Revista Colombiana de Reumatologia最新文献_第3页

A propósito de autoinmunidad y COVID-19 en pediatría 儿科自身免疫与 COVID-19

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreu.2024.09.001

Adriana Diaz-Maldonado

引用次数: 0

Autoinmunidad en pacientes pediátricos de una región de Colombia, tras un pico de SARS-CoV-2 哥伦比亚某地区的儿科患者在 SARS-CoV-2 峰值之后出现自身免疫现象

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreu.2023.08.001

Introduction

With the onset of the 2019 coronavirus pandemic, there was an increase in the number of reported cases of autoimmune manifestations in the midst of the disease and new cases of autoimmunity after infection.

Objective

To correlate the rate of positive tests of SARS-CoV-2 with the rate of new diagnoses of autoimmune disease in paediatric patients of the department of Huila (Colombia), between March 2020 and September 2021.

Methods

The socio-demographic characterization of the subjects diagnosed with autoimmune disease and of the cases of SARS-CoV-2 was performed; an analysis of the monthly trend of events was performed and a correlation model was applied between the rate of SARS-CoV-2 diagnosis and the rate of autoimmune diseases during the study period.

Results

A total of 94 cases of autoimmune disease were diagnosed, with an average age of 8.3 years, most were girls and belonged to the urban area and the subsidized regimen, and immune thrombocytopenic purpura was the most common diagnosis. In addition, 4,303 cases of SARS-CoV-2 were detected, mostly adolescents, from urban areas and the contributory system. Finally, it was evidenced that the highest rate of autoimmune disease was reported just after the highest peak of SARS-CoV-2.

Conclusions

This study did not show a statistical correlation between the rate of SARS-CoV-2 and the rate of diagnoses of autoimmune disease; however, it showed an enormous peak of autoimmunity after the highest peak of infection in paediatric patients of the department during the first eighteen months of the pandemic.

摘要: 随着2019年冠状病毒大流行的到来，在疾病期间报告的自身免疫表现病例和感染后新出现的自身免疫病例数量有所增加。方法对诊断为自身免疫性疾病的受试者和 SARS-CoV-2 病例进行社会人口学特征描述；对每月事件趋势进行分析，并在研究期间应用 SARS-CoV-2 诊断率与自身免疫性疾病发病率之间的相关模型。结果共诊断出 94 例自身免疫性疾病，平均年龄为 8.3 岁，大多数为女孩，属于城市地区和补贴方案，免疫性血小板减少性紫癜是最常见的诊断。此外，还发现了 4 303 例 SARS-CoV-2 病例，其中大部分是青少年，来自城市地区和补助系统。结论这项研究没有显示出 SARS-CoV-2 感染率与自身免疫性疾病诊断率之间存在统计学上的相关性；但是，它显示出在大流行的前 18 个月中，该部门的儿科病人在感染最高峰之后出现了一个巨大的自身免疫高峰。

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引用次数: 0

Evaluación de desenlaces clínicos en los pacientes con artritis reumatoide desde la perspectiva del paciente: revisión narrativa de la literatura 从患者角度评估类风湿关节炎患者的临床疗效：文献叙事回顾

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreu.2023.08.007

Introduction

The evaluation of clinical outcomes in rheumatoid arthritis patients, including the patient's perspective, allows the inclusion of the patient's perspective in clinical decision-making using instruments designed for this purpose.

Objective

To identify and describe the instruments validated in Spanish to evaluate clinical outcomes in rheumatoid arthritis in daily clinical practice and from the patient's perspective, including disease activity, functionality, impact of the disease, adherence to treatment and quality of life.

Materials and methods

A review of the literature in various databases (PubMed, Scopus, Bireme, Scielo) was conducted e looking for questionnaires that evaluate clinical outcomes in rheumatoid arthritis patients, including those with a validated Spanish translation that allow self-assessment of the disease by the patient and clinical monitoring.

Results

Fifteen questionnaires were identified and selected that met the inclusion criteria. Four instruments were found that evaluate quality of life, three that evaluate functionality, four that evaluate disease impact, one that evaluate disease activity, and three that evaluate adherence to treatment.

Conclusion

Questionnaires and scales that evaluate rheumatoid arthritis allow a clinical approach to the evolution of the disease as perceived and reported by the patients, optimizing clinical follow up. Implementation of these tools in clinical decision making allows for an improvement in quality of care of patient with this condition.

目的确定并描述经西班牙文验证的用于评估类风湿关节炎患者在日常临床实践中的临床结果的工具，并从患者的角度进行评估，包括疾病活动、功能、疾病影响、治疗依从性和生活质量。材料与方法对各种数据库（PubMed、Scopus、Bireme、Scielo）中的文献进行了回顾，寻找评估类风湿性关节炎患者临床疗效的问卷，包括那些经过验证的西班牙语翻译，允许患者对疾病进行自我评估和临床监测的问卷。结论评估类风湿性关节炎的问卷和量表有助于临床了解患者感知和报告的疾病演变情况，优化临床随访。在临床决策中使用这些工具可以提高对该病患者的护理质量。

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引用次数: 0

Inadequate sleep as a limiting factor in achieving remission in patients with rheumatoid arthritis 睡眠不足是类风湿关节炎患者缓解的限制因素

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreu.2023.05.005

Introduction

Good sleep has a restorative effect at the cellular level and helps maintain the body's homeostasis.

Objectives

Given our clinical experiences, we propose that sleep quality should be evaluated in patients with rheumatoid arthritis. Poor sleep quality should be considered as a factor that may impact clinical outcomes in patients with rheumatoid arthritis.

Materials and methods

We researched medical literature on clinical and physiological pathways associated with sleep quality.

Results

There is evidence that interleukin-6 and tumor necrosis factor have a role in inflammatory and immune imbalance as well as in sleep disturbance in patients with rheumatoid arthritis, which leads to the chronic inflammatory process seen in these patients. Most patients with rheumatoid arthritis report sleep problems, be it insomnia or other complaints of non-refreshing sleep. Lack of sleep or poor sleep patterns in these patients further compromise their quality of life. In patients with RA, aetiologies such as restless leg syndrome (RLS), sleep apnoea syndrome, and Temporomandibular Joint Dysfunction (TMJ) syndromes might contribute to sleep disturbances. This lack of restful sleep might limit our goal, as treating physicians, to achieve remission states in these patients.

Conclusions

It is our opinion that sleep quality evaluation must be addressed, monitored, and treated as part of the management of patients with RA. Bad sleep adds an additional burden to disease activity in patients with RA, besides, it limits patients’ possibility of achieving disease remission.

导言良好的睡眠在细胞水平上具有恢复作用，有助于维持机体的平衡。目的根据临床经验，我们建议对类风湿性关节炎患者的睡眠质量进行评估。材料和方法我们研究了与睡眠质量相关的临床和生理途径的医学文献。结果有证据表明，白细胞介素-6 和肿瘤坏死因子在类风湿关节炎患者的炎症和免疫失衡以及睡眠障碍中发挥作用，从而导致这些患者出现慢性炎症过程。大多数类风湿性关节炎患者都有睡眠问题，无论是失眠还是其他睡眠不清爽的主诉。这些患者缺乏睡眠或睡眠模式不佳会进一步影响他们的生活质量。在类风湿性关节炎患者中，不宁腿综合征（RLS）、睡眠呼吸暂停综合征和颞下颌关节功能障碍（TMJ）综合征等病因都可能导致睡眠障碍。我们认为，睡眠质量评估必须作为 RA 患者管理的一部分来处理、监测和治疗。我们认为，睡眠质量评估必须作为 RA 患者管理的一部分来处理、监测和治疗。睡眠质量差不仅会增加 RA 患者疾病活动的负担，还会限制患者获得疾病缓解的可能性。

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引用次数: 0

Tolerancia central de las células T, ¿qué hay de nuevo? 中枢 T 细胞耐受性，有何新进展？

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreu.2023.08.002

Introduction

Random somatic recombination of T cell receptors facilitates the variability of response to foreign antigens. Then, central tolerance occurs, a mechanism designed to avoid exit of autoreactive T cells from the thymus. However, failures in this process can induce the appearance of autoimmunity.

Materials and methods

This narrative review was conducted through a literature search focused on describing relevant and recent concepts of central tolerance of T cells.

Results

Multiple cell groups are part of the thymic microenvironment, among them, thymic epithelial cells are responsible for directing development of thymocytes, especially medullary thymic epithelial cells that direct the negative selection process.

Conclusions

Factors that affect thymocytes, the thymic microenvironment, or interaction between them, can lead to development of immunodeficiencies and/or autoimmunity.

导言T细胞受体的随机体细胞重组促进了对外来抗原反应的可变性。然后，中枢耐受发生，这是一种旨在避免自体反应性 T 细胞从胸腺退出的机制。材料与方法本综述通过文献检索进行，重点是描述 T 细胞中枢耐受的相关最新概念。结果胸腺微环境中有多个细胞群，其中胸腺上皮细胞负责指导胸腺细胞的发育，尤其是髓质胸腺上皮细胞指导负选择过程。

引用次数: 0

A comparison of core muscle endurance of females with fibromyalgia versus healthy females: An observational study 纤维肌痛女性患者与健康女性核心肌耐力的比较：观察研究

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreu.2023.10.001

Dewanshu Sindwani, Manjyot Kaur

Introduction

Despite the numerous benefits of core muscle strengthening in improving symptoms of fibromyalgia (FM), limited studies have quantified core muscle function in FM patients.

Objective

To compare the core muscle endurance of FM females with age-matched healthy females and determine whether a correlation exists between core muscle endurance and FM severity.

Materials and methods

Pre-diagnosed female FM patients (n = 7) and age-matched healthy females (n = 19) were assessed using McGill's core endurance tests in four positions – flexion, extension, and bilateral side-bridge. The longest contraction holding time (in seconds) in each position was noted and compared in both groups. Additionally, patient-reported Fibromyalgia Impact Questionnaire (FIQ) scores were obtained to determine disease severity.

Results

The mean holding time for trunk extensors (26.14 ± 7.7 s), right lateral flexors (20.14 ± 8.3 s), and left lateral flexors (20.86 ± 5.3 s) was significantly lower in the FM females than the healthy females (trunk extensors = 55.21 ± 17.1 s; right lateral flexors = 36.05 ± 13.2 s; left lateral flexors = 35.11 ± 13.8 s). The endurance of trunk flexors was statistically similar in both groups (FM females = 52.14 ± 27.9 s; healthy females = 74.37 ± 37.7 s). Lastly, core muscle endurance was not correlated with the FIQ scores in FM patients (p > 0.05).

Conclusion

The results of this preliminary study revealed that core extensor and lateral flexor endurance in FM females was lower than their healthy female counterparts. Larger sample studies are needed to further substantiate our findings.

引言尽管增强核心肌肉对改善纤维肌痛（FM）症状有诸多益处，但对 FM 患者核心肌肉功能进行量化的研究却很有限。目的比较 FM 女性与年龄匹配的健康女性的核心肌肉耐力，并确定核心肌肉耐力与 FM 严重程度之间是否存在相关性。材料和方法使用麦吉尔核心耐力测试，在屈曲、伸展和双侧桥式四种姿势下，对确诊的女性 FM 患者（7 人）和年龄匹配的健康女性（19 人）进行评估。记录每个体位的最长收缩保持时间（秒），并对两组进行比较。结果躯干伸肌（26.14 ± 7.7 秒）、右侧屈肌（20.14 ± 8.3 秒）和左侧屈肌（20.86 ± 5.3 秒）的平均保持时间，FM 女性明显低于健康女性（躯干伸肌 = 55.21 ± 17.1 秒；右侧屈肌 = 36.05 ± 13.2 秒；左侧屈肌 = 35.11 ± 13.8 秒）。两组的躯干屈肌耐力在统计上相似（FM 女性 = 52.14 ± 27.9 秒；健康女性 = 74.37 ± 37.7 秒）。最后，核心肌耐力与 FM 患者的 FIQ 分数不相关（p > 0.05）。要进一步证实我们的研究结果，还需要进行更大规模的样本研究。

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引用次数: 0

Balancing inflammation and adverse effects of glucocorticoids in clinical practice 在临床实践中平衡炎症和糖皮质激素的不良反应

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-10-01 DOI: 10.1016/j.rcreu.2023.08.004

Juan Sebastián Peinado-Acevedo , Tatiana Rivera-Bustamante , Jairo Rivera , Yeison Santamaría-Alza

Corticosteroids play a vital role in enabling the body to tolerate stressful situations and regulate the inflammatory process. Excessive or persistent inflammation can lead to tissue damage and the development of diseases. Glucocorticoids are crucial in modulating the impact of inflammatory disorders, such as allergies, autoimmune diseases, and sepsis. These disorders can be life-threatening and benefit from glucocorticoid administration. Natural and synthetic glucocorticoids are utilized for the diagnosis and treatment of adrenal function disorders and various inflammatory, immune, and neoplastic conditions. The discovery of glucocorticoids is a testament to the ingenuity and collaboration of researchers. For over 70 years, glucocorticoids have revolutionized medicine and are widely employed in various medical conditions. This article provides a comprehensive review of the critical considerations for the clinical application of glucocorticoids, aiming to strike a balance between their benefits and potential risks. Understanding its history, chemical structure, pharmacology, and mechanisms of action provides the foundation for achieving proper use of this type of medication.

皮质类固醇在帮助人体承受压力和调节炎症过程方面发挥着重要作用。过度或持续的炎症可导致组织损伤和疾病的发生。糖皮质激素对调节过敏、自身免疫性疾病和败血症等炎症性疾病的影响至关重要。这些疾病可能会危及生命，而服用糖皮质激素则可使其获益。天然和合成的糖皮质激素可用于诊断和治疗肾上腺功能紊乱以及各种炎症、免疫和肿瘤疾病。糖皮质激素的发现证明了研究人员的智慧和合作。70 多年来，糖皮质激素给医学带来了革命性的变化，并被广泛应用于各种病症。本文全面回顾了糖皮质激素临床应用的关键注意事项，旨在平衡其益处和潜在风险。了解糖皮质激素的历史、化学结构、药理学和作用机制为正确使用此类药物奠定了基础。

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引用次数: 0

Fe de errores del artículo «Complicación hematológica con impacto pulmonar en una paciente con síndrome de Sjögren» [Rev Colomb Reumatol. 2024;31(2):259-263] 文章 "一名斯约格伦综合征患者的血液并发症对肺部的影响 "的更正[Rev Colomb Reumatol.2024;31(2):259-263]。

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-07-01 DOI: 10.1016/j.rcreu.2024.04.006

Laura Gallego , Jhon Buitrago , Diana Guavita-Navarro , Jairo Cajamarca-Barón , Ana María Arredondo , José Fernando Polo Nieto , Juan Pablo Castañeda-González , Alejandro Escobar

引用次数: 0

Comprehensive health assessment based on ICF components using the WOMAC index in patients with osteoarthritis 使用WOMAC指数对骨关节炎患者进行基于ICF成分的综合健康评估

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-07-01 DOI: 10.1016/j.rcreu.2022.08.003

Introduction

Osteoarthritis (OA) is a common degenerative disease associated with functional impairment, activity limitation, participation restriction, and poor quality of life. Therefore, comprehensive assessment is important to determine how complex problems affect patients with OA.

Objectives

The first aim of this study was to link and allocate items of The Western Ontario and McMaster Universities (WOMAC) OA index with the ICF Comprehensive Core Set for OA. The second aim was to examine the relationship between quality of life and each ICF component score based on WOMAC clinical data in OA.

Materials and methods

Health status was evaluated with WOMAC and quality of life with the Nottingham Health Profile (NHP). The WOMAC items were linked with codes of the ICF Comprehensive Core Set for OA and allocated with the ICF components by three researchers. The relationship between WOMAC scores and the NHP was determined by Pearson correlation analysis.

Results

87 patients with OA were included. As distinguished by the researchers, 7 items of WOMAC covered body function and 17 covered activity-participation. Body function and activity-participation had a moderate correlation with the pain subtest of the NHP and low correlation with the energy level subtest and total score of the NHP. Activity-participation had a high correlation with the physical abilities subtest of the NHP.

Conclusion

Although WOMAC does not cover environmental factors, it is a comprehensive tool to assess health status and quality of life. Our results showed that in OA physical abilities can lead to limitations in activity and participation, and these limitations are associated with the individual's pain, energy level, and quality of life.

Clinical trial registration number: NCT04956510.

导言骨关节炎（OA）是一种常见的退行性疾病，与功能障碍、活动受限、参与受限和生活质量低下有关。本研究的第一个目的是将西安大略和麦克马斯特大学（WOMAC）OA 指数的项目与 ICF OA 综合核心组联系起来并进行分配。第二个目的是根据 WOMAC 在 OA 中的临床数据，研究生活质量与 ICF 各组成部分得分之间的关系。材料和方法用 WOMAC 评估健康状况，用诺丁汉健康档案（NHP）评估生活质量。WOMAC项目与ICF OA综合核心集的代码相关联，并由三位研究人员将其与ICF成分进行分配。通过皮尔逊相关分析确定了 WOMAC 评分与 NHP 之间的关系。根据研究人员的区分，WOMAC 的 7 个项目涉及身体功能，17 个项目涉及活动参与。身体功能和活动参与与国家健康标准的疼痛分项测试有中等程度的相关性，而与国家健康标准的能量水平分项测试和总分的相关性较低。结论虽然 WOMAC 不包括环境因素，但它是评估健康状况和生活质量的综合工具。我们的研究结果表明，OA患者的体能会导致活动和参与的限制，而这些限制与患者的疼痛、精力水平和生活质量有关：临床试验注册号：NCT04956510。

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引用次数: 0

A retrospective study of neonatal and pregnancy outcomes in pregnant women suffering from inflammatory arthropathy treated with adalimumab 阿达木单抗治疗炎症性关节病孕妇新生儿和妊娠结局的回顾性研究

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-07-01 DOI: 10.1016/j.rcreu.2023.05.002

Introduction

Anti-tumor necrosis factor-alpha (TNF-α) treatments have been available for over two decades to treat inflammatory arthropathies (IA). Most of these disorders are common among women of reproductive age, which emphasizes the need to evaluate their safety in pregnancy.

Objective

This study aims to scrutinize neonatal and pregnancy outcomes in pregnant IA patients treated with adalimumab.

Materials and methods

The current cross-sectional work was conducted by reviewing the medical files of pregnant IA patients (n = 30) receiving adalimumab referred to Golestan Hospital in Ahvaz (Iran) from 2014 to 2017, followed by extracting demographic profiles as well as neonatal and pregnancy outcomes.

Results

Noteworthy among the findings were PsA (n = 13), RA (n = 5), IBD (n = 4), AS (n = 3), uveitis (n = 2), Behcet's disease (n = 2), and panuveitis (n = 1). The mean age of subjects, duration of illness, and duration of treatment were estimated at 29.53 ± 5.88, 2.85 ± 1.15, and 1.96 ± .90 years, respectively. No delivery outcome was found for 27 (90%) cases, and delivery outcomes observed in three (10%) patients were abortion (n = 2) and preterm complications (n = 1). No neonatal complication was found for 28 (93.3%) cases and neonatal IUGR outcome was reported in 2 (6.7%) cases. Cesarean section was a delivery method in 7 (23.3%) cases and natural method in 21 (70%) cases. There were no significant differences for the prevalence of cesarean section and neonatal outcomes based on the type of disease, but differences were observed for the outcome of delivery based on the type of disease.

Conclusion

According to our findings, definitive conclusions on the safety of adalimumab during pregnancy were impossible and there is a need for further research with a larger sample size.

导言抗肿瘤坏死因子α（TNF-α）治疗炎症性关节病（IA）已有二十多年的历史。这些疾病大多常见于育龄妇女，因此有必要对其在妊娠期的安全性进行评估。本研究旨在仔细研究接受阿达木单抗治疗的妊娠期炎症性关节病患者的新生儿和妊娠结局。材料和方法本次横断面研究通过回顾2014年至2017年期间转诊至伊朗阿瓦士戈勒斯坦医院接受阿达木单抗治疗的妊娠IA患者（n = 30）的医疗档案，然后提取人口统计学特征以及新生儿和妊娠结局。结果值得注意的是PsA（n = 13）、RA（n = 5）、IBD（n = 4）、AS（n = 3）、葡萄膜炎（n = 2）、白塞氏病（n = 2）和泛葡萄膜炎（n = 1）。受试者的平均年龄、病程和治疗时间分别为（29.53 ± 5.88）年、（2.85 ± 1.15）年和（1.96 ± 0.90）年。27例（90%）患者未发现分娩结果，3例（10%）患者的分娩结果为流产（2例）和早产并发症（1例）。28例（93.3%）未发现新生儿并发症，2例（6.7%）报告了新生儿IUGR结果。7例（23.3%）采用剖宫产，21例（70%）采用自然分娩。根据疾病类型，剖宫产率和新生儿结局无明显差异，但根据疾病类型，分娩结局存在差异。

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引用次数: 0