Cristian-Mihai Ilie, Suzana Popescu, S. Daia-Iliescu, I. Saulescu, D. Predețeanu, V. Bojinca, A. Balanescu, D. Opriș-Belinski
Polymyositis is a rare disease that belongs to the idiopathic inflammatory myopathies (IIMs) group, characterized by chronic muscle inflammation, and in rare cases a life-threatening condition due to extra-muscular involvement. Even though steroids constitute the building block of treatment of this disease, in severe cases, escalation treatment should be considered in order to obtain good clinical outcomes. We report a clinical case of a 22-year-old female who developed progressive severe systemic muscular weakness, dysphagia and dysphonia, accompanied by elevated serum muscle enzymes, positive myositis-specific antibodies, and muscle biopsy suggestive of inflammatory myopathy. The clinical features and laboratory results led us to the diagnosis of polymyositis. On additional laboratory tests the patient tested positive for Borrelia burgdorferi (Borrelia b) specific antibodies. Due to life-threatening organ involvement the immunosuppressive treatment, immunoglobulin intravenous infusion and pulse therapy with methylprednisolone were initiated and she needed nasogastric tube in order to be fed. Furthermore antibiotic treatment was administrated. The patient improved almost completely after 3 months of treatment.
{"title":"Severe myopathy in a patient with chronic neurological disease – diagnostic challenges","authors":"Cristian-Mihai Ilie, Suzana Popescu, S. Daia-Iliescu, I. Saulescu, D. Predețeanu, V. Bojinca, A. Balanescu, D. Opriș-Belinski","doi":"10.37897/rjr.2023.2.2","DOIUrl":"https://doi.org/10.37897/rjr.2023.2.2","url":null,"abstract":"Polymyositis is a rare disease that belongs to the idiopathic inflammatory myopathies (IIMs) group, characterized by chronic muscle inflammation, and in rare cases a life-threatening condition due to extra-muscular involvement. Even though steroids constitute the building block of treatment of this disease, in severe cases, escalation treatment should be considered in order to obtain good clinical outcomes. We report a clinical case of a 22-year-old female who developed progressive severe systemic muscular weakness, dysphagia and dysphonia, accompanied by elevated serum muscle enzymes, positive myositis-specific antibodies, and muscle biopsy suggestive of inflammatory myopathy. The clinical features and laboratory results led us to the diagnosis of polymyositis. On additional laboratory tests the patient tested positive for Borrelia burgdorferi (Borrelia b) specific antibodies. Due to life-threatening organ involvement the immunosuppressive treatment, immunoglobulin intravenous infusion and pulse therapy with methylprednisolone were initiated and she needed nasogastric tube in order to be fed. Furthermore antibiotic treatment was administrated. The patient improved almost completely after 3 months of treatment.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44299056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luana Stanciu, Silviu Stanciu, Simona Petrescu, M. Agache, C. Popescu, C. Codreanu
Although both systemic lupus erythematosus (SLE) and multiple sclerosis (MS) are autoimmune diseases, their simultaneous presence in the same patient is rare. Case report. We present the case of a 26-year-old woman who was diagnosed with MS and underwent treatment with interferon beta 1-alfa. After 2 years, she developed cutaneous lesions subsequent to a systemic disorder. After multiple serological tests were conducted, the diagnosis of SLE was established and hydroxychloroquine was added to the patient’s treatment. Conclusion. The presented case report is one of only a few cases published on the association of the two autoimmune diseases.
{"title":"A rare association of multiple sclerosis and systemic lupus erythematosus - A case report","authors":"Luana Stanciu, Silviu Stanciu, Simona Petrescu, M. Agache, C. Popescu, C. Codreanu","doi":"10.37897/rjr.2023.2.3","DOIUrl":"https://doi.org/10.37897/rjr.2023.2.3","url":null,"abstract":"Although both systemic lupus erythematosus (SLE) and multiple sclerosis (MS) are autoimmune diseases, their simultaneous presence in the same patient is rare. Case report. We present the case of a 26-year-old woman who was diagnosed with MS and underwent treatment with interferon beta 1-alfa. After 2 years, she developed cutaneous lesions subsequent to a systemic disorder. After multiple serological tests were conducted, the diagnosis of SLE was established and hydroxychloroquine was added to the patient’s treatment. Conclusion. The presented case report is one of only a few cases published on the association of the two autoimmune diseases.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41804671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrei Blanaru, Mara Adelina Benchea, Doina Nitescu, Iulia Diana Florescu, Razvan Adrian Ionescu
Hyperferritinemic syndrome represents a common nosological classification for systemic inflammatory syndromes, including Catastrophic antiphospholipid syndrome, in which hyperferritinemia (> 500 ng/mL) is present. Recent studies suggest that in this syndrome, ferritin is more than a passive marker of inflammation, playing an active role in the process. We present the case of a 74-year-old female patient with elevated serum ferritin levels (above 1000 ng/mL), along with an intense inflammatory syndrome, non-immune thrombotic microangiopathy, and multisystem involvement (pulmonary, cardiac, hepatic, pancreatic, neurological and renal changes), outlining the picture of a hyperferritinemic syndrome that is hard to classify otherwise. This underlines the necessity for diagnostic and classification criteria for this pathology.
{"title":"Antiphospholipid syndrome, ferritin and fever: Hyperferritinemic syndrome a nosological ally","authors":"Andrei Blanaru, Mara Adelina Benchea, Doina Nitescu, Iulia Diana Florescu, Razvan Adrian Ionescu","doi":"10.37897/rjr.2023.2.6","DOIUrl":"https://doi.org/10.37897/rjr.2023.2.6","url":null,"abstract":"Hyperferritinemic syndrome represents a common nosological classification for systemic inflammatory syndromes, including Catastrophic antiphospholipid syndrome, in which hyperferritinemia (> 500 ng/mL) is present. Recent studies suggest that in this syndrome, ferritin is more than a passive marker of inflammation, playing an active role in the process. We present the case of a 74-year-old female patient with elevated serum ferritin levels (above 1000 ng/mL), along with an intense inflammatory syndrome, non-immune thrombotic microangiopathy, and multisystem involvement (pulmonary, cardiac, hepatic, pancreatic, neurological and renal changes), outlining the picture of a hyperferritinemic syndrome that is hard to classify otherwise. This underlines the necessity for diagnostic and classification criteria for this pathology.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136369679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of the study was to identify any evidence of different patterns of disease for Ehlers Danlos Syndrome (EDS) and Hypermobility Syndrome (JHS) in the White British and South Asian communities in England. The numbers of hospital in-patients in ten NHS Trusts, between 2016 and 2020, in whom a diagnosis of EDS or JHS had been recorded were identified through Freedom of Information (FOI) requests. The condition was either the primary diagnosis or a secondary one, incidental to the reason for admission. The ten Trusts were selected because they served areas with a significant South Asian population and had been involved in previous studies of discrimination in the delivery of care. The study also assessed whether there was evidence of any of the Trusts underserving their South Asian community with lesser levels of recognition of EDS and JHS. Overall South Asian patients were almost four times more likely to have been diagnosed as having JHS. This proportion was statistically significant (z = -11.69, p <0.00001). In Burton and Derby, Cambridge and Leicester the proportion of South Asian patients diagnosed as having EDS was significantly lower than in other Trusts (z = 9.4, p <0.00001). This was also the case for JHS (z = 8.09, p < 0.00001). This would indicate that in these three Trusts both conditions are underdiagnosed in the South Asian community. The significance of these findings is discussed.
{"title":"Ethnicity, hypermobility syndrome and Ehlers-Danlos syndrome: A study based on hospital admissions","authors":"A. Farrukh, J. F. Mayberry","doi":"10.37897/rjr.2023.2.1","DOIUrl":"https://doi.org/10.37897/rjr.2023.2.1","url":null,"abstract":"The purpose of the study was to identify any evidence of different patterns of disease for Ehlers Danlos Syndrome (EDS) and Hypermobility Syndrome (JHS) in the White British and South Asian communities in England. The numbers of hospital in-patients in ten NHS Trusts, between 2016 and 2020, in whom a diagnosis of EDS or JHS had been recorded were identified through Freedom of Information (FOI) requests. The condition was either the primary diagnosis or a secondary one, incidental to the reason for admission. The ten Trusts were selected because they served areas with a significant South Asian population and had been involved in previous studies of discrimination in the delivery of care. The study also assessed whether there was evidence of any of the Trusts underserving their South Asian community with lesser levels of recognition of EDS and JHS. Overall South Asian patients were almost four times more likely to have been diagnosed as having JHS. This proportion was statistically significant (z = -11.69, p <0.00001). In Burton and Derby, Cambridge and Leicester the proportion of South Asian patients diagnosed as having EDS was significantly lower than in other Trusts (z = 9.4, p <0.00001). This was also the case for JHS (z = 8.09, p < 0.00001). This would indicate that in these three Trusts both conditions are underdiagnosed in the South Asian community. The significance of these findings is discussed.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45740596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah A. Sakr, Nora Y. Elsaid, Wafaa H. Hssein, Sherif M. Gamal
Background. Early initiation of Rheumatoid Arthritis (RA) treatment leads to better outcomes and low disease activity. In spite of these, there is a significant delay between symptom onset and the initiation of therapy. Objective. This study aimed to investigate this diagnostic delay and to analyze its associated factors and outcomes. Patients and method. This cross sectional study included 167 RA patients fulfilling the 2010 American College of Rheumatology/ European League against Rheumatism (ACR/EULAR) classification criteria. All patients were subjected to full clinical, laboratory and radiological assessment and treatment received, also; Disease Activity Score (DAS-28) &functional disability evaluation using Modified Health Assessment Questionnaire (MHAQ) MHAQ were reported. Diagnostic delay was assessed regarding duration, associated factors and outcomes. Furthermore, RA patients were divided into early and late diagnosis group with cutoff of one year and were compared regarding different disease parameters. Results. The median (IQR) lag in diagnosis of RA patients was 12 months (4 24), MHAQ score was significantly positively correlated with delay in diagnosis (P=0.02). Early diagnosis group patients were statistically significantly urban resident (P= 0.01), employed (P= 0.02), with higher educational level (P=0.02), lower functional index MHAQ (P= 0.02), and were significantly visiting Rheumatology specialty early in the disease compared to late diagnosis group (P= <0.0001). Conclusion. Early diagnosis is still suboptimal. Unemployment, specialty visited first other than rheumatology, female gender, rural residence, and lower educational level was associated with the delay in diagnosis in RA patients. Patients with delayed diagnosis showed worse functional disability index.
{"title":"Diagnosis delay in Egyptian rheumatoid-arthritis-patients: underlying factors and outcomes — retrospective observational study","authors":"Sarah A. Sakr, Nora Y. Elsaid, Wafaa H. Hssein, Sherif M. Gamal","doi":"10.37897/rjr.2023.2.5","DOIUrl":"https://doi.org/10.37897/rjr.2023.2.5","url":null,"abstract":"Background. Early initiation of Rheumatoid Arthritis (RA) treatment leads to better outcomes and low disease activity. In spite of these, there is a significant delay between symptom onset and the initiation of therapy. Objective. This study aimed to investigate this diagnostic delay and to analyze its associated factors and outcomes. Patients and method. This cross sectional study included 167 RA patients fulfilling the 2010 American College of Rheumatology/ European League against Rheumatism (ACR/EULAR) classification criteria. All patients were subjected to full clinical, laboratory and radiological assessment and treatment received, also; Disease Activity Score (DAS-28) &functional disability evaluation using Modified Health Assessment Questionnaire (MHAQ) MHAQ were reported. Diagnostic delay was assessed regarding duration, associated factors and outcomes. Furthermore, RA patients were divided into early and late diagnosis group with cutoff of one year and were compared regarding different disease parameters. Results. The median (IQR) lag in diagnosis of RA patients was 12 months (4 24), MHAQ score was significantly positively correlated with delay in diagnosis (P=0.02). Early diagnosis group patients were statistically significantly urban resident (P= 0.01), employed (P= 0.02), with higher educational level (P=0.02), lower functional index MHAQ (P= 0.02), and were significantly visiting Rheumatology specialty early in the disease compared to late diagnosis group (P= <0.0001). Conclusion. Early diagnosis is still suboptimal. Unemployment, specialty visited first other than rheumatology, female gender, rural residence, and lower educational level was associated with the delay in diagnosis in RA patients. Patients with delayed diagnosis showed worse functional disability index.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":"210 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136300439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and objectives. Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by the presence of antiphospholipid antibodies (aPL) in the blood. Antiphospholipid syndrome is defined by the presence of antiphospholipid antibodies, including lupus anticoagulant, anticardiolipin antibodies, and anti-beta-2 glycoprotein I antibodies. These antibodies target phospholipids-binding proteins and can leading to various clinical manifestations and complications of thromboembolic nature. Also, the antiphospholipid syndrome is strongly linked to adverse pregnancy outcomes, including recurrent miscarriages, fetal growth restriction, preeclampsia, and preterm birth. Placental dysfunction, impaired blood flow to the fetus, and thrombotic events within the placenta contribute to these complications. The purpose of this review was the research of consequences of antiphospholipid syndrome in pregnancy. Materials and methods. This research involves systematically reviewing and analyzing existing literature on consequences of antiphospholipid syndrome in pregnancy. For relevant literature, academic databases like Pub Med, Scopus, Web of Science, and Google Scholar were used. Search terms and keywords that were used to search for relevant literature in databases was: antiphospholipid syndrome; pregnancy; consequences, and Boolean operator (AND, OR). The criteria used to include literature in this review were; publication date, language, study objectives, study design, research methodology, key findings, and relevance to my research question. For citation and referencing were used the appropriate citation style (e.g., APA, MLA, Chicago, Harvard and Vancouver). Results. The main findings in this review were that antiphospholipid syndrome (APS) of characterizing by dysregulation of the immune system and the production of autoantibodies. These autoantibodies can target various cells and proteins, leading to inflammation, tissue damage, and disrupted physiological processes. This syndrome is associated with a prothrombotic state, increasing the risk of blood clots in veins and arteries. Antiphospholipid syndrome (APS) can affect multiple organs and systems, including the skin, kidneys, heart, and central nervous system. Thrombotic events can occur in various organs, leading to deep vein thrombosis, pulmonary embolism, strokes, and other thromboembolic complications. Also, the antiphospholipid syndrome is strongly linked to adverse pregnancy outcomes, including recurrent miscarriages, fetal growth restriction, preeclampsia, and preterm birth. Placental dysfunction, impaired blood flow to the fetus, and thrombotic events within the placenta contribute to these complications. Manifestations may include skin rashes (livedo reticularis), kidney involvement (glomerulonephritis), heart valve abnormalities, and neurological symptoms etc. Conclusions. We come to the conclusion that it is essential for the pregnant women with antiphospholipid syndrome to receiv
背景和目标。抗磷脂综合征(APS)是一种以血液中存在抗磷脂抗体(aPL)为特征的自身免疫性疾病。抗磷脂综合征的定义是存在抗磷脂抗体，包括狼疮抗凝血剂、抗心磷脂抗体和抗β -2糖蛋白I抗体。这些抗体针对磷脂结合蛋白，可导致各种临床表现和血栓栓塞性并发症。此外，抗磷脂综合征与不良妊娠结局密切相关，包括复发性流产、胎儿生长受限、先兆子痫和早产。胎盘功能障碍、胎儿血流受损和胎盘内血栓形成事件均可导致这些并发症。本综述的目的是研究抗磷脂综合征对妊娠的影响。材料和方法。本研究系统地回顾和分析了妊娠期抗磷脂综合征后果的现有文献。相关文献使用Pub Med、Scopus、Web of Science、b谷歌Scholar等学术数据库。在数据库中检索相关文献的检索词和关键词为:抗磷脂综合征;怀孕;结果和布尔运算符(and, OR)。本综述纳入文献的标准是;出版日期、语言、研究目标、研究设计、研究方法、主要发现以及与我的研究问题的相关性。在引用和参考文献方面，我们使用了适当的引用格式(例如APA、MLA、Chicago、Harvard和Vancouver)。结果。本文综述了以免疫系统失调和自身抗体产生为特征的抗磷脂综合征(APS)。这些自身抗体可以针对各种细胞和蛋白质，导致炎症、组织损伤和生理过程中断。这种综合征与血栓形成前状态有关，增加了静脉和动脉血栓形成的风险。抗磷脂综合征(APS)可影响多个器官和系统，包括皮肤、肾脏、心脏和中枢神经系统。血栓事件可发生在各个器官，导致深静脉血栓形成、肺栓塞、中风和其他血栓栓塞并发症。此外，抗磷脂综合征与不良妊娠结局密切相关，包括复发性流产、胎儿生长受限、先兆子痫和早产。胎盘功能障碍、胎儿血流受损和胎盘内血栓形成事件均可导致这些并发症。表现可能包括皮疹(网状红斑)、肾脏受累(肾小球肾炎)、心脏瓣膜异常和神经系统症状等。结论。我们得出结论，有抗磷脂综合征的孕妇必须接受密切的监测和适当的管理，以降低这些妊娠并发症的风险和严重性。这可能包括抗凝治疗、定期产前护理、监测胎儿生长和健康以及及时处理并发症等干预措施。涉及产科医生、风湿病学家和其他医疗保健专业人员的多学科方法通常是必要的，以优化母亲和婴儿的结果。
{"title":"Consequences of antiphospholipid syndrome in pregnancy - A review","authors":"Astrit M. Gashi","doi":"10.37897/rjr.2023.2.4","DOIUrl":"https://doi.org/10.37897/rjr.2023.2.4","url":null,"abstract":"Background and objectives. Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by the presence of antiphospholipid antibodies (aPL) in the blood. Antiphospholipid syndrome is defined by the presence of antiphospholipid antibodies, including lupus anticoagulant, anticardiolipin antibodies, and anti-beta-2 glycoprotein I antibodies. These antibodies target phospholipids-binding proteins and can leading to various clinical manifestations and complications of thromboembolic nature. Also, the antiphospholipid syndrome is strongly linked to adverse pregnancy outcomes, including recurrent miscarriages, fetal growth restriction, preeclampsia, and preterm birth. Placental dysfunction, impaired blood flow to the fetus, and thrombotic events within the placenta contribute to these complications. The purpose of this review was the research of consequences of antiphospholipid syndrome in pregnancy. Materials and methods. This research involves systematically reviewing and analyzing existing literature on consequences of antiphospholipid syndrome in pregnancy. For relevant literature, academic databases like Pub Med, Scopus, Web of Science, and Google Scholar were used. Search terms and keywords that were used to search for relevant literature in databases was: antiphospholipid syndrome; pregnancy; consequences, and Boolean operator (AND, OR). The criteria used to include literature in this review were; publication date, language, study objectives, study design, research methodology, key findings, and relevance to my research question. For citation and referencing were used the appropriate citation style (e.g., APA, MLA, Chicago, Harvard and Vancouver). Results. The main findings in this review were that antiphospholipid syndrome (APS) of characterizing by dysregulation of the immune system and the production of autoantibodies. These autoantibodies can target various cells and proteins, leading to inflammation, tissue damage, and disrupted physiological processes. This syndrome is associated with a prothrombotic state, increasing the risk of blood clots in veins and arteries. Antiphospholipid syndrome (APS) can affect multiple organs and systems, including the skin, kidneys, heart, and central nervous system. Thrombotic events can occur in various organs, leading to deep vein thrombosis, pulmonary embolism, strokes, and other thromboembolic complications. Also, the antiphospholipid syndrome is strongly linked to adverse pregnancy outcomes, including recurrent miscarriages, fetal growth restriction, preeclampsia, and preterm birth. Placental dysfunction, impaired blood flow to the fetus, and thrombotic events within the placenta contribute to these complications. Manifestations may include skin rashes (livedo reticularis), kidney involvement (glomerulonephritis), heart valve abnormalities, and neurological symptoms etc. Conclusions. We come to the conclusion that it is essential for the pregnant women with antiphospholipid syndrome to receiv","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136300440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Zeca, A. Cotae, C. Cobilinschi, R. Ungureanu, R. Țincu, C. Cobilinschi, L. Mirea, I. Grințescu
Ankylosing spondylitis is one of the global top health burdens and patients affected by it frequently require surgery related to disease progression, such as orthopedic surgery. These patients may prove difficult to manage from an anesthetic standpoint, regardless of the anesthetic technique employed, mainly given the potential for difficult airway access and related comorbidities. We present the case of a 52-year-old male posted for urgent cemented total hip arthroplasty with associated bilateral pulmonary fibrosis and an anticipated difficult airway in whom regional anesthesia was performed with satisfactory results, with a favorable intraoperative and postoperative course. The literature review explores the anesthetic techniques employed when a tailored approach is required in managing patients with ankylosing spondylitis.
{"title":"Anesthetic challenges in patients with ankylosing spondylitis requiring lower limb surgery – A case report and literature review","authors":"V. Zeca, A. Cotae, C. Cobilinschi, R. Ungureanu, R. Țincu, C. Cobilinschi, L. Mirea, I. Grințescu","doi":"10.37897/rjr.2023.1.3","DOIUrl":"https://doi.org/10.37897/rjr.2023.1.3","url":null,"abstract":"Ankylosing spondylitis is one of the global top health burdens and patients affected by it frequently require surgery related to disease progression, such as orthopedic surgery. These patients may prove difficult to manage from an anesthetic standpoint, regardless of the anesthetic technique employed, mainly given the potential for difficult airway access and related comorbidities. We present the case of a 52-year-old male posted for urgent cemented total hip arthroplasty with associated bilateral pulmonary fibrosis and an anticipated difficult airway in whom regional anesthesia was performed with satisfactory results, with a favorable intraoperative and postoperative course. The literature review explores the anesthetic techniques employed when a tailored approach is required in managing patients with ankylosing spondylitis.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43956067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Jugănaru, C. Cobilinschi, C. Jurcut, Andreea Birlez, D. Opriș-Belinski, A. Balanescu
Sjogren’s syndrome (SSj) is a chronic autoimmune disease mainly targeting the exocrine glands, but sometimes associating extra-glandular manifestations. Xerosis, purpura, Raynaud’s phenomenon, cutaneous vasculitis, annular erythema are the main forms of skin involvement. A 26-year-old female patient was admitted for diffuse erythematous rash and angioedema, xerophthalmia and symmetrical arthralgia of hand joints. Anti-nuclear antibodies, anti-SSA and anti-Ro52 antibodies were identified, Schirmer’s test was positive, thus the diagnoses of primary SSj and associated urticarial vasculitis were established. Treatment with oral methylprednisolone, azathioprine and hydroxychloroquine was initiated, with favorable response over the next week. Patients with primary SSj that develop cutaneous vasculitis, lymphadenopathies or lymphopenia may be at risk for additional extra-glandular manifestations, including non-Hodgkin lymphoma.
{"title":"An unusual clue in the diagnosis of primary Sjogren’s syndrome","authors":"E. Jugănaru, C. Cobilinschi, C. Jurcut, Andreea Birlez, D. Opriș-Belinski, A. Balanescu","doi":"10.37897/rjr.2023.1.4","DOIUrl":"https://doi.org/10.37897/rjr.2023.1.4","url":null,"abstract":"Sjogren’s syndrome (SSj) is a chronic autoimmune disease mainly targeting the exocrine glands, but sometimes associating extra-glandular manifestations. Xerosis, purpura, Raynaud’s phenomenon, cutaneous vasculitis, annular erythema are the main forms of skin involvement. A 26-year-old female patient was admitted for diffuse erythematous rash and angioedema, xerophthalmia and symmetrical arthralgia of hand joints. Anti-nuclear antibodies, anti-SSA and anti-Ro52 antibodies were identified, Schirmer’s test was positive, thus the diagnoses of primary SSj and associated urticarial vasculitis were established. Treatment with oral methylprednisolone, azathioprine and hydroxychloroquine was initiated, with favorable response over the next week. Patients with primary SSj that develop cutaneous vasculitis, lymphadenopathies or lymphopenia may be at risk for additional extra-glandular manifestations, including non-Hodgkin lymphoma.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70159376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article aims to establish, on the basis of medical literature and of the authors’ experience, whether bisphosphonates still have a role in treating skeletal diseases, with increased bone resorption. The effects of bisphosphonates on the bone tissue, as well as the diseases in which they are recommended and the benefits obtained are reviewed. Possible side effects are emphasized, both the immediate ones, which are better known and the late ones, occurring after a long-term administration. It is shown that the benefit/risk ratio remains favorable. The conclusions highlight the fact that nowadays bisphosphonates still have an important place in the treatment of skeletal diseases.
{"title":"Use of bisphosphonates in bone pathology – benefits and risks","authors":"D. Antonescu, C. Stoica","doi":"10.37897/rjr.2023.1.6","DOIUrl":"https://doi.org/10.37897/rjr.2023.1.6","url":null,"abstract":"This article aims to establish, on the basis of medical literature and of the authors’ experience, whether bisphosphonates still have a role in treating skeletal diseases, with increased bone resorption. The effects of bisphosphonates on the bone tissue, as well as the diseases in which they are recommended and the benefits obtained are reviewed. Possible side effects are emphasized, both the immediate ones, which are better known and the late ones, occurring after a long-term administration. It is shown that the benefit/risk ratio remains favorable. The conclusions highlight the fact that nowadays bisphosphonates still have an important place in the treatment of skeletal diseases.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43108062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Physical inactivity is a major 21st century public health problem for people with disabilities. The practice of sport in an augmented reality environment appears to be an interesting alternative to promote physical practice for people with disabilities. In this article, our research study will be based on the one hand on the impact and the capacity to increase motivation in rehabilitation by augmented reality (AR) with this population and on the other hand on the degree of acceptability of physical activity (PA) using avatars modeled in three dimensions (3D).
{"title":"Impact of augmented reality on sports performance of disabled","authors":"Naila Bali, A. Fridhi","doi":"10.37897/rjr.2023.1.7","DOIUrl":"https://doi.org/10.37897/rjr.2023.1.7","url":null,"abstract":"Physical inactivity is a major 21st century public health problem for people with disabilities. The practice of sport in an augmented reality environment appears to be an interesting alternative to promote physical practice for people with disabilities. In this article, our research study will be based on the one hand on the impact and the capacity to increase motivation in rehabilitation by augmented reality (AR) with this population and on the other hand on the degree of acceptability of physical activity (PA) using avatars modeled in three dimensions (3D).","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44163788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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