Rheumatology International最新文献

Objective: The aim of present study was to compare abdominal (transversus abdominis (TrA), internal oblique (IO) and external oblique (EO)) and lumbar multifidus muscles (LM) evaluated with ultrasonographic (US) imaging in patients with FM (Fibromyalgia) and asymptomatic individuals and to examine the relationship between these muscle thickness and endurance, pain, fatigue and functional mobility.

Methods: Women with FM group (n: 53, age: 45.96 ± 9.96 years), and asymptomatic control group (n: 49, age: 45.12 ± 7.28), were included in this study. Pain severity, disease activity, physical activity level, fatique, thickness of TrA, IO, EO and LM muscles and endurance, and functional mobility were evaluated with the Visual Analogue Scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), International Physical Activity Questionnaire- Short Form (IPAQ-SF), Fatigue Severity Scale (FSS), US imaging, McGill core endurance tests, and physical fitness tests, respectively. FM patients were classified according to the FSS score.

Results: The thickness of the IO (right side) (p = 0.013) and LM (both sides) (p < 0.001) muscles, lumbopelvic muscle endurance (all p < 0.001) and physical fitness tests (all p < 0.001) were lower in FM group compared to the asymptomatic group. No statistically significant differences were found in TrA, IO (left side), EO muscles thickness between the two groups (all p > 0.05). LM muscle thickness was significantly correlated with lumbopelvic muscle endurance (all p < 0.05), physical fitness tests (all p < 0.001) and fatique (p = 0.001). Moreover, significant differences in LM muscle thickness (p = 0.007), trunk flexor muscle endurance (p = 0.016), left trunk lateral flexor muscle endurance (p = 0.045) and 30-s chair stand test (p = 0.025) in favor of the low-fatigue group were detected.

Conclusion: The thickness of LM muscle, lumbopelvik endurance and functional mobility in FM patients have been affected negatively. These findings should be considered in management of FM.

To determine whether the discharge diagnosis codes used within tertiary hospitals accurately identified patients with Giant Cell Arteritis (GCA), as determined by expert opinion at 6 months. The study was performed across three major hospitals within Perth, Western Australia. Patients with an International Classification of Diseases (ICD) code for GCA (M31.5 and M31.6) at discharge on first inpatient presentation were identified. Review of case notes, discharge summaries, letters, pathology, and imaging results were undertaken. The percentage of patients with an ICD code for GCA at initial discharge with confirmed GCA by expert opinion at 6 months (as the anchor diagnosis) was calculated. As validation of the anchor diagnosis, the percentage who fulfilled the 2022 ACR/EULAR criteria was also calculated, the number of hospital discharges per patient with an ICD code for GCA was calculated, to determine if multiple discharges with an ICD code for GCA increased the specificity of the ICD coding. 93 out of 157 admissions with an ICD for GCA were identified as a first inpatient presentation. At 6 months follow up, 65.6%, 95 CI [55.0%, 75.1%] had confirmed GCA by expert opinion. 88.2%, 95 CI [79.8%, 93.9%] met the 2022 ACR/EULAR criteria for GCA. The specificity of the ICD coding increased with increasing number of discharges- 67.4% with single episode, 80% with two episodes, and 100% with three or more episodes (p = 0.1373). Only 43.8%, 95 CI [26.4%, 62.3%] of patients who did not have GCA had an alternative diagnosis provided. 31.3%, 95 CI [16.1%, 50.0%] of patients who did not have GCA still have the GCA diagnosis listed in their subsequent clinical records and discharge summaries. Only 2/3rds of those patients with an initial discharge ICD code for GCA were found to have confirmed GCA at follow-up. This poor correlation between the ICD coding and confirmed diagnosis of GCA will impact the quality of data extracted from administrative health datasets for epidemiological and longitudinal studies. Selecting patients with two or more GCA coded episodes could improve the homogeneity of the cohort for recruitment into GCA studies, but a larger sample size study is required.

Sjögren's is a chronic autoimmune disease with diverse symptomatology, and varying patient satisfaction with management. Patients with chronic conditions are known to be higher users of complementary and alternative (CAM) practices, yet little information regarding extent of such use exists. This paper describes usage of CAM practices among people living with Sjögren's, encompassing visits to healthcare providers, CAM practitioners, self-administered CAM and self-help practices. We explored both purposes and perceived helpfulness of the various modalities utilised. 296 respondents completed an online survey administered through Sjögren's Research Ireland in 2023. An adapted form of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) was utilised as the survey instrument. 88.5% of respondents had a formal diagnosis of Sjögren's. The majority (93.6%) were female, across all age groups. Over half (52%) of non-retired respondents were at least partially unable to work due to their diagnosis. Over half of all respondents (58.8%) listed at least one concomitant health problem. Most respondents (248, 83.8%) had used some form of CAM within the preceding 12 months. One-in-four had attended a CAM practitioner, most commonly chiropractors (8.4%) or acupuncturists (7.8%). Conventional healthcare and CAM providers were both consulted more commonly for management of chronic conditions or for well-being than for acute symptom management, although this was particularly stark for CAM consultations. 196 respondents (66.2%) reported use of self-administered CAM, predominantly vitamins/minerals or dietary supplements. 69.9% used various self-care practices, with the most reported being meditation, relaxation techniques and prayer. People living with Sjögren's attend both conventional healthcare providers and CAM practitioners to a high degree and use a diverse range of complementary therapies and practices. Health care professionals need to consider and discuss potential CAM use by this patient cohort and offer evidence-based patient education about therapies and practices encountered.

Enthesitis-related arthritis (ERA), a distinct subtype of juvenile idiopathic arthritis (JIA) related to HLA-B27 and peripheral and axial involvement, presents with insidious onset of arthritis and/or enthesitis. However, there is a lack of data concerning axial new bone formation in patients transitioning into adulthood. To evaluate the axial radiographic structural damage (axRxSD), encompassing the sacroiliac joints (SIJ), hips, and spine, in ERA patients across various age groups. A cross-sectional cohort study was conducted with patients aged up to 35 years. Specific tools were used for measuring disease activity (BASDAI, ASDAS), function (BASFI, HAQ-S), mobility (BASMI), clinical enthesitis (MASES), ultrasound evaluation (MASEI), and axRxSD, including mSASSS for spine, Kellgren-Lawrence for hips and modified New York criteria for SIJ. A total of 26 patients were included, of whom 76.9% were males, with a mean age at diagnosis and assessment of 11.9 and 19.7 years, respectively. HLA-B27 positivity was found in 58.3%. Current active arthritis and enthesitis were present in 19.2% and 23%, respectively, with mean MASEI score of 12 (IQR 6-17). Peripheral joint limitation was observed in 50%, despite a BASMI score of 2.2 and 16% occurrence of abnormal FABER test. Most patients were in remission or low disease activity [ASDAS-ESR = 1.2 (0.6-2.3); ASDAS-CRP = 1.55 (0.6-2.4)]. Modified New York criteria were fulfilled by 73.1% of patients and 15.4% had radiographic hip involvement. Spine involvement, measured by mSASSS, was low (IQR 0-4.2), with only two patients exhibiting syndesmophytes. There was no statistical association between any imaging methods and clinical, laboratory, and ultrasound variables, including scores for activity, functionality, and mobility. Significant association was found only between axRxSD and BASMI. Our results showed high frequency of SIJ ankylosis alongside lower radiographic involvement in the spine and hips, suggesting a distinct structural damage phenotype. The early recognition of this outcome and the use of immunobiological therapy may mitigate syndesmophyte occurrence over time.

We aimed to investigate the quality and characteristics of content related to pediatric rheumatology on social media, comparing posts by health professionals (HPs) and non-HP (NHPs). Content creators, engagement metrics, sentiment, and misinformation were evaluated in the 150 most popular posts from 18 hashtags related to pediatric rheumatology on Facebook, Instagram, and TikTok. The Journal of American Medical Association Benchmark Scale (JAMA) and the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V) were used to assess quality, understandability and actionability in educational videos, respectively. Overall, 6723 posts were included (3130 photos, 3593 videos). The content accounted for 37.6 million interactions and 520.8 million views. NHPs represented the majority of creators (5160, 76.8%). Among educational posts (2074, 30.8%), HPs provided longer (59 [IQR 85] sec vs. 50 [IQR 77] sec; p < 0.001) more understandable (PEMAT-A/V 85.7 [IQR 18.9] vs. 75 [IQR 25]; p < 0.001), more actionable (PEMAT-A/V 66.7 [IQR 33.3] vs. 50 [IQR 41.7]; p < 0.001), and higher-quality (JAMA 3 [IQR 0] vs. 3 [IQR 1]; p < 0.001) videos than NHPs. In contrast, NHPs shared more commented educational photos (3 [IQR 11] vs. 1 [IQR 8]; p < 0.001) and videos (8 [IQR 50] vs. 4 [IQR 27]; p < 0.001) and more viewed videos (6181 [IQR 23417] vs. 2967.5 [IQR 20943]; p = 0.034) than HPs. Despite high interest in content related to pediatric rheumatology on social media, HPs are a minority of creators but provide better educational content than NHPs. There is a significant opportunity to provide high-quality educational content through these popular digital platforms.

This study aimed to investigate potential gender differences in illness acceptance and coping strategies in patients with inflammatory arthritis (IA). Furthermore, the study aimed to identify factors associated with illness acceptance and coping strategies specific to men and women. A cross-sectional nationwide survey design was applied. Illness acceptance was measured by using the Acceptance of Illness Scale and coping was measured by using the Medical Coping Modes Questionnaire. Descriptive statistics were used to explore gender differences in illness acceptance and coping strategies in patients with IA, while logistic regression analyses investigated associated factors. The study included 664 participants (85.1% women) with a mean age of 50 and median disease duration of 10 years. Diagnoses included 53.3% rheumatoid arthritis, 27.1% psoriatic arthritis, and 19.6% axial spondyloarthritis. A statistically significant difference was found between men and women in use of avoidance (P = 0.015). Higher illness acceptance was associated with tertiary education in men (OR: 3.90) and older age in women (OR: 1.35 per 10 years). Women with higher disease activity used confrontation more (OR: 1.64) than women with less activity. Men relied more on avoidance when facing psychological distress (OR: 1.29) or severe fatigue (OR: 1.31), as did women with high disease activity (OR: 2.09). Acceptance-resignation was linked to higher disability and psychological distress in men (OR: 1.32 and 1.52) and higher disease activity in women (OR: 2.09). We identified factors associated with illness acceptance and coping strategies among IA patients. Gender-sensitive approaches are needed to address specific factors influencing illness acceptance and coping in men and women.

Teleradiology, the transmission of radiologic images for remote assessment and consultation, has transformed modern medical care by mitigating geographical inequities and improving diagnostic accuracy. This technology employs telecommunications, digital imaging, and data-sharing systems developments to deliver swift and precise image analysis across various healthcare environments. Teleradiology has been essential in identifying and controlling diseases, including osteoarthritis, osteoporosis, rheumatoid arthritis, and spondyloarthritis, especially in musculoskeletal radiology and rheumatology. The combination of teleradiology and telemedicine has transformed multidisciplinary cooperation, enhancing communication among radiologists, rheumatologists, and other healthcare practitioners to provide patient-centered treatment. It has markedly enhanced access to highly specialized knowledge, especially in rural and disadvantaged areas, facilitating prompt consultations and alleviating patient travel constraints. However, despite its benefits, teleradiology encounters several challenges, including standardization issues, ethical dilemmas, and infrastructure constraints. The absence of uniform standards and inequalities in access to high-speed Internet and digital health records impede extensive implementation. Addressing these constraints is crucial to fully utilizing teleradiology's potential in musculoskeletal and rheumatic care. This article highlights the transformational potential of teleradiology and its incorporation into telemedicine for musculoskeletal and rheumatological treatment. Teleradiology is set to enhance global healthcare delivery by addressing disparities in healthcare access, fostering multidisciplinary cooperation, and utilizing advanced technologies. It underscores the necessity for ongoing innovation and investment in infrastructure, education, and standards to optimize the advantages of this crucial technology and guarantee equitable, efficient, and high-quality care for all patients.

Fibromyalgia causes widespread pain, exhaustion, and cognitive deficits, lowering sufferers' quality of life. Exercise supports the management of fibromyalgia by reducing pain and improving mood. This study examines global fibromyalgia and exercise research trends using bibliometric analysis to identify major contributors, citation patterns, and prospective research areas. Data were obtained from the Web of Science (WoS) database utilizing the keywords "fibromyalgia exercise" for publications from 2014 to 2023. The inclusion criteria prioritized original articles and reviews published in the English language. Bibliometric characteristics were examined, including publication year, country, journal, and citation metrics. Statistics adjusted for population and gross domestic product (GDP) were computed to evaluate research productivity in relation to economic and demographic variables. A total of 497 publications satisfied the inclusion criteria. A significant increase trend in publication counts was noted (p = 0.003), with Spain (25.75%), the United States (15.09%), Brazil (13.88%), Türkiye (7.24%), and Sweden (5.23%) identified as the major contributors. Publications were produced by 37 countries, 19 of which were the main active countries. Spain displayed remarkable productivity, ranking first in population- and GDP-adjusted contributions. Based on publication type, 388 (78.06%) were original articles, and the rest were reviews. The median number of original article and review citations were 11 (min = 0; max = 289) and 14 (min = 0; max = 1092). Review citations outnumbered original articles (p = 0.013). The median number of citations for SCIE and/or SSCI and ESCI articles were 12 (min = 0; max = 1092) and 3 (min = 0; max = 92). SCIE and/or SSCI articles were significantly more cited than ESCI ones (p < 0.001). INT J ENV RES PUB HE (n = 18), RHEUMATOL INT (n = 17), ARCH PHYS MED REHAB (n = 15), J CLIN MED (n = 14) and DISABIL REHABIL (n = 13) were the top five journals in terms of article count. This bibliometric analysis evaluates and summarizes global scholarly output on fibromyalgia and exercise, underscoring the increasing research interest in the two. High-income countries, notably Spain, the United States, and Sweden, significantly contributed to the area, underscoring differences in research capacities.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that can significantly affect reproductive health. This study aims to assess reproductive health metrics among SLE patients in Indian settings to compare fertility rates and the impact of the disease on pregnancy with data from the general population. The independent, prospective, multicenter, observational study collected data from SLE patients at seven centres in India through a database created by the Indian Rheumatology Association. Data were gathered using structured proformas validated by experts. The final analysis included women aged > 15 years (total cohort), after excluding male subjects and those with inadequate data. Participants were categorized into married and unmarried cohorts, and various reproductive health metrics were analyzed pre- and post-disease. The total cohort included 631 subjects with an average age at recruitment of 36.46 ± 12.31 years, and mean age at menarche of 13.74 ± 1.44 years. The total cohort had an average of 1.8 pregnancies per woman, with an abortion rate of 0.35. The married cohort showed a pregnancy wastage ratio of 201.43. The cumulative fertility rate noted for the married cohort was 1.40, while for the total cohort was 1.04. Significant differences in pregnancy outcomes were observed before and after the onset of SLE, with pregnancies declining from 703 to 136 (P < 0.0001). A significant increase in pregnancy complications, including pregnancy-induced hypertension, small for gestational age, and pre-eclampsia, was noted before and after disease onset (P < 0.0001). Central nervous system and skin involvement also became more prevalent post-disease (P = 0.046 and P = 0.040, respectively). The study highlights the significant impact of SLE on pregnancy, both before and after disease onset, noting reduced pregnancies and live births, along with increased rates of pregnancy loss, stillbirths, and abortions. Complications such as hypertension and pre-eclampsia were more common after disease onset. These findings emphasize the need for targeted healthcare strategies and collaborative efforts to improve reproductive outcomes in patients with SLE.