Zeitschrift fur Rheumatologie最新文献

The remitting seronegative symmetric synovitis with pitting edema (RS3PE) syndrome is a rare inflammatory rheumatic disease of older adults, which can also be paraneoplastic. The main symptom is a rapidly progressing symmetric edematous swelling of both hands, sometimes also both feet, accompanied by (teno-)synovitis. Autoimmune serologies (rheumatic factor, antibodies against cyclic citrullinated peptides, antinuclear antibodies) typically remain negative. When a diagnosis of RS3PE is made, age-appropriate screening investigations for malignancies should be carried out. In addition, a comprehensive history should be taken and physical examination should be performed focusing on signs of neoplasia, followed by further investigations if necessary. The RS3PE syndrome typically shows an excellent response to treatment with glucocorticoids. A drug-free remission is frequently achieved but sometimes treatment with disease-modifying antirheumatic drugs (DMARDs) is necessary.

Background: Comics are increasingly being discussed as an innovative means of communication in healthcare. In rheumatology there has so far been a lack of studies on the acceptance and potential use of medical comics.

Aim of the study: The aim of this study was to determine the acceptance of medical comics among rheumatologists and to evaluate their potential for use in clinical practice.

Material and methods: At the German Rheumatology Congress 2024 a total of 8 medical comics designed jointly in advance by patients and artists were exhibited. Congress participants were able to take part voluntarily and anonymously in a standardized online survey. Sociodemographic data, assessments of the comprehensibility and usefulness of the comics and their potential usability in everyday clinical practice were recorded.

Results: A total of 94 people took part in the survey, 58.5% of whom had a specialist medical qualification. The exhibition was rated with a Net Promoter Score of 37.2%. The understanding effect was rated at 6.3 ± 2.7 and the potential to promote public awareness at 8.4 ± 1.8 (scale 0-10). Of the participants 78.7% could imagine displaying the comics in their practice or clinic and 63.8% were in favor of their use for therapy and diagnosis clarification.

Discussion: The results show a high level of acceptance of comics among healthcare professionals and confirm their potential for use in education and communication. A structured further development of German language, medically validated comic formats appears to make sense.

Objective: The objective of this meta-analysis was to assess the relationships of the systemic immune-inflammation index (SII) and the systemic inflammation response index (SIRI) with systemic lupus erythematosus (SLE) and to determine the correlation of these indices with disease activity as measured by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI).

Methods: We performed a systematic search of Medline, Embase, and the Web of Science databases to identify eligible studies. Standardized mean differences (SMDs) were calculated to compare SII and SIRI between individuals with SLE and healthy controls. Pooled correlation coefficients were used to estimate the strength of the associations between SII, SIRI, and SLEDAI scores.

Results: Eleven studies qualified for inclusion in the meta-analysis. The aggregated analyses indicated that SII was markedly higher in SLE patients than in healthy controls (SMD 0.961; 95% CI 0.632-1.291; p < 0.001), a finding that remained consistent irrespective of data type, study sample size, or lupus nephritis status. Similarly, SIRI was elevated in those with SLE (SMD 0.761; 95% CI 0.320-1.203; p = 0.001). Analysis of correlation revealed that SII had a statistically significant positive association with SLEDAI scores (correlation coefficient 0.322; 95% CI 0.146-0.478; p < 0.001), supporting its value as a marker of increased disease activity. In contrast, SIRI did not present a significant association with SLEDAI (correlation coefficient 0.133; 95% CI -0.119 to 0.369; p = 0.302).

Conclusion: This meta-analysis provides evidence that both SII and SIRI are significantly increased in patients with SLE compared to healthy controls, supporting their utility as inflammatory biomarkers in SLE. Additionally, SII demonstrated a moderate positive correlation with disease activity, emphasizing its relevance for evaluating SLE severity.

Transarterial periarticular embolization (TAPE) is a novel interventional procedure for local pain therapy in osteoarthritis. The reduction of local hypervascularization is achieved by supraselective embolization of periarticular arteries using embolic agents. The procedure described herein results in a reduction in both pain and the use of analgesics. The drug was originally developed for the treatment of knee osteoarthritis and initial small studies and case reports indicated that it was effective for other joints, including the fingers and shoulders. In the domain of rheumatology TAPE opens up new therapeutic perspectives, particularly for cases of treatment-resistant monoarthritis and arthritis associated with checkpoint inhibitors.

The targeted and personalized cell and gene therapy with autologous chimeric antigen receptor (CAR) transduced T‑cells (CAR T‑cells) has become established as the standard therapy for patients with B‑cell diseases, such as CD-19 positive leukemia and lymphomas and B‑cell maturation antigen (BCMA) positive multiple myeloma (MM). This therapy has been approved in Europe since 2018 and is administered in more than 50 clinics in Germany. With increasing experience and expertise in understanding of the principles of action and underlying mechanisms as well as mitigation of side effects have significantly improved. In the near future expansion of CAR T‑cell applications are to be expected, aimed at addressing further targets and therefore other disease entities. Currently, the indications have already expanded beyond hematology and oncology to rheumatology, neurology and other fields.