Revista Colombiana de Reumatologia最新文献

英文中文

Evaluating the efficacy and safety of sodium thiosulfate in calcific tendinitis of the rotator cuff – Data from an ongoing randomized clinical trial 评估硫代硫酸钠治疗肩袖钙化性肌腱炎的疗效和安全性--来自正在进行的随机临床试验的数据

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-07-01 DOI: 10.1016/j.rcreu.2023.12.003

引用次数: 0

Evaluaciones económicas en reumatología. Nuevos aprendizajes 风湿病学的经济评估。新收获

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-07-01 DOI: 10.1016/j.rcreu.2024.05.001

Juan Manuel Bello Gualtero

引用次数: 0

Antinuclear antibody staining patterns by indirect immunofluorescence assay observed in patients from a tertiary health center in Latin America 用间接免疫荧光法观察拉丁美洲某三级卫生中心患者的抗核抗体染色模式

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-07-01 DOI: 10.1016/j.rcreu.2023.05.003

Introduction/Objective

This study aimed to describe the frequency of antinuclear antibody (ANA) staining patterns by indirect immunofluorescence assay observed in patients from a tertiary health center in Latin America.

Materials and methods

This retrospective, descriptive, and observational study evaluated data from all patients undergoing antinuclear antibody indirect immunofluorescence assay from a single-tertiary center (University Hospital Fundación Valle del Lili, Cali-Colombia) in 2020.

Results

One thousand and eight patients met the inclusion criteria. The median patient age was 47 (34–59.2) years, and most were female (769, 75.3%). A positive ANA immunofluorescence assay was observed in approximately two-thirds of patients (664, 65.8%). ANA test results were primarily used to exclude a suspected diagnosis in approximately half of the patients (466, 46.2%). Thirty-seven percent (250/664) of the cohort with ANA-positive titers had a systemic autoimmune rheumatic disease (SARD). The most prevalent SARDs included rheumatoid arthritis (RA) (55, 8.2%) followed by systemic lupus erythematosus (SLE) (37, 5.5%). The vast majority of ANA-positive patients had a reported speckled pattern (anti-cell [AC]-2,4,5; 269; 40.5%) followed by homogenous (AC-1; 266; 40%), nucleolar (AC-8,9,10; 46; 6.9%), and centromere (AC-3; 16; 2.4%). The most frequent patterns observed among SLE patients included homogenous (AC-1) patterns in 17 (45.9%) patients, speckled (AC-2,4,5) nuclear patterns in 11 (29.7%) patients, mixed patterns in 7 (18.9%) patients, and reticular/anti-mitochondrial antibody (AMA, AC-21) cytoplasmic patterns in 2 (5.4%) patients.

Conclusion

This study is the first to describe ANA patterns in a Colombian population. Speckled and homogenous patterns were predominant in patients with SARDs.

导言/目的本研究旨在描述拉丁美洲一家三级医疗中心的患者通过间接免疫荧光测定观察到的抗核抗体（ANA）染色模式的频率。材料和方法这项回顾性、描述性和观察性研究评估了 2020 年在一家三级医疗中心（哥伦比亚卡利市 Valle del Lili 基金会大学医院）接受抗核抗体间接免疫荧光检测的所有患者的数据。患者年龄中位数为 47（34-59.2）岁，大多数为女性（769 人，75.3%）。约三分之二的患者（664 人，65.8%）ANA 免疫荧光检测呈阳性。约半数患者（466 人，46.2%）的 ANA 检测结果主要用于排除疑似诊断。在 ANA 滴度呈阳性的人群中，37%（250/664）的患者患有系统性自身免疫性风湿病 (SARD)。最常见的系统性自身免疫性风湿病包括类风湿性关节炎（RA）（55 例，占 8.2%），其次是系统性红斑狼疮（SLE）（37 例，占 5.5%）。据报道，绝大多数 ANA 阳性患者有斑点模式（抗细胞[AC]-2,4,5；269；40.5%），其次是均质模式（AC-1；266；40%）、核仁模式（AC-8,9,10；46；6.9%）和中心粒模式（AC-3；16；2.4%）。在系统性红斑狼疮患者中观察到的最常见模式包括：17 名患者（45.9%）的均质（AC-1）模式、11 名患者（29.7%）的斑点（AC-2,4,5）核模式、7 名患者（18.9%）的混合模式，以及 2 名患者（5.4%）的网状/抗线粒体抗体（AMA，AC-21）细胞质模式。在 SARDs 患者中，斑点和均质模式占主导地位。

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引用次数: 0

Análisis de costo-efectividad del abordaje clínico en fase temprana vs. fase establecida en una cohorte de pacientes con artritis reumatoide de una institución prestadora de servicios de salud de cuarto nivel en Colombia 对哥伦比亚一家四级医疗机构的一组类风湿关节炎患者进行早期临床方法与成熟期临床方法的成本效益分析。

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-07-01 DOI: 10.1016/j.rcreu.2023.06.004

Introduction

Rheumatoid arthritis (RA) is a high-cost disease, which allows patients to be classified into early or established phase approaches.

Objective

The purpose of this work was to perform a cost-effectiveness analysis comparing both phases with patient data at a 6-month time horizon from a third-party payer perspective.

Materials and methods

The population was delimited. The costs and effectiveness of each of the phases were estimated. A decision tree-type economic evaluation model was developed, and the Incremental Cost-Effectiveness Ratio (ICER) was calculated with the respective sensitivity analyses, both deterministic and probabilistic.

Results

In terms of costs, it was found that for effectiveness in goals, the cost was 85% higher in the established than in the early phase. Similarly, for non-target effectiveness, the cost was 77% higher in the established than in the early phase. On the other hand, the effectiveness results were better in the early phase compared to the established phase. Regarding the ICER, it was determined that the early phase approach saves $2,326,389 COP_cte (colombian pesos current currency) per patient in goals at 6 months of treatment, compared to the established phase approach.

Conclusion

The clinical approach to early-stage rheumatoid arthritis is a less costly and more effective alternative vs. the established phase, as it generates savings for the third-party payer over a 6-month time horizon, from a third-party payer perspective.

导言类风湿性关节炎（RA）是一种高成本疾病，可将患者分为早期和成熟期两种治疗方法。估算了每个阶段的成本和有效性。结果在成本方面，研究发现在目标有效性方面，既定阶段的成本比早期阶段高 85%。同样，在非目标效果方面，既定阶段的成本比早期阶段高 77%。另一方面，早期阶段的有效性结果优于既定阶段。结论从第三方支付方的角度来看，早期类风湿关节炎的临床治疗方法是一种成本更低、效果更好的替代方法，因为它能在 6 个月的时间跨度内为第三方支付方节省费用。

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引用次数: 0

Patients with psoriatic arthritis followed in tertiary centers in Southern Brazil have a high prevalence of metabolic syndrome 在巴西南部三级中心随访的银屑病关节炎患者代谢综合征的患病率很高

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-07-01 DOI: 10.1016/j.rcreu.2022.12.004

Introduction/Objective

Patients with psoriatic arthritis (PsA) have a significant prevalence of metabolic syndrome (MS), however studies conducted in Latin America describing comorbidities of PsA patients are still scarce. The aim of the present work was to estimate the prevalence of MS in patients attending PsA clinics in tertiary university centers in the south region of Brazil and to evaluate the achievement of the minimal disease activity criteria among those with and without MS.

Materials and methods

A cross-sectional study was conducted; patients were recruited in two university hospitals and data collected during a routine clinic visit. The prevalence of MS was estimated using the National Cholesterol Education Programme's Adult Treatment Panel III (NCEP/ATP III). The prevalence of patients achieving the MDA criteria was compared between individuals with and without MS using Chi-square test.

Results

One hundred and five patients with PsA were evaluated, 81 in center A (Rio Grande do Sul) and 24 in center B (Paraná); 54.3% were female (N = 57), the average age was 55.7 (SD 11.6) years and the median time of diagnosis in years was 7.4 (.16–42.2). A total of 51.9% (N = 54) were diagnosed with MS., hypertension was found in 51.4% (N = 54) and obesity in 38.1% (N = 40) of the sample. There was no statistically significant association between MS and MDA.

Conclusion

Patients followed in PsA clinics in university tertiary centers in the south of Brazil have a significant prevalence of MS. This work emphasizes the importance of the screening and treatment of comorbidities in PsA.

引言/目的银屑病关节炎（PsA）患者的代谢综合征（MS）发病率很高，但在拉丁美洲进行的描述 PsA 患者合并症的研究仍然很少。本研究旨在估算巴西南部地区三级大学中心 PsA 诊所就诊患者的 MS 患病率，并评估患有和未患有 MS 的患者达到最小疾病活动度标准的情况。使用美国国家胆固醇教育计划成人治疗小组 III（NCEP/ATP III）估算多发性硬化症的患病率。结果评估了 105 名 PsA 患者，其中 81 名在 A 中心（南里奥格兰德州），24 名在 B 中心（巴拉那州）；54.3% 为女性（N = 57），平均年龄为 55.7 岁（SD 11.6），诊断时间中位数为 7.4 年（.16-42.2）。51.9%的样本（样本数=54）被确诊为多发性硬化症，51.4%的样本（样本数=54）患有高血压，38.1%的样本（样本数=40）患有肥胖症。结论在巴西南部的大学三级中心PsA门诊就诊的患者中，多发性硬化症的发病率很高。这项研究强调了筛查和治疗 PsA 并发症的重要性。

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引用次数: 0

Hallazgos ecocardiográficos en pacientes con lupus eritematoso sistémico: análisis retrospectivo en un centro de referencia terciaria 系统性红斑狼疮患者的超声心动图发现:三级参考中心的回顾性分析

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-07-01 DOI: 10.1016/j.rcreu.2022.08.002

Introduction

Introduction:Transthoracic echocardiography is a useful noninvasive tool in the assessment of cardiac involvement in patients with systemic lupus erythematosus.

Objective

We aimed to investigate the main echocardiographic alterations in patients with a diagnosis of systemic lupus erythematosus and to describe the relationship between various disease factors and echocardiographic findings.

Materials and methods

We performed a retrospective review of patients with a diagnosis of SLE between 2016 and 2020 at a referral centre. All 98 patients were included, 87% were female, the mean age for the whole population was 35 years (IQR 27.0- 49.7), 40% had a recent diagnosis, 55% with previous or new diagnosis of arterial hypertension, 37% were using steroids at admission.

Results

Among the echocardiographic findings, 64.3% had valvular disease, 63% had pericardial involvement, 25.5% systolic function compromise, 27.5% some degree of diastolic dysfunction, 13% ventricular hypertrophy, 46% left atrial enlargement, 87% right ventricular systolic dysfunction, 24.5% some probability of pulmonary hypertension, 3% non-infectious vegetations. The presence of lupus activity was associated with a higher percentage of abnormal echocardiographic findings. There was no significant relationship between disease duration and cardiac abnormalities, anti-DNA and positive antiphospholipid antibodies were more frequently observed in the cardiac involvement group.

Conclusion

We consider that echocardiography should be part of the routine evaluation in patients with lupus. Right ventricular systolic dysfunction, pericardial involvement and non-significant valvular disease were the most frequently reported abnormalities.

导读：经胸超声心动图是评估系统性红斑狼疮患者心脏受累情况的一种有用的无创工具。目的我们旨在研究确诊为系统性红斑狼疮患者的主要超声心动图改变，并描述各种疾病因素与超声心动图结果之间的关系。结果在超声心动图检查结果中，64.结果在超声心动图检查结果中，64.3%有瓣膜疾病，63%有心包受累，25.5%收缩功能受损，27.5%有一定程度的舒张功能障碍，13%心室肥厚，46%左房增大，87%右室收缩功能障碍，24.5%可能有肺动脉高压，3%有非感染性植被。狼疮活动与较高比例的超声心动图异常发现有关。病程与心脏异常之间没有明显关系，抗 DNA 抗体和抗磷脂抗体阳性在心脏受累组更常见。右心室收缩功能障碍、心包受累和非显著性瓣膜病是最常见的异常情况。

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引用次数: 0

Fe de errores del artículo «Artritis por Cryptococcus neoformans en un paciente con lupus eritematoso sistémico: reporte de un caso» [Rev Colomb Reumatol.2024;31(1):97 -102] 文章《一名系统性红斑狼疮患者的新型隐球菌关节炎：病例报告》的更正 [Rev Colomb Reumatol.2024;31(1):97 -102] [Rev Colomb Reumatol.2024;31(1):97-102]。

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-07-01 DOI: 10.1016/j.rcreu.2024.04.004

Diana C. Quintero-González , Andrés F. Cardona-Cardona , Adriana L. Vanegas-García , Carlos H. Muñoz-Vahos , Gloria Vásquez , Luis Alonso González-Naranjo

引用次数: 0

What it means to live with fibromyalgia for Peruvian women: A phenomenological study 秘鲁妇女患纤维肌痛意味着什么：一项现象学研究

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-07-01 DOI: 10.1016/j.rcreu.2023.07.003

Introduction

Patients with fibromyalgia experience pain at a constant and incapacitating pace. It is still a complex entity yet to be fully understood but meanwhile affects patients in every aspect of their lives.

Objective

The purpose of this study is to describe what living with fibromyalgia means for Peruvian women and how it affects their family, work, and social lives in 2021.

Materials and methods

The study has a qualitative design with a phenomenological approach; snowball sampling and theoretical saturation sample size; 10 patients were interviewed through semi-structured in-depth interviews. An ideographic and a nomothetic analysis were conducted, divergences and convergences in the statements were sought and units of analysis were obtained.

Results

There were 12 categories: meaning of fibromyalgia, clinical picture, complications and sequelae, diagnostic process, impact on work, impact on family life, impact on social life, experience with health personnel, lessons learned from fibromyalgia, ecclesiastical support, and myths, misinformation, and prejudices about fibromyalgia.

Conclusion

The experiences and the clinical picture are diverse, the family remains an active and reliable support network for patients, unlike social and work lives, where there is a lack of initiative or empathy towards patients. In light of our findings, we expect healthcare workers and the public in general to learn and see beyond “just histrionics” or “attention seekers” and thus improve the patient's quality of life.

导言：纤维肌痛患者会持续感到疼痛，使人丧失工作能力。本研究的目的是描述纤维肌痛对秘鲁妇女的意义，以及纤维肌痛如何影响她们 2021 年的家庭、工作和社会生活。材料和方法本研究采用定性设计，采用现象学方法；滚雪球式抽样和理论饱和样本量；通过半结构式深度访谈对 10 名患者进行了访谈。结果共分为 12 个类别：纤维肌痛的含义、临床表现、并发症和后遗症、诊断过程、对工作的影响、对家庭生活的影响、对社会生活的影响、与医护人员接触的经历、从纤维肌痛中吸取的经验教训、教会支持以及关于纤维肌痛的神话、错误信息和偏见。结论纤维肌痛患者的经历和临床表现多种多样，家庭仍然是患者积极可靠的支持网络，但与社会和工作生活不同的是，家庭对患者缺乏主动性或同情心。根据我们的研究结果，我们期望医护人员和公众能够学习并超越 "病态 "或 "寻求关注者"，从而改善患者的生活质量。

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引用次数: 0

Capillaroscopic abnormalities in systemic lupus erythematosus and its association with clinical manifestation 系统性红斑狼疮的瞳孔镜异常及其与临床表现的关系

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-07-01 DOI: 10.1016/j.rcreu.2023.05.006

Introduction

Capillaroscopy is a non-invasive tool used to evaluate microcirculation and determine whether a Raynaud's phenomenon is primary or secondary. Capillaroscopic changes are well-described in systemic sclerosis; however, these alterations have been less studied in other autoimmune diseases.

Objective

The aim of this study is to determine videocapillaroscopic alterations in lupus, and its association with clinical manifestations.

Materials and methods

A cross-sectional study with analytical intention was performed. Videocapillaroscopy and medical evaluations were performed on 76 patients with lupus, according to SLICC 2012 classificatory criteria, from January to June 2019. Chi², Fisher, and Mann–Whitney U tests were used to evaluate association, and the prevalence ratios (PR) were determined. A multivariate analysis was performed.

Results

Seventy-one (93.4%) of the patients were female with a median age of 33.5 years (interquartile range [IQR]: 27–44.8); the median lupus duration was 84 months (IQR: 30–168). The main clinical manifestations were articular, cutaneous, hematological, and Raynaud's phenomenon. A non-specific pattern was found in 43 patients (56.6%), and a systemic sclerosis-like pattern was found in 7 patients (9.2%). In bivariate and multivariate analyses, Raynaud episodes occurring more than once a week (PR 1.24; 95% CI: 1.13–1.33) were more frequent in patients with a sclerosis-like or a non-specific pattern.

Conclusion

Lupus patients frequently have videocapillaroscopic alterations with non-specific and systemic sclerosis like patterns, which are more common in patients with Raynaud's phenomenon that occurs more than once a week. Due to the study's design, it is impossible to determine causality.

导言毛细血管镜检查是一种非侵入性工具，用于评估微循环并确定雷诺现象是原发性还是继发性。本研究旨在确定狼疮患者的视频毛细血管镜改变及其与临床表现的关系。材料和方法本研究进行了一项具有分析意图的横断面研究。2019年1月至6月，根据SLICC 2012分类标准，对76名红斑狼疮患者进行了视频毛细血管镜检查和医学评估。采用Chi2、Fisher和Mann-Whitney U检验来评估相关性，并确定患病率比（PR）。结果71例（93.4%）患者为女性，中位年龄为33.5岁（四分位距[IQR]：27-44.8）；中位狼疮病程为84个月（IQR：30-168）。主要临床表现为关节、皮肤、血液和雷诺现象。43名患者（56.6%）表现为非特异性模式，7名患者（9.2%）表现为系统性硬化症样模式。在双变量和多变量分析中，每周发生一次以上的雷诺现象（PR 1.24；95% CI：1.13-1.33）在硬化样或非特异性模式的患者中更为常见。由于研究设计的原因，无法确定因果关系。

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引用次数: 0

Comite Editorial online 编辑委员会在线

Q3 Health Professions

Revista Colombiana de Reumatologia

Pub Date : 2024-07-01 DOI: 10.1016/S0121-8123(24)00038-0

引用次数: 0

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