Rheumatology International最新文献

Recent years have seen a marked increase in the number of patients diagnosed with spinal disorders, including chronic cervical myofascial pain syndrome (CMPS). This article aims to explore the potential of inflammatory process biomarkers in the blood and brain-derived neurotrophic factor (BDNF) as a means to assess the efficacy of collagen mesotherapy in the management of chronic CMPS. The second objective of this article is to evaluate the safety of collagen mesotherapy in chronic CMPS. The study comprised 23 subjects, who were randomly assigned either to the collagen mesotherapy group (n = 11) or the lignocaine mesotherapy group (n = 12). Blood was collected from each patient, and also the subjects were evaluated with the numerical rating scale (NRS) and the neck disability index (NDI). Results Both collagen and lignocaine mesotherapy have been observed to cause a significant reduction in pain intensity (NRS) and disability (NDI) over time, with no significant differences seen between the two interventions. However, the fluctuations in the levels of inflammatory biomarkers (TNFα, IL-1β, IL-6) and BDNF did not correspond with the clinical improvement noted. No adverse events related to the intervention were also observed. The potential of inflammatory biomarkers and BDNF, when assessed in blood serum, to serve as a basis for evaluating the efficacy of collagen mesotherapy in chronic CMPS; remains to be elucidated. Nevertheless, collagen mesotherapy appears to be an effective and safe treatment for chronic CMPS. However, further research in this area is required. Trial registration: NCT06807177. https//clinicaltrials.gov/study/NCT06807177.

Immunoglobulin G4-related disease (IgG4-RD) is a systemic immune-mediated disease, and antigenic stimulation by allergen or malignancy is considered a potential pathogenesis. To date, IgG4-RD complicated by acid-fast bacterial infections, such as tuberculosis or nontuberculous mycobacteria (NTM), has been sporadically reported, and can be considered as potential antigens contributing to IgG4-RD onset. These cases pose a clinical dilemma because immunosuppressive therapy may exacerbate the underlying infection. Herein, we present a case of IgG4-RD complicated by NTM infection that was successfully treated solely with antimicrobial therapy. A 64-year-old male, initially treated for IgG4-related autoimmune pancreatitis with glucocorticoids, developed pulmonary lesions with elevation of IgG4 levels shortly after glucocorticoid cessation. While lung biopsy revealed typical IgG4-RD histology, culture specimens also identified concomitant infection of Mycobacterium intracellulare. Notably, following antimicrobial therapy for NTM, both the pulmonary lesions and serum IgG4 levels improved without re-administering glucocorticoids. Our literature review identified eight additional cases of IgG4-RD complicated by acid-fast bacterial infection, and two out of eight previous cases; three in total including the current case showed improvement of IgG4-RD using antibiotics alone. These findings raise the possibility that acid-fast bacteria could potentially serve as infectious antigens triggering IgG4-RD, and targeting the underlying infection can be a therapeutic strategy, not only for infection, but also for IgG4-RD, while further studies are warranted.

Fibromyalgia is a widespread chronic condition. Although Clinical Practice Guidelines for fibromyalgia currently exist, their application in diagnostic and therapeutic settings faces significant implementation challenges across healthcare systems. This has led to a persistent gap between knowledge and clinical practice, a phenomenon yet to be explored in the Danish context. A cross-sectional study was conducted to investigate the level of knowledge and adherence to Clinical Practice Guidelines for fibromyalgia among Danish physical therapists, throughout a questionnaire consisting in the selection of the elements that they would consider for the adequate assessment, treatment, and expected duration of the therapeutic approach, to classify professionals as adherent, partially adherent, or non-adherent based on their selection of assessment and treatment components, and to evaluate their responses to 24 statements on a 5-point Likert scale reflecting their alignment with recommendations from Clinical Practice Guidelines. A total of 149 physiotherapists (mean age 39.26 ± 11.50, and gender-balanced) participated, amongst which 35 (23.49%) were classified as 'adherent', and 46 subjects (30.87%) were labelled as 'partially adherent' to Clinical Practice Guidelines. Participants' assessment and therapeutic tools selection was generally aligned with the Clinical Practice Guidelines' extolled recommendations, except for tender points examination and massage therapy. A number of 14 out of the 24 statements exceeded the predefined 70% agreement threshold. The current study reflects an adequate level of knowledge and adherence amongst physiotherapists in Denmark. Further research and targeted implementation strategies are needed to reduce the evidence-to-practice gap.