首页 > 最新文献

JCR: Journal of Clinical Rheumatology最新文献

英文 中文
Scleroderma Renal Crisis and Musculoskeletal Corticosteroid Injections. 硬皮病肾危象与肌肉骨骼皮质类固醇注射。
IF 2.4 4区 医学 Q2 RHEUMATOLOGY Pub Date : 2025-01-01 Epub Date: 2024-11-11 DOI: 10.1097/RHU.0000000000002168
Maheswari Muruganandam, Eyerusalem B Akpan, Matthew K McElwee, N Suzanne Emil, Meredith C Keller, Adarsh S Vangala, Fatmah Dihowm, Sharon E Nunez, James I Gibb, Frank X O'Sullivan, Roderick A Fields, Wilmer L Sibbitt

Background/objective: Inflammatory arthritis frequently affects patients with systemic sclerosis (SSc) but musculoskeletal corticosteroid (MSKC) injections are often avoided due to concerns of scleroderma renal crisis (SRC). This study investigated the incidence of SRC following MSKC injections.

Methods: In a 136-SSc cohort, 46 subjects underwent a total of 330 MSKC injections each receiving a significant dosage of triamcinolone acetonide (mean, 95.2 ± 44.2 mg per injection session). Data on blood pressure (BP), serum creatinine and glucose, urine protein, and complications were obtained before and after injection from the patients' medical records.

Results: MSKC and control subjects were similar in age (MSKC: 58.9 ± 12.1 vs. 55.5 ± 14.9 years), female (MSKC: 97.8% [45/46] vs. 89.9% [81/90]), antinuclear antibody (MSKC: 71.7% [33/46] vs. 81.1% [73/90]), anti-centromere antibody (MSKC: 47.8% [22/46] vs. 37.8% [34/90]), anti-topoisomerase antibody (MSKC: 26.1% [12/46] vs. 26.7% [24/90]), and anti-RNA polymerase III antibody (MSKC: 17.4.1% [8/46] vs. 24.4% [22/90]) (all p > 0.05). Pre- and post-MSKC demonstrated nonsignificant changes in systolic BP (pre: 127 ± 22 vs. post: 127 ± 21 mm Hg, p = 1.0), diastolic BP (pre: 71 ± 13 vs. post: 71 ± 11 mm Hg, p = 1.0), creatinine (pre: 0.78 ± 0.56 vs. post: 0.76 ± 0.20 mg/dL, p = 0.64), glucose (pre: 100 ± 21 vs. post: 99 ± 24 mg/dL, p = 0.67), and urine protein-creatinine ratio (pre: 0.14 ± 0.12 vs. post: 0.12 ± 0.11 mg/mg, p = 0.41). One case of SRC with mortality occurred in the controls and none in the MSKC group. No infections, hematologic abnormalities, or tendon rupture were noted.

Conclusion: MSKC injections in established SSc are generally safe with low incidences of SRC and complications. However, it is still prudent to monitor high-risk individuals and recent-onset SSc post-MSKC injection.

背景/目的:炎症性关节炎经常影响系统性硬化症(SSc)患者,但由于担心硬皮病肾危象(SRC),患者通常避免注射肌肉骨骼皮质类固醇(MSKC)。本研究调查了注射 MSKC 后 SRC 的发生率:在136例SSc群组中,46名受试者共接受了330次MSKC注射,每次都接受了相当剂量的曲安奈德(triamcinolone acetonide)(平均每次95.2 ± 44.2毫克)。对注射前后的血压(BP)、血清肌酐和葡萄糖、尿蛋白以及并发症进行了回顾性分析:MSKC 和对照组受试者在年龄(MSKC:58.9 ± 12.1 岁 vs. 55.5 ± 14.9 岁)、女性(MSKC:97.8% [45/46] vs. 89.9% [81/90])、抗核抗体(MSKC:71.7% [33/46] vs. 81.1% [73/90])、抗中心粒抗体(MSKC:47.8% [22/46] vs. 37.8% [34/90])、抗拓扑异构酶抗体(MSKC:26.1% [12/46] vs. 26.7% [24/90])和抗 RNA 聚合酶 III 抗体(MSKC:17.4.1% [8/46] vs. 24.4% [22/90])(均 p > 0.05)。MSKC前后,收缩压(前:127 ± 22 vs. 后:127 ± 21 mm Hg,p = 1.0)、舒张压(前:71 ± 13 vs. 后:71 ± 11 mm Hg,p = 1.0)、肌酐(前:0.78 ± 0.56 vs. 后:0.76 ± 0.20 mg/dL,p = 0.64)、葡萄糖(前:100 ± 21 vs. 后:99 ± 24 mg/dL,p = 0.67)和尿蛋白-肌酐比值(前:0.14 ± 0.12 vs. 后:0.12 ± 0.11 mg/mg,p = 0.41)。对照组有一例 SRC 死亡病例,MSKC 组无一例。未发现感染、血液学异常或肌腱断裂:结论:对已确诊的 SSc 进行 MSKC 注射总体上是安全的,SRC 和并发症的发生率较低。结论:对已确诊的 SSc 进行 MSKC 注射总体上是安全的,SRC 和并发症的发生率较低,但仍需谨慎监测注射 MSKC 后的高危人群和新发 SSc。
{"title":"Scleroderma Renal Crisis and Musculoskeletal Corticosteroid Injections.","authors":"Maheswari Muruganandam, Eyerusalem B Akpan, Matthew K McElwee, N Suzanne Emil, Meredith C Keller, Adarsh S Vangala, Fatmah Dihowm, Sharon E Nunez, James I Gibb, Frank X O'Sullivan, Roderick A Fields, Wilmer L Sibbitt","doi":"10.1097/RHU.0000000000002168","DOIUrl":"10.1097/RHU.0000000000002168","url":null,"abstract":"<p><strong>Background/objective: </strong>Inflammatory arthritis frequently affects patients with systemic sclerosis (SSc) but musculoskeletal corticosteroid (MSKC) injections are often avoided due to concerns of scleroderma renal crisis (SRC). This study investigated the incidence of SRC following MSKC injections.</p><p><strong>Methods: </strong>In a 136-SSc cohort, 46 subjects underwent a total of 330 MSKC injections each receiving a significant dosage of triamcinolone acetonide (mean, 95.2 ± 44.2 mg per injection session). Data on blood pressure (BP), serum creatinine and glucose, urine protein, and complications were obtained before and after injection from the patients' medical records.</p><p><strong>Results: </strong>MSKC and control subjects were similar in age (MSKC: 58.9 ± 12.1 vs. 55.5 ± 14.9 years), female (MSKC: 97.8% [45/46] vs. 89.9% [81/90]), antinuclear antibody (MSKC: 71.7% [33/46] vs. 81.1% [73/90]), anti-centromere antibody (MSKC: 47.8% [22/46] vs. 37.8% [34/90]), anti-topoisomerase antibody (MSKC: 26.1% [12/46] vs. 26.7% [24/90]), and anti-RNA polymerase III antibody (MSKC: 17.4.1% [8/46] vs. 24.4% [22/90]) (all p > 0.05). Pre- and post-MSKC demonstrated nonsignificant changes in systolic BP (pre: 127 ± 22 vs. post: 127 ± 21 mm Hg, p = 1.0), diastolic BP (pre: 71 ± 13 vs. post: 71 ± 11 mm Hg, p = 1.0), creatinine (pre: 0.78 ± 0.56 vs. post: 0.76 ± 0.20 mg/dL, p = 0.64), glucose (pre: 100 ± 21 vs. post: 99 ± 24 mg/dL, p = 0.67), and urine protein-creatinine ratio (pre: 0.14 ± 0.12 vs. post: 0.12 ± 0.11 mg/mg, p = 0.41). One case of SRC with mortality occurred in the controls and none in the MSKC group. No infections, hematologic abnormalities, or tendon rupture were noted.</p><p><strong>Conclusion: </strong>MSKC injections in established SSc are generally safe with low incidences of SRC and complications. However, it is still prudent to monitor high-risk individuals and recent-onset SSc post-MSKC injection.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"12-19"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rituximab Treatment in Adult Patients With Idiopathic Inflammatory Myositis: A Systematic Review and Meta-analysis. 利妥昔单抗治疗特发性炎症性肌炎成人患者:系统回顾与元分析》。
IF 2.4 4区 医学 Q2 RHEUMATOLOGY Pub Date : 2025-01-01 Epub Date: 2024-11-11 DOI: 10.1097/RHU.0000000000002151
Lilian Otalora Rojas, Karishma Ramsubeik, Luis Sanchez-Ramos, Shastri Motilal, Jasvinder A Singh, Gurjit S Kaeley

Objective: This systematic review and meta-analysis assess the efficacy and safety of rituximab (RTX) in treating idiopathic inflammatory myositis (IIM).

Methods: PubMed and Embase were systematically searched for trials and observational studies involving RTX use in IIM. Data were analyzed using a random-effects model to generate pooled estimates for overall response, complete remission, partial response, and adverse events, with subgroup analyses by myositis type and RTX dosage (PROSPERO registered number CRD42022353740). Risk of bias assessments were done using the Newcastle-Ottawa Scale for observational studies and risk of bias 1 tool for trials.

Results: Seventeen studies (1 randomized controlled trial and 16 observational studies), encompassing 362 patients, were included. The overall pooled response rate was 70% (95% confidence interval [CI]: 57%-82%; I2 = 74%, p < 0.001). Complete remission occurred in 13% (95% CI: 3%-25%; I2 = 79%, p < 0.001) and partial response in 48% (95% CI: 30%-67%; I2 = 87%, p < 0.001), both with significant heterogeneity. Subgroup analysis revealed high response rates across all myositis types: polymyositis 69%, dermatomyositis 67%, antisynthetase syndrome 70%, juvenile dermatomyositis 60%, and immune-mediated necrotizing myopathy 86%. Response rates were similar between RTX induction doses of 1 g IV on days 0 and 14 (68%) and 375 mg/m 2 weekly for 4 weeks (71%). Reported adverse events totaled 120, including infusion reactions (18.5%) and infections (12.4%).

Conclusions: RTX shows a favorable clinical response in IIM treatment, though response rates vary. There was a significant heterogeneity in treatment effect estimates that are based on a small number of patients. The incidence of infusion reactions and infections highlights the need for careful monitoring. Further controlled trials are essential to refine treatment protocols and evaluate long-term outcomes for RTX's role in IIM.

目的:本系统综述和荟萃分析评估了利妥昔单抗(RTX)治疗特发性炎性肌炎(IIM)的有效性和安全性:本系统综述和荟萃分析评估了利妥昔单抗(RTX)治疗特发性炎症性肌炎(IIM)的有效性和安全性:系统检索了PubMed和Embase中涉及RTX用于特发性炎症性肌炎的试验和观察性研究。采用随机效应模型对数据进行分析,得出总体反应、完全缓解、部分反应和不良事件的汇总估计值,并根据肌炎类型和RTX剂量进行亚组分析(PROSPERO注册号为CRD42022353740)。对观察性研究采用纽卡斯尔-渥太华量表进行偏倚风险评估,对试验采用偏倚风险1工具进行评估:共纳入 17 项研究(1 项随机对照试验和 16 项观察性研究),涉及 362 名患者。总体汇总反应率为 70%(95% 置信区间 [CI]:57%-82%;I2 = 74%,P < 0.001)。完全缓解发生率为 13%(95% 置信区间:3%-25%;I2 = 79%,p < 0.001),部分应答发生率为 48%(95% 置信区间:30%-67%;I2 = 87%,p < 0.001),两者均存在显著的异质性。亚组分析显示,所有肌炎类型的应答率都很高:多发性肌炎为69%,皮肌炎为67%,抗合成酶综合征为70%,幼年皮肌炎为60%,免疫介导的坏死性肌病为86%。RTX诱导剂量为第0天和第14天静脉注射1克(68%)和每周注射375毫克/平方米持续4周(71%),两者的应答率相似。报告的不良事件共计120起,包括输液反应(18.5%)和感染(12.4%):结论:RTX在IIM治疗中显示出良好的临床反应,尽管反应率各不相同。结论:RTX 在 IIM 治疗中显示出良好的临床反应,尽管反应率各不相同,但基于少数患者的治疗效果估计值存在明显的异质性。输液反应和感染的发生率凸显了仔细监测的必要性。进一步的对照试验对于完善治疗方案和评估 RTX 在 IIM 中的长期疗效至关重要。
{"title":"Rituximab Treatment in Adult Patients With Idiopathic Inflammatory Myositis: A Systematic Review and Meta-analysis.","authors":"Lilian Otalora Rojas, Karishma Ramsubeik, Luis Sanchez-Ramos, Shastri Motilal, Jasvinder A Singh, Gurjit S Kaeley","doi":"10.1097/RHU.0000000000002151","DOIUrl":"10.1097/RHU.0000000000002151","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis assess the efficacy and safety of rituximab (RTX) in treating idiopathic inflammatory myositis (IIM).</p><p><strong>Methods: </strong>PubMed and Embase were systematically searched for trials and observational studies involving RTX use in IIM. Data were analyzed using a random-effects model to generate pooled estimates for overall response, complete remission, partial response, and adverse events, with subgroup analyses by myositis type and RTX dosage (PROSPERO registered number CRD42022353740). Risk of bias assessments were done using the Newcastle-Ottawa Scale for observational studies and risk of bias 1 tool for trials.</p><p><strong>Results: </strong>Seventeen studies (1 randomized controlled trial and 16 observational studies), encompassing 362 patients, were included. The overall pooled response rate was 70% (95% confidence interval [CI]: 57%-82%; I2 = 74%, p < 0.001). Complete remission occurred in 13% (95% CI: 3%-25%; I2 = 79%, p < 0.001) and partial response in 48% (95% CI: 30%-67%; I2 = 87%, p < 0.001), both with significant heterogeneity. Subgroup analysis revealed high response rates across all myositis types: polymyositis 69%, dermatomyositis 67%, antisynthetase syndrome 70%, juvenile dermatomyositis 60%, and immune-mediated necrotizing myopathy 86%. Response rates were similar between RTX induction doses of 1 g IV on days 0 and 14 (68%) and 375 mg/m 2 weekly for 4 weeks (71%). Reported adverse events totaled 120, including infusion reactions (18.5%) and infections (12.4%).</p><p><strong>Conclusions: </strong>RTX shows a favorable clinical response in IIM treatment, though response rates vary. There was a significant heterogeneity in treatment effect estimates that are based on a small number of patients. The incidence of infusion reactions and infections highlights the need for careful monitoring. Further controlled trials are essential to refine treatment protocols and evaluate long-term outcomes for RTX's role in IIM.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"33-39"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hypervirulent Klebsiella pneumoniae in Rheumatoid Arthritis on Abatacept. 阿帕他赛治疗类风湿性关节炎时出现的高病毒性肺炎克雷伯氏菌
IF 2.4 4区 医学 Q2 RHEUMATOLOGY Pub Date : 2025-01-01 Epub Date: 2024-11-11 DOI: 10.1097/RHU.0000000000002167
Atsuhiko Sunaga, Takuya Inoue
{"title":"Hypervirulent Klebsiella pneumoniae in Rheumatoid Arthritis on Abatacept.","authors":"Atsuhiko Sunaga, Takuya Inoue","doi":"10.1097/RHU.0000000000002167","DOIUrl":"10.1097/RHU.0000000000002167","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e4"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Myophosphorylase Deficiency. 肌磷酸酶缺乏症
IF 2.4 4区 医学 Q2 RHEUMATOLOGY Pub Date : 2025-01-01 Epub Date: 2024-11-11 DOI: 10.1097/RHU.0000000000002164
Justine K Weksel, Stephen Soloway
{"title":"Myophosphorylase Deficiency.","authors":"Justine K Weksel, Stephen Soloway","doi":"10.1097/RHU.0000000000002164","DOIUrl":"10.1097/RHU.0000000000002164","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e3"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genetic Risk Scores for the Clinical Rheumatologist. 临床风湿病学家的遗传风险评分。
IF 2.4 4区 医学 Q2 RHEUMATOLOGY Pub Date : 2025-01-01 Epub Date: 2024-10-25 DOI: 10.1097/RHU.0000000000002152
Austin M Wheeler, Thomas R Riley, Tony R Merriman

Background/historical perspective: The advent of genome-wide sequencing and large-scale genetic epidemiological studies has led to numerous opportunities for the application of genetics in clinical medicine. Leveraging this information toward the formation of clinically useful tools has been an ongoing research goal in this area. A genetic risk score (GRS) is a measure that attempts to estimate the cumulative contribution of established genetic risk factors toward an outcome of interest, taking into account the cumulative risk that each of these individual genetic risk factors conveys. The purpose of this perspective is to provide a systematic framework to evaluate a GRS for clinical application.

Summary of current literature: Since the initial polygenic risk score methodology in 2007, there has been increasing GRS application across the medical literature. In rheumatology, this has included application to rheumatoid arthritis, gout, spondyloarthritis, lupus, and inflammatory arthritis.

Major conclusions: GRSs are particularly relevant to rheumatology, where common diseases have many complex genetic factors contributing to risk. Despite this, there is no widely accepted method for the critical application of a GRS, which can be a particular challenge for the clinical rheumatologist seeking to clinically apply GRSs. This review provides a framework by which the clinician may systematically evaluate a GRS.

Future research directions: As genotyping becomes more accessible and cost-effective, it will become increasingly important to recognize the clinical applicability of GRSs and identify those of the highest utility for patient care. This framework for the evaluation of a GRS will also help ensure reliability among GRS research in rheumatology, thereby helping to advance the field.

背景/历史视角:全基因组测序和大规模遗传流行病学研究的出现,为遗传学在临床医学中的应用提供了大量机会。利用这些信息形成对临床有用的工具一直是这一领域的研究目标。遗传风险评分(GRS)是一种试图估算已确定的遗传风险因素对相关结果的累积贡献的方法,同时考虑到这些单个遗传风险因素所传递的累积风险。本视角的目的是提供一个系统框架,以评估临床应用中的遗传风险评分:自 2007 年首次提出多基因风险评分方法以来,医学文献中对 GRS 的应用越来越多。在风湿病学中,这包括类风湿性关节炎、痛风、脊柱关节炎、狼疮和炎症性关节炎的应用:主要结论:GRS 与风湿病学尤为相关,因为常见疾病的风险有许多复杂的遗传因素。尽管如此,目前还没有一种被广泛接受的方法来关键性地应用遗传风险预测系统,这对寻求临床应用遗传风险预测系统的临床风湿病学家来说是一个特殊的挑战。本综述提供了一个框架,临床医生可据此系统地评估基因分型系统:未来的研究方向:随着基因分型变得越来越容易获得,成本效益也越来越高,认识到基因分类系统的临床适用性并确定那些对患者护理最有用的基因分类系统将变得越来越重要。这一全球基因分型系统评估框架也将有助于确保风湿病学中全球基因分型系统研究的可靠性,从而推动该领域的发展。
{"title":"Genetic Risk Scores for the Clinical Rheumatologist.","authors":"Austin M Wheeler, Thomas R Riley, Tony R Merriman","doi":"10.1097/RHU.0000000000002152","DOIUrl":"10.1097/RHU.0000000000002152","url":null,"abstract":"<p><strong>Background/historical perspective: </strong>The advent of genome-wide sequencing and large-scale genetic epidemiological studies has led to numerous opportunities for the application of genetics in clinical medicine. Leveraging this information toward the formation of clinically useful tools has been an ongoing research goal in this area. A genetic risk score (GRS) is a measure that attempts to estimate the cumulative contribution of established genetic risk factors toward an outcome of interest, taking into account the cumulative risk that each of these individual genetic risk factors conveys. The purpose of this perspective is to provide a systematic framework to evaluate a GRS for clinical application.</p><p><strong>Summary of current literature: </strong>Since the initial polygenic risk score methodology in 2007, there has been increasing GRS application across the medical literature. In rheumatology, this has included application to rheumatoid arthritis, gout, spondyloarthritis, lupus, and inflammatory arthritis.</p><p><strong>Major conclusions: </strong>GRSs are particularly relevant to rheumatology, where common diseases have many complex genetic factors contributing to risk. Despite this, there is no widely accepted method for the critical application of a GRS, which can be a particular challenge for the clinical rheumatologist seeking to clinically apply GRSs. This review provides a framework by which the clinician may systematically evaluate a GRS.</p><p><strong>Future research directions: </strong>As genotyping becomes more accessible and cost-effective, it will become increasingly important to recognize the clinical applicability of GRSs and identify those of the highest utility for patient care. This framework for the evaluation of a GRS will also help ensure reliability among GRS research in rheumatology, thereby helping to advance the field.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"26-32"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sonographic and Disease Activity Findings Related With Medication Change in JIA: A Historical Cohort Study. 与 JIA 换药相关的声像图和疾病活动度结果:历史队列研究
IF 2.4 4区 医学 Q2 RHEUMATOLOGY Pub Date : 2025-01-01 Epub Date: 2024-11-12 DOI: 10.1097/RHU.0000000000002171
Ysabella Esteban, Pinar Ozge Avar-Aydin, Tracy V Ting, Amy Cassedy, Patricia Vega-Fernandez

Background: Musculoskeletal ultrasound (MSUS) is increasingly used to evaluate pediatric inflammatory arthritis. This study aimed to explore the relationship between MSUS findings with medication modifications in patients with juvenile idiopathic arthritis (JIA) and clinical disease activity measurements (clinical Juvenile Arthritis Disease Activity Score [cJADAS-10], active joint count [AJC], patient/parent global assessment [PPGA], and physician global assessment [PGA]).

Methods: Data from patients with JIA who underwent a 12-joint (bilateral second and third metacarpophalangeal, wrist, elbow, knee, and ankle) MSUS examination during a 57-month period were collected. Patients were categorized into 2 groups: a medication change group and a control group (patients without medication change). A pediatric-specific MSUS scoring system was used to assess MSUS findings. The association between clinical and MSUS findings was examined for the study groups.

Results: A total of 38 patients, 23 in the medication change group and 15 in the control group were included. The medication change group had higher AJC, PGA, and cJADAS-10. These patients also had a statistically significant presence of abnormal knee MSUS findings. For other joints, the frequency of abnormal MSUS findings was slightly higher in patients with a medication change, but the difference was not statistically significant. No strong correlation was observed between MSUS findings and clinical disease activity measurements.

Conclusions: Abnormal MSUS findings were not observed to be higher in patients with a change in medication except for the involvement of the knee joint. Further longitudinal studies are needed to understand the role of MSUS in the medical decision-making process in JIA.

背景:肌肉骨骼超声(MSUS)越来越多地被用于评估小儿炎症性关节炎。本研究旨在探讨幼年特发性关节炎(JIA)患者的 MSUS 检查结果与药物调整以及临床疾病活动度测量(临床幼年关节炎疾病活动度评分 [cJADAS-10]、活动关节计数 [AJC]、患者/家长全局评估 [PPGA] 和医生全局评估 [PGA])之间的关系:收集在 57 个月内接受过 12 个关节(双侧第二和第三掌指关节、腕关节、肘关节、膝关节和踝关节)MSUS 检查的 JIA 患者的数据。患者分为两组:换药组和对照组(未换药患者)。采用儿科专用的 MSUS 评分系统来评估 MSUS 检查结果。对研究组的临床和 MSUS 结果之间的关联进行了研究:共纳入 38 例患者,其中换药组 23 例,对照组 15 例。换药组的 AJC、PGA 和 cJADAS-10 值较高。这些患者的膝关节 MSUS 检查结果异常率也有显著统计学意义。就其他关节而言,换药组患者出现异常 MSUS 结果的频率略高,但差异无统计学意义。MSUS检查结果与临床疾病活动性测量结果之间并无明显相关性:除膝关节受累外,未观察到换药患者的 MSUS 检查结果异常率更高。需要进一步开展纵向研究,以了解 MSUS 在 JIA 医疗决策过程中的作用。
{"title":"Sonographic and Disease Activity Findings Related With Medication Change in JIA: A Historical Cohort Study.","authors":"Ysabella Esteban, Pinar Ozge Avar-Aydin, Tracy V Ting, Amy Cassedy, Patricia Vega-Fernandez","doi":"10.1097/RHU.0000000000002171","DOIUrl":"10.1097/RHU.0000000000002171","url":null,"abstract":"<p><strong>Background: </strong>Musculoskeletal ultrasound (MSUS) is increasingly used to evaluate pediatric inflammatory arthritis. This study aimed to explore the relationship between MSUS findings with medication modifications in patients with juvenile idiopathic arthritis (JIA) and clinical disease activity measurements (clinical Juvenile Arthritis Disease Activity Score [cJADAS-10], active joint count [AJC], patient/parent global assessment [PPGA], and physician global assessment [PGA]).</p><p><strong>Methods: </strong>Data from patients with JIA who underwent a 12-joint (bilateral second and third metacarpophalangeal, wrist, elbow, knee, and ankle) MSUS examination during a 57-month period were collected. Patients were categorized into 2 groups: a medication change group and a control group (patients without medication change). A pediatric-specific MSUS scoring system was used to assess MSUS findings. The association between clinical and MSUS findings was examined for the study groups.</p><p><strong>Results: </strong>A total of 38 patients, 23 in the medication change group and 15 in the control group were included. The medication change group had higher AJC, PGA, and cJADAS-10. These patients also had a statistically significant presence of abnormal knee MSUS findings. For other joints, the frequency of abnormal MSUS findings was slightly higher in patients with a medication change, but the difference was not statistically significant. No strong correlation was observed between MSUS findings and clinical disease activity measurements.</p><p><strong>Conclusions: </strong>Abnormal MSUS findings were not observed to be higher in patients with a change in medication except for the involvement of the knee joint. Further longitudinal studies are needed to understand the role of MSUS in the medical decision-making process in JIA.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"20-25"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intermittent Oral Hemorrhage in Systemic Sclerosis. 系统性硬化症间歇性口腔出血。
IF 2.4 4区 医学 Q2 RHEUMATOLOGY Pub Date : 2025-01-01 Epub Date: 2024-11-12 DOI: 10.1097/RHU.0000000000002161
Hirotaka Yamamoto, Yoshinori Taniguchi
{"title":"Intermittent Oral Hemorrhage in Systemic Sclerosis.","authors":"Hirotaka Yamamoto, Yoshinori Taniguchi","doi":"10.1097/RHU.0000000000002161","DOIUrl":"10.1097/RHU.0000000000002161","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e1"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nationwide Analysis of Variables Associated With Sarcoid Inpatient Mortality. 肉样瘤住院病人死亡率相关变量的全国性分析。
IF 2.4 4区 医学 Q2 RHEUMATOLOGY Pub Date : 2025-01-01 Epub Date: 2024-11-11 DOI: 10.1097/RHU.0000000000002162
Michael Manansala, Janelle Castellino, Shilpa Arora, Augustine M Manadan

Background: Sarcoidosis is a multisystem autoimmune disease that can result in significant morbidity and mortality. This study aims to identify factors associated with in-hospital death for sarcoid patients on a national level.

Methods: We performed a medical records review study of all adult sarcoid hospitalizations from 2016 to 2020 National Inpatient Sample database. A univariable screen followed by multivariable analysis was completed to identify predictors of in-hospital death among sarcoid patients.

Results: There were 405,650 admissions with a diagnosis of sarcoidosis, 10,210 of whom died. Multivariable analysis showed the following factors were independently associated with a higher odds of in-hospital death: age (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.026-1.034), Charlson Comorbidity Index (OR, 1.09; 95% CI, 1.066-1.116), male sex (OR, 1.21; 95% CI, 1.101-1.331), other race (OR, 1.45; 95% CI, 1.073-1.954), arrhythmia/heart blocks (OR, 1.80; 95% CI, 1.617-1.995), cirrhosis/hepatic failure (OR, 8.26; 95% CI, 6.928-9.844), hemophagocytic lymphohistiocytosis (OR, 11.15; 95% CI, 4.172-29.802), infection (OR, 3.31; 95% CI, 3.007-3.633), interstitial lung disease (OR, 1.31; 95% CI, 1.193-1.438), heart failure/myocarditis (OR, 1.29; 95% CI, 1.157-1.436), neurologic diagnoses (OR, 1.37; 95% CI, 1.241-1.502), and pulmonary hypertension (OR, 1.47; 95% CI, 1.305-1.652).

Conclusions: Our multiyear national analysis showed that 2.5% of hospital admissions with a sarcoid diagnosis ended in death. The following factors were associated with death: age, Charlson Comorbidity Index, male sex, other race, arrhythmia/heart blocks, cirrhosis/hepatic failure, hemophagocytic lymphohistiocytosis, infection, interstitial lung disease, heart failure/myocarditis, neurologic diseases, and pulmonary hypertension. This information can help clinicians by improving awareness of these life-threatening complications because early recognition and intervention may improve inpatient sarcoid outcomes.

背景:肉样瘤病是一种多系统自身免疫性疾病,可导致严重的发病率和死亡率。本研究旨在从全国范围内确定肉样瘤患者院内死亡的相关因素:我们对 2016 年至 2020 年全国住院病人抽样数据库中所有成人肉样瘤住院病例进行了病历回顾研究。先进行单变量筛选,再进行多变量分析,以确定肉样瘤患者院内死亡的预测因素:诊断为肉样瘤病的入院人数为405650人,其中10210人死亡。多变量分析表明,以下因素与较高的院内死亡几率独立相关:年龄(几率比 [OR],1.03;95% 置信区间 [CI],1.026-1.034)、Charlson Community(Charlson Community,Charlson Community,Charlson034)、查尔森合并症指数(OR,1.09;95% CI,1.066-1.116)、男性(OR,1.21;95% CI,1.101-1.331)、其他种族(OR,1.45;95% CI,1.073-1.954)、心律失常/心脏阻滞(OR,1.80;95% CI,1.617-1.995)、肝硬化/肝功能衰竭(OR,8.26;95% CI,6.928-9.844)、嗜血细胞淋巴组织细胞增多症(OR,11.15;95% CI,4.172-29.802)、感染(OR,3.31;95% CI,3.007-3.633)、间质性肺病(OR,1.31;95% CI,1.193-1.438)、心力衰竭/心肌炎(OR,1.29;95% CI,1.157-1.436)、神经系统诊断(OR,1.37;95% CI,1.241-1.502)和肺动脉高压(OR,1.47;95% CI,1.305-1.652):我们的多年全国性分析显示,2.5%的入院肉样瘤患者最终死亡。以下因素与死亡有关:年龄、夏尔森综合指数、男性、其他种族、心律失常/心脏传导阻滞、肝硬化/肝功能衰竭、嗜血细胞淋巴组织细胞增多症、感染、间质性肺病、心力衰竭/心肌炎、神经系统疾病和肺动脉高压。这些信息可以帮助临床医生提高对这些危及生命的并发症的认识,因为早期识别和干预可以改善住院肉样瘤患者的预后。
{"title":"Nationwide Analysis of Variables Associated With Sarcoid Inpatient Mortality.","authors":"Michael Manansala, Janelle Castellino, Shilpa Arora, Augustine M Manadan","doi":"10.1097/RHU.0000000000002162","DOIUrl":"10.1097/RHU.0000000000002162","url":null,"abstract":"<p><strong>Background: </strong>Sarcoidosis is a multisystem autoimmune disease that can result in significant morbidity and mortality. This study aims to identify factors associated with in-hospital death for sarcoid patients on a national level.</p><p><strong>Methods: </strong>We performed a medical records review study of all adult sarcoid hospitalizations from 2016 to 2020 National Inpatient Sample database. A univariable screen followed by multivariable analysis was completed to identify predictors of in-hospital death among sarcoid patients.</p><p><strong>Results: </strong>There were 405,650 admissions with a diagnosis of sarcoidosis, 10,210 of whom died. Multivariable analysis showed the following factors were independently associated with a higher odds of in-hospital death: age (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.026-1.034), Charlson Comorbidity Index (OR, 1.09; 95% CI, 1.066-1.116), male sex (OR, 1.21; 95% CI, 1.101-1.331), other race (OR, 1.45; 95% CI, 1.073-1.954), arrhythmia/heart blocks (OR, 1.80; 95% CI, 1.617-1.995), cirrhosis/hepatic failure (OR, 8.26; 95% CI, 6.928-9.844), hemophagocytic lymphohistiocytosis (OR, 11.15; 95% CI, 4.172-29.802), infection (OR, 3.31; 95% CI, 3.007-3.633), interstitial lung disease (OR, 1.31; 95% CI, 1.193-1.438), heart failure/myocarditis (OR, 1.29; 95% CI, 1.157-1.436), neurologic diagnoses (OR, 1.37; 95% CI, 1.241-1.502), and pulmonary hypertension (OR, 1.47; 95% CI, 1.305-1.652).</p><p><strong>Conclusions: </strong>Our multiyear national analysis showed that 2.5% of hospital admissions with a sarcoid diagnosis ended in death. The following factors were associated with death: age, Charlson Comorbidity Index, male sex, other race, arrhythmia/heart blocks, cirrhosis/hepatic failure, hemophagocytic lymphohistiocytosis, infection, interstitial lung disease, heart failure/myocarditis, neurologic diseases, and pulmonary hypertension. This information can help clinicians by improving awareness of these life-threatening complications because early recognition and intervention may improve inpatient sarcoid outcomes.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"1-6"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Granulomatous Synovitis Caused by a Mycobacterial Avium-Intracellulare Complex.
IF 2.4 4区 医学 Q2 RHEUMATOLOGY Pub Date : 2024-12-12 DOI: 10.1097/RHU.0000000000002185
Tomomi Tada, Shinji Higa
{"title":"Granulomatous Synovitis Caused by a Mycobacterial Avium-Intracellulare Complex.","authors":"Tomomi Tada, Shinji Higa","doi":"10.1097/RHU.0000000000002185","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002185","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Age-Related Differences Between Juvenile and Adult Autoimmune Inflammatory Myopathies. 青少年和成年自身免疫性炎症性肌病之间与年龄有关的差异
IF 2.4 4区 医学 Q2 RHEUMATOLOGY Pub Date : 2024-12-12 DOI: 10.1097/RHU.0000000000002180
Melike Mehveş Kaplan, Zahide Ekici Tekin, Elif Çelikel, Vildan Güngörer, Cüneyt Karagöl, Nimet Öner, Merve Cansu Polat, Didem Öztürk, Emine Özçelik, Mehveş Işıklar Ekici, Pınar Akyüz Dağlı, Şükran Erten, Banu Çelikel Acar

Background: Clinical features and prognosis of autoimmune inflammatory myopathies (AIMs) can vary depending on the age of disease onset. The aim of this study was to compare the demographic characteristics, clinical features, laboratory findings, and long-term prognosis of juvenile and adult AIMs.

Methods: Patients diagnosed with AIM between 2009 and 2023 in the pediatric rheumatology and rheumatology departments of our hospital were included in this medical records review study. Demographic characteristics, clinical features, laboratory findings, treatments, and prognosis of juvenile and adult AIM patients were compared with statistical methods.

Results: Of the 94 patients diagnosed with AIM, 34 (36.2%) patients were juvenile and 60 (63.8%) patients were adult. At the time of diagnosis, while Gottron papules, dysphonia, and subcutaneous edema were more common in juvenile patients, fever was more common in adult patients (p = 0.003, p = 0.05, p = 0.005 p = 0.05, respectively). During follow-up, while calcinosis was more common in juvenile patients, lung involvement and malignancy were more common in adult patients (p = 0.022, p = 0.009, p = 0.006, respectively). The methylprednisolone pulse therapy requirement was significantly higher in juvenile patients (p = 0.0001). Clinically inactive disease was more common in juvenile patients (p = 0.01).

Conclusions: AIM with different onset ages is associated with distinct clinical manifestations and outcomes. The present study reported that in AIM patients, lung involvement and malignancy increase with age while clinically inactive disease decreases.

背景:自身免疫性炎症性肌病(AIMs)的临床特征和预后会因发病年龄而异。本研究旨在比较幼年和成年自身免疫性炎症性肌病的人口统计学特征、临床特征、实验室检查结果和长期预后:方法:将本院儿童风湿病科和风湿病科 2009 年至 2023 年期间确诊的 AIM 患者纳入病历回顾研究。用统计学方法比较了幼年和成年 AIM 患者的人口统计学特征、临床特征、实验室检查结果、治疗方法和预后:在 94 名确诊为 AIM 的患者中,34 名(36.2%)为青少年患者,60 名(63.8%)为成人患者。确诊时,幼年患者多见戈特龙丘疹、发音障碍和皮下水肿,而成年患者多见发热(分别为 p = 0.003、p = 0.05、p = 0.005、p = 0.05)。在随访期间,青少年患者更常见钙化,而成年患者更常见肺部受累和恶性肿瘤(分别为 p = 0.022、p = 0.009、p = 0.006)。青少年患者的甲基强的松龙脉冲疗法需求量明显更高(p = 0.0001)。临床上不活跃的疾病在青少年患者中更为常见(p = 0.01):结论:不同发病年龄的 AIM 具有不同的临床表现和预后。本研究报告显示,AIM 患者的肺部受累和恶性肿瘤随年龄增长而增加,而临床非活动性疾病则随年龄增长而减少。
{"title":"Age-Related Differences Between Juvenile and Adult Autoimmune Inflammatory Myopathies.","authors":"Melike Mehveş Kaplan, Zahide Ekici Tekin, Elif Çelikel, Vildan Güngörer, Cüneyt Karagöl, Nimet Öner, Merve Cansu Polat, Didem Öztürk, Emine Özçelik, Mehveş Işıklar Ekici, Pınar Akyüz Dağlı, Şükran Erten, Banu Çelikel Acar","doi":"10.1097/RHU.0000000000002180","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002180","url":null,"abstract":"<p><strong>Background: </strong>Clinical features and prognosis of autoimmune inflammatory myopathies (AIMs) can vary depending on the age of disease onset. The aim of this study was to compare the demographic characteristics, clinical features, laboratory findings, and long-term prognosis of juvenile and adult AIMs.</p><p><strong>Methods: </strong>Patients diagnosed with AIM between 2009 and 2023 in the pediatric rheumatology and rheumatology departments of our hospital were included in this medical records review study. Demographic characteristics, clinical features, laboratory findings, treatments, and prognosis of juvenile and adult AIM patients were compared with statistical methods.</p><p><strong>Results: </strong>Of the 94 patients diagnosed with AIM, 34 (36.2%) patients were juvenile and 60 (63.8%) patients were adult. At the time of diagnosis, while Gottron papules, dysphonia, and subcutaneous edema were more common in juvenile patients, fever was more common in adult patients (p = 0.003, p = 0.05, p = 0.005 p = 0.05, respectively). During follow-up, while calcinosis was more common in juvenile patients, lung involvement and malignancy were more common in adult patients (p = 0.022, p = 0.009, p = 0.006, respectively). The methylprednisolone pulse therapy requirement was significantly higher in juvenile patients (p = 0.0001). Clinically inactive disease was more common in juvenile patients (p = 0.01).</p><p><strong>Conclusions: </strong>AIM with different onset ages is associated with distinct clinical manifestations and outcomes. The present study reported that in AIM patients, lung involvement and malignancy increase with age while clinically inactive disease decreases.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
JCR: Journal of Clinical Rheumatology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1