healthy females (n = 19) were assessed using McGill's core endurance tests in four positions – flexion, extension, and bilateral side-bridge. The longest contraction holding time (in seconds) in each position was noted and compared in both groups. Additionally, patient-reported Fibromyalgia Impact Questionnaire (FIQ) scores were obtained to determine disease severity.

Results

The mean holding time for trunk extensors (26.14 ± 7.7 s), right lateral flexors (20.14 ± 8.3 s), and left lateral flexors (20.86 ± 5.3 s) was significantly lower in the FM females than the healthy females (trunk extensors = 55.21 ± 17.1 s; right lateral flexors = 36.05 ± 13.2 s; left lateral flexors = 35.11 ± 13.8 s). The endurance of trunk flexors was statistically similar in both groups (FM females = 52.14 ± 27.9 s; healthy females = 74.37 ± 37.7 s). Lastly, core muscle endurance was not correlated with the FIQ scores in FM patients (p > 0.05).

Conclusion

The results of this preliminary study revealed that core extensor and lateral flexor endurance in FM females was lower than their healthy female counterparts. Larger sample studies are needed to further substantiate our findings.

引言尽管增强核心肌肉对改善纤维肌痛（FM）症状有诸多益处，但对 FM 患者核心肌肉功能进行量化的研究却很有限。目的比较 FM 女性与年龄匹配的健康女性的核心肌肉耐力，并确定核心肌肉耐力与 FM 严重程度之间是否存在相关性。材料和方法使用麦吉尔核心耐力测试，在屈曲、伸展和双侧桥式四种姿势下，对确诊的女性 FM 患者（n = 7）和年龄匹配的健康女性（n = 19）进行评估。记录每个体位的最长收缩保持时间（秒），并对两组进行比较。结果躯干伸肌（26.14 ± 7.7 秒）、右侧屈肌（20.14 ± 8.3 秒）和左侧屈肌（20.86 ± 5.3 秒）的平均保持时间，FM 女性明显低于健康女性（躯干伸肌 = 55.21 ± 17.1 秒；右侧屈肌 = 36.05 ± 13.2 秒；左侧屈肌 = 35.11 ± 13.8 秒）。两组的躯干屈肌耐力在统计上相似（FM 女性 = 52.14 ± 27.9 秒；健康女性 = 74.37 ± 37.7 秒）。最后，核心肌耐力与 FM 患者的 FIQ 分数不相关（p > 0.05）。要进一步证实我们的研究结果，还需要进行更大规模的样本研究。

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引用次数: 0